Nearly four in 10 workers (38 per cent) said they would not tell their manager if they had a mental health problem, according to a survey by the Centre for Addiction and Mental Health (CAMH) in Toronto.
“They’re afraid for their careers, they’re afraid they’re going to lose friends, and then there’s a large proportion that think it’s going away so they can handle it and they don’t need help,” said Carolyn Dewa, head of CAMH’s Centre for Research on Employment and Workplace Health.
“There was a proportion who said they wouldn’t tell because other people had had bad experiences so part of it is their organizational context.”
For those who would reveal they had a problem, a positive relationship with their manager was the key reason, found the survey of 2,219 working adults in Ontario.
“It’s more than just when things are bad because you have a health problem, I think it’s the everyday management relationship, and then its relationships with co-workers. So it’s how the team has been built and is managed as well that affects it,” said Dewa.
“It’s a very social thing, work is, so (it’s about) the manager being able to manage co-workers and their expectations and helping them understand, ‘No, we’re not playing favourites, we’re being supportive because at some point, everybody is going to need support — maybe not for the same reason, but they’ll need support.’”
Adrian Wall has always tried to have an open-door policy when it comes to employees with mental health issues. An Aboriginal Affairs advisor at Fisheries and Oceans Canada in Kamloops, B.C., he feels it’s critical for employers and employees to have open discussions about problems at work or outside of work.
“I try to follow through with some good, positive actions to basically put some emphasis behind those requests (so) they’re not just a discussion, and then also encourage others to have those discussions amongst themselves and take that practice broader than just my area of influence.”
Supportive organizational policies were another factor influencing employees’ decision to come forward.
“There’s policies and procedures, so understanding what the company is saying and the company’s policies and philosophy is important as well,” said Dewa.
Employees may also be concerned about revealing their problems because of the perceptions of co-workers. Almost two-thirds (64 per cent) of the CAMH respondents said they’d be concerned if a worker had a mental illness and more than four in 10 indicated concerns about both reliability and safety.
“Part of that is (ignorance) and part of it is when you look at the media, the stories that do come up about mental illness are scary, and those are the rare events,” said Dewa.
Mental illness is a major workplace issue that shouldn’t be ignored, according to a survey by Morneau Shepell that found one-third of Canadian employees are suffering or have suffered from a mental health condition such as depression or anxiety disorders.
“Some symptoms of mental health conditions actually mimic and co-exist with physical health, so I think in the past we’ve really sort of under-recognized the impact on the population in general and the prevalence in the workplace,” said Paula Allen, vice-president of research and integrative solutions at Morneau Shepell in Toronto.
A further 27 per cent of employees said they are experiencing significant symptoms of stress, found the survey of 1,005 employees, 117 physicians and 100 employers. And that stress has an impact: Almost one-half (45 per cent) of employees said they have thought about leaving their job because of stress, while 31 per cent have taken time off work and one-quarter have become ill in the last six months.
Stress is one of the leading issues around mental health in the workplace, said Wall.
“I notice a lot more challenges that people have at home, trying to balance the financial end of people’s own lives — paying for mortgages, daycare is huge now — so those are things that I didn’t see 20 years ago. I didn’t see the same level as I do today.
“So I notice that employees are having to come to terms with how to address so many stressors outside the work environment, initially, and that’s not even addressing what happens within the workplace.”
Not surprisingly, stigma is a challenge — one in five employees (19 per cent) believes that whether someone becomes mentally ill is fully within his control (compared to 12 per cent of employers).
A lot of these attitudes are based on unfounded beliefs, said Allen, such as viewing a disability leave as a vacation.
“No, it’s quite unpleasant to be separated from your workplace, have less money, be concerned about taking a break in your career,” she said. “So the way the employer can really help is to directly address those unfounded beliefs — stigma doesn’t go away unless you have knowledge.”
Managers also play a role in setting the tone and setting expectations, said Allen.
“If a manager hears concerns about somebody returning to work — ‘Are they going to be able to pull their weight?’ — all these negative tones, if the manager says, ‘No, the person was off work, of course they had difficulty being off work, they were feeling ill, that’s why they needed to take time off work, we are going to allow this person to have a fresh start. I would do that for any of you.’ It completely changes the conversation.”
Self-stigma a challenge
But it’s not just about what others think — two-thirds (65 per cent) of employees cited self-stigma in the Morneau Shepell survey. It’s a very distinct concept that can make the situation worse, said Allen.
“There’s concepts of self-stigma where people have lower self-worth because of a label such as an illness or a condition or being a part of a group where they feel badly about themselves as a result of a bad issue being attached to them,” she said.
“It can co-exist within the same person — not having stigma about someone else, being enlightened and not having discriminatory behaviour, but still feeling differently about your own self.”
These people are among the three in 10 in the CAMH survey who won’t reveal their mental illness because they feel it won’t affect their work, said Dewa.
“That’s people thinking that they’re flying under the radar and… that’s part of the self-stigma: ‘I don’t need help, I’m OK, I can do this if I’m just strong enough.’”
Furthering the issue are the 53 per cent of respondents who cited concerns of stigma from their physicians in the Morneau Shepell survey. That may be linked to the fact they’re authority figures, said Allen.
“People tend to want to look good in front of people who are authority figures; however, if they feel that the physician is going to think more negatively of them, judge them more harshly because of a mental health condition versus if they approach the physician for support on a physical condition, it’s pretty clear that that’s going to impact people’s willingness to get care as well,” she said.
“And when you’re with the physician, you’re probably not going to be as honest as you should be, so it’s a huge, huge issue that we’ve uncovered and something that needs to be addressed directly.”
When polled, almost every physician respondent indicated work plays a role in the mental health issues they see on a regular basis. And when asked what employers could do to foster psychologically healthy workplaces, the number one recommendation among physicians was better workplace communication and social support, followed by counselling and guidance, found Morneau Shepell.
These two factors were considered more important than reduced workload or time off work.
“It was a little surprising to us because you hear a lot about physicians saying that people should take time off work or physicians giving unrealistic recommendations about how people should have a stress-free work environment — that was not what they were saying,” said Allen.
“It’s pretty well-known that how you communicate can make a situation seem more difficult or seem more positive, so for workplace communication, (physicians) had recommendations around conflict management, addressing interpersonal difficulties, training your managers — making sure that the workplace actually really didn’t… cause harm.”
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