The Working Mind Workplace Mental Health and Mental Illness Stigma ReductionMicheal Pietrus, Director, Opening Minds and MHFA Canada, MHCC Dr. Andrew Szeto, Director, Mental Health Strategy and Associate Professor, University of Calgary

Work Wellness Institute WebinarJuly 14, 2020

Overview

• Background• Stigma• TWM• Evaluation Research• Next Steps• Questions?

BACKGROUND

• 1 in 5 Canadians• 21.4% of Canada’s working population• Depression is now the leading cause of

disability worldwide. • In 2015, over 300 million people with

depression.

Facts About Mental Illnesses

Introduction - Laying the Groundwork

World HealthOrganization

Work & Mental Ill Health

Signs and Symptoms of Burnout: Chronic fatigue; Insomnia; Impaired Concentration; Increased illness;Physical complaints; Loss of appetite; Anxiety; Depression; Anger; Cynicism

Link

• Workplace stress a leading cause of mental health issues

• Depression and anxiety top two mental health issues

• 49% of Canadians suffer from mental illness at some point

WorkplaceSurvey

Workplace Costs

Source: https://milled.com/optimity-live-work-play/new-post-canadians-and-mental-health-webinar-recap-IXLCjJ-b4LuzxOiD

STIGMA

The Problem

Stigma

Time

Injury Diagnoses Treatment Return to Work

Physical Injury/Illness

Mental Injury/Illness

INC

IDE

NT

Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC. Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry, June 2005;62(2):603-1

Why reduce the stigma of mental Illness in the

Workplace?

The Importance of Stigma Reduction

Reducing Stigma

Better prognosis &

outcome

More acceptance of MH;

More supportive environment

Increase productivity

Earlier help-seeking

Positive financial impact

Positive outcomes for those with

mental illnesses

Cultural shift in thinking and

attitudes

THE WORKING MIND

TWM Objectives

• Reduce the stigma of mental illness

• Promote mental health in the workplace

• Reconceptualize how one thinks and talks about mental health and mental illnesses

• Help one identify poor mental health in themselves and how to support their peers

• Introduce/teach coping skills to manage stress and poor mental health, and increase resiliency

• Create a more supportive environment for all

Mental Health Continuum Model

1) Moves from good to poor mental health along a

gradient

2) Emphasizes the possibility to back and forth

along the continuum

3) Eliminates the need for stigmatizing labels and non-

professionals diagnosing

4) Each phase outlines signs and indicators for self-

assessment

The Big 4

Goal Setting

Visualization

Self-Talk

Deep Breathing

• Series of videos throughout the program with people with lived experience discussing their journeys in mental health

EVALUATION RESEARCH

Evaluation Design for TWMPre-workshop questionnaire

Post-workshop questionnaire

• Stigma• Resilience

• Workplace culture-related questions

Quantitative Measures

TWM3 Month-follow up

questionnaire

Qualitative Measures

• Program perceptions• Program use

• General comments• Key informants study

TWM and TWM FR Results

TWM• 8 sites• 1292 overall

•1155 participants with matched pre to post data•415 with pre, post, 3 month follow-up data

• 16 sites; 5 different first responder groups • 5598 overall

• 4659 participants with matched pre to post data

• 814 with pre, post, 3 month follow-up data

TWM For First Responders

Dobson, Szeto, & Knaak, 2019; Szeto, Dobson, & Knaak, 2019

TWM: Reduction in Stigma

Scores can range from 1 to 5; lower scores indicate greater perceived resiliency. *pre to post p<.001. Some loss of gains at follow-up but scores still significantly improved from those at baseline (p >.001)

1.781.72

1.611.54

1.62

1.4

1.5

1.6

1.7

1.8

1.9

2

2.1

2.2

2.3

2.4

Pre-post completers (n=1155)* All three surveys (n=415)*

Pre Post Follow-up

• Statistically significant improvement on total scale and all subscales

• Some loss of gains at follow-up but scores still significantly improved from baseline

