Improving mental health in the workplace – promising practices for employers

Improving mental health in the workplace – promising practices for employers


(VIBRANT MUSIC) It’s a real pleasure
to be here with you today. I love coming to Australia. I’ve formed some really wonderful
friendships here. And one of the things
that I wanted to talk about was just how friendly and giving
and warm Australians are and how it’s really touched me,
heart-wise. But on with
the business of the day and… Brief overview of what
I’m going to be talking about. Want to talk a little bit of a scene setter in Australia, because I think you’re very much further ahead than many countries around the world when it comes to
workplace mental health and the work
that’s been going on here, so that’s a huge advantage. I did a little bit of homework
to sort of take a look at whether or not
Australians are prepared and ready to undertake
something like this. Also, I want to
talk about a program that we’ve developed in Canada,
the first of its kind, a National Standard
for Psychological Health and Safety in the Workplace, and the case study that we undertook to get a better understanding and look at providing tools
to others, sharing information so that it’s easier for them
to undertake this kind of project. Something that’s near and dear
to my heart – stigma reduction. And as you’ll learn, that unless you begin
to tackle stigma, it becomes very difficult
to do many other things. And we’ve heard so much about stigma
in different forms today from some of our speakers. I’m also going to talk about
a program that we’ve initiated called The Working Mind, which is one of the tools I think that can be effective
for many workplaces in terms of a foundational piece, beginning that work to
change the culture in the workplace. And the approach that we’ve taken, if I leave you with
no other messages than if you are going to adopt
a program, make sure that that program is evidence-informed
or evidence-based. There are so many programs
out there that are basically
people’s best guesses, hunches, and really don’t have the data
to back them up, so… That’s what I’ll be talking about
briefly today, just to provide you with
that overview. So $200 billion. When I was doing
some of my homework, I was shocked to find out that’s what the folks who prepared the Fairfax Lateral Wellbeing Index say that it costs Australia every year – mental illness. And what they essentially say is that the traditional evaluation of mental health, sort of looking at it
from an economic point of view, really misses so much, that people with a lived experience or poor mental health have lower levels of wellbeing. And that’s how they’re able to
come up with that figure. So you’ll see
that I provide citations with all of the figures
that I’m presenting in Australia, so you’ll be able to
look those up yourself to get more details on those. But let’s take a look at
a more traditional… ..sort of look at mental health and the direct economic impact in Australia, and we heard Minister Davies talking about it and the
potential savings that are out there. And, in fact, I would say that this is probably a considerable underestimate. You take a look at absenteeism, you take a look at
presenteeism, you take a look at the cost
of compensation claims… One of the things
that’s not factored in here is the cost of medical services, again, which really begins
to drive up those costs. Looking outside of the workplace, when you’re talking about
students in university who are experiencing difficulties, the elderly who are experiencing
difficulties and require treatment, that cost goes up very, very quickly
and needs to be addressed. Talking about readiness to accept change in the workplace,
change in culture, that’s gonna be another theme
that I’m gonna be talking about. Certainly,
when you take a look at employees and how they feel about
mental health in the workplace, interesting to see that 91%, greater than the number who actually think
physical safety is important, support a change – improve
mental health in the workplace. So that readiness is there,
that acceptance, so that’s why we’re saying that
Australia is so much further ahead in terms of laying that groundwork and being able to
make it acceptable. So the readiness is there. Interestingly enough, though, only slightly more than half
actually believe that their workplace
is mentally healthy. And most don’t believe
that their leaders are in a position
where they value mental health, so that needs to change
a little bit. Again, I think you’re on
the positive side of that, but there’s certainly room
for improvement. Take a look at the benefits
of promoting mental health. Really interesting, and again,
this was a study that was done for beyondblue. Take a look at the difference
between those employees who work in a place or an environment where
they think it’s mentally healthy versus one where they consider it
mentally unhealthy, in terms of reporting being off because of not feeling mentally well or noticing or observing
fellow colleagues and employees who may be experiencing problems. So you can begin to see
the difference. So the data is there. It supports that this is a direction
that, really, we need to move in. And you heard Minister Davies
talk about this in terms of
the return on investment. We’re doing this because
it’s the right thing to do. But there’s a side benefit to it
as well. So for every dollar you invest,
there’s a 2.3 return on investment. How can you argue with that? You’re actually making money if you’re in the private
or public sectors and saving. So, enough about the groundwork
and preparations that have been done here
in Australia and some of the interesting
statistics around it. I’m now gonna move to
our programs in Canada and sort of…perhaps
a starting point for you. I wish there was a magic pill,
a silver bullet, that addressed everything. There isn’t.
