Returning to Work


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Evelyn Sparks, Acting VP of Professional Practice at The Royal shared her tips for returning to work after taking a leave to recover from a mental illness.

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  • Returning to Work

    1. 1. Returning to Work? Things to Consider Evelyn Sparks, B.A, B.Sc.OT, MBA, OT Reg. (Ont.) Acting Vice President, Professional Practice
    2. 2. Statistics Mental illness-related disability claims (short-term and long-term) account for up to one third of the workplace claims, equaling approximately 70% workplace costs and translating to 33 billion dollars to the Canadian economy on an annual basis (Sroujian, 2003).
    3. 3. Disability Rights People living with mental health problems and illnesses must not only be able to access the services and supports they need to assist in their journey of recovery, but must have the opportunity to be active citizens and to participate fully in community life, as employers, workers, students, volunteers, teachers, caregivers, and parents. (Mental Health Commission of Canada, 2009).
    4. 4. Disability Rights Mental illness is a disability which is explicitly recognized under the Canadian Human Rights Act. Section 25 of the Act defines disability as including “any previous or existing mental or physical disability…” The Act prohibits discrimination in employment on the basis of a disability or on the basis of a perceived disability and requires accommodation. Canadian Human Rights Act.
    5. 5. Return to Work after Mental Illness
    6. 6. Time Away from Work • May occur gradually due to accommodations, decreased ability to the job due to symptoms of illness • May occur suddenly when it no longer becomes possible to work, possibly due to hospitalization
    7. 7. Signs of Mental Illness Look for changes and patterns. We all have off days. Clues: • Confused thinking; • Difficulty in completing tasks • Decreased tolerance of routine • Emotional outbursts or withdrawal • Heightened anxieties, fears, anger or suspicion; blaming others. • Loss of interest in preferred work • Feedback from others, “you are not yourself!”
    8. 8. And Still More Signs • Denial of obvious problems and a strong resistance to offers of help, • Dramatic, persistent changes in eating or sleeping habits, • substance abuse, • thinking or talking about suicide or self-harm. “How does mental illness interfere with work performance?”, Centre for Psychiatric Rehabilitation,
    9. 9. Possible Impact of Illness on Work Performance Essential Psychological Factors Needed for Work (Fischler et Al.) • Cognition • Pace • Persistence • Conscientiousness and Motivation • Interpersonal Functioning • Stress Tolerance • Job Specific Requirements (typing speed, people skills etc.)
    10. 10. Supporting Work The primary goal is to continue work or to return as soon as possible to work with appropriate supports.
    11. 11. Are You Ready? • Consult with your physician and care team • Consult with Occupational Health Judge for yourself: • Symptoms are coming under control • Sufficient energy to get through the day • Daily routines are in place • There is a return to work plan
    12. 12. Which Work? • One thing to consider is that your previous work might not be the best going forward • Some workplaces are difficult and lacking support • Some work does not “fit” and therefore creates stress • Some work is difficult to re-enter gradually
    13. 13. Strategies for a Successful Return
    14. 14. Employee Issues Impacting Return to Work • Symptom Management • Level of shame related to leave • Level of fear of negative judgment • Perceived level of support in the workplace • Current stress/frustration tolerance • Coping strategies with interpersonal conflicts • Level of interest/satisfaction with work prior to leave • Recovery expectations
    15. 15. Environmental Issues • Supervisory support (crucial) • Organizational culture/ willingness and ability to accommodate • Co-worker perceptions of mental health leaves • Prior relationship with employer/co-workers • Physical environment (lighting, noise level etc.) • Degree of control over work/work schedule (night shifts may no longer be possible.) • Communication between worker, insurance company, employer and health professionals.
    16. 16. Supporting Recovery Programs that address workforce needs may include: • Facilitated access to professional advice (EAP, Occ Health); • Flexible work scheduling practices; • Union representation and consultation in addressing needs where available.
    17. 17. Flexibility • Flexibility at the start or end of work hours to accommodate effects of medication or for medical appointments. • Part-time or split shifts • More frequent breaks • Graduated return to work http:/