• Full retention of gains to follow-up on three subscales: ‘social distance/ avoidance’, ‘responsibility for illness’ and ‘work-related beliefs/competency’

TWM: Improvement in Resiliency Skills

Scores can range from 1 to 5; higher scores indicate greater perceived resiliency. *p < .001.Significant improvement from pre to post (p<.001). Some loss of gains at follow-up but scores still significantly improved from those at baseline (p >.001)Pre to post effect size = .50

3.5 3.52

3.813.84

3.7

3

3.1

3.2

3.3

3.4

3.5

3.6

3.7

3.8

3.9

4

Pre-post completers (n=1134)* All three surveys (n=398)*

Pre Post Follow-up

TWM: Skills/learning used 3 Months Later

n=232

1.9%

5.0%

9.9%

11.2%

11.8%

19.3%

20.5%

29.2%

35.4%

Other

Sought professional help (self/other)

Less stigma/more accepting/less judgmental

More/better self care

More understanding/appreciation of MH

Big 4 skills

More talking/openess about MH

Provided support to another / using empathy

Mental health continuum

0% 5% 10% 15% 20% 25% 30% 35% 40%

% of participants

I was faced with a colleague going off on stress leave for depression. One of my other coworkers spoke to me about his frustration with having to

take over her tasks. I was able to use the strategies in the workshop to stick up for my colleague going

through a rough time. I was able to help my frustrated co-worker to see the situation

differently and react with more empathy. (non-supervisory staff, health organization)

TWM: Qualitative Comments

I used deep breathing to alleviate stressful situations and also visualization to go over things prior to meetings. I also step back

and make sure I am not reacting to emotions but responding with facts and

ensuring that I express my self professionally. (non-supervisory staff,

educational organization)

Applying the MHCM, I observed and acted on an employee's behaviour (yellow zone) with interest and concern …. The employee later thanked me, confirmed was dealing was a personal matter and the support was very

helpful. Employee now appears to be back in the green zone. (supervisory staff, government

organization)

I used the continuum to assess my mental health as 'injured', which prompted me to work with our HR benefits group to seek the necessary

assistance. The program also helped me identify that I was impacted by self-stigma in the

workplace and was very concerned with the perception of my colleagues and leaders. (non-

supervisory staff, private industry)

TWM RCT

• Nova Scotia Healthy Authority• Immediate and Delayed Delivery Groups• Reduction in stigma• Increase in resiliency skills• Compared with Dobson et al. 2019 and Szeto et al. 2019

• More impactful (larger effect size) • More rigorous design

• Decreases Stigma• Increases Resiliency• Improves overall mental wellness• Trained about 200,000 employees &

managers from more than 800 organizations

• Program has expanded internationally• US, Australia

Outcomes

NEXT STEPS

Presented by:Name, TitleSeptember 2013

Opening Minds:Lessons Learned

Next Steps

• TWM/TWM for First Responders– Online Boosters – Virtual Training

• TWM Crisis Response Virtual Training• The Inquiring Mind Post-Secondary• The Inquiring Mind Youth

What Works?• One-offs don’t work• Voluntary programs generally ineffective• Booster sessions required• People need to be engaged• Literacy programs can be harmful• Not all contact based education is effective• Big media campaigns aren’t effective at changing attitudes• Structural or cultural change is needed • It’s easier to change behaviours…attitudes will follow• Grassroots networks and champions are needed

https://www2.deloitte.com/content/dam/Deloitte/ca/Documents/about-deloitte/ca-en-about-blueprint-for-workplace-mental-health-final-aoda.pdf

National Standard for Psychological Health and Safety

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You already know about physical first aid, now find out about the importance of Mental Health First Aid Training

More information

https://theworkingmind.ca/working-mind

https://www.mentalhealthcommission.ca/English/what-we-do/workplace/national-standard

http://mindsmatter.openingminds.ca/

https://www.mentalhealthcommission.ca/English/implementing-standard

https://www.mhfa.ca/en/course-types

Questions?

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