But there are places to start. For us, one of those places is the National Standard for
Psychological Health and Safety in the Workplace. We launched this program
back in 2013. And we had some help
in terms of developing it. We brought
the Canadian Standards Association and an organisation in Quebec
known as the BNQ – the Bureau de normalisation
du Québec. These are two groups that are expert
in terms of developing standards, things like occupational safety
and other standards, to get behind us, to make sure
that we were doing the right thing. And so, these programs
are essentially… ..or the Standard, rather,
is designed to provide a voluntary set of guidelines,
a framework, a starting place. Now, I’ll also
be honest with you. My colleagues,
who sort of helped develop this, would hate me saying this, it was a little bit high-level, and we kept getting feedback, so… “Yeah, we understand
there’s a framework, “but how do we actually roll up
our sleeves and get engaged?” And that’s when we developed
Assembling the Pieces, which essentially
is a step-by-step process in terms of how to set up
your own standard in the workplace. Now, interestingly enough,
for about the next six months, the Standard is free. We’ve had it for free
for five years. CSA essentially distributes it
for the commission. They generally ask for
your email address, and that’s primarily in case
there are any updates. They can keep you updated. And, again, the…
Assembling the Pieces is free if you get it
in a digital version. If you buy a hard copy,
there’s a cost involved. But, again, these have been
very, very successful. Now, let me tell you
a little bit more about how these
particular programs work, particularly the Standard. So if I was to use an analogy
of building a house, a metaphor, what you’re looking at
are five basic elements or key pillars that go into making up
the Standard – programs, policies,
benefits, training, and, importantly, assessment – making sure you know
what you’re doing is actually
working and delivering on the outcomes
that you’re looking for. So when you’re talking
about programs, you’re talking about
workplace awareness, education for employees. Policies – dealing with issues like bullying and harassment
in the workplace as not being acceptable and becoming core values
within your organisation. Benefits – things like
EAP and EFAP programs, making them available. Accommodating staff
so that they can take time off work for appointments. Also helping support them if
they need psychological assessments. In Canada… I’m not sure
what the situation is here. Psychological support isn’t paid for
as part of our universal health care. And psychologists
are treated differently. And the time to see a psychiatrist,
the waits are horrendous. We just don’t have enough
psychiatrists in our country. However, that counselling is a great holding position
and support. Training. Training is so important
in terms of being able to develop resiliency,
for example, and self-awareness
about mental health issues that you may be experiencing. Again, being able
to identify problems early and get that intervention, the greater the possibility
of successful treatment occurring. And, again, assessment – you need to be able to gauge
the improvements that you’re making and make sure that what you’re doing
is actually working. So that’s really key
and vital importance. So one of the other key factors in terms of looking at the Standard is what we call
13 psychosocial factors. Now, these are things that affect people’s responses
in the workplace – the working conditions, for example. And what we’re talking about
are things like civility and respect, and I use the words, and a couple
speakers have used them as well, things like harassment and bullying. How do you begin to address those, bringing in policies that actually
prevent those kind of things from happening? Making people feel that they are…
have some control. All too often, people in
the workplace feel disenfranchised, feel that they have no control, and that leads to things like
stress, anxiety and depression. So, again, these are factors
that you can deal with if you have the appropriate programs and approaches in place. So, how do you begin to implement
these kind of programs? How do you begin to implement
a standard? Well, there are certainly
some key elements to doing that. One of the most important is
having that support from leadership at the top,
at the most senior levels. So it’s top-down, to that degree. If you don’t have
that leadership, you don’t get the buy-in
from middle managers, who play a very vital role. At the same time,
and not to be ignored, though, you need the support and feedback from the grassroots level as well. So it’s also bottom-up. It’s not only top-down
but bottom-up as well. Planning. It’s going to be
different and unique for each individual employer
and program. They have different needs. They have different issues
that they’re dealing with. So you have to tailor it
to your particular organisation, your particular company, your particular sector. Implementation. People need to see it being done
and rolled out and understand
what it’s all about. So communication
and implementation, again, really key and important factors. Evaluation. Again, there’s that word again.
