A newly released survey on mental health in the workplace shows there could be a connection between stressful and negative working conditions and the mental health of workers. Most mental health problems, the study finds, are a result of a negative or mentally toxic workplace.
Workers often joke that their jobs are making them sick, but a recently released survey on mental illness and addiction in the workplace has concluded they could be right.
The survey, conducted by the Institute of Health Economics (IHE), a not-for-profit research organization in Alberta, found that most mental health problems stem from negative working conditions. Researchers went on to conclude that the most effective way to promote mental well-being in the workplace is to change the work culture.
The study, which noted a strong relationship between mental illness and addiction, reported that the most significant factors determining mental health are: risk of injury, after-hours work, irregular work-time (including shift work), job satisfaction and, most importantly, stress. Apart from after-hours work, these factors are all characterized by a sense of hopelessness.
According to the survey, the third done by IHE since 1992, stress among Alberta workers is on the rise.
Dr. Angus Thompson, a research affiliate at IHE and a co-author of the study, said that while the findings are in line with other recent studies in Canada, it is still unexpected because the population is aging and stress levels at work should be going down.
“In spite of that, the levels of extreme stress are staying the same —16 to 18 per cent, depending on how we measure it. That’s quite a few that report they have extreme stress at work, and the majority [of workers] feel they have some kind of stress. And stress can have some serious consequences,” he says.
“So the work culture — whether you’ve got a toxic manager, whether people are not feeling those kinds of satisfactions at work — all add up, and stress is part of it.”
It’s important to understand, Thompson added, that work factors are not the prime cause of mental problems. Rather, they aggravate vulnerabilities.
“Most of us come into the work situation with the beginnings of various problems already in place, so workplaces don’t cause mental illness or drug addictions,” he said. “But if you get a toxic workplace, it means that those who are even a little bit vulnerable can be set off and can start having difficulties at work.”
A common indicator of mental illness at work is the inability to finish tasks, he said. People who are mentally healthy and find their jobs rewarding get up in the morning and look forward to the day. They will be proactive at work and don’t need constant reminders about what they have to do.
But workers who are depressed are dragging themselves around. While they can do assigned tasks, they find it very difficult to work up any energy to show initiative.
Other mental health problems, such as schizophrenia, can undermine a person’s judgment, he adds. And people with either depression or schizophrenia are even more responsive to stress than healthy workers.
An effective mental health program in the workplace starts at the management level, Thompson says. Employers need to be able to recognize mental illness early on in a worker, understanding the difference between real problems and personality eccentricities.
“They need to detect the early signs that something is amiss,” he says, adding that intervening at an early stage would be beneficial for the well-being of the individual and for the company’s bottom-line.
“If you see people who used to get things done on time, and all of a sudden they’re late — the excuses are always pretty good, but what really counts is that they’re late,” Thompson says.
Adam Fisher, business development manager at Renascent, a mental health treatment facility in Toronto, says a clear sign that a worker has an addiction problem is change in productivity — it’s usually down. However, a person on stimulants may also show a sudden increase in productivity.
Addiction can also cause an employee to have more safety infractions or actual accidents, and attendance is often affected; many start missing work Mondays or regularly the day after payday.
“That’s absenteeism, but there’s also ‘presenteeism’,” he explains. The employee is attending and is physically on the job, but they are just not there. The concern and distraction caused by the addiction makes them — even though they’re coming into work — unable to be focused on the job.”
Workers with addiction problems also show a change in appearance, he adds. They may lose a lot of weight or be tired all the time.
While recognizing the signs of addiction is vital, Fisher says, it’s also important for an employer not to try to diagnose the problem. It’s not their responsibility, and the Human Rights Act sets out limits of what they can say. Bosses should leave the diagnosis to a professional and confine themselves to identifying performance problems, such as erratic behaviour and poor attendance.
“You have to give the employee an opportunity to change,” he says. “It’s a very delicate world, and it can be very messy.”
In addition to recognizing problems, Thompson says, managers need to take action to improve the workplace environment. One essential step is to arrange time and tasks to increase workers’ job satisfaction.
Sometimes, that’s a matter of helping people understand what their role in the company is. This problem is especially prevalent among those who work in the knowledge-based sector.
“Some people haven’t got it clear what their real purpose at their job is,” he says. “You go into some workplaces, and you ask four or five people what the purpose of the organization is, and you get some interesting answers.”
Where there are negative work cultures, managers themselves are often at the centre of the problem, Thompson adds. “Toxic” bosses must be trained out of the practices that promote mental problems — berating employees, not recognizing workers’ strengths and, especially, making unfair judgments.
Thompson believes courts will in the future be called on to issue legal opinions on the environment bosses create. If a workplace is extremely stressful and doesn’t need to be, then a worker could take the employer to court, saying the workplace was damaging to their mental state.
“There’s going to be increased onus on employers to avoid psychological damage to employees,” he said. “There will be more attention on increasing the well-being of worksites. That, itself, would be a good thing.”
According to the survey, changing work culture to increase employee satisfaction and reduce stress helps all workers and can affect improvement faster than providing psychological treatment through employee assistance programs (EAP), where a therapist treats one employee at a time. Yet, researchers note, EAPs are an important part of any company’s mental health program.
Businesses that have evaluated the effectiveness of their EAPs have found that providing treatment pays off, Thompson says. “Workers can become more productive, as well as feel better in the workplace. Mental well-being is increased.”
Fisher agrees that improving the work environment plays a key role in workers’ mental well-being. Employers can do a lot to alleviate stressors by taking steps such as ensuring a safe work environment, establishing regular breaks and creating a supportive, confidential EAP process.
“It’s incredibly helpful for an employee to know that they can ask and seek and receive help without the concern about consequences. An employer may say ‘our door is always open,’ but there may be a concern about whether that’s true. So, to have a third party they can approach is very helpful,” he says.
Many studies have found, Fisher adds, that it’s the workplace that most often drives people with addiction problems to get help. Where friends and family have failed to persuade them, the boss will succeed.
“When their job is on the line, you see a lot more people who will actively go into a treatment program. Hopefully, during the process they begin to do it for other reasons,” he says.
More than therapy
EAPs may be taking on a greater role in workers’ mental health. The survey shows that in Alberta the use of assistance programs is growing, and Thompson says that’s a positive sign. The trouble is many companies have partial programs — they allow time off but give only some or no payment for the therapy — and many don’t provide the programs at all.
He believes governments should do more to reinforce the use of EAPs by providing funding for companies. As the study notes, the programs are found much less frequency in small firms, which have too few employees to justify the cost. In addition to government support, these firms might also look to industry co-operation — with several companies contributing to one therapy program — to increase the number of EAPs and provide their workers access to paid mental services.
“But I’d worry if that’s all we did,” he adds, “because when you provide treatment programs, that means we’re waiting until people are at their worst before we provide an intervention.”
Because mental illness and addiction have similar causes — which have to do with the work environment — the study advised that an effective EAP therapist should have expertise in more than mental health problems.
“As soon as a person has one kind of mental health or addiction problem, they’re likely to have another,” Thompson says. “So it’s not just the luck of averages that puts them together; they’re connected. And if you’re talking about a common, underlying cause with many similar symptoms, then you need to have your therapists able to work in both areas.”
Thompson says the IHE is currently working on identifying further the features of a good workplace mental health program. They plan to set up a workshop to try out and evaluate their results.
“We’re going to know more by this time next year if all goes well,” he says.