1. Dealing with mental health issues in the workplace And the effect on your bottom line Presentation to the HRPA – North Bay January 16, 2013 Denis Deschênes Caroline Workman The Great-West Life Assurance Company

2. Mental Health Issues in the Workplace Presenters Denis Deschênes B.A. B.Ed. Senior Account Executive, Group Benefits Division Caroline Workman, B.HSc., CRTWC Organizational Health Consultant, Group Benefits Division

3. Mental Health Issues in the Workplace Agenda Introduction Costs of mental health issues in your workplace Identifying mental health issues in the workplace What do we know about mental health in the workplace Addressing the barriers Mental health resources for HR professionals Video clip- Why Workplace Mental Health Matters Q & A

4. Mental Health Issues in the Workplace Costs of mental health – where are they? In the workplace Higher turnover, higher levels of job dissatisfaction, absenteeism, presenteeism, alcoholism, mental illness and indifference. Loss of productivity On your bottom line Salary related costs and lost production costs Short term disability Long term disability Health claims

5. Mental Health Issues in the Workplace Costs of mental health – where are they? It is estimated that between compensation to sick workers and lost productivity, mental health issues cost the Canadian economy $51 billion a year, of which $20 billion alone would be lost productivity. The total loss represents 4% of GDP. (Towers Watson, 2012) Benefit costs – a closer look

6. Mental Health Issues in the Workplace Source: Great-West Life Mental health and its costs - what we are seeing Top five conditions for new claims in 2011 STD Condition% Accidents & Injury17.7% Musculoskeletal14.7% Mental Disorders11.9% Respiratory13.1% Digestive8.8% Primary diagnosis Condition% Mental Disorders25.8% Musculoskeletal22% Cancer14.9% Accidents & Injury12.8% Circulatory6.9% Secondary diagnosis Condition% Mental Disorders32.3% Musculoskeletal19.7% Accidents & Injury9.4% Circulatory System7.9% Endocrine, Metabolic & Immunity Disorder 6.1% 82.4% 75.4% LTD 66.2%

7. Mental Health Issues in the Workplace LONG-TERM DISABILITY – DIAGNOSIS CLAIMS ANALYSIS Top Diagnosis Classifications by Occupation Category % Open Claims% Paid Sales & Service Musculoskeletal & Connective Tissue4.08%3.03% Mental Disorders3.76%3.16% Transport & Equipment Operators Musculoskeletal & Connective Tissue1.85%1.48% Mental Disorders1.05%0.92% Professional & Management Occupations Mental Disorders12.93%16.42% Musculoskeletal & Connective Tissue8.04%9.06% Processing & Manufacturing Musculoskeletal & Connective Tissue3.12%2.54% Mental Disorders2.22%1.91% Other Technical & Skilled Occupations Musculoskeletal & Connective Tissue7.67%7.44% Mental Disorders6.55%7.19% Source: Great-West Life

8. Mental Health Issues in the Workplace Mental health and its costs For short term and long term disability claims, mental disorders are the leading cause of disability among professional and management occupations. Mental Disorder short term claims have the longest durations and last between 10 weeks to 14 weeks (longer for professional and management categories). Many of these claims would likely reach the maximum benefit period and may transition into a Long-Term Disability claim. Also, Mental Disorder long term claims have the longest duration (over 3.1 years) and are the longest for professional and management categories. Females have a higher incidence than men for Mental Disorders.

9. Mental Health Issues in the Workplace Mental health and its costs STD costs, although short-term, can amount to large amounts at the end of the year. In a 100 employee workplace, up to 10 employees may be away from work for 10 days or more during a year. At least one of these employees will suffer from a mental health issue. At an average salary of $50,000, that employee will cost $12,500 in lost salary at 100%. Whether the short term disability is self funded or insured, there is a direct cost to the employer.

10. Mental Health Issues in the Workplace Mental health and its costs LTD costs can have a major impact on companies Need to hold enough funds to pay for current and future claims Costs increase by age and the Canadian population is aging. Out of 1000 employees, 9.5 will fall on LTD this year. Of these, at least 2 employees will have a mental disorder as a primary diagnosis. Based on a $50,000 salary and a 66% benefit, total benefit payout could exceed $200,000. To this is added the disability reserve which, on average, would exceed $175,000 per claimant. (This does not include the Life reserve.) Total potential cost of the claims (while on claim): $550,000

11. Mental Health Issues in the Workplace Distribution of Health Benefits by Age (2011) Source: Great-West Life Note: The “All” category does not include age bands 65+

