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Theme: Workplace Mental Health Insights for Employers Topic: Being OK is not Being Happy! The Slippery Slope About 21.4% of the working-age population (20-64 years of age) was living with a mental health problem or illness in 2011 with prevalence peaking at 20-29 years of age among both males and females. Or 1 in 5 people in Canada lives with a mental illness each year Making the Case for Investing in Mental Health in Canada The study conservatively estimates that in 2011 annual direct costs (healthcare, certain social services and income support) attributable to mental illness reached over $42.3 billion, increasing to some $290.9 billion in 2041. The cumulative economic impact of direct costs alone over the next 30 years is expected to reach more than $2.5 trillion. ESTIMATED TOTAL C0ST OF MENTAL ILLNESSES IN CANADA The study estimates that approximately 21.4% of the working population experienced a mental illness in 2011. The potential impact of mental illness on productivity includes absenteeism, presenteeism or leaving the workforce altogether. The annual productivity impact of mental illness in the workplace is estimated to be over $6.4 billion in 2011, increasing to $16.0 billion in 2041. The present value of the cumulative 30-year productivity impact is expected to be $198 billion. Happiness: AKA Mental Health Mental health is an ideal state. It is a balance of mental, emotional, physical and spiritual health. (e.g., caring relationships, a place to call home, a supportive community, and work and leisure all contribute). Mental Health requires coping skills. Happy – Discouragement – Risk Activity – Estimate percentage of your workforce in each of the five positions. % Happy % OK % Chronic Strain Risk % Mental Health Issue % Mental Disorder (Organic/ Cognitive) Problem Statement: Current negative population health trend The Case of Sam: – Sam is struggling to cope with job stress in his current role. He thinks he is trapped with no options. – He developed the habit of over-eating at night to feel better (e.g., chips, ice cream, pop, and fast foods). – His lifestyle choice after work was dominated by watching TV at night and snacking. He has no structured pro-health habit (e.g., exercise, hobbies or outlets). – This unhealthy coping resulted in this 44-year-old putting 60 pounds on his 5-8 body frame over a period of 30 months. – He drastically increased his body fat. At age 46 he was put on hypertension medication. – At age 48 he was put on medication for clinical depression. – At 49 he became a Type 1 diabetic. Happy – Discouragement – Risk Happy OK Chronic Strain Mental Health Issue Mental Disorder (Organic/ Cognitive) Examples ONLY Presents self in a positive manner Typically enjoys engaging in pro-social behaviours (exercise, community, etc.) Energy and drive are evident – presents to the world a positive light Proven cognitive coping skills to manage and balance the challenges life and work present Happy – Discouragement – Risk Happy OK Chronic Strain Mental Health Issue Mental Disorder (Organic/ Cognitive) Examples ONLY Presents as being content – and, yes, experiences happy moments Self-disciplined to push through day – lives life M-T-W-T-F-S-S Most days has enough energy to get through day Able to cope with most days – but often has some script running ………. Happy – Discouragement – Risk Happy OK Chronic Strain Mental Health Issue Mental Disorder (Organic/ Cognitive) Examples ONLY Feels pressure that often releases when changing environments (e.g., leaving work) Stress is often situational (e.g., peer conflict) and when away from stress can feel OK. Find it hard being around stressors. Increased fatigue (mental and physical) Health habits slip and struggle to cope. Can appear in some situations not as confident as some onlookers would expect. Happy – Discouragement – Risk Happy OK Chronic Strain Mental Health Issue Mental Disorder (Organic/ Cognitive) Examples ONLY Internally struggling more with internal dialogue to find options that could give some relief Symptoms starting to chronically have a negative impact on quality of life – happiness and health Stressful events harder to recover from; often just shut person down. Symptoms increasing, stress May be introduced to psychotropic drugs to cope with anxiety or depression, or sleep medication Happy – Discouragement – Risk Happy OK Chronic Strain Mental Disorder (Organic/ Cognitive) Mental Health Issue Examples ONLY Nature vs. Nurture: Some folks are born; some develop; there is not one road! Chronic symptoms to be managed, risk for self-harm increasing, risk to others increasing Some type of medical intervention is commonly