Mental illness a top concern, but only gets Band-Aid treatment

With new evidence to show workplace mental illness is an increasing concern, two Canadian research initiatives will soon be underway to hopefully find a remedy.

Preliminary findings from Watson Wyatt’s Staying at Work survey show more than one-half of respondents (56 per cent) say the continuous rise in employees’ mental health claims is a top concern, and more than three-quarters believe mental health issues are a leading cause of short- and long-term disability claims.

The findings were based on a survey of about 100 Canadian organizations and were presented at a meeting of the Global Economic and Business Roundtable on Addiction and Mental Health in Toronto last month (www.mentalhealthroundtable.ca).

Clearly these survey findings show mental illness is one of the issues keeping benefits managers up at night, said Joseph Ricciuti, national director, group and health care practice, Watson Wyatt Canada. It is quickly becoming their number one concern, ahead of an aging workforce and other problems.

Two studies announced at the roundtable meeting should provide invaluable information to tackle these problems and address some of these concerns, said roundtable co-founder and CEO, Bill Wilkerson.

The first is a 10-year study by the Canadian Institutes of Health Research, which will attempt to transfer scientific knowledge into practical workplace solutions, including the reduction of the disabling effects of mental disorders and the delay and prevention of their onset.

The second study, spearheaded by the Harvard Medical School with Canadian partners, will document the health-care and economic cost benefits of early and effective treatment of depression in the labour force. The study will involve a survey of up to 100,000 Canadian employees.

Despite the rising scale of the problem, the Watson Wyatt survey shows most organizations are doing little if anything about it, said Ricciuti.

Just one-third of respondents have return-to-work processes designed specifically for mental health claims, and even fewer (27 per cent) have functional mental health capacity assessments.

It is both surprising and disturbing that so few organizations plan to do something about the problem, he said. Just 31 per cent of respondents plan to undertake new initiatives to manage mental health claims over the next one to two years. And only five per cent plan to address the stigma surrounding mental health issues. “If we don’t deal with the stigma, it is going to take longer to address the problems,” said Ricciuti.

Organizations need to introduce as quickly as possible mental illness disability management programs and policies to allow for cognitive capacity assessments. “Companies that do that see reduced costs in the workplace, happier and healthier employees and productivity increases.” The final results from the survey, to be released in June, will likely provide a clearer picture of the extent of those savings, he said.

The survey also revealed many organizations are tracking the costs of disability claims informally and sporadically. “If we are going to treat this as a business issue, then you have to deal with it the same way you deal with all business investments,” he said. That means employers have to do a better job of capturing the costs of things like casual absences.

“This lack of decisive action by organizations to address what they acknowledge is a growing issue, coupled with an ongoing failure to accurately measure its impact, is alarming,” he said.

Though it is hard to say why so few have done anything, Ricciuti believes it is not from a lack of interest. It isn’t that business leaders don’t want to do this — they just aren’t sure what to do or where to begin.

“I don’t think corporate Canada is saying, ‘We are not going to do this.’ It is saying, ‘How do you deal with it?’”

Finding solutions to that question was the focus of the roundtable meeting of business and mental health care experts.

Michael Kirby, chair of the Senate Committee investigating mental illness, was unable to make the meeting as planned, but instead issued a statement.

“I believe very strongly that enduring change in the way Canadians perceive, deal with and accept mental illness must, to a very large extent, start in the workplace,” he stated.

“One in five Canadians suffers some form of mental illness each year but only one in three get treatment; if this was any other part of the health-care system, there would be complete public outrage. Yet, it is greeted by silence.”

Another statement was issued by the publishers of four of Canada’s leading newspapers.

“There are in the life of a nation when a generation is defined by the challenges it stands up to. For this generation, terrorism is one such challenge. The integrity of our public institutions is a second. And, mental illness is a third,” reads the statement signed by Neil Fowler, publisher of the Toronto Sun, Michael Goldbloom, publisher of the Toronto Star, Jim Orban, publisher of the Ottawa Citizen and Les Pyette, publisher of the National Post.

Publishers can’t directly influence the editorial agenda of their newsrooms, but there is no reason they can’t raise their awareness of mental health issues and events, said Orban.

“I will not unduly try to persuade (editor Scott Anderson) or anyone else to try and do something, but I can lead them to the information and say it is your call,” he said.

One of the objectives for Canadian employers looking to reduce lost time and mitigate productivity losses from depression has to be early diagnosis followed by aggressive treatment, said Wilkerson.

“The literature shows that if you get it in the first 14 to 16 days, the odds of keeping it from becoming a protracted episode are higher than if it goes on for a month or more.”

The difficulty is determining how to make early detection and intervention standard practice is every organization.

Currently, if there is suspicion of a mental health problem, it can take months to see a specialist, usually only after a referral from a family doctor, said Wilkerson. Employers might be better off if they can bring in a psychiatrist at the first sign of trouble.

Some people will argue this violates the Canada Health Act but right now the act is not sufficiently addressing mental illnesses, he said. “I would love to have the luxury of arguing about a one- or two-tier system for mental health. In mental health we have a no-tier system.”

Wilkerson said the numbers in the Watson Wyatt study do not concern him. In 1998, when he began raising awareness of the issues, he would regularly give talks at conferences to empty rooms. Today, hundreds of people are turning out for his sessions, he said. “The issue has come alive. We are effecting social change here, attitudinal change. I am very encouraged by all this.”

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