    18. 18. Flexibility, con’t • Assigning minor task to other employees (balance of work) • Modifying the way instructions are given (i.e. written instructions may help employee focus on tasks) • Having brief weekly meeting (i.e. 10 mins) to deal with issues before they become a problem. http:/
    19. 19. Maintain Stamina • Vary tasks throughout the day • Take on some opportunities to learn new skills • Request a self-paced workload • Where possible do some of the work from home • Consider job sharing/temporary shift to part-time work • Break up big tasks into smaller ones
    20. 20. Employees Dealing with Stress • Request clear expectations • Ask for help from counselors or EAP • Ask for constructive feedback and positive reinforcement • Take needed time for doctors appointments, therapies
    21. 21. Employee Support at Home • Let loved ones know that returning to work may cause fatigue and added stress. Let them know how they can provide support. • There are support groups for family, friends or others to help them understand illness and how to best help the individual recovering from mental illness and to provide support for careproviders.
    22. 22. Reluctance to Disclose • Stigma • Safety / employment security • Privacy • Toxic workplace • Assumptions about impact on career progression
    23. 23. Whether to Disclose Reasons to Disclose: • Allows opportunities for accommodations • Creates opportunity to educate and reduce stigma • If the employee becomes unwell, work adjustments can be made more quickly • If there has been a prolonged absence the employee may wish to share the reason with the supervisor / colleagues
    24. 24. Whether to Disclose Reasons Not to Disclose: • Judgment, expertise, and actual performance may be devalued • Negative attitudes about mental illness • Illness may not impact on your performance
    25. 25. Stigma and Employment In a study by the Canadian Mental Health Association, it was shown that employees with mental health problems tend to be more loyal, have an attendance rate comparable to other employees without mental health problems and their performance level is at about the same or above those of other employees.
    26. 26. Impacts of Stigma • Delays in seeking medical attention. One-fifth will have significant mental illness, one-third of those will seek help for it. • Shame (“pull up your boots” mentality). • Reluctance to take time off work from employment with attendance management systems. • Pressure for early return as disability is invisible.
    27. 27. Self Stigmatization People with mental illness often face a double problem: symptoms of their mental illness and public stigma Brief Reports: Self-Stigma, Empowerment, and Perceived Legitimacy of Discrimination AmongWomen With Mental Illness Nicolas Rüsch, M.D., Klaus Lieb, M.D., Martin Bohus, M.D. and Patrick W. Corrigan, Psy.D. Psychiatr Serv 57:399-402, March
    28. 28. Self Stigmatization • Review your strengths • Be aware of your rights • Make use of therapies • Use the time for honest reflection • Decide what parts of the problem are actually yours and what parts are the environment • Make a plan • Celebrate successes
    29. 29. Resources Available Mental Health Works Mental Health Commission of Canada GWL Mental Health
    30. 30. References Toward Recovery & Well-Being : A Frame Work for a Mental Health Strategy for Canada (2009). Mental Health Commission of Canada. Retrieved on 10-11-2010 from Fishchler, G. Assessing Fitness-For-Duty and Return-To-Work Readiness for People with Mental Health Problems in the Minnesota Career Development Association Newsletter, The MCDA Communique, summer 2000. Retrieved on 15-11- 2010 from Fischler, G., Booth, N. Vocational Impact of Psychiatric Disorders, An Aspen Publication : Maryland, 2009. Definition of the word ‘work’, Merriam-Webster Online Dictionnary (2010). Retrieved on 17-11-2010 from http://www.merriam- Ross, J. Occupational Therapy and Vocational Rehabilitation, John Wiley & Sons Ltd : England, 2007. Saint-Arnaud, L., Saint-Jean, M., & Damasse, J. (2006). Towards an enhanced understanding of factors involved in the return-to-work process of employees absent due to mental health problems. Canadian Journal of Community Mental Health, 25(2), 303-315. Workplace strategies for mental health : Mental Health Facts and Figures. Retrieved on 10-11-2010 from : Workplace strategies for mental health : Accomodations that work. Retrieved on 10-11-2010 from : Evelyn Sparks, OT Reg. (Ont), Rosemarie Lidstone, OT Reg (Ont), Mood Disorders: Employment Issues and Dealing with Stigma, November, 2011 Emily Deacon MSW, Claude Lurette, Recovery Is Possible, Stats Can Presentation, September, 2012.