Group plans should empower employees to combat mental illness

Insurers are questioning the actions businesses take to stem the devastating effect of mental illness on group insurance plans. Their challenge is to equip employers to use programs more effectively and promote a healthy lifestyle among their staff.

The Rassemblement pour la santé et le mieux-être en entreprise recently held in Montreal, brought together five insurers and an independent specialist to discuss health and wellness in the workplace. Led by Stéphan Bureau, this forum stimulated a debate on solutions to rein in the increase in mental health problems affecting employees. The consensus: employees must be empowered.

Psychological distress

Jean-Pierre Brun, director of the Chair in Occupational Health and Safety Management at Laval University, launched the round table. He claims that 24% of Canadians are living with a psychological condition, and 35% to 55% have experienced an episode of psychological distress.

Carl Laflamme, senior vice-president, Group Insurance, at SSQ Financial Group, was the first to respond to these statistics. “When I heard the high percentages of psychological illness Brun said, it makes me wonder whether we have really put the right things in place. In the past 24 years, we have seen programs evolve considerably. However, there is still much work to be done and we should think about which practices to adopt.”

Nathalie Laporte, vice-president of Product Development and Marketing for Group and Business Insurance at Desjardins Insurance, pointed out that today, employers want insurers to do more than just pay disability benefits. “They also want the insurer to offer solutions to improve their employees’ health. An important key is to get employees more involved in managing their health,” she says.

Laflamme also stressed the participant’s role. “If a patient has a cholesterol problem, the doctor will ask him to change his diet for six months and come back after that. Very often, doctors’ appointments are very short. Do they have enough skills to treat mental health problems as quickly as they do a cholesterol problem?” Laflamme asks.

He explains how lifestyle may play a role in psychological distress. Debt is a significant stressor in society. “I don’t think people are inclined to discuss their financial situation with their doctor. They would be more likely to tell the doctor about problems at work,” he says.

For their part, employers should help employees reach a better balance. “But when taboo subjects like personal finance or family problems never come up, it is difficult for employers to assess the situation. Employees may need financial planning services in some cases,” Laflamme explains.

Avoid paternalism

Employers must never act paternalistic, says Diane Miller Bourdon. Organizational Health consultant, Great-West Life. “They cannot become their employees’ therapist. Instead, they should put in place mechanisms to prevent the situation from reaching that point,” she says.

Amélie Meilleur, director, National Disability Best Practices at Manulife Financial, agrees that people want to be part of the decision-making process.   Paternalism would be a step backward. Employees must be empowered and must play an active role in their recovery. Treating them like victims reduces their ability to take responsibility, she says

Miller Bourdon adds that reintegration of employees on disability leave at the workplace needs much improvement. Prevention is also crucial, “because often, people want to remain at work,” she says.

Marie-Hélène Pelletier, director of Workplace Mental Health for Group Benefits at Sun Life Financial, thinks that emerging mental health problems often go unnoticed, like a ghost.

“Have you ever felt trapped in a bad situation for so long that your health is affected? Too often we only react when it becomes visible. We should be leaders in this area, both personally and professionally,” she says.

“Employers listen to insurers when things are going badly, but are they ready to be pro-active?” moderator Stéphan Bureau asked the participants.

Organizational culture

It all depends on the organizational culture, Carl Laflamme replies. “Often, employers are in reaction mode. The best equipped ones have integrated support programs. But it takes more than that. Most insurers have programs in place to help SMEs. Insurers and employers must not neglect other parties involved. In addition to the employee, don’t forget the physician and employee assistance program (EAP) supplier,” he points out.

Amélie Meilleur recommends the use of multidisciplinary teams of specialists. She says that psychologists, occupational therapists, nurses and social workers can offer different perspectives. This interaction can enrich programs, she says. “Insurers and employers must apply an overall disability management approach. This approach must go beyond ensuring that the patient receives good treatment based on the diagnosis,” she says.

Diane Miller Bourdon stresses that if an employee’s return is poorly coordinated, you are back to square one. “The employee will then relapse and disability leave may be even longer,” she says. A poorly prepared return will cause a relapse in over 50% of cases, Nathalie Laporte points out.

The timing of an employee’s return is critical. Cases are not always as hopeless as people think, says Manon Charbonneau, president and founder of the Groupe de travail sur la stigmatisation-discrimination, citing a case presented to the board of directors of the Mental Health Commission of Canada.

“I recently saw someone who suffered from post-traumatic stress, for whom a return to work seemed impossible. Yet we thought that recovery was feasible. We suggested a return to work with seven months of supplementary assistance, and the return succeeded. You dash hopes if you rule out a return,” Charbonneau explains.

Stigmatization

Miller Bourdon also mentioned stigmatization of people with mental illness. “I heard employees say: I gave 25 years of my life to this company. I’m leaving because of a mental health problem and it’s as if I don’t exist anymore,” she says.

Developing managers’ skills to avoid stigmatization is essential, but it is not as easy as that, Carl Laflamme says. “Many businesses are not equipped to train managers. Neither is it easy for managers, often overloaded, to attend training. A business can’t develop managers’ skills if the executives are unaware of this need. You have to speak to the top. If you think it comes from the bottom, you’re on the wrong track,” he explains.

Even though depression causes most of the absenteeism for psychological reasons, Marie-Hélène Pelletier urges the industry not to underestimate adaptation problems, which are growing.

Nathalie Laporte agrees. She says that she has already seen workers under age 30 affected barely two years after entering the workforce.

Laflamme is not surprised by this trend. Cases of mental illness in young children are rising. If they are not treated properly at this stage, there will be serious risks of relapse, he says. Manon Charbonneau adds that 70% of adults with a mental illness felt the first symptoms in childhood or adolescence.

“Are we sicker than we were 20 years ago? 20 or 30 years ago, we worked at more physically demanding jobs than we do now. Today, technology can perform many physical tasks,” Miller Bourdon says.