OHS Canada Magazine

Population health crucial in facilitating workplace mental health


July 11, 2022
By Bill Howatt

Health & Safety Human Resources Mental Health

EDITOR’S NOTE: ‘Solving the Puzzle: How to facilitate psychological safety at work’ is a monthly series published by OHS Canada and Talent Canada, in partnership with Dr. Bill Howatt of Howatt HR Consulting in Ottawa.


One growing focus on workplace mental health is the desire for more evidence-based outcomes. Practically speaking, that is evidence that the dollars being invested in workplace mental health are having an impact.

The success metrics most boards, CEOs, COOs, CHROs, and CFOs care most about are attraction, retention, disability costs, and productivity. One Mental Fitness Index study demonstrated a positive causal relationship between flourishing employees and better outcomes on the above metrics. More employers are becoming aware and understanding the potential benefits of protecting and supporting workers’ mental health.

The link between population health realities and obtaining targeted workplace mental health outcomes may not be clearly understood. To impact workplace mental health, it is beneficial for individuals assigned to facilitate workplace mental health initiatives to have a foundational understanding of the link between population health and workers’ productivity.

One key lesson from population health is the financial power that small improvements can have. Small changes matter, even 1 per cent to 3 per cent changes across a spectrum of population health conditions, including mental health. Population health can be impacted by workplace mental health by increasing the percentage of the workforce flourishing compared with languishing and decreasing the number of workers experiencing anxiety or depression. There is no magic formula. Mental illness, obesity, and diabetes continue to have a negative financial impact on the global economy.

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How small percentage changes in population health matter

Like any other country, Canada has population health profiles for many common diseases and conditions. There is ample research on the prevalence rates for each condition in the general population represented in the average workforce. For each condition, there are reliable assumptions on associated costs like medication, treatment, absenteeism, and presenteeism. Following are five examples found in every workforce with just two assumptions.

To help understand the math, let’s begin with an example of Company ABC with 1000 employees at an average salary, including benefits, of $100,000 for 240 days of service per year.

Observing depression in the following table, it is not difficult to estimate the costs for 11 FTEs at six lost days of work at a cost of $2500 per FTE equals $27,500. For presenteeism, assuming full productivity is 90 per cent (90 per cent-82 per cent) per FTE is a loss of 8 per cent (11x$100,000) of total paid time that equals to $88,000. The sum of just these two factors for 11 FTEs with depression can be estimated at $115,000.

This math does not include all the other potential costs previously mentioned. Most senior leaders do not get reports on the real costs associated with their workforce’s health.

Disease/Condition Prevalence Rate Absenteeism (Additional Lost Days of Work) Presenteeism (percentage rate of productivity)
1.     Chronic Pain 20.5 per cent 6.12 82.5 per cent
2.     Depression 11.0 per cent 9.22 92.4 per cent
3.     Diabetes 6.4 per cent 3.32 96.0 per cent
4.     Obesity 24.5 per cent 1.3[13] 95.8 per cent
5.     Smoking 12.4 per cent 2.0[18] 90.5 per cent
6.     Anxiety Disorder (GAD) 8.2 per cent 1.02 96.1 per cent

Making things more complex is the reality that some workers have more than one of the above conditions, and many other conditions are not on this example list. The good news for employers is it is not difficult to obtain a reasonably accurate understanding of the costs of doing nothing regarding chronic disease in the workplace. One user-friendly tool I was involved in developing for Health Solutions by Shoppers Drug Mart estimates the costs of chronic illness based on the workforce size and current spending on employees’ benefits.

Key considerations for obtaining evidence-based outcomes

  • Positively impacting workplace mental health will happen by positively influencing the psychological health and safety of the culture. It also requires helping workers develop positive habits to improve their mental and physical health.
  • Be mindful of comorbidity regarding mental illness. For example, what comes first in workers, obesity or depression? The correct answer is bi-directional, meaning one condition can influence the other. One of employers’ most effective actions to impact workplace mental health is to have evidence-based programs that facilitate emotional well-being and mental health. Programs can include establishing psychologically safe workplaces and providing opportunities for employees to build and master their resiliency.
  • Employers must set realistic expectations for any program or support. Consider the above table’s six conditions for 2000 lives. Small may not sound interesting, but the math is compelling when done year over year. If just a 1 per cent improvement were made in each of the six conditions, what would the financial benefit be? Now imagine if this were done year over year for five years. The cost-benefit ratio is compelling, provided the facilitators of workplace mental health have realistic success metrics that can demonstrate the financial value of small changes.
  • Research demonstrates that in addition to employers creating a psychologically safe workplace, helping workers improve their lifestyle choices and habits by strengthening their mental (behavioural) health can positively impact their overall physiological and psychological health. Such actions also positively impact employers’ desired outcome measures.
  • Design program evaluation to include population health to provide decision-makers with evidence of how small changes in population health can pay for themselves over and over.
  • Population health requires playing the long game and staying focused on a Plan – Do – Check – Act model with a goal of continuous improvement and search for evidence that programs are improving population health and workplace mental health key performance metrics.

The Psychologically Safe Workplace Awards (PSWAs) are a national, evidence-based annual competition that measures the employee experience with respect to workplace mental health.

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