The Episodic Challenges of The Episodic Challenges of Living with a MentalLiving with a Mental IllnessIllness

Presented byPresented by Dave Gallson Richard ChenierDave Gallson Richard ChenierNational Program Director Managing Partner National Program Director Managing Partner National Network for Mental Health Chenier Consulting National Network for Mental Health Chenier Consulting

CanadaCanada

Mental Health Facts:Mental Health Facts:• In less than 20 years depression will be the second-In less than 20 years depression will be the second-

leading cause of disability in the world. leading cause of disability in the world. (World Health Organization)(World Health Organization)

• Statistics Canada survey released in September Statistics Canada survey released in September 2003 is that 2.6 million people live with mental 2003 is that 2.6 million people live with mental health disordershealth disorders

• 450 million people worldwide are affected by 450 million people worldwide are affected by mental, neurological or behavioral problems at any mental, neurological or behavioral problems at any time. time. (World Health Organization)(World Health Organization)

• In 1998, Health Canada conservatively estimated In 1998, Health Canada conservatively estimated that the economic burden of mental health that the economic burden of mental health problems was $14.4 billion a year. More recent problems was $14.4 billion a year. More recent calculations, which include indirect costs, suggest calculations, which include indirect costs, suggest that upwards of $30 billion is lost to the Canadian that upwards of $30 billion is lost to the Canadian economy annually due to mental health and economy annually due to mental health and addiction problems addiction problems (Scientific Advisory Committee to the Global Business and Economic (Scientific Advisory Committee to the Global Business and Economic Roundtable on Addiction and Mental Health. (2002))Roundtable on Addiction and Mental Health. (2002))

Mental Health Facts:Mental Health Facts:

• Three million (est.) Canadians suffer from Three million (est.) Canadians suffer from depression. Only 187,500 (est.) are both depression. Only 187,500 (est.) are both diagnosed and properly treated. That’s slightly diagnosed and properly treated. That’s slightly

more than six per cent.more than six per cent. (“Depression At Work” The Unheralded (“Depression At Work” The Unheralded Business Crisis In Canada - Global Business And Economic Roundtable On Business Crisis In Canada - Global Business And Economic Roundtable On Addiction And Mental Health (Addiction And Mental Health (July 2000))July 2000))

• 20% of Canadians will personally experience a 20% of Canadians will personally experience a

mental illness in their lifetime.mental illness in their lifetime. Wilkerson (2000) (2001) Wilkerson (2000) (2001) (2002)(2002)

• Many mental health issues are episodic. Many mental health issues are episodic. Symptoms may appear periodically, and with Symptoms may appear periodically, and with little advance notice.little advance notice.

Workplace Mental Health Workplace Mental Health Facts:Facts:• Disability represents anywhere from 4% to 12% of Disability represents anywhere from 4% to 12% of

payroll costs in Canada; mental health claims payroll costs in Canada; mental health claims (especially depression) have overtaken (especially depression) have overtaken cardiovascular disease as the fastest growing cardiovascular disease as the fastest growing category of disability costs in Canadacategory of disability costs in Canada (Wilson, M., Joffe, R., (Wilson, M., Joffe, R., & Wilkerson, B. (2002)& Wilkerson, B. (2002)

• Stress, burnout and physical or mental health issues Stress, burnout and physical or mental health issues are the main issues limiting productivity in Canada, are the main issues limiting productivity in Canada, Canadian CEOs sayCanadian CEOs say (Productivity Through Health: A FGIworld CEO (Productivity Through Health: A FGIworld CEO Study on Health and Productivity in Canadian Industry. (2005)Study on Health and Productivity in Canadian Industry. (2005)

• Depression is distributed within the Canadian labor Depression is distributed within the Canadian labor force of 14 million at a 10 per cent rate, meaning force of 14 million at a 10 per cent rate, meaning about 1.4 million working Canadians have the about 1.4 million working Canadians have the diseasedisease. (“Depression At Work” The Unheralded Business Crisis In Canada - . (“Depression At Work” The Unheralded Business Crisis In Canada - Global Business And Economic Roundtable On Addiction And Mental Health Global Business And Economic Roundtable On Addiction And Mental Health ((July 2000))July 2000))

Implications of Implications of EmploymentEmployment

““ Employment, or engaging in some form of Employment, or engaging in some form of meaningful work/ activity, is well recognized as a meaningful work/ activity, is well recognized as a key determinant of health and essential to mental key determinant of health and essential to mental

health. Conversely, unemployment has a health. Conversely, unemployment has a negative effect on mental health. We know that negative effect on mental health. We know that unemployment is the leading cause of poverty, unemployment is the leading cause of poverty,

and that poverty is a leading cause of poor and that poverty is a leading cause of poor physical and mental health. Therefore, physical and mental health. Therefore,

meaningful work and employment must be meaningful work and employment must be viewed as essential components to establishing viewed as essential components to establishing

and maintaining positive mental health.”and maintaining positive mental health.”

Ontario Ministry of Health and Long-Term CareOntario Ministry of Health and Long-Term Care Mental Health Implementation Mental Health Implementation

Task Force Final ReportTask Force Final Report

Impact of Mental HealthImpact of Mental Health • Stress and mental health-related problems currently Stress and mental health-related problems currently

represent 40-50% of the short-term disability claims represent 40-50% of the short-term disability claims among employees of some of Canada's largest among employees of some of Canada's largest corporationscorporations Wilkerson (2000) (2001) (2002) Wilkerson (2000) (2001) (2002)

• Psychiatric claims are now the fastest growing Psychiatric claims are now the fastest growing category of long-term disability in Canada.category of long-term disability in Canada. (Manulife (Manulife Financial Group)Financial Group)

• In Canada, the cost of mental illness represents In Canada, the cost of mental illness represents nearly 14% of all corporate income.nearly 14% of all corporate income. Wilkerson (2000) (2001) Wilkerson (2000) (2001) (2002) (2002)

• One-third (35%) of Canadian organizations have One-third (35%) of Canadian organizations have enacted return to work processes as well as enacted return to work processes as well as functional mental health capacity assessments functional mental health capacity assessments (27%). (27%). Ralph Ricciuti, National Director, Group and Health Care Practice, Ralph Ricciuti, National Director, Group and Health Care Practice, Watson Wyatt Canada - April 2005 Watson Wyatt Canada - April 2005

Why Episodic Mental Health Why Episodic Mental Health Issues are Often Hidden in the Issues are Often Hidden in the

Workplace.Workplace.

