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: [email protected]
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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@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
[email protected] | 613-299-2924
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