Mental health awareness in the workplace is an evolving thing which has grown in a relatively short period of time to become part of the corporate culture for a lot of companies.
At insurance companies providing benefits to these employers, the shift is also noticeable. In the insurers’ case, the shift has been from a position where services and benefits are delivered “just in time,” that is, after a mental health event has already occurred and the employee needs treatment, to a position where they are proactively rolling out services intended to catch employees before their condition becomes unmanageable, in an effort to keep them at work for longer.
“Employers’ interests are shifting,” says Medavie Blue Cross vice president of product and disability management, Marc Avaria. “Historically, the role of the employer had been to provide a safe work environment and good benefits plan. That has evolved over the years. I think now, specifically in the area of mental health, employers are really starting to look at how to support employees who are experiencing an event, before it gets to the stage of disability leave.”
Generational differences driving change
He says generational differences are in part driving some of this change. “The generational acceptance around mental health is different,” he adds. “Employers have a stronger understanding that caring about the health of employees needs to be balanced in the equation.”
While employers adapt, at Medavie, Avaria says there’s also been a shift from providing access to treatment and access to assessments, to a place where the company is building capabilities designed to help employees self-manage their conditions sooner. “Ideally the employee stays at work and accesses those services,” he adds, instead of accessing their benefits only after they’ve stopped working. “This can help improve health outcomes for the employee.”
He says company leaders and supervisors have a big role to play – both in helping employees to understand what benefits are available to them, but also in making the workplace environment civilized enough that employees feel comfortable disclosing the fact that they are experiencing a mental health challenge in the first place.
Their task is not an easy one, but it is also not quite as involved as some might imagine either.
“I do not believe that leaders need to be mental health experts. I do not recommend it,” says Mary Ann Baynton, director of collaboration and strategy for Workplace Strategies for Mental Health, a notable resource created by Canada Life. “It is not their job to diagnose or become an armchair therapist. Their job is to do no harm and protect psychological safety. If we look at physical safety, they are not supposed to become a doctor or clinician, they are supposed to make sure they do no physical harm and keep their employees safe. This is no different.”
Creating a psychologically safe space
She says problems occur when well-intentioned but ill-informed leaders feel that the mental health of every employee is their personal responsibility. “First of all, it is not ethical because they’re in a power relationship. They should not be telling employees how to manage their personal, health, family or financial issues. That should be up to the employee.” Instead, she says the focus should be on creating a psychologically safe space and on providing support so employees are successful in their work. “Not only does this take away that overwhelming and unrealistic expectation that leaders are going to be mental health experts, but it also balances out what they are responsible for and what is really within their influence.”
To help those interested in learning more about creating psychologically safe workplaces, Canada Life has invested a considerable amount over the past 14 years to create the Workplace Strategies for Mental Health (workplacestrategiesformentalhealth.com).
In addition to providing materials discussing psychological safety, the resource also includes help for dealing with issues in the moment – employees with dementia, burnout, conflict and performance are all addressed – and includes individual and team exercises for building resilience. The company says the resources are free for anyone to use or adapt, with attribution. “This reduces the expense, the feeling that you do not have enough expertise, and the time it takes to develop resources,” she says. “The intention is to make it really easy for any employer to be able to take action.”
Breakthroughs in pharmacogenomics
When asked for other examples where insurers are more proactively getting involved, earlier than they may have been involved in the past, at Medavie, Avaria points to breakthroughs in pharmacogenomics and the introduction of virtual ICBT (Internet-based, Cognitive Behavioural Therapy) to many benefits plans, as examples of benefits that are intended to be used well before an employee reaches a crisis point requiring disability leave.
Manulife, meanwhile, has been something of a pioneer in preventative benefits. The Manulife Vitality Group Benefits program, for example, uses behavioural science to inspire healthy habits and reduce the risk of chronic conditions that often lead to disability. “Vitality’s studies show the program can lead to fewer sick days, about two days less each year, higher workplace engagement and stronger job performance,” says Manulife Canada’s head of group benefits, Donna Carbell.
In pharmacogenomics, she says a pilot project resulted in more than 44 per cent of the project’s participants changing their medications or dosage, leading to better outcomes. For its own employees too, back in 2017 the company introduced a $10,000 mental health practitioner benefit for its Canadian employees and their dependents.
Greater emphasis on prevention
“Placing greater emphasis on prevention, early intervention and wellness can help employees stay at work, reduce the likelihood of long-term disability and get them back to work sooner and healthier.” - Donna Carbell
“We know from our experience that placing greater emphasis on prevention, early intervention and wellness can help employees stay at work, reduce the likelihood of long-term disability and get them back to work sooner and healthier,” Carbell says. “Even before the pandemic, mental illness was the number one cause of disability, costing employers about $20-billion annually. In fact, around 70 per cent of disability costs are mental health related.”
On the flip side of that, there is also research to show that an investment in workplace mental health can actually generate measurable returns. “A Deloitte Insights piece of research calculated the return on investment of workplace mental health programs at various stages of maturity. It found that for every dollar invested in workplace mental health, the median yearly return was $1.62, a figure that rises to $2.18 for programs that have been in place for three years or more,” she adds.
“We have the chance to take everything we know about the health of Canadians and offer back relevant information, options, suggestions and guidance to help make their lives easier. I’m talking about the kind of information that might help a plan member avoid an illness or reduce its effects and, in some cases, its costs,” Carbell says. “I think our true value as a benefits provider lies in being far more proactive.”