• Fear of losing one’s jobFear of losing one’s job• Fear of not being promotedFear of not being promoted• Fear of being isolated or shamed by co-Fear of being isolated or shamed by co-

workers and colleagues may discourage workers and colleagues may discourage employees from seeking treatment or employees from seeking treatment or asking for accommodationasking for accommodation

• Fear that long-term career goals may be Fear that long-term career goals may be affectedaffected

What is Episodic Disability?What is Episodic Disability?

A re-occurring illness which may move a A re-occurring illness which may move a person in and out of the labour force in an person in and out of the labour force in an

unpredictable manner.unpredictable manner.Some examples of episodic disability are:Some examples of episodic disability are:- Multiple SclerosisMultiple Sclerosis- LupusLupus- ArthritisArthritis- Mental Health (Bi-Polar/ Schizophrenia/ Mental Health (Bi-Polar/ Schizophrenia/

Depression, etc)Depression, etc)

Most income support and benefits programs Most income support and benefits programs have inherent disincentives to working to have inherent disincentives to working to

one’s capacity, particularly if one’s capacity one’s capacity, particularly if one’s capacity to work is unpredictable and episodicto work is unpredictable and episodic

COMPONENTS OF CONDUSIVE COMPONENTS OF CONDUSIVE ENVIRONMENTS ENVIRONMENTS

• Flexible timeFlexible time

• Income and benefits whether or not workingIncome and benefits whether or not working

• Allowance for restAllowance for rest

• Meaningful workMeaningful work

• Supportive work environmentSupportive work environment

• Social inclusionSocial inclusion

A Supportive A Supportive EnvironmentEnvironment

Peer support and education are keyPeer support and education are key

- Using the philosophy of the BUILT Network - Using the philosophy of the BUILT Network program, peer support and employment program, peer support and employment maintenance components are crucial to successful maintenance components are crucial to successful entry/ re-entry to the workforceentry/ re-entry to the workforce

- Establish organizational and employee health as - Establish organizational and employee health as “twin priorities” among managers in business“twin priorities” among managers in business

- Hope is a critical pathway to recovery- Hope is a critical pathway to recovery - Empowerment and recognition of hope fosters - Empowerment and recognition of hope fosters

recovery and the achievement of life goalsrecovery and the achievement of life goals

Employer SupportEmployer Support Employers, Unions, Rehabilitation Specialists, Peer Employers, Unions, Rehabilitation Specialists, Peer

Support, and Private and Public insurance are major Support, and Private and Public insurance are major stakeholders and must be included at all phases of the stakeholders and must be included at all phases of the program including consultations, program development program including consultations, program development and employment supportand employment support

Employers need the tools to support people who suffer Employers need the tools to support people who suffer from episodic illnessesfrom episodic illnesses

Conversely, employees need the tools and requisite Conversely, employees need the tools and requisite support to re-integrate successfully back into the support to re-integrate successfully back into the workplaceworkplace

Early intervention programs must be designed to assist Early intervention programs must be designed to assist employees navigate the Disability Insurance Claim and employees navigate the Disability Insurance Claim and Accommodation ProcessesAccommodation Processes

• Obtain the support of workers and their representativesObtain the support of workers and their representatives Obtain the commitment, support and participation of Obtain the commitment, support and participation of

managementmanagement

Where are the Gaps?Where are the Gaps?• Supportive Skills Training and MentoringSupportive Skills Training and Mentoring• Self-Esteem, Structure and ConfidenceSelf-Esteem, Structure and Confidence• AdvocacyAdvocacy• Participant Representation between Program and Participant Representation between Program and

EmployerEmployer• Flexible SchedulingFlexible Scheduling

– Time and placeTime and place• Income Support whether working or notIncome Support whether working or not

- - When episodic illness occurs, barrier free re-entry to When episodic illness occurs, barrier free re-entry to supportsupport

• Benefit Support whether working or notBenefit Support whether working or not

- - A comprehensive benefits coverageA comprehensive benefits coverage

• Supportive Work EnvironmentSupportive Work Environment– Management and Peer support through workplace Management and Peer support through workplace

training and inclusive programming training and inclusive programming

In ConclusionIn Conclusion Multi-sector collaboration is needed if people with Multi-sector collaboration is needed if people with

episodic disabilities, such as some mental episodic disabilities, such as some mental illnesses, are to work to their potential in a illnesses, are to work to their potential in a supportive environment, as well as have the supportive environment, as well as have the supports they need when not able to work.supports they need when not able to work.

The National Network for Mental Health through its The National Network for Mental Health through its BUILT Network Program is seeking meaningful and BUILT Network Program is seeking meaningful and sustained partnerships to develop and facilitate sustained partnerships to develop and facilitate return to work for people with episodic disabilities. return to work for people with episodic disabilities.

We look forward to collaborating with you over We look forward to collaborating with you over these next two days. these next two days.

www.nnmh.cawww.nnmh.ca www.builtnetwork.cawww.builtnetwork.ca