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Transcript of IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ......patient is the right course of...
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
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dialogue on mental health
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Mike Allen Wanda McKenna Tony Fasulo Shelley Kee Paul Foley
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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
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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
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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
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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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