Employee mental health has become a topic of increased focus and awareness, especially in light of the COVID-19 situation. While mental health includes mental illness, the two aren’t interchangeable. An employee can go through a period of poor mental health but not necessarily have a diagnosable mental illness.
This is the first of our 2-part series addressing mental health in the workplace. This article addresses the current state of mental health in the workplace and the second part will help employers support employee mental health with some tips to help employees.
While 1 in 5 adults experience mental illness annually, a recent study by Deloitte revealed that less than half receive treatment. A study from the Mental Health in the Workplace Summit also found that mental illness is the leading cause of disability for adults ages 15 to 44 and that more workdays are lost to mental health-related absenteeism than any other injury or illness.
Given its prevalence, you can expect that employees at your organization are experiencing mental health challenges or mental illness. That’s why it’s so important that your organization creates a culture that supports employees’ mental health. While this may sound complicated, creating a workplace that is supportive of mental health and illness is easier than it seems.
This series serves as an introduction to mental health and provides several ways that employers can help promote a stigma-free environment and support employees’ mental health. It is not intended as legal or medical advice and should only be used for informational purposes.
Mental Health in the Workplace
An employee’s mental health includes how they think, feel and act, as well as their emotional and social well-being. Additionally, an employee’s mental health can change over time, depending on factors such as their workload, stress and work-life balance.
Employee Mental Health by the Numbers
According to the Centre for Addiction and Mental Health (CAMH):
- In any given year, 1 in 5 Canadians experience a mental illness or addiction problem
- 40% of Canadians have experienced feelings of anxiety or depression but never sought medical help for it
- Mental illness can cut 10 to 20 years from a person's life expectancy
- About 4,000 Canadians per year die by suicide - an average of almost 11 suicides a day.
Mental health is different for each of your employees and doesn’t just refer to mental illness. As a result, major health organizations are referring to mental health as mental well-being. According to the World Health Organization (WHO), there’s not a specific definition of mental well-being. However, various studies agree that achieving a state of mental well-being includes being able to:
- Realize one’s full potential
- Work productively
- Cope with the normal stresses of life
- Contribute meaningfully to one’s community
Despite talking about mental well-being becoming more prevalent socially, many employees are still wary of discussing mental health struggles. According to a study by the health benefits administrator Businessolver, 68 per cent of employees fear that asking for help with a mental health issue could jeopardize their job security. Moreover, while 50 per cent of employees reported struggling with their mental health, only one-third of those employees asked for help.
Employees afflicted with poor mental health could potentially experience the following symptoms:
- Reduced focus
- Low productivity
- Reduced cognitive abilities
- Poor physical well-being
According to CAMH, the economic burden of mental illness in Canada is estimated at $51 billion per year. This includes health care costs, lost productivity, and reductions in health-related quality of life.
Fortunately, your business can implement programs to help your employees cope with an manage their mental health.
Common Mental Health Conditions
When it comes to mental health conditions, there are a wide variety of illnesses with which employees could be struggling. The following list isn’t all-inclusive or exhaustive but does provide a general overview of the most prevalent mental health conditions. Familiarizing yourself with what employees may be going through is essential for educating yourself and managers on how to recognize the signs that an employee may be struggling and to destigmatize mental health at your organization.
Anxiety disorders commonly occur in conjunction with other mental or physical illnesses, last at least six months and can get worse without treatment. There are a few different types of conditions that are commonly classified as anxiety disorders: generalized anxiety disorder, panic disorder, social phobia and specific phobia.
Generalized anxiety disorder (GAD)
People with GAD go through the day filled with exaggerated worry and tension, even when there is little or nothing to worry about. GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least six months. Physical symptoms accompanying this condition include fatigue, headaches, irritability, nausea, frequent urination and hot flashes.
This condition is characterized by sudden attacks of terror—known as panic attacks—which are usually accompanied by a pounding heart, sweating, dizziness and/or weakness. During these attacks, sufferers may flush or feel chilled, their hands may tingle or feel numb, and nausea or chest pain may occur. Panic attacks usually produce a sense of unreality, a fear of impending doom or a fear of losing control. They can occur at any time—even during sleep. About one-third of people who experience panic attacks become so fearful that they refuse to leave home. When the condition progresses this far, it is called agoraphobia—a fear of open spaces.
Also called social anxiety disorder, social phobia is diagnosed when individuals become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with this phobia have an intense, persistent and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They may worry for days or even weeks before a dreaded situation. Many with social phobia realize that their fear is unwarranted, but are still unable to overcome it.
A specific phobia is an intense, irrational fear of something that poses little or no threat—such as heights, escalators, dogs, spiders, closed-in places or water. Like social phobia, sufferers understand that these fears are irrational, but feel powerless to stop them. The causes of these phobias are not well-understood, but symptoms usually appear in childhood or adolescence and continue into adulthood.
In general, anxiety disorders are treated with medication, specific types of psychotherapy or both. Before treatment begins, a doctor must conduct a careful diagnostic evaluation to determine whether a person’s symptoms are caused by an anxiety disorder or a physical problem. Sometimes alcoholism, depression or other coexisting conditions have such a strong effect on the individual that treating the anxiety disorder must wait until those conditions are brought under control. Those with anxiety disorders usually try several different treatments or combinations of treatment before finding the one that works for them.