Collecting the data. Making sure that you know that what is actually happening
is working. And if it’s not, identifying the gaps and then coming up
with solutions to those gaps so that the program is fixed
and so that the program is working. And at the end,
you need management to review it, to make sure that it’s effective and it’s delivering
on the objectives, goals that you’ve set out. So, in order to get
a better understanding, because, again, as I just mentioned,
it’s different for each workplace. Each workplace is unique,
has its own particular issues that it’s dealing with. We embarked in 2014
on a major national case study involving various partners
that had undertaken to implement the Standard itself. So, what we were doing is sort of
trying to help others as well, because what we could see is that many companies and organisations
would benefit from the work that were being done
by these pioneers, these people
that were being proactive and taking on this leadership role. And, as you’ll see in a few minutes,
we work with big companies, medium-sized companies
and organisations and small, private sector, public sector. So we tried to
cover the waterfront when it came to working with
this particular program. So, what we wanted to do was
to look at breaking down barriers, identifying those barriers
and breaking them down, determine promising practices. Again, why reinvent the wheel
if you don’t have to, if you can help support others
in the work going forward? Building a strong business case
for implementation. And I think, again,
looking at some of the work that’s been done here in Australia, you already have
a pretty impressive business case in terms of moving
in this particular direction. Identifying tools and resources
that can be shared. One of the things
that always amazes me, and maybe perhaps it shouldn’t – I’ve been doing this for 10 years now
with the commission – is how generous people are and willing to share
what they’ve learned, the tools that they’ve developed
that will benefit everybody. And creating that blueprint
for the future is vitally important. So here are some of the companies. We had 40 companies,
again, as I was mentioning, from our largest telecommunications
media giant, Bell Canada, to some small organisations,
maybe less than 20 individuals, who were part of a law firm,
for example, so… We can show you that it works
at large level, medium-size level and smaller level. One thing that
we did find out, though, it’s generally much easier
for larger organisations. They’ve got the infrastructure
largely in place, many of the things in place,
such as EAP programs, well set up HR departments – it’s easy to identify people and
resources that you can throw at this. Little bit tougher,
but not impossible, for smaller organisations that don’t
have the benefit of those aspects. So, again, you can see,
essentially, from coast to coast, 40 different organisations
reporting back to us. Changing culture
isn’t something that comes easy, and it’s not something
that you can do overnight. You’re in this for the long haul. And you’re not going to begin to see
dramatic results or improvements for a period of time. Some of the things that you will see,
for example, you’ll see an increase
in the uptake of services. Some people get panicky and say,
“Wow. You’re costing us more money. “All of a sudden,
more people are demanding support, “demanding services.” But what we’ve seen over a 2-year
period is that begins to level off and, in fact, begins to decline, and what you also begin to see
is a reduction in absenteeism levels. You begin to see a reduction in short-term
and long-term disability cases. So, in effect, there’s a little
short-term pain but long-term gain, but, again, it’s the kind of thing that if you’re going to
embark on this, you have to be there and provide
the leadership for the long term. So, again,
I was talking about Bell Canada. It embarked on what I would call partial engagement, so it didn’t throw its whole organisation behind the program. It has a staff of about 55,000. Instead,
about two-thirds of that staff were engaged in the program. They did something
really interesting, and they had actually started
before we got them engaged – they had developed a scorecard,
a 90-point scorecard, which we’d be more than happy
to share with you – and things that they were looking at was uptake of services, reductions in disability claims, taking a look at events, taking a look at training programs, so they were measuring all of these kind of factors to help them determine whether or not they were having a positive impact and achieving the goals
that they were looking at. So, again,
you can be really strategic and it’s very practical, and it’s not really rocket science when you really begin to put your mind to it. So, taking a look
at some of the outcomes. Some of these companies
are a little bit cagey when it comes to sharing
too much information. We just write it off to sort of not wanting to
give their competitors any knowledge or advantage, so… Bell did share some things with us. They talked about the… ..doubling the increase in utilisation of services, EAP and things of that nature, which is what
I was just mentioning before when you see
that increase taking place. They also saw a double-digit decrease in terms of disability claims, particularly
short-term disability claims. So begin to think of that
in dollar terms, if you’re a company
and looking at the bottom line, in terms of
what those kind of savings are, and that certainly has to make the
business case for implementing it. We know that
the real reason for doing it is that we want
mentally healthy employees, we want employees who are engaged,
who are enjoying what they’re doing, are productive
