Effectively promoting employee mental, as well as physical, health is critical to the success of individuals, employers, and Canada.
— By James Hsu

Depression is not usually a topic that comes up in discussions on cultural competency, but it should. It is an excellent starting point for addressing mental health issues in a diverse workforce. An anonymous quote says, “Diversity is the one true thing we have in common.” That really is true, but there is something else – the need to enjoy good physical and mental health to live a productive life.

Whereas physical conditions can easily be assessed with modern medical equipment, poor mental health may not be obvious until productivity inexplicably declines. Depression and other mental health issues are significant business issues, and providing adequate accessibility to services and managing on-the-job stress are employer imperatives.

The nonprofit national initiative of the Canadian Mental Health Association, Mental Health Works, estimates that one out of every five Canadians will experience a mental health problem, and depression is one of the most common expressions. Employees experiencing depression are less productive, experience higher rates of absenteeism, are more prone to illness and injuries, and are more likely to diminish workplace safety for themselves and co-workers. Yet, this widespread health condition is rarely acknowledged publicly.

Changing the Legacy One of the many reasons for this state of affairs is Health Canada’s policy legacies in which national Medicare focused on hospital-based treatments and considered family physicians and psychiatrists as primary treatment providers. Over time, physicians assumed the primary service provider roles and co-managed treatment programs with psychiatrists. The reason this is mentioned in relation to workplace mental health is that certain stigmas are attached to mental health issues and Health Canada’s well-intentioned efforts have unintentionally perpetuated those stigmas.

Health Canada is working towards finding ways to provide the type of mental health services needed. In 2006, the Mental Health Commission of Canada was created to develop a mental health strategy. The Commission established a legal and regulatory case for creating psychologically, and not just physically, safe workplaces. The onus is on employers to provide a workplace free of the main contributors to workplace depression: unreasonable and excessive management demands, and unpaid work hours. The Canadian courts have been increasingly supportive of employees bringing legitimate claims involving these issues.

Another problem is that the healthcare system is only free to Permanent Residents and Canadian Citizens. The uninsured face access inequities and delayed acculturation. Landed immigrants must wait three months before applying for health insurance in British Columbia, Quebec, and Ontario. There is confusion about application procedures and required documentation, which discourages people obtaining healthcare.

Canada’s diverse workforce also presents challenges in delivering services even when people hold provincial health cards. There are language barriers, limited access to public system services, a shortage of physicians and nurses, and long waiting periods. Pay disparities mean immigrants are less likely to be able to afford the services of private healthcare providers compared to those who are wealthier. Even when healthcare services are available, there is a great need for employers to assist with educating employees unfamiliar to the culture of their new home and helping immigrants integrate into the workplace and the health care system. Though it seems so obvious, it is easy to forget that people in an unfamiliar culture, or people who are hesitant to ask for help for fear of consequences, will try to cope on their own.

Half at Risk
Employers can take a leadership role in reducing workplace contributors to depression. Working conditions do matter, and there is an established link between the level of stress in the workplace and emotional well-being. There is a business case for preventing work stress and thus reducing the risk of employees developing mental health conditions. Estimates indicate that companies can realize a 30 percent savings due to higher employee productivity, reduced absenteeism, fewer worker’s compensation claims, and reduced health-related expenses.

Each dollar spent on stress prevention is returned more than threefold in future savings and over four times in health costs. The returns on lowering workplace stress can be substantial because national health studies report that half of all Canadians will have a mental health issue at some stage of their lives.

Managing the risks of employee depression in the workplace may seem like an overwhelming task. However, like most business initiatives, it begins with strategy development. Strategies helping employees manage stress naturally fit into workplace health programs. Employers can begin by adopting the National Standard of Canada for Psychological Health & Safety in the Workplace, a best practice. The standards include tools and expert guidance in developing and implementing a Psychological Health & Safety (PHS) system and a set of policies and procedures for managing factors that affect mental well-being.

Employers need to develop a work stress policy that brings attention to the issue of mental health and how it relates to work-life balance and healthy lifestyles. To reduce the rates of depression associated with the workplace, employees need the information and tools to personally manage the stress experienced in the workplace. These tools include conflict management, recognizing symptoms of stress, learning about available workplace and community support resources for getting help, and work-based resources like stress management seminars and walking paths.

The reality is that there are multiple workforce factors that impact employee well-being. They include the workplace culture, co-worker support systems, job fit, recognition and reward systems, workload management, employee engagement, and what could be called employer acceptance and understanding of mental health issues. Depression in the workplace is a very real issue, and shying away from addressing workplace stress and mental health will not do anyone any good. In the final analysis, employers have a responsibility to promote employee health for the total person.