IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ......patient is the right course of treatment. But you can have ev-erything line up perfectly—so the employer provides

Employers and service providers tackle mental illness in the workplace

hat are the signs of a troubled employee? What is best practice

for addressing a workplace mental health issue? How can man-

agers support an employee struggling with a mental illness? At

Working Well’s first stakeholders’ forum held in October, we

posed these and other questions to a panel of human resources

professionals, ability management and wellness consultants,

insurers and pharmaceutical industry executives to gain insight into how mental illness

affects the workplace and what employers can do about it. The following report presents

edited highlights from that two-hour discussion.

Speaking out

WW: What is mental illness in the workplace?Paula Allen: Mental illness is sometimes a catch-all term.

When we talk about mental illness in the workplace, we’re

typically talking about depression and anxiety disorders.

Those are the most prevalent.

WW: What are the implications of mental illness on the workplace?Paul Foley: The obvious implications are lost productivity,

the impact on the individual and the individual’s impact

on others.

Terry Martin: It could also have a negative impact on cus-

tomer satisfaction—if you’re unable to deliver on service

commitments.

PA: If left unaddressed, mental illness can impact the suc-

cess of a business. Most businesses today demand many

cognitive abilities, such as communication and interper-

sonal skills, which feed into profitability and sustainability.

When those are impacted by key people the success of the

business is impacted as well.

Wanda McKenna: There are also the challenges of manag-

ing performance and productivity when issues of mental

illness exist in a work unit. Typically managers don’t know

how to respond or talk to an employee [about their mental

illness]. We are still battling the stigma attached to mental

illness.

Mike Allen: There’s also the safety factor. Yes, we have

to deal with that person or try to intervene, but we also

have an obligation to protect other employees from harm.

We have to be sensitive when we intervene, especially

in a situation where there could be conflict. It wouldn’t

take much to trigger someone, especially somebody with

anxiety. It just needs that little explosive thing inside to

get them to that point.

WW: How can managers recognize a mentally ill employee? PF: Managers have to recognize when there’s a change in

behaviour and performance and that something is causing

it. Their role is to facilitate and support the employee, and

provide the individual with whatever tools and direction

are necessary to address the matter—not diagnose the

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I

dialogue on mental health

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I

Mike Allen Wanda McKenna Tony Fasulo Shelley Kee Paul Foley

february 2008 | working well 21

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behaviour. The underlying cause isn’t their responsibility.

Tony Fasulo: It’s dangerous to assume front-line managers can

recognize and diagnose mental health issues. It’s hard enough

for doctors and psychiatrists to diagnose. But it’s important to

recognize how the problem is affecting the workplace. Also,

many times the cause of an employee’s depression and anxiety

is the workplace itself, so it becomes a catch-22. The manager

may not see that he or she is part of the problem.

WM: Managers will see a change in performance. When a

supervisor has had a long-standing working relationship with

an individual, hopefully their first response isn’t to jump into

performance management, but rather to have a discussion

with the employee, such as “I noticed you are not yourself late-

ly. Is there something going on? Is there something I should

be aware of, or can help with?” Hopefully then we’ll find out

whether we’re dealing with a health issue or a performance is-

sue. [If it’s the former] we can start the employee down a path

of recovery with the right tools and resources.

WW: How can managers support an employee struggling with a mental disorder? PA: A manager has a need to expect people to perform at a

certain level and to protect the interpersonal relationships in a

workgroup. If somebody is deteriorating, is unable to perform

and it’s impacting co-workers, that needs to be managed. So in

a very caring and considerate way, you tell the employee what

you’re observing and offer them ways to get support, whether

through an employee-family-assistance program (EFAP) or

another kind of personal/community support. But you also

ask them if there’s anything you can do to help better organize

their work. You keep having those conversations. Sometimes

a person won’t hear it the first time. Sometimes they might

hear it the second or third time, but it’s important they hear it

more than once to take it seriously. At the end of the day, the

employee has to take care of themselves, but the manager has

to continue bringing the issue to their attention.

Fanny Karolev: Within Campbell Canada, we train our

managers to recognize the signs of a troubled employee. Our

staff tends to know each other well. Should there be evidence

of [mental illness], a conversation will take place. Most of the

time, that will be followed up with a referral to the onsite occu-

pational health nurse or human resources. The nurse will assess

the situation and collaborate with the family physician as far as

next steps. If there’s medication involved, being a manufactur-

ing environment, we are concerned for the employee’s safety.

Psychotropic drugs, until properly adjusted, are a huge issue.

We will give the family physician the employee’s job descrip-

tion, so he or she is aware if the employee works around forklifts

and high-speed conveyor systems. The physician can then de-

cide on a suitable treatment plan while the employee continues

to work, and perhaps recommend a period off work to allow the

medications to be adjusted to the right levels.

We also partner with Shepell•fgi to provide our managers

with a number to call to talk about their circumstances with

an employee. Our utilization is at 11%. Obviously people are

using the service—and with positive results. But it’s the trust-

ing relationship between the employee and the occupational

health nurse that makes the biggest difference. She is a critical

resource in managing mental health in the workplace because

she acts as the hub, communicating with the physician and

keeping in contact with the employee regularly.

