Every week in Canada, 500,000 people miss work due to a mental health problem or illness, according to a 2013 report from Statistics Canada.
What’s especially worrisome is that it’s not the same 500,000 people every week. And that number doesn’t take into account people living with mental illness who want jobs, but can’t break into the workforce. Nor does it include those people who had jobs, but have been sidelined due to a mental health concern.
Even more troubling, those half-a-million people don’t include employees who call in sick citing a migraine or lower back pain because they don’t feel comfortable talking about their anxiety or depression. They stay silent due to the stigma that makes them feel they could lose their reputation, the respect of their colleagues, or even their job.
But growing awareness around mental health and the application of new technologies are intersecting to create fresh opportunities to address this concern through e-mental health, particularly in the workplace.
E-mental health involves “mental health services and information delivered or enhanced through the Internet and related technologies,” according to the Centre for Mental Health Research in Australia.
It encompasses everything from computerized treatments to cellphone apps. While not yet widespread, applying e-mental health to workplaces makes a great deal of sense. In Canada, 60 per cent of adults spend two-thirds of their waking hours at work. In short, they spend more time on the clock than they do with family and friends.
Given that about one-third of short- and long-term disability claims in Canada are attributed to mental health problems and illnesses, at a cost to Canadian employers of upwards of $6 billion — according to a 2011 report from the Mental Health Commission of Canada — efforts to address mental health in the workplace are not only justified, they are necessary.
As many as 11.3 per cent of Canadian workplaces have adopted the National Standard of Canada for Psychological Health and Safety in the Workplace, according to a 2016 survey by the International Foundation of Employee Benefits Plan. This voluntary set of guidelines, tools and resources helps organizations to promote mental health and prevent psychological harm at work.
As part of implementing preventative measures to maintain and promote psychological health, the standard calls for organizations to offer resources to workers who are experiencing mental health difficulties, whether they originate at work or in an employee’s personal life.
With the ubiquity of the Internet, e-mental health can provide workplaces with convenient and customizable tools to support employee mental health. E-mental health can be used for self-help; screening, assessment and monitoring; therapeutic intervention (standalone or with the assistance of a therapist); and peer support.
Not only has e-mental health proven to be as effective as face-to-face treatment for certain types of illnesses, there are also distinct advantages: accessibility, flexibility, anonymity and cost-effectiveness.
There are e-mental health programs in both public and commercial domains that have been developed with workplace settings in mind. Often, they are based on models of cognitive behavioural therapy (CBT) or interpersonal therapy (IPT), both of which can effectively treat depression and anxiety.
E-mental health self-help tools in the workplace can allow users to better understand their mental state, and improve their self-management. Considering that many people in Canada struggle to access timely, traditional mental health services — due to wait lists, complicated pathways to care or lack of services — e-mental health is poised to fill a critical void.
From a workplace perspective, that means employees are able to access mental health support with minimal disruption to their workday. Additionally, they save the time otherwise expended getting to and from the appointment. E-mental health is also ideal for those who prefer to seek support in anonymity.
E-mental health can be tailored to respond to difference linguistic, cultural or gender needs. For example, as part of the Movember-funded “BroMatters” project, the BroHealth e-mental health website and online CBT program were designed to meet the needs and preferences of working men. This project empowers men to address work-related stress and maintain positive mental health.
Recognizing that there are different risk factors in the workplace for major depression for men and women, e-mental health tools that are researched, designed and evaluated to consider gender experiences in the workplace could prove to better meet the needs of employees.
Another example of an e-mental health tool is found at FeelingBetterNow, which helps employees identify mental health issues early and take immediate action, allowing them to stay healthy and productive at work. It uses the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) assessment to connect individuals to a personalized and immediate action plan for self-help or collaborative care with a counsellor, psychologist or physician and works with existing benefits and disability management programs.
Or at SilverCloud, interactive programs are delivered via a user-friendly platform. It’s an anonymous, safe and secure environment that’s accessible online, so it’s available at any time or place.
However, it is important to note e-mental health is not intended to be a complete replacement for face-to-face services, but rather a complement.
Here are some elements to take into account with e-mental health:
Program selection: When evaluating if a program is a good fit for your organization, consider programs that are supported by rigorous scientific evidence and were developed with the involvement of users (employees). Beyond the selection process, introducing an e-mental health program will require strategic communications, as well as buy-in from leaders and employees alike.
Boosting communication: Employees will need reassurance about the privacy, confidentiality and security of a given program. Ideally, the program should be introduced as part of wider organizational efforts to create and promote a psychologically safe and healthy workplace. This is where the psychological standard can be a vital resource.
Cost considerations: Costs will need to be considered both in terms of acquiring a program and maintaining it over the long-term. Understanding the real cost incurred to workplaces by mental health problems and illnesses makes a strong business case for investing in employee mental wellness. Further, e-mental health is generally seen as a cost-effective option for delivering mental health care and support.
Big picture thinking: We are living and working in the digital age. The past decade has seen tremendous growth in e-mental health programs and services and the evidence base is growing. When considering the importance of attracting and retaining employees, a focus on mental health and wellness can be seen as an indicator of overall progressive and an inclusive workplace culture.
Louise Bradley is president and CEO of the Mental Health Commission of Canada in Ottawa. JianLi Wang is senior scientist and director of the work and mental health research unit at the University of Ottawa Institute on Mental Health Research, and principal investigator at BroMatters in Ottawa. For more information, visit www.mentalhealthcommission.ca/English/focus-areas/e-mental-health.
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