October-18-18

Mental Health in the Workplace

Leeds Grenville and Lanark District Health Unit

Education Day October 2018

Tegan Slot, R.Kin MSc PhD Health and Safety Consultant

Mobile: 613.299.2924

Email: tslot@pshsa.ca

Who We Are

PSHSA serves 1.67 million workers across 10,000 workplaces within broad range of Public sectors and subsectors

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Health & Safety Systemof Ontario

Ministry of Labour (MOL)

WSIBWorkplace

Safety & Insurance

Board

Safe Workplace

Associations (SWA)

Enforcement & Strategy

Injury Compensation and Return to Work

Chief Prevention Office

Prevention

PSHSA

IHSA

WSPS

WSN OHCOW & WHSC

Employer premiums $$$$$

• Impact and Prevalence

• Definitions

• Mental Health Literacy

• Legislation

• Building a Prevention Program

• Psychological Health & Safety Support

Session Objectives

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Impact and Prevalence

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Mental Illness: What you see/What you don't see

Mental Health Is Real

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• The Mental Health Commission of Canada found that in

any given week, 500,000 Canadians do not go to work

due to a psychological health issue.

• Workplace factors such as harassment or excessive

workload may directly contribute to some causes of poor

psychological health

Psychological Health in the Workplace, Gov’t Canada, July 2016

Fact

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• 1 in 5 Canadians experience a psychological health

problem or illness in any given year.

• Psychological health problems and illnesses are the

number one cause of disability in Canada.

• Psychological health problems cost the Canadian

economy ~$51 billion per year, $20 billion of which is

attributable to work-related causes.

Psychological Health in the Workplace, Gov’t Canada, July 2016

Fact

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• 47% of working Canadians consider their work to be the

most stressful part of daily life.

• Psychological health problems affect mid-career workers

the most, lowering the productivity of the Canadian

workforce.

• Only 23% of Canadian workers would feel comfortable

talking to their employer about a psychological health

issue

Fact

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• 88% of all healthcare workers report insomnia, headaches,

depression and panic attacks related to work stress

(Statistics Canada, 2006)

• Average number of days of work lost due to illness or

disability is 1.5 times greater for workers in healthcare than

workers in other organizations

• Mental health issues at work can lead to poor work quality,

interpersonal conflicts, on the-job errors and accidents

Mental Health in Healthcare

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• “As healthcare providers, we spend so much time just

‘sucking it up’ emotionally to do our job, that we often

don’t take care of ourselves properly.”

• It’s very challenging, especially when you are already

dealing with a very, very heavy workload. … Sometimes

it’s just too much. People have too much on their plate.

They just can’t do it”

• “We are in a caring profession and we don’t care about

our own co-workers”

Mental Health in Healthcare

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Definitions

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A state of well‐being in which the individual realizes his or

her own abilities, can cope with the normal stresses of life,

can work productively and fruitfully, and is able to make a

contribution to his or her community.

World Health Organization, as sited in CSA, 2015

Mental Health (Psychological Health)

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Mental Health Continuum

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Mental Health – Good Stress vs Distress

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Are characterized by alterations in thinking, mood or

behaviour or some combination thereof associated with

significant distress and impaired functioning.

The Human Face of Mental Health and Mental Illness in

Canada 2006

Mental Illnesses

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A workplace that promotes employees’ psychological well-

being and actively works to prevent harm to worker

psychological health, including in negligent, reckless, or

intentional ways.

Guarding Minds @ Work, as sited in CSA, 2015

Psychologically Healthy and Safe Workplace

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Psychological Health & Safety

Mental Health vs Physical Health

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Mental Health Literacy

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• Aims to increase the knowledge to recognize specific

mental health disorders, risk factors, knowing how to

seek mental health information; and developing a

prevention program.

Mental Health Literacy

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• Refers to negative attitudes (prejudice) and negative

behaviour (discrimination) toward people with mental

health problems.

• Our goal is to breakdown the stigma by increasing our

Mental Health Literacy.

Mental Health Stigma

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• Anxiety

• Depression

• Stress

• Panic Disorder

• Postpartum Depression

• Obsession-Compulsive Disorder

• Adult Attention Deficit

PsychCentral

Mental Health Disorders

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Categories of Work Stressors Examples of Sources of Stress

Task Design Workload (Overload & underload)

Lack of appreciation

Role in Organization Conflicting roles/demands

Lack of clarity in responsibilities

Career Development Job satisfaction

Lack of growth

Relationships at work Lack of supervisor or co-worker support

Harassment and/or violence

Organizational structure/climate Lack of support and recognition

Work/Life Balance Conflicts

Workplace Concerns Exposure to hazards i.e. MSD,

Biological

Workplace Stressors or Risk Factors

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What education opportunities are available?

What programs are available?

How can we increase our mental health literacy at work?

