Feature Article

Changing Landscape of Mental Health in Canada

By Mark Attridge, PhD, MA: Dylan Davidson, BAA; and Joti Samra, PhD, R.Psych

Changes over the past decade have produced many promising trends in workplace mental health, although certain problems remain. That is the consensus of a recent research project that examined the evolution of workplace mental health policies and strategies in Canada. The study focused on the five areas of legal advances, shifts in business priorities, changes in education and training, media trends, and research priorities. 

Multi-method Approach to Research
Three research methods were utilized for the project. First, we reviewed empirical and business literature to investigate the state of workplace mental health in 2007 and find out what has changed. Second, we interviewed 87 key informants from across Canada, who collectively represented a wide breadth and depth of knowledge and expertise across aspects of workplace mental health.

Finally, we surveyed 2,148 Canadians working in human resources, management, government, mental health services, EAP, and other roles. More specifically, we wanted to assess these individuals’ attitudes, opinions, and knowledge of current mental health practices in the workplace. This article presents highlights from the full 80-page report (Samra, 2017).  

Then and Now
Only 10 years ago, efforts to promote workplace mental health in Canada were generally unsystematic, fragmented, and in some cases, frivolous. Mental health in the workplace was often considered peripheral and certainly secondary to physical-related illnesses and injuries. Respondents to our survey characterized the 2007 state of workplace mental health as being a stigma-laden area.

The business case for addressing workplace mental health issues was also in its early stages, and research was only just beginning to reliably measure employee health and connect it to work performance. However, workplaces were characterized as less stressful and with fewer demands on time and more resources provided than what is typical in today’s work environments.

A decade later, much has changed. Work-related stress and mental health problems such as depression are acknowledged as global issues affecting a wide range of professions and workers. The workplace is seen as a major source of psychosocial risks and thus is recognized as the ideal venue for protecting the health and well-being of workers. 

Accordingly, there has been a remarkable increase in new policies, initiatives, approaches, and strategies targeted at improving mental health in the workplace. Some of the most meaningful changes have occurred at the personal level in the form of increased awareness, understanding, and compassion for workers with mental health and/or addiction issues.  

The Evolving Legal & Standards Landscape
In 2007, the political landscape changed dramatically with the formation of the first-ever Mental Health Commission of Canada (MHCC), which included an advisory committee on mental health in the workplace.

Six years later, the National Standard of Canada for Psychological Health and Safety in the Workplace was released. This document, known as “the Standard”, provides a comprehensive framework employers can use to assess, respond, and evaluate workplace psychological health and safety. 

Considered a first of its kind in the world, the Standard is championed by the MHCC, and developed through a consensus approach by the two leading standards-making organization in Canada – the Bureau de normalisation du Quebec (BNQ) and the CSA Group.

Another advance came in 2015 when the Public Service Alliance of Canada and Canadian government established a joint task force to address mental health in the workplace. 

It should come as no surprise then, that in our survey, 72% of respondents reported that legislation to protect employees with mental health issues in the workplace is better today than in 2007. Examples of this change include laws in several Canadian provinces that provide specific protections for accommodating workers with a mental health disability; the bolstering of compensation for mental health injury under workers’ compensation laws, particularly for those in high risk positions (e.g., first responders); and explicit definitions and protection against acts of workplace bullying and harassment. 

The Evolving Business Landscape
Significant shifts in attitude about mental health have occurred in the business community, particularly among leaders and CEOs of large organizations. These changes include an increase in awareness, understanding, value, and prioritization of addressing psychological health and safety issues.

Noteworthy changes in behavior have also occurred on both organizational and individual levels. This has especially been the case in terms of development and utilization of resources and supports for managers, supervisors, and other workplace leaders. In our survey, 67% said that employees with mental illness are treated better at work today than in 2007. 

Greater value is now placed on considering the psychological health and safety of the work environment. This value is demonstrated through emerging awards that recognize employers with good practices as being desirable places to work. Indeed, the business community in Canada has been a major catalyst for promoting workplace mental health issues as essential to employee recruitment, engagement, and retention. An example of this was the series of bi-annual meetings hosted by the Global Business and Economic Roundtable on Addiction and Mental Health.

The Evolving Education and Training Landscape
Most (73%) of survey respondents reported that the availability of mental health educational and training programs is better now than in 2007. Many evidence-based mental health resources have emerged over the last decade. These resources, including webinars, workshops, and online university certificates, have resulted in enhanced public awareness about mental health, as well as reducing barriers to accurate information.

Prominent examples include Mental Health Works (by the Canadian Mental Health Association), Mindful Employer Canada, and Workplace Strategies for Workplace Mental Health (by Great-West Life Centre for Mental Health in the Workplace). All told, these resources enhance the likelihood of implementing workplace mental health initiatives for employers, regardless of their financial limitations or geographic location. 

Additionally, education in psychological health and safety is now being incorporated into professional trade shows and conferences, such as The Better Workplaces Conferences held by the Conference Board of Canada and the Bottom Line Conference by CMHA. This reflects the broadening value that professions are placing on psychological health and safety as a foundational training piece for all work environments.

Further, advanced training in psychological health and safety in the workplace are now available at the University of Fredericton, Humber College, and other academic institutions. 

The Evolving Public Media Landscape
Societal shifts in the general public’s attitudes toward mental health issues have reduced stigma. Mental health is increasingly being viewed as an important component of overall health; the World Health Organization proclaims, “There is no health without mental health.” General awareness of mental health has increased, and thus the average person’s understanding of mental health issues has become less judgmental and more compassionate. 
These changes have been reflected in shifting stories and broader attention in the media. Celebrities and influential individuals have increasingly spoken publicly about their own personal struggles, resulting in increased exposure, accessibility, and normalizing of mental health challenges. For example, our survey found that 73% felt that attitudes toward workplace mental health issues are better now than they were in 2007. 