12. Mental Health Issues in the Workplace Trend in Top Therapeutic Classifications of Drugs (2001 vs. 2011) Therapeutic Classification 20112001 10 Year CAGR for Average Paid by Disease Rank Average Paid by Disease % Paid by Disease Rank Average Paid by Disease % Paid by Disease Cholesterol Disorders1$54.847.8%3$86.437.9%(4.4)% Diabetes2$53.467.5%11$38.032.7%3.5% Rheumatoid Arthritis3$1,680.957.3%30$760.190.7%8.3% Blood Pressure4$28.307.1%2$35.318.0%(2.2)% Depression5$44.316.8%1$54.338.4%(2.0)% Ulcers6$45.085.6%5$67.927.4%(4.0)% Asthma and Inflammatory Diseases7$47.825.5%7$35.305.6%3.1% Antibiotics/Anti-Infectives8$26.394.7%4$26.497.5%0.0% Skin Disorders9$38.873.4%8$27.113.7% Narcotic Analgesics10$27.183.2%13$20.852.3%2.7% Source: Telus Health Solutions

13. Mental Health Issues in the Workplace Percent of Plan Members using Paramedical Benefits (2001 vs. 2011) Source: Great-West Life

14. Mental Health Issues in the Workplace Mental health and its costs Inflation coupled with an increase in the utilization of benefit plans has resulted more than a doubling of healthcare costs over the last decade. Although the cost of drugs to treat depression has decreased, the number of prescriptions have not gone down. These drugs still make up 6.8% of all drug costs. There is a growing tendency of employees to seek paramedical help to assist with their mental health. Plan members are now 2.5 times more likely to visit a Massage Therapist than they were ten years ago.

15. Mental Health Issues in the Workplace A disturbance in thoughts, feelings and perceptions that has a direct affect in day to day functioning. Mental illness affects thinking, mood and behaviour; This is associated with distress and or functional impairment with symptoms varying from mild to severe Mental illness affects people of all ages, from all walks of life Mental illness affects people on a personal, social and financial level Identifying Mental Illness

16. Mental Health Issues in the Workplace What do we know about mental health in the workplace? Most prevalent workplace mental health conditions: -Depression -Anxiety -Substance abuse Most often, it affects people in their prime working years, between the ages of 24 and 44. (CMHA ) Work/life balance plays a large factor. The demands of the workplace continue to increase, as do the number of hours most Canadians spend at their jobs. - 1 in 4 Canadians work 50 hours per week or more, compared to 1 in 10 a decade ago. (HRDC)

17. Mental Health Issues in the Workplace What do we know about mental health in the workplace? 1 in 5 Canadians will experience depression in their lifetime. 2 out of 3 will not seek help. (Health Canada) Treatment is not adequate for the condition and response is not often monitored effectively Stigma continues to prevent people from seeking treatment for mental illness. (Stats Canada ) According to research, stigma within the community, the workplace and internalized stigma has been cited to cause a 70% misdiagnosis rate. (Nielson)

18. Mental Health Issues in the Workplace What do we know about mental health in the workplace? 71% of Canadian employees surveyed report some degree of concern with psychological safety in their workplace While 91% of managers recognize the importance of emotional intelligence in the workplace, only 47% claim to know how and only 1%, report being strong at this skill set. Ipsos Reid Survey 2012

19. Mental Health Issues in the Workplace What do we know about mental health in the workplace? About 27% of working adults said they felt a lot, or an extreme amount, of stress on a daily basis. 62% of respondents reported work stress as the main reason for their stress (Statistics Canada) Other sources of stress amongst highly-stressed workers included: Financial concerns – 12% Not having enough time – 12% Family issues – 8% Personal/other issues – 6% Access to EAP counselling for workplace stress represented 6.2% of all cases (Shepell-fgi)

20. Mental Health Issues in the Workplace Early warning signs an employee is struggling with a mental health issue: lateness or frequent breaks away from office excessive sick leave & ‘presenteeism’ (on the job absenteeism) reduced quality of work high rate of accidents withdrawal/avoidance employee errors missed deadlines changes in physical appearance confusion or forgetfulness employee conflict inappropriate behaviour, mood swings, negative attitude

21. Mental Health Issues in the Workplace Sources of the Problem What you see What you don’t see WORKPLACE SYMPTOMS ARE ONLY THE “TIP OF THE ICEBERG” S p i l l o v e r Work Issues Environmental Interpersonal Job-Related KNOWING THE SOURCE OF THE PROBLEM ALLOWS THE MANAGER/SUPERVISOR TO DETERMINE A COURSE OF ACTION Health Issues Heart Health Nutrition Sleeping Depression Life Issues Stress/Emotional Relationships Legal/ Financial Addictions Lateness Emotional outbursts Withdrawal Mood Swings S p i l l o v e r Troubled employee in the workplace

