Integration

A holistic approach to mental health and disability

For two decades, workplace specialists have been trying to take a new approach and break down the silos in our workplace health, wellness and disability programming as a means to better serve employees.

Previously a mental health disability was somewhat mysterious. Detailed information was scarce and only existed with a small number of employees. Actual data was held in confidential personnel files, and in private databases of disability insurance companies. In many cases when an employee left the workplace on a disability leave for depression, trauma, or substance abuse, it was likely that an “out-of-sight, out-of-mind” attitude would arise. Mental disorders were not well understood. Supervisors and managers often did not know how to respond, or the disabilities were hidden and employees made claims for physical ailments or other conditions that were less stigmatized.

This scenario is finally changing. A dramatic rise in the number of mental health disability cases and the associated rise in costs has placed a spotlight on mental disability. Each year 12% of all Canadian adults have a diagnosable mental disorder. Canadian Disability Pension Plan data suggests that substance abuse and mental disorders combined account for 46% of all STD (short-term disability) and LTD (long-term disability) claims.

In light of this, recent years have witnessed the formation of an active national commission on mental health, a call to action by leaders in the business community, resulting in a wealth of new scientific findings across Canada. According to a 2009 review, disability management was the second of 11 areas identified as the top trends in health research.

…one in eight employees who go on leave related to mental health subsequently have another disability leave from work…

There are now many evidence-based reports on the nature of mental-health disability, its impact, treatment and what helps get people back to work and to stay at work after their return. For example, “one in eight employees who go on leave related to mental health subsequently have another disability leave from work” (Roberts-Yates, C., Disability and Rehabilitations). This is a remarkable finding and may actually grow when multiple sources of employer data are included.

We must adopt an integrated and holistic employee heath and wellness model. We intuitively know that working together with the employee’s best interest as our central guiding principle is the way to move towards managing mental health and creating a culture of health and wellness. But so few organizations do this effectively.

Some key elements in developing a holistic approach include gaining a better understanding of mental health and why early diagnosis is critical to getting the right treatment. Mental disorders go undiagnosed or misdiagnosed more than twice as often as physical disabilities. High rates of co-morbidity and rates of relapse are complicating factors in successfully returning employees to health and work. Depression and other mental illnesses interact with physical illnesses to complicate and amplify the problems of the disabled employee.

Consider the levels of integration when trying to become more holistic in your approach.

Consider the levels of integration when trying to become more holistic in your approach. Specifically, can the departments of Employee Assistance, Disability Management, Health, Safety and Wellness all work together?

Employees report feeling a high level of discomfort returning to work after a mental health related absence as opposed to any other. An integrated approach may reduce the stress and pressure employees feel. In some cases employees feel the need to authenticate their illness and corresponding symptoms. Many state enormous fear of discrimination by co-workers and social isolation. Organizational and workplace efforts that de-stigmatize mental health issues are key to encouraging both early treatment and successful return to work.

Originally published in issue 12-2 of Your Workplace magazine.