I come from a long line of short-lived men. Although the women in my family typically live into their 80’s and 90’s, most of my male relatives (including my own father and all of my uncles except 1) died before they were 65. Invariably in my family the issue was heart disease with heart attacks and strokes being the primary cause of death in every case. So, there is a pretty good chance that I too will be the victim of a cardiac “incident”. If and when that happens, I am one of the lucky ones. I live in Canada where health care is free. I have a good employee benefits package that will ensure that my income will be protected and that I will be able to access whatever therapies or services I need in my recovery. I have supportive colleagues who will encourage me to take advantage of these resources and an employer who will not question my use of the benefits.
I also live in an area of the country with high rates of depression and the Mental Health Commission of Canada tells us that 1 in 5 of us will suffer from a mental health problem at any given point. If I experience depression or any other mental health problem, again there is a public health care system – but, by all accounts, the mental health care system in Canada is “broken” and it is extremely unlikely that I will be able to access these free resources in a timely fashion. Again, I have a good benefits package that will pay for psychological treatment and provide income stability if I need to take leave. There are even provisions for me to access counselling through my benefits plan. But… the plans do not typically provide for enough services to treat the most common disorders. Moreover, the stigma associated with mental health (particularly in workplaces where admitting to a problem may be career suicide) is likely to prevent me from accessing these services.
There are three specific things that all labor organizations and employers should be doing in their initial attempts to respond to issues of mental health in the workplace.
- Review and adjust benefit plans. Most plans provide for payment for private mental health/psychological services. In most cases these provisions are woefully inadequate. The most common disorders (e.g., anxiety, depression) are effectively treated with 15-20 sessions of cognitive behavioral therapy. With psychologists and similar therapists charging on the order of $150-$200/session, plans need to provide for at least $3000 of psychological services on an annual basis. Given the potential of relapse/reoccurrence this is not a “lifetime cap” but an annual allotment.
In anticipation of the argument that this adjustment is cost prohibitive, it is instructive to note that the organizations with the most relevant data on this issue have recently announced a major increase to mental health benefits. Great West Life, London Life and Canada Life – all major insurance companies – have just announced that they are increasing their psychological services benefit to $5000 per employee annually. Who is better placed to assess costs and benefits than the providers of these benefits?
2. Educate As I have noted before, one of the great cultural changes in recent years is our increased willingness to talk about mental health issues. For a variety of reasons, many are still unwilling to disclose their problem or seek help when issues arise. We have shown that providing managers with mental health training (including both mental health literacy and training in company-specific policies and procedures) reduces managers’ stigma and increases their willingness to assist employees with mental health issues. In our most recent study just accepted for publication in the Journal of Occupational Health Psychology, we have shown that this same type of training results in employees’ reporting significant changes in managers’ behavioral support for employees. Taken together these results suggest that mental health training for managers results in changed attitudes and changed behaviors both of which result in employees being more willing to ask for, and utilize, organizational resources.
3. Prevent: Although mental health problems do not always originate in the workplace, it is clear that organizational practices and policies can contribute to stress and mental health. In a real sense, work can be both part of the problem and part of the cure. A first response to this observation is to assess the workplace identifying both the stressors and resources commonly experienced by employees. This is the strategy advocated, for example, by the National standard on psychological health and safety, released by the Canadian Standards Association.
However, we can also learn from decades of research and practice around employee engagement where, all too often, the only action taken was the initial measurement. We do a survey, spend countless hours in discussing and debating the results and by the time we process all the information it’s time to do the next survey.
A better strategy is to identify the “low hanging fruit”. What workplace features are causing employees the most problems? How can we change those conditions? It is only after we make changes that it makes sense to re-assess to ensure that our changes are having the desired effect. It should go without saying that, as noted in the standard, employees and their representatives need to be involved in all phases of this cycle – being consulted on the nature of the issues and involved in the change efforts.
The call for action is clear. Employers and labor organizations are increasingly aware of the issues surrounding workplace mental health. These three steps (review and adjust benefit plans, educate the workforce, and prevent psychosocial stressors) are three concrete actions that can be initiated now to ensure that individuals are getting the support and help they need, when they need it.
Dimoff, J.K. & Kelloway, E.K. (2016), Resource Utilization Model: Organizational Leaders as Resource Facilitators, in William A. Gentry , Cathleen Clerkin , Pamela L. Perrewé , Jonathon R. B. Halbesleben , Christopher C. Rosen (Eds.) The Role of Leadership in Occupational Stress (Research in Occupational Stress and Well-being, Volume 14) Emerald Group Publishing Limited, pp.141 – 160.
Dimoff, J. K., Kelloway, E. K., & Burnstein, M. D. (2016). Mental Health Awareness Training (MHAT): The Development and Evaluation of an Intervention for Workplace Leaders. International Journal of Stress Management, 167-189.
Dimoff, J.K. & Kelloway, E.K. (in press). With a little help from my boss: The impact of workplace mental health training on leader behaviors and employee resource utilization. Journal of Occupational Health Psychology
Kelloway, E.K. & Day, A.L. (2005). Building healthy organizations: What we know so far. Canadian Journal of Behavioural Science, 37,223-236.