Mental illness and disability: employers need action-based programs

By Alain Thériault | September 25 2015 07:00AM

By triggering a growing number of long-term disability claims, mental illnesses are threatening the viability of group insurance plans. A study shows that programs that concretely modify employees’ stressful situations instead of giving vague advice rein in the damage more effectively.  

The report The Life and Economic Impact of Major Mental Illnesses in Canada published on the Mental Health Commission of Canada website finds that lost productivity caused by mental health problems cost $6.4 billion in 2011 in terms of absenteeism and presenteeism at work. The report adds that these costs may reach $16 billion by 2041.  

Asked to discuss this trend at the Rassemblement pour la santé et le mieux-être en entreprise a conference on occupational health and well-being held in Montreal on May 25 and 26, Jean-Pierre Brun, the professor at Université Laval, replied: “The World Health Organization predicts that in 2020, major depression will become the main cause of disability on the planet. In industrialized countries we reached this milestone last year.” 

The results of phase 2 of SALVEO, an inter-university study of mental health at the workplace, are just as dismal. Unveiled at the Rassemblement by Manulife, they show that 30% of claims for short-term and long-term disability are linked to mental illness. These requests represent 70% of disability costs.  

In the first phase of the SALVEO study, researchers reviewed 63 management practices by interviewing 2,000 workers at 63 workplaces for two years. Published in 2013, the first draft found that 24% of workers “may suffer symptoms of psychological distress,” says Dr. Pierre Durand, one of the study architects. The researchers asked the workers if in the last two weeks they had felt particular symptoms.  

SALVEO also demonstrated that 6% of workers “had an indicator showing that they may be suffering from depression and 4% from professional burnout,” Durand adds. For depression, researchers asked if in the last two weeks people had felt symptoms stated in the questionnaire. People suffering from burnout claimed that they felt the associated symptoms at least once a week.  

Programs that work

Some programs businesses put in place have little or no effect on the claims rate, Durand explains. 

The results of the second SALVEO study are based on three years of research on the incidence of mental health problems based on the sample of the first study. “We divided businesses into two groups: those with a rate lower than the median and those with a higher rate. 35% of businesses were situated below the median and 65% above,” Durand says.

Practices that are not sufficiently integrated at all levels of the business were singled out, and labelled as “macro” by the study. For example, the study showed that communication or information practices to promote stress management aimed at employees did not have a real impact on the claims rate. The same was true for risk control measures.  

“We have seen that nutrition, general health and stress management programs have an insignificant impact. Employees will not manage their stress simply because they are told to. They need support and a guide to do it,” Durand explains.

In contrast, practices aimed at modifying stressful conditions in the workplace are more successful because they are necessarily better integrated in the company. Practices centred on task design reduce the probability of a plan receiving claims due to mental illness by 6.8 times over a three-year period.  

Companies that offer physical activities or access to them and that promote a policy of work-family balance are 3.3 times less likely to see such claims.  

Next come bonus and recognition practices and career advancement possibilities for employees, with a probability 2.8 times lower. For individual-based practices, physical activity programs have a probability index of 2.2. Schedule flexibility reduces claims by 1.8 times and is often coupled with task design.  

“Overall, giving employees more autonomy and possibilities to participate in task design, flexible work hours and more possibilities of using their skills make the difference. These practices make up the most important factor that lets a group find itself in the category of the 35% with fewer mental health claims,” he says.

For these practices to work, they must be supported by human resources managers. Durand points out that mental health problems at work account for 33% of absenteeism due to medical problems and 40% of the indemnification costs of group plans. He estimates that mental health problems generally lead to long absences.


Quality of life and work: employers’ Achilles’ heel  

Jean-Pierre Brun founded the Chair in health and safety management at Université Laval 15 years ago. He is also an associate consultant at the firm Empreinte Humaine, and helps businesses improve quality of life at work. In Canada, 21% of the workforce is currently facing mental illness, he says. How can we reverse this trend, Brun asked, referring to programs at businesses.  

Quality of life at work seems to be key to solving this problem. “We often hear radio silence when we ask business managers to define their criteria for quality of life at work,” Brun says.

Achieving a good quality of life at work is not just a question of willingness, he adds. The workload must be balanced, schedules flexible and employees must be able to participate in company decisions. “Generations X, Y and even Z are expecting this and more,” Brun cautions.

Employees want their work to have meaning and usefulness. “The workload is an important challenge that we do not tackle well enough, with performance demands and efficiency coupled with cuts. Expectations are often unrealistic,” he says.

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