Furthermore, additional information about mental health disorders is now widely accessible, particularly through the expansion of venues such as social media, blogs, and specialty publications (such as Moods Magazine) that provide personal and intimate real-world stories. One such example is popular Canadian athlete Clara Hughes serving as a spokesperson for Bell Canada’s Let’s Talk nationwide anti-stigma campaign for mental health.

The Evolving Research Landscape
Several landmark industry and government white papers on workplace mental health were generated in Canada during the past decade. In addition, global scientific literature now has over 1,000 papers exploring workplace mental health topics. Past emphasis on studying individual factors has been augmented by an increasing focus on broader organizational and work environment factors that affect employee mental health, and ultimately drive company success.

Enhanced value within the scientific community is also being placed on participating in collaborate initiatives between researchers and businesses. This has resulted in companies’ deepening knowledge not only about workplace mental health in general, but also their impact on absenteeism and productivity (including presenteeism) in real-world settings.

Evidence of the cost-effectiveness of prevention and treatment services provided by workplace wellness, EAPs, and mental health providers, has increased substantially in the past 10 years. Employers who used to question the impact and return on investment (ROI) of mental health programs are now asking how to identify best practices for promoting and integrating these services in order to drive program awareness and use.

For instance, every year millions of men in Canada (and all over the world) shave off their moustaches during November to raise money (over $750 million since 2004) for the Movember Foundation. The foundation funds innovative projects that promote men’s health, such as the BroMatters.ca website for preventing depression in Canadian working men.

Gaps Remain
Although much progress has been made, certain problems and gaps stubbornly remain. Our study indicated that cultural gaps were the most commonly reported concern (36% of key informants), followed by gaps in leadership (33%), and gaps in resources (23%).

* Cultural gaps indicated the need to further address the stigma of mental health and addiction in the workplace and admit that many businesses still enable a work culture that ignores the role of psychological factors or that focuses solely on the physical aspects of worker safety and disability.
* Leadership gaps included a lack of training and education for leaders, a lack of awareness of the benefits to the business of addressing mental health issues in the workplace, a lack of rigor in selecting which specific organizational initiatives to pursue, and a lack of emotional intelligence of some leaders. 
* Resource gaps included a lack of workplace research, poor dissemination of the existing body of research, inadequate workplace accommodation for mental health disability and return-to-work practices, and low utilization or ineffective employee assistance and family programs that are not properly integrated to the workplace.

A new book by Mary Ann Baynton and Leanne Fournier, The Evolution of Workplace Mental Health in Canada, shares the stories of individuals who contributed to this transformation and highlights results of the research study.  The Great-West Life Centre publishes both the book and the research report for Mental Health in the Workplace. 

Adapted from: Samra, J. (2017). The Evolution of Workplace Mental Health in Canada: Research Report (2007-2017). Retrieved from https://www.workplacestrategiesformentalhealth.com/pdf/Evolution_Research_Project_Full_Report__Jan_2017_0.pdf

The research project, led by Joti Samra, was supported by the Great-West Life Centre for Mental Health in the Workplace (the Centre), as well as the Mental Health Commission of Canada, and was conducted through the University of Fredericton. The project was completed through support from students Dylan Davidson and Marissa Bowsfield, as well as advisory committee members Mark Attridge, Graham Lowe, and Martin Shain. In addition, the Centre’s Program Director, Mary Ann Baynton, was instrumental in creating and nurturing this project as part of the Centre’s 10th anniversary. 

Dr. Mark Attridge is an independent research scholar as President of Attridge Consulting, Inc., based in Minneapolis. He has delivered keynote presentations at EAPA World Conferences in 2013 and 2016 and is past Chair of the EAPA Research Committee. He can be reached at mark@attridgeconsulting.com.

Dylan Davidson, B.A.A. is a Master’s student in Clinical Psychology at the University of Manitoba.  His graduate research on efforts to improve public mental health literacy is supported by the Canada Graduate Scholarship and the University of Manitoba.

Dr. Joti Samra, R.Psych. is the director of an organizational, research and media consulting practice and also maintains an active clinical practice located in Vancouver, British Columbia.  She is a national thought leader on issues relating to mental health, with particular expertise in issues relating to workplace psychological health and safety.  Joti is Co-Founder and Clinical Director of Boreal Wellness Centers, and Program Lead for the Centre for Psychological Health Sciences at the University of Fredericton. Contact her at info@drjotisamra.com or visit https://www.workplacestrategiesformentalhealth.com/centre-initiatives.


Recommendations for EA Professionals

The findings of this research study have numerous implications for the EA profession in Canada and other countries.

* EA professionals should get more involved with advancing legislation and regulatory changes that support workplace mental health. This includes serving on EAPA member chapters and industry legislative committees, as well as encouraging political advocacy among staff.
* EA professionals should educate both employees and corporate leaders about the widespread prevalence of mental health issues in the workplace and that they are preventable and treatable. Websites, smart phone apps, and other technological tools offer the modern EAP many avenues for increasing awareness and access to resources.
* EA professionals should create additional opportunities for positive media by collaborating with employers to present together at professional and business conferences on mental health topics. Individuals with appropriate experience and/or expertise can share their own stories and advice through blogs, online videos, contributing articles to business publications, and offering presentations for local civic events and community groups. As they say in Ontario, “Every door is the right door” for opportunities to raise awareness about mental health.
* EA professionals should collect better empirical data on the quality and workplace outcomes of their counseling, management, and crisis services. These metrics are needed as inputs to demonstrate the business value of EAPs to corporate clients.  EAPs can also collaborate with university professors and consultants to share their data, and thus contribute to new research on workplace mental health.

-- Mark Attridge, PhD