Everyone experiences feeling sad or being in a bad mood, but employees who suffer from mood disorders live with constant and more severe symptoms. Studies show that 1 in 10 adults suffer from some type of mood disorder. Of the different types of mood disorders, depression and bipolar disorder are the most common.
When a person has a depressive disorder, it interferes with daily life. Depression is a common but serious illness. There is no single cause of depression, but it likely results from a mix of genetic, biochemical, environmental and psychological factors. Depression commonly coexists with other illnesses, such as anxiety disorders or substance abuse. There are a variety of different types of depression, including major depressive disorder, psychotic depression, postpartum depression and seasonal affective disorder. Depression symptoms are different in every person, as is the frequency, severity and duration of those symptoms. However, common symptoms include:
- Persistent sad, anxious or “empty” feelings
- Feelings of guilt, worthlessness and/or hopelessness
- Irritability, restlessness and/or fatigue
- Loss of interest in activities once found pleasurable
- A dramatic change in appetite
- Thoughts of suicide
Depression is a treatable disorder. The first step is to visit a doctor for a medical examination to rule out other factors that may be causing the condition, such as medications or a thyroid disorder. Once diagnosed, a person will likely be treated with psychotherapy and/or medication. In the meantime, it is important to exercise regularly, participate in activities, spend time with friends and family, and think positively. It is wise to postpone major decisions, such as marriage or a career change, until feeling better.
Bipolar disorder causes dramatic mood swings—from overly “high” (mania) to sad and hopeless, and back again, often with periods of normal mood in between. Symptoms of mania include:
- Increased energy, restlessness
- Excessively euphoric mood
- Extreme irritability
- Racing thoughts, talking very fast and being easily distracted
- Unrealistic belief in one’s abilities and powers
- Poor judgment
- Increased sexual drive
- Substance abuse
Symptoms of depression include:
- Feelings of hopelessness and pessimism
- Loss of interest in activities once enjoyed, including sex
- Sleeping too much or not at all
- Change in appetite
- Decreased energy
- Thoughts of suicide
People with bipolar disorder can lead healthy and productive lives when the illness is effectively treated. Without treatment, however, it tends to worsen. Because bipolar disorder is a recurrent illness, long-term preventive treatment is strongly recommended. A strategy that combines medication and psychological treatment is optimal for managing the disorder over time. If those methods are ineffective, electroconvulsive therapy may be considered.
Other Common Disorders
In addition to the mental health conditions discussed above, there are a few other conditions employers should learn about.
Post-traumatic stress disorder (PTSD)—PTSD develops after a traumatic event or experience that involved physical harm or the threat of it. PTSD is common in war veterans, but it can result from a variety of traumatic incidents, such as kidnapping, abuse or a car accident. People with PTSD may startle easily, become emotionally numb (especially to people with whom they used to be close), lose interest in things they used to enjoy, and become irritable, aggressive or violent. They avoid situations that remind them of the original incident, and anniversaries of the incident are usually very difficult.
Obsessive-compulsive disorder (OCD)—OCD sufferers have persistent, upsetting thoughts or obsessions, and use rituals to control the anxiety these thoughts produce. Most often, the rituals end up controlling the person with OCD. For example, if someone is obsessed with germs and dirt, he or she may develop a compulsion for excessive handwashing.
Substance abuse—Substance abuse is the unhealthy use of alcohol, drugs or other substances that negatively interfere with a person’s functioning or well-being. Substance abuse can negatively affect people’s physical or emotional well-being, significant relationships, educational achievements, finances and other parts of their lives. Substance abuse problems also affect productivity, workplace safety and health care costs.
Substance abuse is preventable and treatable, with recovery rates comparable to other chronic health problems like diabetes and asthma. If employers promote prevention, provide employee access to treatment and support employee recovery from substance abuse, they can help create healthier and more productive employees, workplaces and communities.
Having a mental illness issue does not guarantee you will be suicidal. However, depending on the illness, it can make positive thinking much harder. Suicide is a leading cause of death for Canadians, but much like mental health in general, the topic rarely gets the attention it deserves. There is a stigma against discussing suicide and mental health that hinders meaningful conversation about the topic. Open dialogue is an important part of preventing these tragic deaths and establishing safety outlets for those in need.
According to Health Canada, there are approximately 4,000 deaths by suicide per year in Canada, or about 10 suicides per day. For every suicide, there are five self-inflicted injury hospitalizations, 25-30 attempts and 7-10 people profoundly affected by the suicide loss.
Beyond the human toll, the economic consequences of suicide are staggering. According to the Centre for Suicide Prevention, one estimate put the economic cost at around $51 billion annually. Factors like potential underreporting of suicide, total lifetime costs and per capita calculations were used in the estimates.
How Employers Can Help
Companies cannot expect employees with mental illnesses to “snap out of it” or wipe away thoughts of self-harm. Employers need to acknowledge that mental illness comes in many forms and that it probably affects more of their employees than they know. This is why employer-sponsored assistance programs are so important.
Employers should foster a safe environment that encourages employees to speak up if they’re feeling overwhelmed by work, as this is a significant stressor for depression and other mental illnesses. Beyond reassessing company culture, organizations can offer referrals or access to mental health professionals through their employee assistance programs (EAPs). One of the most effective ways to reduce suicide is by being there for someone in need. With this in mind, consider empathy training for managers so they can recognize the warning signs of severe depression and can address them with the individual.