The World Health Organization estimates that one in four people in the world will be affected by mental or neurological disorders at some point in their lives. It notes that mental disorders are already among the leading causes of ill health and disability, and expects that by 2020 depressive disorders will be second only to ischemic heart disease as a leading cause of the global disease burden.

Despite the growing crisis, most organizations have been slow to respond. Only about one-third of Canadian organizations say they have enacted return-to-work processes specific to mental health claims, according to preliminary results of Watson Wyatt’s “Staying at Work” survey, presented at the Global Business and Economic Roundtable on Addiction and Mental Health in April 2005. The Roundtable, which brings together science and business leaders, is affiliated with the Centre for Addiction and Mental Health and the National Quality Institute (NQI).

According to the Roundtable mental disability now accounts for an estimated 30 to 40 per cent of disability claims

Companies that fail to act on mental health issues are paying the price. A recent report from Health Canada suggests that mental health disorders in the workplace cost nearly 14 per cent of the net annual profits of Canadian companies, with an annual price tag of up to $16 billion.

Confronting painful workplace realities

On average, an episode of serious depression can take an employee off the job for an estimated 40 days. And depression has been linked to other serious physiological conditions, among them diabetes, hypertension, asthma, heart disease and stroke.

Unlike cardiovascular disease that typically strikes people in their late 40s, mental disorders have an average age of onset of 15 years, creating career-long implications and a heavy burden of disability costs.

Mental health’s not my problem. It doesn’t cost me anything, right?

Wrong. As an employer, you pay directly through increasing costs of benefit claims for medical treatment, prescription drugs and short- and long-term disability. You also pay indirectly through lost productivity, absenteeism, the cost of replacement workers and overtime, as well as turnover. According to the Roundtable, mental disability now accounts for an estimated 30 to 40 per cent of the disability claims being recorded by Canada's major insurers and employers. In addition, disruptions in the workforce can impair employee relations, the quality of products and services, and may ultimately affect customer satisfaction. Unfortunately, there is still a significant social stigma attached mental disorders. Many employees are fearful of seeking treatment, which only exacerbates the problem. Nearly two-thirds of people with a known mental disorder never seek help from a health professional.

Finding answers . . . and hope
Advances in treatment are giving newfound hope to sufferers of mental disorders. Researchers at the Centre for Addiction and Mental Health find that 75 per cent of those who get the treatment they need successfully return to work.

And there is positive news on the workplace front too.

Commenting on his firm’s survey, Joseph Ricciuti, National Director, Group and Health Care Practice, Watson Wyatt Canada, said, “What’s fascinating is those progressive organizations that are dealing with the issues overwhelmingly indicate that mental health management practices help reduce costs, improve employee health and satisfaction, and increase productivity. This is good news for those employers who are trying to find ways to manage mental health concerns in their work environment.”

Mind over Matter: The value of innovation

Dofasco Inc.

Established in 1912, Canada's largest steel producer has moved from a “strong back” to a “strong mind” business model, concentrating on the intellectual side of employee capacity. Why? Because Dofasco’s success is tied to the innovation of its people. About 90 per cent of the steel products made today were not even available 10 years ago.

“For years, our work was concentrated in the very physical demands of steel production,” says Brian Mullen, director of Human Resources, Dofasco Inc. “But today, we make valueadded steel products, produced in a high-tech, innovationdriven way. Our finishing facilities, for example, rely on computers that require high levels of mental performance to operate.”

Perhaps it’s not surprising that a company recognized as a top employer and celebrated with a Canada Award of Excellence in 2002 for its Healthy Workplace, would be blazing a trail in the mental health area. After all, the company refers to its "triple bottom line" of sustainability: financial performance, environmental responsibility and social well-being. But what may be surprising is that mental health has become much more than a business issue for Dofasco.

“We see this as a community issue, affecting kids and their parents, teachers and health care practitioners,” says Mullen. “These kids are our future pool of talent, and they may have already suffered the effects of depression and be vulnerable to relapses.”

Dofasco has been focusing on early intervention and removing the stigma of mental illness, surveying its workforce to understand how it compares with Canadian norms for incidence of depression and partnering with the Canadian Mental Health Association and the Roundtable to develop workshops that raise awareness, promote earlier identification of mental health problems and help managers, supervisors and employees become part of the solution.

Acknowledging the community aspect of mental health, Dofasco is piloting a program called “Feeling Better Now” developed by Mensante. The online early detection and referral module creates a care map, which an individual can take to a family physician for ongoing support, referrals and monitoring.

“The idea is to support the work of family physicians who don’t have time to do this kind of assessment,” explains Mullen. “It’s one thing to encourage employees to seek treatment but they need a whole support network to help them succeed.”

Charting a course: A holistic approach to health

OPG

In detecting ever-higher costs of long- and short-term disability, Ontario Power Generation Inc. (OPG) was not unlike many other organizations. But its distinction may lie in what it did with that information.

The company that generates and sells electricity in Ontario and to interconnected markets has designed a specific strategy in 2005 to manage and improve mental health in the workplace.

Taking a three-pronged approach, OPG’s strategy encompasses prevention and education, reactive responses and organizational effectiveness.

For example, OPG runs a proactive employee assistance program and regular lunch-and-learns that educate employees about mental health issues. “We emphasize ‘workplace behaviours,’ which help destigmatize mental health issues, separating the behaviour from the person,” says Diane Westcott, director of Wellness, OPG. “Co-workers don’t always intuitively know what to do and without clear understanding their response can be profoundly unhelpful.”

OPG responds to mental health issues through an inhouse disability management program that includes a process and professional resources for mental health case management. And it is working to implement the Health Canada and NQI models for healthy workplaces, which take a holistic view of health, recognizing physical risk factors, work conditions and stress.

In a pilot, the Lambton plant conducted surveys and focus groups, then acted on managing personal risk factors through weight management and back care programs, fitness subsidies, blood pressure monitoring and other ways of promoting mental and physical well-being.

In a highly decentralized structure such as OPG’s, implementing such practices consistently across the enterprise can be a challenge. “But we have to start somewhere and right now our emphasis is on helping individuals manage their mental wellness,” says Westcott.

With good data collection on disability rates, absenteeism, employee engagement and other indicators, she expects to demonstrate the positive effects of the strategy in the years to come.

“Ultimately it’s about improving the bottom line through higher productivity, better safety, fewer errors and other benefits,” she adds. “We do a lot on faith… and we know we’ll get there,” she adds.