A study released in January, 2010 examined stress levels at four Ottawa hospitals. It suggested that stress is associated with poor physical and mental health, conflict between family life and work, and declining relationships between people at work and at home. This is a concern for all workplaces. In the study, concerns included workers quitting their jobs, looking for other jobs, and even taking ‘mental health’ days off in order to regroup.
Linda Duxbury of Carleton University, who helped conduct the study on behalf of the Workplace Safety and Insurance Board (WSIB), said that the work of doctors, nurses and technicians had changed in terms of complexity and intensity due to the growing emphasis on reducing hospital stays. “This is a system that ran the 100-yard dash, then the 800-metre and then the marathon with no break,” she said.
Indeed, there is now growing awareness about how mental health impacts the workplace, and the high-pace environment of hospitals merits special attention. Today we know that the issue of mental health, long hidden due to stigma, impacts on absenteeism, short-term and long-term disability, and productivity. We also know that the duration of absence for a physical disability increases by two to three times when accompanied by depression, and that one in four Canadians suffers from depression, anxiety, substance abuse, or other mental health disorders, but only 6 per cent seek or receive treatment.
In 2010 the Canadian Nurses Association did a national study on nurse fatigue involving 6,312 registered nurses, most of whom worked in hospitals. While more than half the participants said the most common reason for missing work was due to physical illness, 15.9 per cent said they were off work due to a stress-related illness. The survey cited such issues as nurses working unpaid hours, and called for such solutions as health and wellness programs for nurses.
The Mental Health Commission of Canada launched this country’s first ever mental health strategy in the spring with 100 recommendations grouped into six strategic goals. One of those goals was about promoting mental health, and in the workplace a key component of that involves training managers how to deal with employees who have mental health issues.
Bell is a company that has made great headway in developing a customized, workplace, mental health training strategy for thousands of its managers, with the help of Morneau Shepell. What’s more, this training is mandatory, demonstrating the importance of this initiative for Bell’s leaders. Among other things, the program provides better access to information right across the organization, equips team leaders with resources to support employees, establishes a return-to-work program after absences due to mental health issues, and builds a culture of support.
The mental health management model developed by Bell is a comprehensive approach to support all employees, including those at risk of mental illness or who are experiencing it. It involved three phases:
1. Pre-disability (recognize warning signs, step in and intervene)
2. Disability (understand your employee’s experience, stay in touch, manage the absence, support the team)
3. Return to work (prepare the team, review functional assessment and required accommodations, manage communications).
Hospitals are well advised to consider such an approach. Earlier this year the North Bay Regional Health Centre helped sponsor a new, continuing medical education program to support family physicians and specialists combat the stigma of mental illness, which existed within the profession. The purpose of that program was to help increase physicians’ understanding of the needs of a person suffering from mental illness. Key to this is helping healthcare professionals understand that they and their colleagues are not exempt from these issues themselves.
Morneau Shepell has been committed to promoting workplace mental health for several years. Over the past few years, our focus has been to increase the access options and service flexibility for individuals, and to increase our support to organizations and people leaders. We have provided training on mental health to literally thousands of people, most of them managers, at a great many organizations. The purpose was to identify mental health issues and provide assistance in order to prevent health and safety issues, and potential absences from work.
Here are a few things hospitals can do:
1. Develop a mental health strategy that includes proactive communications, e-counselling, and an online website specific to this issue. All this will help reduce the stigma and get valuable information into the hands of your people.
2. Integrate this strategy with your Employee Assistance Program (EAP).
3. Focus on workplace training, especially managers and anyone who has people reporting to them.
4. Support your employees with a stay-at-work program, coordination of services when they are away from work, and a specialized return-to-work program once they come back from an absence.
It would be difficult for any workplace to argue that mental health is not an issue worthy of strategic focus. A 2011 Conference Board of Canada survey indicated that over 40 per cent of working Canadians experienced a mental health issue (12 per cent currently and the remainder in the past). Mental health is typically one of the top two cost drivers in health benefits plans. Optimum mental health is correlated with workplace productivity, making mental health support an imperative in high-demand/high- performance environments. With this, a clear mental health strategy needs to be part of the core cost and performance strategy for most, if not all, organizations, and definitely for healthcare.