required. But not in all cases! Greatly benefit from the development of coping strategies to be able to function at full potential in society Happy – Discouragement – Risk Estimate the percentage of your workforce in each of the five categories. Happy OK Chronic Strain Mental Health Issue Mental Disorder (Organic/ Cognitive) Examples ONLY Presents self in a positive manner Presents as content – and, yes, experiences happy moments Feels pressure that often releases when changing environments (e.g., leaving work) Internally struggling more with internal dialogue to find options that could give some relief Nature vs. Nurture: Some folks are born; some develop; there is not one road! Typically enjoys engaging in pro-social behaviours (exercise, community, etc.) Self-disciplined to push through day – too many live life M-T-W-T-F-S-S Stress is often situational (e.g., peer conflict) and when away from stress can feel OK. Find it hard being around stressors. Symptoms starting to chronically have a negative impact on quality of life – happiness and health Chronic symptoms to be managed, risk for selfharm increasing, risk to others increasing Energy and drive are evident – presents to world a positive light Most days have enough energy to get through day Increased fatigue (mental and physical) Stressful events harder to recover from; often just shut person down. Symptoms increasing, stress Some type of medical intervention is commonly required. But not in all cases! Proven cognitive coping skills to manage and balance the challenges life and work present Able to cope with most days – but often have some script running ………. Health habits slip and struggle to cope. Can appear in some situations not as confident as some onlookers would expect. May be introduced to psychotropic drugs to cope with anxiety or depression, or sleep medication Greatly benefit from the development of coping strategies to be able to function at full potential in society QWL ™ Predictive Health Index – Summary of Sam Psychological & Physical Health Risk <20th Percentile Stage 0 – Employee reports no negative distress, or any psychological or physical symptoms impacting employee’s overall state of well being. Sam’s Progression Entered job Stage 1 – Employee reports low levels of stress, may report periods of fatigue due to work-life balance challenges. There can be some psychological regret that in times of pressures make it difficult to engage in activity of choice such as exercise, hobbies. This can result in mild impairments to well being. First six months 45-60th Percentile Stage 2 – Employee is experiencing chronic stress; more fight/flight responses result in increased stress hormones. Strain increases risks for high blood pressure, digestive problems. Common for employee to look for coping mechanisms. Strain is also associated with decreased levels of physical health and moderate impairments to well being. Six months to year two Year two 61-75th Percentile Stage 3 – Employee is at risk for experiencing mental health symptoms that can drastically disrupt quality of life, such as depression, anxiety and drug abuse. Risk factors are higher and employee may be receiving some medical/prescriptive interventions. The longer the employee stays in this state, the greater the risk for permanent health issues. At this stage there are significant impairments to well being. Year four 75-100th Percentile Stage 4 – Employee is at risk for severe physical or mental health issues that may or may not be diagnosed. Employee is at great risk and requires immediate mental attention (if not already obtaining medical support). It is common for employees at this level to have comorbidties and several health-related issues. The employee is often off work or at risk to be in the near future if things go not improve. 21-44th Percentile Burnout Did You Know? • Though burnout is not a DSM disorder, the ICD-10 describes it as “State of Vital Exhaustion” • Negative impacts of burnout: job function, health outcomes (e.g., increase in stress hormones) and mental health (e.g., depression) • Burnout does impact coping skills – research suggests it can result in cognitive impairments Stage 1: Stage 2: Enthusiasm Stagnation Stage 3: Frustration Notice any similarities? Stage 4: Apathy Making the business case for action! What is the cost of doing nothing? Leaders are advised to act to fully understand the tangible and intangible costs of doing nothing for current and YOY trends. Examples: Tangible Costs: • • • • • Percentage of disability claims linked to mental health Population health trends (e.g., percentage of diabetics, obesity) Absenteeism Drug costs Productivity (e.g., average employee puts forth 80% of