22. Mental Health Issues in the Workplace Management & HR have responsibility in improving and addressing workplace mental health issues. Five key areas: Prevention & promotion Understand your organizational needs & identify potential and existing issues Develop prevention and management strategies for psychological health or safety issues in your workplace Education to staff on mental illness Remove stigma by education on the realities of mental illness Learn mental health coping strategies are strained by stress, burnout, conflict or life events Awareness of mental health resources i.e.: HR, OH&S, EAP, community resources etc. Posters, articles, newsletters,lunch & learns, health fairs etc. Addressing the Barriers

23. Mental Health Issues in the Workplace Manager training to identify and address workplace mental health issues Effectively recognize and manage mental health related issues in the workplace Principles and practicalities to manage issues related to employee mental health in the workplace including communication Managing conflict, performance management, return to work etc. Early intervention and employee support Prevention & crisis response Temporary accommodation Mental health resources for their employees i.e.: EAP, health & disability management programs Accommodation Return to work process Accommodation ideas for mental health related situations Addressing the Barriers

24. Mental Health Issues in the Workplace Mental Health in the Workplace - Resources for HR Professionals

25. Mental Health Issues in the Workplace Global Business and Economic Roundtable on Addiction and Mental Health Provides information, analysis and ideas concerning the linkage between business, the economy, mental health and work. Provides executives, HR, managers, and supervisors information and advice on reducing the business and economic dollar costs of mental illness and addictions among employees and management www.mentalhealthroundtable.ca

26. Mental Health Issues in the Workplace Mental Health At Work Université Laval, Chair in Occupational Health and Safety Management Prevention tool kit to help employers understand mental health issues and offer guidance on policies and programs to address mental health issues in the workplace. http://www.cgsst.com/eng/publications-sante-psychologique-travail/trousse-la-sante- psychologique-au-travail.asp

27. Mental Health Issues in the Workplace Canadian Centre for Occupational Health and Safety Promotes a safe and healthy working environment by providing information and advice to all parties about occupational health and safety. Provides access to a wide range of publications, databases and information products. Mental Health Awareness e-course www.ccohs.ca

28. Mental Health Issues in the Workplace Mental Health Works Provides employers and employees with information about mental health issues in the workplace. Covers topics such as early identification, prevention, accommodation, legal rights and responsibilities. Includes news, fact sheets, resource lists, and information on publications and services www.mentalhealthworks.ca

29. Mental Health Issues in the Workplace Canada’s Healthy Workplace Month Web-based initiative designed to increase the awareness of workplace health for the short- and long-term success of organizations and for the well-being of their employees CHWM takes place each October, but it is now a year round program that encourages workplaces to promote healthy workplace practices throughout the year. Provides a comprehensive list of health & wellness resources to help an employer build their path to a healthy workplace www.healthyworkplacemonth.ca

30. Mental Health Issues in the Workplace www.workplacestrategiesformentalhealth.com Practical strategies & tools for all employers Incubator for innovative new initiatives Expand knowledge on workplace mental health for senior leaders, HR, OH&S, managers, employees, unions etc. Resources available at no cost Workplace Strategies for Mental Health

31. Mental Health Issues in the Workplace Voluntary and confidential support service Information Assessing needs Short term support/counselling to help employees and their immediate family members in assessing and resolving work, health and life issues. Telephonic and face-to-face Employee Assistance Program (EAP)

32. Mental Health Issues in the Workplace Services to support workplace mental health initiatives may include: Assistance with targeted health & wellness programs to address mental health, life stages, stress, change, addictions, return to work etc. i.e.: Printed material Online resources, articles Electronic newsletters Workplace health and life learning sessions that address important topics including stress, work-life balance, communication, conflict, change etc. i.e.: Lunch & learns Virtual classrooms E-learning Employee Assistance Program (EAP)

33. Mental Health Issues in the Workplace Video - NOW is the time to address mental health in the workplace Bill Wilkerson – Co-Founder, Chairman and CEO - Global Business and Economic Roundtable for Mental Health Michael Wilson – Former Senior Chairman - Global Business and Economic Roundtable for Mental Health Why Workplace Mental Health Matters

34. Mental Health Issues in the Workplace Questions? Thank you