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Scenario-based video training program to assist

Managing:

Accommodation

Performance

Emotions

Conflict

Return to Work

Workplace Strategies for Mental Health

Managing Mental Health Matters

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• The goal as an employee is to understand:

• How the 13 psychological workplace factors influence Mental

Health

• How you can help yourself and others.

• Free certificate program

Mental Health Commission of Canada &

Canadian Centre for Occupational Health & Safety

Being a Mindful Employee: An Orientation to Psychological Health & Safety

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• Beyond Silence is a new evidence-based workplace

mental health training program customized for healthcare

workers.

• A 2-day program, led by peer educators, builds

knowledge, skills and resources to promote early

intervention and support for mental health at work, and

psychological health and safety in the workplace.

Beyond Silence

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Remember:

1. Language matters

2. Educate yourself about mental illness

3. Be kind

4. Listen and ask

5. Break the silence and increase dialogue

Mental Health Literacy – Eliminate Stigma

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The First Follower

Leadership – Mental Health Literacy

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Legislation

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• Occupational Health & Safety Act

• Workplace Violence & Harassment

• s. 32.0.1 - 32.0.7

• Responsibilities of Workplace Parties

• s. 25-28 Employer, Supervisor and Worker

• Health Care and Residential Facilities, Regulation 67/93

• s. 8 - 9 Written measures

Legislation

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• Workplace Safety & Insurance Act: Entitlement for

Mental Stress Injuries

• Traumatic Mental Stress Policy (15-03-02)

• Chronic Mental Stress Policy (15-03-14)

• Posttraumatic Stress Disorder in First Responders & other

Designated Workers Policy (15-03-13)

Legislation

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Diagnostic Requirements By a regulated health professional, i.e.

physicians, nurse practitioner,

psychologist or psychiatrist

Examples include acute stress disorder,

PTSD, adjustment disorder, an anxiety

or depressive disorder

Injuring Process Events must be clearly and precisely

identifiable and objectively traumatic

Causation WSIB decision maker must be satisfied

that the diagnosed mental stress injury

was due to the traumatic event(s)

Traumatic Mental Health Policy (15-03-02)

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Diagnostic Requirements By a regulated health professional, i.e.

physicians, nurse practitioner,

psychologist or psychiatrist

Examples include acute stress disorder,

PTSD, adjustment disorder, an anxiety

or depressive disorder

Injuring Process Stressor(s) must be beyond the normal

pressures experienced by workers in

similar circumstances.

Causation WSIB decision-maker must be satisfied

that substantial work-related stressor is

the main cause of the CMS

Chronic Mental Stress Policy (15-03-14)

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• Effective April 5, 2016

• Supporting Ontario’s First Responders Act which

amends the Workplace Safety and Insurance Act.

• PTSD diagnosis in first responders made by a

psychiatrist or psychologist

• 6 more categories, including nurses who directly

provide patient care, provincial bailiffs, probation officers

and their direct supervisors

Posttraumatic Stress Disorder in First Responders & other Designated Workers Policy (15-03-13)

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Building a Prevention Program

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• Three components of prevention

• Primary

• Secondary

• Tertiary

Prevention

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• Changes to individual or organizational conditions that

may contribute to psychological health problems.

• This involves determining and managing psychological

risk factors to prevent further occurrences.

Primary Prevention

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• Individual level – providing employees with support or

skill to reduce risk i.e. stress management course

• Organizational level – change workplace risk factors to

reduce likelihood of psychological health problems i.e.

organizational culture, work scheduling.

Primary Prevention

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• Use a Psychological Health & Safety Lens for Job

Design

• Consider:

• Workload – pacing the flow of work

• Work scheduling – flexibility to support work/life balance

• Psychological Risk Factors

• Job match - job demands vs employees psychological

competencies such as concentration, emotional intelligence, self-

management

Primary Prevention – Organizational

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CSA-Z1003

• Provides a framework for addressing mental injury and harm prevention

• First in the world

• Voluntary standard is available at no cost

• Systematic approach to address workplace factors that affect psychological health & safety

• Focuses on workplace practices & processes not individual health issues

• Tailored to the needs & existing resources of each workplace

• Developed by employer/worker/regulator and subject matter stakeholders

Primary Prevention – Organizational

• Cognitive Demands Analysis – focuses on the essential cognitive

demands of the job

• StressAssess – OHCOW – Mental Injury Toolkit

• Guarding Minds @ Work Survey – Psychosocial Risk Factors

• Beyond Silence

Primary Prevention – Resources - Organization

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Primary Prevention – Resources - Organization

Primary Prevention - Individual

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“It takes discipline to do the things that are

good for us instead of what feels good in the

moment. It’s takes even more discipline to

refuse to take responsibility for other people’s

emotional well-being. And it takes discipline to

take full and complete responsibility for our

own well-being.

Self-care is also a discipline because it’s not

something you do once in awhile when the

world gets crazy. It’s what you do every day,

every week, month in and month out. It’s

taking care of yourself in a way that doesn’t

require you to “indulge” in order to restore

balance. It’s making the commitment to stay

healthy and balanced as a regular practice.”