and have fulfilling careers, as a few of the speakers mentioned. In Canada, for example,
we look at it, 60% of the time, your waking hours are spent
in the workplace for most adults. That is a large portion of time that you have available
that’s spent in those workplaces, and as one of the speakers
just mentioned, talking about finding friends, talking about finding colleagues
and relating to people, much of that takes place
in the workplace. Now, here’s one of the small firms
that participated in the study. This was a legal firm specialising in human resources and labour law, just under 20 employees, and they began to notice things, for example, a new-found awareness
of mental health that they may not have been aware of in the past. They were identifying some of those factors that could be seen as harmful in terms of psychological safety within the workplace, health and safety within
the workplace, and also,
they began talking about it more, and that’s so important. Just beginning to talk about it, to break the silence, to take it out of the shadows and to normalise it, really goes a long way. There is probably a greater number of public sector organisations
that participated, rather than private sector, but there were a number of
big private sector organisations – insurance companies,
media and communications giants and other groups as well
that participated in the study. So in terms of
our preliminary findings, in terms of things
that we were looking for, we saw that 72% of the companies
that participated in adopting the Standard were using those five key pillars or key elements
that I was talking about, and we saw improvements in that area. That was up from three years ago, where it was only about 55% of those companies who were using it. Many more companies
are now using data. They’re now measuring it. Again, be evidence-informed
when you’re developing programs. Make sure
that you’re measuring them so that you know
that you’re achieving the goals, and that helps support
the business case behind it. Some of the programs
that were implemented, respectful workplace programs
and policies, for example, education – creating more awareness
within the workplace and informing employees so that they were more aware
of their mental health and what was going on
within the workplace – more EAP services and supports as well as, as I’ve just mentioned
a second ago, enhancing knowledge. So, we’re going to move into
a different realm right now, and there are a couple of people
I know in the audience know the answer to this, so I’m going
to ask you not to tell anybody else, but can anybody hazard a guess
what this is, what this little squiggle is? Pardon me? An ear? It looks like an ear. Nope. Stomach? No. So this is the Greek letter
for ‘stigma’. That’s the sort of the origin
of the term ‘stigma’. Anybody care to hazard a guess on
how the ancient Greeks used this? Yep. It was a mark or a brand. They had a stick called a stig and they would carve it on people
that were to be shunned, that were considered unworthy – prisoners, slaves, criminals. Now, fortunately for us, we’ve moved
a long way from the ancient Greeks, but stigma is still alive and well. And we know that in terms
of the barrier in Canada, two-thirds of people with
a mental illness won’t seek help, largely because of the stigma. They often describe
the stigma that they experience as being worse
than the illness itself. They’re afraid to come forward. They’re concerned about
things like constructive dismissal. They’re concerned about, again, some of the stereotypes
and misconceptions that people have
about mental illness. So it’s a huge challenge
that you’re dealing with in terms of trying to
overcome that stigma and get buy-in, but I think we are beginning
to make breakthroughs and people are beginning
to talk about it more openly and more comfortably. So why reduce the stigma
of mental illness? Well, it goes back, in a way, to what we were talking about
in the programs. You can begin to see, and this is one of the things
that’s so important, is making people comfortable at early help-seeking. The earlier somebody gets help, the sooner
they’re likely to get better, the more positive the outcomes. Increase productivity – again, that early intervention and comfort and support that you need within the workplace environment. When you’re talking about
changing culture, you want a workplace environment
that’s supportive, that gets behind its employees so they know that it’s OK
for them to come forward. That cultural shift
that we were talking about in terms of attitudes and behaviours, not taking those
negative attitudes or beliefs and turning them
into discrimination, and greater acceptance
of mental health in the workplace. And, again, ultimately,
positive outcomes for those people that are dealing with
mental health problems. So, one of the programs
that we’ve also been working on in addition to the Standard
and the case study is a program that we call
The Working Mind. Its origins start with
our Defence Department. They developed a program called
the Road to Mental Readiness. And it was designed to help troops
going into combat be more resilient after what they knew
they were going to be exposed to in combat
and within theatres of operation. So we’re able
to take that program, because we saw
a lot of positive benefits, and sort of translate it
into something that was usable within the general workplace, taking away a lot of
the military terminology but using some of the fundamental
tools that are part of the program, reconceptualising it. So one of the things
that’s important about the program is that its goals are
to increase help-seeking, create a more supportive
environment, to break down
that stigma barrier that exists, and also to give people