their full potential daily) Intangible Costs: • • • • • Negative gossip Manager time correcting behaviour Presenteeism Lateness for work and returning from breaks 1-hour medical appointments through the shift Go to www.howatthr.com and click on What is your cost of doing nothing? to get a benchmark for discussion purposes only. Game Changers Are you ready? • • The law is recognizing an increasingly demanding standard for protecting employees from mental injury at work RCMP jail guard traumatized by harassment, awarded $500,000 – 2004: A judge of the Newfoundland and Labrador Supreme Court has awarded almost $500,000 in damages to a former RCMP jail guard who developed post-traumatic stress disorder, severe depression, and suicidal tendencies as a result of workplace harassment. • Coming soon to workplace law near you… LIABILITY – Such as BC’s BILL M 212 — 2012 WORKPLACE BULLYING PREVENTION ACT, 2012 – This bill targets the reduction and elimination of workplace bullying by modifying the Worker's Compensation Act. The bill allows incidents of workplace harassment to be investigated, compensated, and dealt with in the same manner as workplace accidents. It provides less strenuous requirements for the award of compensation for mental stress in situations that involve harassment. It also requires employers of 10 more employees to write and implement a policy on harassment. • Human Right – If the BC Human Rights Tribunal is any guide, all you have to do is fire an employee who is absent from work for an extended period of time due to a medical disability by email and you could find yourself paying damages of $35,000 (not including legal fees) for “hurt feelings” because the employee was not terminated in person. • Employee education on rights for accommodations • Mental Health is now providing a definable framework for workplace stress and a path for short-term disability claims Liability Landslide: How is your organization benchmarking and supporting the 13 factors? National Voluntary Standard for Psychologically Safe Workplaces* Occupational Health & Safety Creates new standard for due diligence Human Rights While the National Standard for Psychologically Safe Workplaces* is voluntary, it now offers a standard of reference for employer due diligence in protecting employees. Employment Law Employer’s Duty to Keep Employees Safe *http://shop.csa.ca/en/canada/occupational-health-and-safety-management/cancsa-z1003-13bnq-97008032013/invt/z10032013/?utm_source=redirect&utm_medium=vanity&utm_content=folder&utm_campaign=z1003 Bill C-45 Bill C-45 is federal legislation that amends the Canadian Criminal Code. Bill C-45 became law on March 31, 2004, and is now the new Section 217.1 in the Criminal Code, which reads: "217.1 Every one who undertakes, or has the authority, to direct how another person does work or performs a task is under a legal duty to take reasonable steps to prevent bodily harm to that person, or any other person, arising from that work or task." The bill established new legal duties for workplace health and safety, and imposes serious penalties for violations that result in injuries or death. See: http://www.ccohs.ca/oshanswers/legisl/billc45.html National Standard of Canada on Psychological Health and Safety in the Workplace (Standard) The Standard is a voluntary guide for Canadian employers to ensure that their workplaces are psychologically safe and healthy. The Standard identifies three key factors to be satisfied in order to promote such workplaces, but does not offer a tool for measurement; Howatt HR’s QWL™ Study can provide benchmarks for these factors. “The requirements for an employee’s physical health and safety in the workplace are a longstanding concern for Canadian employers. Now it’s time to consider the mental wellbeing of the workforce the same way”. Louise Bradley, Mental Health Commission of Canada Psychological Health & Safety Evolution of Occupational Health: the promotion and protection of employees’ psychological health and safety. – Psychological Health – this goes beyond mere safety to describe a workplace environment that supports and promotes resilience by mitigating sources of stress and empowering employees to improve their coping skills. – Psychological Safety – a workplace environment that does not directly cause psychological injury or harm to employee psychological well-being. The goal is to prevent risk for injuries that can impact one’s psychology mind (e.g., PTSD, bullying, etc.) 13 Factors Summary Aligned to Five Key Themes 2 1 Self-Management PF 8 – Involvement & Influence PF 4 – Workload Management PF 10 – Engagement Safety PF 1 - Psychological Support PF12 – Psychological Protection PF 13 – Protection