Why Mental Health Matters
bh IN BRIEF
Mental health matters to employers because it is typically the most common diagnosis – either primary or secondary – among those on long term disability. Mental illnesses impact families as well, primarily because many are first diagnosed in youth and young adults. Families need more say in research agendas, policy, programs, and service delivery. Employers can’t do it all, but do have important and practical avenues to improve health and create a stronger business. Insurers have developed standards for handling these claims, though it is not yet clear how practices may have changed.
For too long, mental health issues have been swept under the carpet, out of sight but certainly not "out of mind". I was struck by a statement in Patient’s Voice, a recent report from Merck and Rogers, which was attributed to Donna Carbell, Manulife’s Vice President of Life, Disability and Absence Management Solutions. She said: "When we look at our long-term disability claims, when people are off for a significant amount of time, at least half of them have a secondary diagnosis of mental illness."(p.5) That’s a big percentage, and indicates a remarkable impact on Canadian workplaces, as well as those who are suffering.
The Role of the Family
One group believes we should be thinking more about who gets a say in directing that mental health budget. I had the pleasure of working with two dynamic and dedicated individuals who founded the Institute of Families for Child and Youth Mental Health (IF). Keli Anderson and Dr. Jana Davidson want to address the need for children and youth to gain timely access to necessary mental health services. Among Canadian children and youth aged 24 and younger, about 15% (1.5 million) will have a diagnosable mental disorder. One study published in 2010 described the outcome of these illnesses as a significant struggle "to learn, make friends, participate in activities and function in their families…" Not what we would want for our
The IF wants to influence research, policy, programs and services. I was surprised to learn how little influence patients and caregivers – generally families considering the young age of most patients at time of diagnosis – have in these realms. Researchers tend to feed off each other’s published studies, and governments tend to consult with recognised and credentialed "experts" when they want to investigate policy options or the need for new programs and services. The real-world credentials of parents and families need to be as well recognised as those of academics and health professionals.
Ms. Anderson and Dr. Davidson have their capable hands in many worthwhile mental health initiatives, including National Child & Youth Mental Health Day. At the inaugural event in 2009, former Senator Michael Kirby said: "Then – and now – only one in six children and youth with a mental health problem or illness will be adequately diagnosed, often not until long after the onset of symptoms. Only one in six children who are diagnosed will receive treatment." The next National Day is May 7, 2011.
Imagine if those sorry figures applied to other health issues – childhood asthma, diabetes, heart disease, or cancer. Imagine the headlines, and yet while we acknowledge the issue, we have not yet successfully addressed it. Mental illnesses are no less important than physical afflictions.
The Role of the Employer
Some workplace health promotion programs seem to pin the responsibility on individuals. If only "they" would eat better, drink less, exercise more, manage their time better, and behave, then "we" wouldn’t have to spend so much. But there are many influences on health, including some like genetics over which we have no control. Employers have significant influence over the work environment though – how work is done, how managers are trained, how leaders behave – but these issues require courage and integrity to measure and manage. High demand, low control work environments and imbalances in effort and reward have significant negative effects on mental health, as well as musculoskeletal disorders, heart disease and pain. Good management can ensure job fit, role clarity, and supportive environments which can reduce levels of stress and mental illnesses. While many employers provide supportive workplaces, it is important to think deliberately about actual practices relative to policy and good intentions.
The Role of Insurers
In the world of benefits, there have been some encouraging developments which reflect the severity of mental health claims, particularly in disability. In 2007, Great-West Life launched their Centre for Mental Health in the Workplace and the company has sponsored other solid web-based initiatives such as Guarding Minds @ Work. Manulife Financial has launched Workplace Solutions for Mental Health, and in October 2009, the Canadian Life and Health Insurance Association issued Guiding Principles to Support Good Mental Health in the Workplace. Employee Assistance Plan providers have also been active, of course, but all parties need to collect, analyse, and disseminate more comprehensive, current, and action-oriented information.
This edition of business health is focused on mental health conditions at work and in Canadian society. We hope you’ll resolve to do all you can to address these important health issues in your own workplace.
Sources: (1) Statistics Canada, 2009; (2) Davidson
J, S Wiens, K Anderson, 2010. Creating a Provincial Family Council to Engage Youth and Families in Child & Youth Mental Health Systems. Journal of the Canadian Academy of Child and Adolescent Psychiatry: 19(3). (3) Mental Health Commission of Canada; (4) www.gwlcentreformentalhealth.com. (5) www.clhia.ca.