the tools that they need. One of those tools is something that
we call the Mental Health Continuum, and, again, I think
it’s the simplicity of the program, and leave it to the military
to come up with something that’s simple and works. It’s a simple little colour chart. You’ll see that it moves from good to poor along a gradient. That gradient moves back and forth. So you’re reconceptualising how you look at mental health and mental wellness. Traditionally, we looked at it
in black-and-white terms – either you’re healthy
and able to work or not healthy
and shouldn’t be working, shouldn’t be there. This identifies
that at any given time, you’re somewhere along a continuum, and even though
you may be experiencing issues, it doesn’t mean that it’s going to
impair your functioning doing a particular job. What this program does in particular is that it reduces
the stigmatising labels. It’s not meant to be
a diagnostic tool at all but, rather, one of self-awareness, it’s a preventative tool, so that people can begin to identify some of the indicators that are there that show that they may be moving into dangerous waters. So, each phase in the continuum, and normally we show
the entire phase, and I won’t do that
just because of time’s sake, but there are indicators
such as sleep, for example, which is a great bellwether. It’s sort of the canary
in the coalmine. If you get six, seven,
eight hours of sleep a night, depending on the individual, that’s a good place to be. You may be in the yellow,
which is ‘reacting’, where I was this morning
at three o’clock, sort of thinking
about my presentation. How many of you have had that unexpected three o’clock
in the morning wake-up call? It’s pretty healthy, actually. It sort of gets you focused,
gets the adrenaline going. As long as it’s not prolonged or
sustained over a long period of time, you come out of it OK
and, in fact, sometimes it’s helpful. But imagine if you’re
not sleeping for weeks on end, or sleeping very well
for weeks on end. How well do you think you function, and are you particularly easy
to get along with? Would your work colleagues
sort of say that, you know, you’d be voted
Mr or Miss Congeniality? Probably not. Now, imagine that
you get to the stage when you’re moving into the red,
which is ‘ill’, and you may actually have
a diagnosable mental illness where you can’t fall asleep
or you can’t wake up, you’re having serious nightmares, all of those kind of things. So these are really simple factors
that you can look at. Changes in mood. Going from, well, maybe not being
as patient as you might be in the yellow with somebody, having a little bit
more difficulty focusing, to getting into
displaced or sarcastic humour, withdrawing, becoming negative – all of these kind of things
are certainly things that can help you become aware of what your mental wellness
or mental health state is. So, what we’ve also
been able to do is to direct people to strategies
and tools that they can use to keep themselves in the green,
or if they’re beginning to slip, move back into the green. One of the tools
that we’ve identified, we thought it to be
a promising practice initially, but we’ve now moved and think
it’s the best practice, and you saw some wonderful examples
of it today here, with Caroline telling her story, and seeing the stories
that were on the screen, but something that we call
contact-based education. I think that
the way we’re programmed, the way that we can empathise
with people and actually see that those stereotypes and misconceptions
are wrong – people can get better
and do get better. There is that hope and there is
that recovery that can take place. So, some of the coping strategies
that we talk about… I’m running out of time, but… Things that basically have been
around for a very long time and are well-proven – CBT theory-based elements, SMART goal setting, mental rehearsal,
positive self-talk, things that have been used by high-performance athletes,
for example, for a very long time, diaphragmatic breathing. When we’re dealing with
first responders, we call it tactical breathing, because it sounds
a little sexier to them. But, again,
reducing cortisol levels, adrenaline. It’s amazing what happens
when you do deep breathing. Just to give you an idea, and, again, because of time,
I won’t get into it, but I’d be more than happy
to share the research results. We have two papers right now
that are being reviewed for scientific journals. But we’ve seen
really impressive impacts. And we’re also working with
the University of California, who’s come up with a shorter version
of the program, and, again, they’re seeing
the same consistent improvements across the board with the program. So, what we did was
we looked at qualitative research as well as quantitative, or quantitative and then qualitative, so, in other words, focus groups, and finding out about
whether or not the programs
actually work for individuals. And, again, we’re very, very happy
to see what the results. It’s a 4-year study involving close to 5,000 people,
first responders, and another 1,000 or more
in the general workplace, and we’re able to use
matched sets of data and then do post evaluations as well. For those researchers here
in the group, again, as I said, I’d be happy to share it with you. We’ve only actually
shared some of the details with a few colleagues
in a conference, the World Psychiatric Conference
in Copenhagen, and the papers
will be coming out shortly. So that’s it for now, and, again,
I’m going to be here for two days, so I’d be more than happy to talk
with you, if you have any questions, and go from there. Thank you very much for being such
an attentive audience. Appreciate it. (VIBRANT MUSIC)

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