- Forbes -

“Self-care is not an indulgence.

Self-care is a discipline”

Primary Prevention - Individual

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Study after study has shown what

we all instinctively know—regular

physical activity is essential for

good mental health.

Yet very few Canadians get

enough. Just 36% of kids. Only

18% of adults. That leaves a lot of

people missing out on the mental

health benefits of activity.

When you exercise, your body

releases endorphins, chemicals

that reduce feelings of pain and

increase feelings of pleasure,

literally boosting your mood. At the

same time, it also reduces the

amount of stress hormones, like

cortisol, floating around in your

body. - Participaction

• Working Through It – Workplace Strategies for Mental

Health• Self Care Strategies

• Stress Response

• Coping Strategies

• Managing Emotions

• Creating a Workplace Plan

• EFAP – Stress Management

Primary Prevention – Resources - Individual

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• Addresses psychological health problems while in a mild

and early stage.

• Consider:

• Self Care Resources

• Providing Managers with training on how to recognize and

address difficult situations.

• Provide EFAP

Secondary Prevention

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• Ensure prompt access to treatment and return to work.

• Consider:

• Non-medical treatments for depression or anxiety such as

Cognitive Behavioural Therapy

• Support Stay/Return to Work.

Tertiary Prevention

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Procedural• Actively seek information

• Consider and explore options

Substantive

• Make modifications or provide accommodation to allow the employee to fully participate in the workplace (within and consistent with relevant restrictions)

Duty to Accommodate

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Ontario Human Rights Commission

Under the Human Rights Code, employers have a legal duty to

accommodate the needs of people because of their physical and

psychosocial disabilities (mental health and addictions), unless it would

cause undue hardship.

• Cost

• Outside sources of funding, if any or

• Health and safety requirements

• Severity of the consequences if the risk were to materialize

• The probability of the risk materializing

• The identity of the people who are exposed to the risk

Undue Hardship

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ONUS OF PROOF IS ON THE EMPLOYER

Ontario Human Rights Commission

Under the Code, employers have a duty to accommodate

the needs of people with psychosocial disabilities to make

sure they have equal opportunities, equal access and can

enjoy equal benefits. Employment must be designed

inclusively or adapted to accommodate people with

psychosocial disabilities in a way that promotes integration

and full participation.

Duty To Accommodate

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Mental Health Accommodations

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Workplace Strategies for Mental Health

https://www.workplacestrategiesformentalhealth.com/

Part 1 – Job Expectations to be completed by employer,

employee and healthcare professional.

Supporting Employee Success

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Memory Exposure to Environmental Stimuli

Attention to Detail Overlapping Tasks

Time Pressures Working Relationships

Exposure to Emotionally Stressful

Situations

Exposure to Confrontational

Situations

Part 2 – Workplace Supports to be completed by the

employer

Part 3 – Employer and Employee Additional Comments

Part 4 – Supporting Success Conversation to be

completed by healthcare professional

Supporting Employee Success

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• Who – physician or nurse practitioner completes

• Why - work-related chronic mental stress disorders or

conditions. Physicians and nurse practitioners can use

this form to provide details about a patient’s condition for

adjudication and case management purposes

• Form CMS8 supports WSIB’s work-related chronic

mental stress policies.

Health Professional’s Report for Occupational Mental Stress (Form CMS8)

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• An informal way to move forward through some

workplace issues.

• A plan developed in good faith by each the manager and

worker, working together to maintain productivity and

health.

• A process to communicate solutions.

• This plan can be used for everyday issues to complex

RTW planning.

Mental Health Works, Workplace Plan

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The plan asks you to answer 3 questions:

1. What do you need to be successful at your job?

2. How do you want future issues to be addressed, should

they arise?

3. For your contribution to being successful at your job,

what will you commit to?

Mental Health Works, Workplace Plan

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Example for question #1:

What do you need to be successful at your job?

Scenario: “An employee who is struggling with competing

demands at work and last-minute requests from manager”.

Work plan: “last-minute requests that interrupt other tasks

may cause me to feel overwhelmed. I will ask my manager

to help me prioritize my other tasks.”

Mental Health Works Workplace Plan

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Accommodation Strategies – inventory

Topics such as:

• Communication and supervision techniques

• Training approaches

• Environmental needs

• Adaptability and Flexibility

• Attention to Detail

• Exposure to Emotionally Stressful Situations

Workplace Strategies for Mental Health

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Psychological Health & Safety Support

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www.pshsa.ca “Find your Consultant”

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@PSHSA.ca

Public Services Health and

Safety Association on LinkedIn

Connect with us:

Phone: 416.250.2131

Toll free: 1.877.250.7444

YouTube.com/PSHSA

Instragram.com/PSHSA

Questions?

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Tegan Slot

Health and Safety Consultant

tslot@pshsa.ca | 613-299-2924