Why is it that I'm increasingly asked -- by people working in large Canadian corporations -- to help them find care for themselves or for their loved ones who are depressed or suicidal? I'm not a doctor. My sole qualification to help anyone in such circumstances is thin: I'm the son of neuropsychiatric researchers, and I have written books about mental illness. Even so, I'm sometimes the only person people know who can offer some help in a crisis.
This is not the way it should be. It should be vastly easier than it is today to reach out to a qualified mental health professional. Yet depression exists in the shadows. Depression is a kind of melancholy visible only to its sufferers, as William Styron explains in his 1992 book about his own challenges with depression, Darkness Visible: A Memoir of Madness.
Over the years, I've grown more comfortable helping people in need, working as an informal navigator to people who don't know that a mental health "system" even exists. In my own work and writing, I've tried to do the little I can to improve mental health awareness.
To be sure, corporate Canada has come a long way in the past two decades. I remember businesspeople snickering when I told them my charitable cause was mental health. One prominent business leader once told me this was a "left-wing" cause. What rubbish. Many of the greatest benefactors to mental health causes are conservatives; there are no politics to this disease.
Sadly, though, many workplaces still implicitly discourage the admission of mental health problems.
Even when psychological resources such as employee assistance programs exist, most employees show great reluctance in using them. Managers typically underestimate the extent that employees suffer from stress, anxiety, and depression. They lack the important skill of being able to identify and help troubled employees. They don't know how to go about eradicating the stigma of mental illness.
Evidence suggests that exercise, a balanced diet, and a healthy work pattern can help prevent depression and many companies don't realize this is something they can foster. Workplace stress is a significant factor in depression.
A paper this year in the Journal of the American Psychological Association finds that people who felt that they had the emotional support of their colleagues and enjoyed positive social interactions at work were less likely to die over a 20-year period than those who reported a more hostile work environment.
Workplace programs should increase knowledge about mental health issues, decrease stigma, turn down the intensity, and increase the ease with which workers can seek help without worrying that it will affect their job security. And yet, in this period of global financial turmoil, some of the first programs cut are exercise benefits and workplace health programs.
Clinical depression has become one of the most costly problems in the North American workplace. In Canada, it is estimated that four per cent of the population will experience a major depressive episode during a 12-month period. Three times that number will suffer from minor depression. Female workers have twice the rate of depression as their male counterparts. Depression is the largest single cause of disability.
Depression presents a combination of lost productivity from absenteeism (depressed at home) and presenteeism (depressed at work). Presenteeism means reduced productivity. An estimated 70 to 80 per cent of lost productivity time and associated costs are attributable to presenteeism. Other costs to an organization include sick leave, short- and long-term disability, extended health benefit use, employee replacement costs and turnover. Costs can further rise if depression leads to alcoholism, drug abuse or other physical or mental disorders.
What assistance can companies provide? First, accommodation in the form of job and workplace design, group assignment, flex time or workload adjustment and, second, provision of medical and psychological attention. One idea to reduce workplace tension and stress is to listen better: to resolve conflicts through open communication, negotiation and respect. Ask employees how their work is going, listen to them proactively, and address issues that are raised. Recognize and reward accomplishments and contributions. In other words, be human.
Evidence-based depression management programs or anti-stigma initiatives at work can help, too. One exciting initiative comes from Healthy Minds Canada, which is building an online anti-stigma toolkit for parents whose children may be suffering from mental illness. Parents will be able to figure out how best to access care for their children and share stories and tips with other parents.
In this era of Dragon's Den, American Idol and Survivor, I find it is fashionable for businesspeople to tout the benefits of being blunt and vicious in performance reviews of their employees. We all know one or more of these brutish managers. They may be taking their cues from Hollywood. Simon Cowell told one early American Idol aspirant: "That was terrible, I mean just awful." This kind of talk may be entertaining on reality television shows, but it's a surefire way to create a toxic workplace.
Common law requires that employers provide medical care and workplace adjustments to accommodate depressed employees so their rights and those of their co-workers are protected. Failure to do so may expose an employer to litigation, fines, back pay and punitive damages. But we shouldn't need to rely on costly litigation to prevent workplace negligence, or, worse, the all-too common tragedy of someone who takes their own life because there was nobody they could talk to.
This first appeared as a blog by the author on Longwoods.com