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Mental Health: The Ultimate Productivity Weapon

By: Michael Wilson

By 2020, depression is projected to be one of the leading causes of workdays lost in the global economy. Michael Wilson, senior chairman of the Global Business and Economic Roundtable on Addiction and Mental Health, explains what Canadian business can do today to deal with this issue.

Business, the economy, and mental health; we are bearing witness to an issue whose time has come. The disabling impact of mental ill health on men and women in the prime of their working lives is enormous.

It already costs between $6 billion and $8 billion a year to treat those who suffer mental ill health. Yet, fewer than one in 5 gets the help they need when they need it. Mental illness health problems cost business $33 billion a year through lost production. By 2020, depression and heart disease are projected to be the leading causes of workdays lost in the global economy.

Mental disorders are attacking our future – our children. The average age of onset for anxiety is age 12; substance abuse, age 18; and depression, age 21.

Large numbers of people are entering the workforce who already bear the burden of undetected and untreated mental health problems – a burden they need not shoulder alone, but often do.

I served as Canada’s minister of finance. If I knew then what I know now about the impact of mental health on the economy, I would have put the subject on Canada’s economic agenda. It is time we put it on the business agenda.

We live today in an economy of mental performance where mental health has tangible, functional value to business.

Human disability, not life expectancy, is the public health concern of the 21st century. And, by definition, worker disability is a business issue.

Mental ill health is the principal source of disability today in an economy where 85 per cent of all the new jobs coming on stream in the U.S. call for cerebral, not manual, skills.

The recent U.S. presidential commission on mental health found that 24% of short-term disability in that country was a result of mental disability illness. Addiction, a related illness, added a further 13 per cent.

Despair – which often characterizes serious depression – costs our economy more than strikes and work stoppages. This is the stake business has in the matter.

Principal Weapon

The principal weapon with which to change this is early detection and access to timely treatment to pre-empt disablement.

Myth and misinformation is the number one barrier to treatment and recovery. For generations, our compassion and common sense have been frozen by the cold stare of stigma.

This is hugely important because the most supportive instruments of recovery that we have are a welcoming community, supportive family, a job, a decent place to live and belong, an understanding word, or a visit in the afternoon.

Yet, the mythology of mental illness holds:

All are untrue, yet 85 per cent of those living with serious mental illness are unemployed.

This is a national disgrace. We know that people living with mental illness can, and do, recover. This is the theme of the Roundtable’s Business Year for Mental Health in 2004- 05.

Last year, the Roundtable sought and received business support for the centrepiece of this strategy – the ‘Charter for Mental Health in the Global Economy.’ The charter sets our four concrete goals:

Depression is growing as the main source of workdays lost in the global economy. We must arm companies with strategies and tools to measurably reduce the main sources of workplace stress. We must encourage the training of executives and managers to deal properly with the behavioural symptoms of mental ill health.

We must train managers and supervisors to help a distressed colleague seek and find the help they need when they need it.

But these are tactical measures. Strategically, we need a broad set of objectives which unify business and science behind larger purposes over the next four to five years. The charter may serve that purpose.

Ready For This Challenge

Business is ready for this challenge. We have no choice. Mental illness in the workforce is draining industrial productivity out of the economy like a slow, unseen leak in a ship at sea.

As an industrialized society, we have become hardened to emotional distress for growing numbers of people – even in good times – as a ‘natural’ implication of doing business in a highly-competitive global economy.

We have become accustomed to mass lay-offs and perpetual downsizing as the first, not last, alternative for companies dealing with cost or competitive problems. As a result, millions of Canadians live their daily lives hurried, worried, and rattled by the risks of sudden change.

We are hardened to the effects of irrationality in our financial markets. We live in an intensified society and workplace.

Ironically, out of these challenges comes an opportunity. The workplace is now the most appropriate environment in which to:

Research can show us how to keep people healthy and working; how employees can recover their health once lost; and return to work, once off.

In this day and age, work is more than a job that people go to. The workplace is a community that people belong to. Losing one’s job is losing one’s identity, losing one’s meaning, and losing contact with one’s friends.

