Since 2013, a Canadian standard has put mental health at work on par with physical health and safety.
Is exposure to a bad boss comparable to exposure to harmful chemicals in the workplace? The Canadian National Standard for Psychological Health and Safety says yes. The 2013 introduction of the Canadian National Standard for Psychological Health and Safety positioned Canada as a world leader in workplace mental health. This introduction heralded significant shifts in thinking about mental health in the workplace, putting it on par with physical health and safety. The workplace itself is seen as a potential source of poor mental health.
Organizations are encouraged to implement best practices for mental-health promotion and to mitigate or eliminate workplace risk factors in the same way they take responsibility for workplace risk to physical health. To date, mental-health practice in the workplace has focused on individual accountability and on providing access to individual mental-health resources. A second shift in thinking expands the definition of mental health beyond the mere absence of illness. This definition of health includes the ability to cope with normal life stresses, to experience joy and to participate in one’s community (including the work community).
The Standard is still a voluntary guideline for Canadians. But it is embedded in a climate of changing legislation. Common psychological risk factors such as bullying, violence and harassment in the workplace are now subject to labour and human-rights legislation in almost all Canadian provinces and territories. In 2008, the Bureau de Normalisation du Québec (BNQ) released the Healthy Enterprise Standard. Quebec is the first province to introduce a healthy-workplace standard providing guidance and norms for good organizational practice to foster healthy lifestyles, healthy workplaces and sustainable improvement.
A number of provinces have adapted, or are in the process of adapting, workers’ compensation regulations to include work-related mental health as eligible for compensation. Initially, this focused on awarding claims for post-traumatic stress disorder for first responders. Eligibility is starting to expand to include any workers exposed to trauma in the workplace. Ontario introduced Bill 127, acknowledging mental injury due to chronic stress at work as a legitimate claim for workers’ compensation.
The 2013 Standard has garnered international attention. It offers a method and tools for implementing processes, protocols and policies to foster psychological health and safety (PH&S) as well as a deeply researched profile of the 13 features of PH&S in the workplace. The framework is particularly powerful because it is universally relevant to psychological health and can be filled in differently to reflect a unique industry/sector or national culture. For instance, workplace psychological stressors in mining will be different from the stressors related to working in retail. Similarly, respect and recognition are expressed differently in a Canadian cultural context than they are in a Japanese context.
Awareness of the connection between mental health and physical health has been growing in the media and with the general public. A steady stream of academic research has legitimized the understanding and concept of psychosomatic illness and the physical impact of stress. A recent study published in the International Journal of Environment Research and Public Health found that trust in the workplace, or lack thereof, was associated with other cardiovascular-disease risk factors, including high blood pressure, high cholesterol and diabetes.
Disability and health statistics show a co-morbidity as high as 50 per cent between physical illness and mental illness such as depression. Consider the psychological effects of breaking a leg. Challenges to independence, mobility, access to social networks and meeting family responsibilities can negatively affect mental health for workers.
Psychological concerns about trust and support in the workplace, as well as about reinjury and competence, can lead to reluctance to return to work from disability leave and unnecessarily lengthen time away from work.
The drivers for changing attitudes and employer accountability regarding mental health in Canada and worldwide are manifold. They are social, legislative and monetary.
Social drivers include the global movement to de-stigmatize mental illness and mental-health concerns, including celebrities speaking out about their mental-health issues and openness by Millennials about their mental health. Holistic recognition as human is becoming a key driver in the workplace, requiring human resources and management to shift to a human-centred approach. Corporate social responsibility has become a focus for both employees and customers.
In Canada, the legislation mentioned above, as well as successful court cases under human-rights legislation and tort law, have held employers accountable for foreseeable mental harm due to workplace behaviour. The Supreme Court of Canada has acknowledged both mental and physical injury as legitimate personal injury caused by employer neglect. This could conceivably be applied to employees suffering from burnout, which the World Health Organization recently classified as an occupational syndrome.
With the rising awareness and recognition of mental health comes an understanding of the economic impact of mental-health-related concerns on organizations and the economy. Mental health is the leading cause of disability and has a high cost to the Canadian and worldwide economy. The Mental Health Commission of Canada estimates the cost of psychological health problems to the Canadian economy to be $51 billion, and of that, $20 billion is due to work-related stresses. These numbers are compounded by the indirect and often overlooked costs of mental health complicating physical illness, the potential cost of recruiting replacement staff and the negative impact of increased workload for colleagues.
Investing in psychological health and safety reaps rewards. Socially responsible companies that invest in the health and well-being of their workers demonstrate a higher market valuation than those that do not, according to the January 2016 issue of the Journal of Occupational and Environmental Medicine.
Introduction of the Standard is credited with improving leader awareness and commitment to mental health, a higher likelihood of recognition of work-related psychological damages in court and for workers’ compensation, more willingness by employers to investigate complaints and making it easier for employees to talk to managers about mental-health concerns. Implementation remains a work in progress. In a 2017 survey, approximately 23.2 per cent of non-unionized and 26.3 per cent of unionized responders reported that their organization was actively involved in implementing the Standard or involved in ongoing efforts to maintain and improve key elements of the Standard.
While the Standard both reflects and contributes to attitude change and increased awareness of psychological health in the workplace, its complexity and the time, energy and resource investment needed for compliance are reported as inhibiting its uptake. Investing in psychological health is still often perceived as a cost centre, rather than as a savings centre.
Yet there are undeniable signs that workplaces are recognizing their role in the mental health of their employees. Increasingly, organizations are providing mental-health awareness training to employees and managers and participating in mental-health awareness campaigns. Other signs of change include the introduction of awards such as the Aon Best Employer award and the Top 100 Employers project, which focus on workplace culture and care.
A full adaptation of the Standard requires leadership commitment and dedicated resources. Gaining top-down support has proven a slow development. To remedy this, a clear business case needs to be built and, potentially, outside experts need to be involved.
In the meantime, it is very possible to take steps to improve psychological health and safety and build an internal business case to persuade leadership.
Awareness of mental health in the workplace is here to stay. That genie cannot be put back into the bottle. Workplaces play a pivotal role in fostering psychological health. They are called on to take steps to leverage what they’ve got and strengthen areas where they are leaving workers.
Rensia Melles is the founder of Integral Workplace Health.