The current economy has shifted over the last 50-plus years to one as dependent on cognitive skills as on physical ability – perhaps more so in some parts of the world. As a result, workplaces are moving to safeguard mental health, much like when workplace safety measures were introduced to protect physical health. The emphasis is on both reducing risk and facilitating a productive and stable return to work for those who have been on disability.
One factor, however, makes managing mental health absence more challenging: stigma. Employees are often reluctant to admit they have a problem, as well as hesitant to return to work after disability leave, because they’re afraid of how they’ll be perceived.
Stigmatizing those with a mental health issue costs the employer money and causes suffering for the employee. Anti-stigma campaigns, which often require education and training as a necessary first step, are no longer optional if organizations wish to manage absence effectively.
Reducing risk factors
While addressing stigma is a necessary prerequisite to any mental health strategy, another important element is prevention or risk reduction. Employers are not likely able to prevent mental illness, but they can facilitate good mental health practices and take steps to create a workplace culture that does not negatively impact employees, and lead to an otherwise avoidable mental health disability leave.
Undue or unmitigated workplace stress is a key focus as it can also lead to reduced employee engagement, increased non-illness related absenteeism, and lower productivity. In addition, the youngest cohort of employees will soon be the dominant group in the workplace in terms of numbers, and may be most vulnerable given certain mental health risk factors, including the quality of social supports. Morneau Shepell’s research report, The True Picture of Workplace Absence, 2016,
found that of those employees who had taken mental health disability leave, 55 per cent stated their employer could have done something to prevent the leave. Their feedback centres primarily on addressing emotional/interpersonal issues at work that lead to extreme stress.
Employers should consider the following key actions to minimize conditions that lead to mental health absence:
Facilitating return to work
- Recognize risk. Train managers to recognize and address presenteeism and other risk factors. Well-equipped managers can problem-solve and respond to other behaviour changes in employees before an absence pattern emerges, whether for groups or individuals.
- Provide tangible, real-time support. Day-one attendance tracking and real-time reporting enable immediate identification of patterned absences and, as such, the need for intervention. Employees receive support/problem-solving help as soon as an absence occurs.
- Avoid “over-medicalizing” absences. Direct problem-solving with the employee by a case manager is more effective than medical notes, which only mask and validate the problem while providing no solution. Timely intervention prevents avoidable disability leave.
If an employee does need to take mental health disability leave, two factors, in particular, have been shown to impact the length of that leave. The first is receiving an accurate diagnosis with appropriate counselling and medication in a timely fashion. This may be challenging: mental illness is complex and difficult to diagnose in any circumstances. As a result, some employers are making recovery support systems available to employees. They use screening and assessment resources to confirm diagnoses and advise on medication and facilitate access to recovery support resources.
The second factor that can lengthen disability leave, whether physical or mental, is a feeling of isolation on the part of the employee. Communication is key throughout the disability period, with the overarching message being that the employee will be welcome back to work when ready. It’s important to begin that welcome-back process before the employee actually returns to work, with contact between the manager and employee before the return date so as to allay any fears the employee has about being able to reassume his or her position.
The employee’s manager, supervisor and disability case manager should work together to develop a detailed return-to-work plan, with input from the employee. Accommodation is typically temporary (two to eight weeks), generally low or no cost, and can be adapted to most work environments through discussion with the employee and his or her supervisor.
Cognitive impairment is the most typical reason for job accommodation following a mental health leave.
The symptoms of cognitive impairment may heighten with fear, anxiety and frustration — all of which are typically most acute during the initial period of return to work, but generally diminish with support and success. Respectful behaviour, open communication, and reasonable flexibility are the basis of any successful return to work, and often are all that is needed.
An organization that implements best-in-class absence management programs with problem-solving and care support can result in reduced disability duration of 15 to 40 per cent within 12 months. Savings can be reinvested to continuously improve workplace mental health. Most importantly, knowledgeable and experienced employees, including those with mental illness, are able to remain productive and on the job.
Paula Allen is vice-president, research and integrative solutions, with Morneau Shepell.
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Perspectives on absence management are evolving. The rationale for implementing an effective absence management program is no longer only about direct costs, although the expense of replacement workers and disability leave is a persuasive factor. Employing absence management best practices is now recognized to be about retention and productivity.