Hand-in-hand

Recovery from mental illness and return-to-work go hand-in-hand. Research can help us turn this to the advantage of employer and employee alike.

We have seen tremendous progress in preventing physical injuries and illnesses at work. Across the economy, the rates and costs of disability-leave among employees suffering physical conditions have been greatly moderated.

But the rates and costs of disability associated with mental conditions have exploded.

What a shame it would be for the great progress employers and unions have made over the past 30 years in physical health and safety at work to be undone by massive losses of productive capacity due to untreated mental illness.

John Hunkin, president and CEO of CIBC, says job stress is the single most important issue facing business today – not number three, not number two, but number one.

From that question flows another – where from here?

To start, the Canadian Institutes for Health Research should establish overarching objectives for co-ordinating and funding research in this area – mental health and work. If research of mental illness in the workplace becomes a universe of unconnected planets, the effect will be lost.

Business will tune out. Business and science must see themselves as funding partners, strategic partners, and forceful allies in a cause too long ignored by us both.

We need research on the impact of stress in the workplace on mental illness and addiction and learn how changes in management and other workplace practices will reduce stress.

Finally, we need to understand better the cost/benefit balance of these changes so we can demonstrate to management and shareholders that there is a clear bottom line payoff from these efforts. For research in this area to really matter to business, it must be actionable.

For research in this area to resonate with business, it must equip corporations with the knowledge to measure the return on their investment in the health and wellbeing of their employees.

We must forge the link between recovery and return-to-work and integrate these concepts at the heart of our future approach to disability management.

For research in this area to summon corporate funding, on a broad basis, it must demonstrate how absenteeism and productivity loss can be reduced on a continuing basis.

What are the influences of gender, age, occupation, or geography on the prevention and management of mental disability?

Why do younger men and women employees, who go on mental disability leave, never return in such high numbers?

What is behind the phenomenon of men and women with longer company service – in, say, their 12th to 14th year of employment with the same company – apparently being more vulnerable to depression than employees with fewer years of service?

How can line managers facilitate the earlier detection of mental disorders among the people reporting to them?

What form of integrated mental health service system – public and private – is best suited for an economy where cognition, mental performance, and innovation keep business competitive?

Major Financial Upsides

There are major financial upsides in this for the healthcare system itself.

The healthcare costs for people suffering mental ill health are five times higher than average. Reducing these costs represents a potential taxpayer windfall saving.

The fact is this. People with mental illness do recover, get back to their jobs, get well, and stay well.

In 2004-05, the roundtable itself will undertake certain research to help employers, employees, insurance companies, and disability managers define better practices in the management and prevention of mental disability. With the Centre for Addiction and Mental Health, the Institute for Work and Health, and Watson Wyatt Worldwide, the Roundtable is joining the Harvard Health and Work Performances project. This research will help business understand the return on investing in the treatment of depression.

Further, with these partners, we are doing an analysis of insurance drug-claims data, coupled with data on lost time at work, short-term disability, and long-term disability.

This will help us really understand more clearly the benefits of drug treatment on the return-to-work of employees disabled by depression.

Finally, this year, we will consult companies in Canada and the U.S. to learn about employer-employee success stories in the return-to-work of distressed employees.

Research is important in all these matters. But we must also do now what we know now.

To that end, we are publishing Mental Health and Safety Guidelines for corporate boards of directors, CEOs, and in this edition, a Roadmap (see page 17) to mental disability management in 2004-05, we pegged the Business Years for Mental Health.

I said earlier that business has no choice but to step up and meet the mental health crisis in the labor force. One reason is that mental health and mental illness are quietly emerging as an explosive human rights issue. The U.S. is moving toward new and significant human rights protections with regard to the access of healthcare for the mentally ill.

This shouldn’t be the only reason why business should act to arrest the mental health crisis in this country, but it is a darn good one.

Michael Wilson, a former finance minister of Canada, is chairman of UBS Canada and senior chairman of the Global Business and Economic Roundtable on Addiction and Mental Health.

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