of Physical Safely 3 Management PF 3- Clear Leadership and Expectations PF 7 – Recognitions and Reward PF 11 – Balance Work & Life (Flexibility) 4 Culture PF 2 – Organizational Culture PF 4 – Civility and Respect 5 Strategic HR PF 5 – Psychological Competencies and Requirements PF 6 – Growth & Development Workplace Conduct Psychological Impact Discretionary Friendliness, Kindness Job Satisfaction & Organizational Engagement Responsibility Respectfulness, Civility, Fairness Loyalty Commitment Incivility, Unfairness, Rudeness Tension, Demoralization, Disengagement Abuse (verbal, physical, psychological), Harassment, Discrimination Bullying Anxiety, Depression, PTSD, Suicide Liability Extreme Danger Zone Risk Increases Risk Level Psychologically Unsafe Workplaces Produce Liability & Costs • Increased likelihood of mental injuries – More incidents of depression, anxiety and PTSD – Less chance of recovery from mental injury such as PTSD • Fewer successful returns to work What is mental injury? • Mental injury (or mental suffering) is harm to a person for which another person is held responsible. – Results in either mental distress or mental illness – Doesn’t always require medical evidence • Reasonably foreseeable that significant harm to mental health could result in temporary or long-term inability to function as normal (work or home ) • It is a legal ground for damages Medical proof not needed • Employees do not necessarily need to prove they have a clinically diagnosable mental illness in order to win a legal claim for mental injury or suffering at work. • Psychologically unhealthy work conditions – Excessive work demands – Harassing, demeaning treatment • Where mental suffering is foreseeable. What is ‘clinically diagnosable’? • Refers to clinical conditions defined under the current version of the Diagnostic and Statistical Manual (DSM – 5) • Mental diseases or states of a debilitating nature, e.g., – Clinical depression – Anxiety – Bipolar disorder and – Schizophrenia. • Only qualified professionals (physicians and psychologists) are entitled to make such diagnoses. Liability is Subjective • Intent to cause harm is irrelevant • Harm is a dual test of – Victim’s subjective perceptions of the behaviors – Whether a reasonable person would foresee potential for psychological harm Psychologically Safe vs. Psychologically Healthy • Psychologically Safe – Where every reasonable effort is made to protect the mental health of employees • Psychologically Healthy – Where every reasonable effort is made to promote the mental health of employees The Solution – E & E Power The UK National Institute for Health and Clinical Excellence estimates that improving the management of mental health in the workplace including prevention, early action to combat stress and early identification of problems could decrease losses to productivity by as much as 30% and result in annual savings of £250,607 ($397,713) in an organization of 1000 employees. Your Life at Work Survey On February 3rd, The Globe and Mail, in conjunction with Howatt HR, launched Your Life at Work. This study is using a short version of the Quality of Work Life (QWL™) survey. Today there are nearly 4000 completed surveys To learn more go to: tgam.ca/yourlifeatwork We want to start a conversation about what the risks in the workplace can affect: Physical and mental health Productivity Job satisfaction Worker retention Staff-engagement Cost of doing nothing Your Life at Work Findings Self-Reported Productivity Levels Employees who report their productivity levels are 50% or less have a different profile than employees that report productivity levels of 80% or higher. The following was found: • Lower coping skills were found to be a lead indicator in predicting • Higher stress • Higher health risk Lack Indicator • Lower engagement Lack Indicator Your Life at Work Findings Estimated Cost of Doing Nothing per FTE Average productivity 40% group (Assumption 60 percent lost opportunity) = CODN per FTE (45 k X .60) = $27,000.00 per FTE Compared to higher group average productivity 90% (assumption 10 percent lost opportunity) = CODN per FTE (75 k X .10) = $7500.00 per FTE Note: Assumption does not include lost time due to increased sick time or time lost due to injuries, or lost opportunity for productivity. Our Key Finding Perceived Stressors Intrapersonal Coping Skills Leading Indicator Employee Health Employee Productivity Success Metrics Employee Engagement Lagging Indicators We Often Become What We Happy OK Chronic Strain Mental Health Issue … Think Mental Disorder (Organic/ Happiness – OK – Strain – Mental Health – Mental Cognitive) Disorder Coping Skills Life and Work Stress What do you think? Budgets