TF: I agree we need to let doctors know about the employee’s

cognitive and physical demands at work. We need assessment

tools that we don’t really have to keep people at work. Just

because somebody is suffering from anxiety and depression

doesn’t mean he or she should be off work for six weeks. In fact,

that’s a detriment to the employee. People need to stay in the

workplace and be supported. Some doctors don’t know how to

assess the situation, so they give the employee the green light to

be off work. That’s why we are seeing short-term disability as

30% of all claims. We don’t try to accommodate these employ-

ees because we don’t know what they can and cannot do.

Theresa Rose: Based on the research, recovery involves medi-

cation coupled with that support network. However, while

we’re seeing claims for antidepressants skyrocket on our drug

plans and disability rates go up, we’re not seeing that correla-

tion with EFAP utilization or that of the psychology benefit.

The two combined tend to have a greater impact.

Shelley Kee: There’s also the issue of compliance and whether

the employee actually takes the medication. I think we all

recognize that medication in the right case for the right

february 2008 | working well 23


Just because somebody is suffering

from anxiety and depression

doesn’t mean he or she should

be off work for six weeks.

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Terry Martin Paula Allen Theresa Rose Martin Chung Fanny Karolev

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patient is the right course of treatment. But you can have ev-

erything line up perfectly—so the employer provides support

and encourages the employee to access assistance, and the

employee accesses the EFAP program, gets to the doctor and

receives medication—but does the person actually take it? Or

do they take it until they feel better, think they have kicked the

illness, but haven’t necessarily, and then elect to discontinue

treatment? So compliance is important. We need to recognize

when that person’s prescription is not being renewed and

whether it’s because the medication isn’t working, or because

the employee has chosen to take himself or herself off it.

WW: How can employers help fight the stigma attached to mental illness? PF: You make mental health a part of your wellness culture, so

you layer it into your health education programs. You send the

message that you’re treating the person as a whole so the men-

tal and the physical are linked and can’t be separated—one

drives the other.

PA: One of the biggest eye-openers for many people is the fact

that there are successful people in leadership positions who,

at some point in their lives, have suffered from a mental ill-

ness. You can transition in and out and you’re not necessarily

marked for life after one episode. That’s helpful for employers

[to know] as well when returning people to work.

FK: At Campbell Canada, we discourage phraseology like “stress

leave.” You don’t leave work because you are stressed. You leave

because you are unable to work. It’s really no different than

going off [work] for a hysterectomy. I discourage our manage-

ment team from focusing on the diagnosis. If you focus on that,

subliminally it can put up a glass ceiling over the individual. The

manager may think, “Am I giving this person too much stress by

promoting them?” Unless the employee is willing to share [his or

her diagnosis], there’s no need for management to know.

WM: At McMaster, we monitor our STD claims closely and know

that more than 50% of them are attributed to mental health

diagnoses. We deal regularly with supervisors who are manag-

ing this issue. Some of them are fantastic and supportive, while

others are at the other end of the spectrum. They think, “I can pull

up my socks and get this done, so why can’t they?” Fortunately

I don’t hear that often. We have to appreciate that mental illness

represents a significant part of the population—one in five people

within their lifetime. We need to realize that these can be episodic

issues and that these employees can be productive members of the

workforce. Supervisors need more education and awareness about

the issue and how they can be more supportive. W

Participants:Mike Allen, manager, health, safety and emergency,

Moosehead Breweries

Paula Allen, vice-president, health solutions and Shepell•fgi

Research Group

Martin Chung, senior manager, private sector strategy and

partnership development, Pfizer Canada

Tony Fasulo, managing partner, ACCLAIM Ability Manage-

ment Inc.

Paul Foley, director, private health plans, Shoppers Drug Mart

Fanny Karolev, manager, worklife, health and wellness,

Campbell Company of Canada

Shelley Kee, senior director, corporate accounts, Medavie

Blue Cross

Terry Martin, senior product management consultant, group

marketing, Sun Life Financial

Wanda McKenna, director, workplace health, benefits and

pensions, McMaster University

Theresa Rose, director, group product management, Medavie

Blue Cross

Moderator: Nancy Kuyumcu, associate editor, Working Well

24 working well | february 2008


Nancy Kuyumcu

Employer resources When Something is Wrong: Strategies for the Workplace (Canadian Psychiatric Research Foundation, 2007)

Mental Health: A Workplace Guide (Rogers Media, 2006)

A Tool for Managers: What You Need to Know About Mental Health (Conference Board of Canada, 2005)

Mental Health Works www.mentalhealthworks.ca

Global Business and Economic Roundtable on Addiction and Mental Health www.mentalhealthroundtable.ca

I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I

You don’t leave work because you are stressed. You leave because you are unable to work. It’s really no different than going off [work] for a hysterectomy.



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IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ......patient is the right course of treatment. But you can have ev-erything line up perfectly—so the employer provides