vs. Beings Tangible + Intangible Activity • Cost of Doing Nothing Calculator – Math is simple. No pressure. No Grade. Five minutes discussion with one or two neighbours: • What other intangible factors could you have added? • Whether the assumptions are defendable or not – what is the key point for leaders to consider today? • What could your organization’s potential cost of doing nothing be? Consider in your conversation how employees who are just OK may still be at risk. Facilitating Culture Change Problem Statement Best Practices Business Case Growing Mental Health Problem – 13 Factors – Cost of Doing Nothing 1. Awareness & Senior Leadership Support 4. Improved Outcomes 2. Benchmark & Educate Attitudes and Behaviours 3. Supporting Best Practices Beyond Engagement - Culture Change Problem Statement Best Practices Business Case Growing Mental Health Problem – 13 Factors – Cost of Doing Nothing 4. Improved Outcomes 1. Awareness & Senior Leadership Support Make your business case – get buy in 2. Benchmark & Educate Attitudes and Behaviours Measurement ROI analysis – that isolates the effect of the interventions 3. Supporting Best Practices Leadership development Coping skills PAS support Strategic HR alignment QWL study – employees get feedback in real time Report – strategy Exploring the Benefits of Green vs. Red Percentage of organizations that have no process to address significant changes in employee productivity or behaviour: 84%. When You Are Ready to Go Beyond Engagement… For more information on the Beyond Engagement model, QWL studies, and products, contact Dr. Bill Howatt [email protected] Pricing is driven by number of employees and/or organization’s size. Free E-book at www.howatthr.com 6585 Hwy. 221, Kentville, NS B4N 3V7 • t: 902.678.8668 • f: 902.678.6255 • howatthr.com Keynote Summary Dr. Bill will share his insights on the current conversations around employee stress, productivity, engagement, and mental health in the workplace. He will share some findings from his national Globe and Mail study Your Life at Work. He will provide leaders with the facts on trends in legislation and what employers may want to prepare for. He will attempt to influence leaders to understand the real potential Cost of Doing Nothing. Good intentions and kind lip service will not be enough. Leaders will benefit from obtaining insight and benchmarks that provide transparency into the variables that predict health risk and costs. These insights and benchmarks provide the landmarks for setting and implementing strategic actions to reduce risk and increase opportunities for employees to be happy, with or without a mental health issue. He will encourage leaders to ask the tough questions that look beyond engagement for long-term workforce sustainability. Dr. Bill Howatt – Bio Reality started when Bill failed grade 2. This was the first sign of being different. From there, education, sports, social interaction, and work have been interesting, with lots of stops and starts. Growing up with dyslexia and ADHD, there was no road map for Bill. However, through caring mentors and a passionate mother he finally got the tools to figure out the reading, writing, and focus thing. Bill went on to obtain more than seven post-secondary degrees, a Post Doc in Behavioral Science from UCLA Semel Institute for Neuroscience and Human Behavior, authored more than 60 books, became a business columnist for The Globe and Mail, and spent more than 10 years consulting in the financial district of Wall Street. He is now returning to his roots, helping employers and employees explore their thinking and how it will predict their future. Bill is the founder of Howatt HR and TalOp® that offer services for solving complex people problems and facilitating organizational productivity while keeping a keen eye on employee care. With respect to the conversation on mental health, not only living with an issue himself, he has helped thousands of folks who learned there are left turns allowed. He is a Registered Counselling Therapist, Registered Social Worker, and ICADC with over 20 years of clinical experience. He created the original Nova Scotia Community College Addiction Counsellors curriculum and trained addiction counsellors for 15 years. He coedited the Wiley Addiction series, The Human Services Counseling Toolbox: Theory, Development, Technique, and Resources, and The Addiction Counselor's Desk Reference. He is a member of the Editorial Committee of Counselor Magazine, and most recently created the Beyond Engagement: Quality of Work Life (QWL™) Study – an applied research method for assessing employee stress, coping skills, engagement, health, and mental health risk. www.howatthr.com