Mental Health and Psychosocial Disorders in the Workplace

THE SILENTTSUNAMI: MENTAL
HEALTH AND PSYCHOSOCIAL
DISORDERS INTHE WORKPLACE
Presented by:
Bernard L. Fontaine, Jr., CIH, CSP, FAIHA
TheWindsor Consulting Group, Inc.
Copyright @ 2017 WCG All rights reserved.

The following presentation is based on the current level of
knowledge and understanding of mental health issues and
psychosocial disorders in the workplace. Not all issues are
discussed or presented in detail due to the length of PDC.
This training doesn’t replace site or company specific training
on the recognition and control of hazards in the workplace.
Photos and videos shown may depict situations that are not
compliant with applicable OSHA and other requirements.
It is the responsibility of the employer and its employees to
comply with all pertinent OSHA rules and regulations.
DISCLAIMER
Copyright @ 2017 WCG All rights
reserved.

 Build awareness about the continuum of mental health in
the workplace;
 Compare myths and misconceptions about mental health
problems with factual information;
 Explore the impact of different forms of stigma towards
people living with mental health problems;
 Identify the indicators and workplace factors of
psychological health and safety in the workplace;
 Discuss the legal responsibilities and the roles and
responsibilities in ensuring healthy workplaces;
• LEARNING OBJECTIVES

 Explain the compelling reasons for ensuring psychological
health and safety in the workplace;
 Expand participants’ understanding of some signs and
symptoms of mental health and psychosocial problems and
discuss different support and accommodation measures;
 Examine different dimensions of mental health wellness;
 Discuss key factor for recovery from mental health
problems;
 Determine actions that can be taken to support
psychological health and safety in the workplace.
• LEARNING OBJECTIVES

WHAT IS MENTAL HEALTH?
Mental health refers to the maintenance of
successful mental activity
 Includes maintaining productive daily activities and
maintaining fulfilling relationships with others
 It also includes maintaining the abilities to adapt to change
and to cope with stresses

Is mental health really an illness?
 Yes. The brain is an organ that is susceptible to illness.
 Chemicals in the brain regulate how people think, feel and
act.
 Brain function can become affected if these chemicals are
out of balance or disrupted, contributing to mental illness.
 Thus, mental illness is a real bodily illness, not just
something “in your head.”

Does the prevalence of mental health
problems differ among different racial or
ethnic groups?
 No. The prevalence of mental health problems is similar
for all racial and ethnic groups.
 However, members of racial or ethnic minority groups
may experience greater disability from mental health
problems because of difficulties in accessing culturally
sensitive, good quality care.

Is it true that mental illness can’t be cured?
 This is a complex question. In many cases, mental illness
cannot be “cured” in the sense that it will go away and
never return.
 Most often, the symptoms of mental illness can be
eliminated or reduced and managed through treatment
with medication, therapy or a combination of both.
 For example, 80 to 90% of people with depression or
anxiety can be helped when properly assessed and
treated, though it is still possible that the illness will
return at a future time.

Are people with mental health problems likely
to be dangerous?
 No. Research shows that people with mental health
problems do not commit significantly more violent acts
than do people in the general population.
 Research does indicate, however, that substance abuse is
frequently involved in violent acts committed by
individuals with or without other mental health problems.

If someone has a mental health problem,
should they abandon their hopes for a fulfilling
career?
 No. Although mental health problems can negatively
affect individuals in a significant manner, with treatment
and appropriate work accommodations, even people
diagnosed with a serious mental illness have succeeded
famously.

Are men or women affected by mental health
issues and psychosocial disorders?
 European Foundation survey found men tend to be more
exposed to physical and chemical hazards (Kauppinen and
Kandolin, 1998) than women
 Women are more frequently exposed to emotionally
demanding work, and to work in low-status occupations
with often restricted autonomy, as compared to men (EU-
OSHA, 2002).

Is there are difference between older workers
and younger workers?
Older workers differ from those of younger workers by:
 Increased exposure to certain psychosocial risks at work;
less training over a similar period of time;
Decreased opportunities to gain further knowledge,
expertise and develop new skills;
 Less opportunities for task rotation, less support from
supervisors, less access to professional development and
discrimination in terms of selection, career development,
learning opportunities, and redundancy.

DEFINITIONS
Well-being: refers to individuals who experience stress
and discomfort from occasional problems of everyday
life, but express no impairments to daily functioning.
Emotional problems or concerns: individuals
experiencing “emotional problems”, discomfort rises to
distress level beginning with impairments in functioning.
Disorders may be mild and/or result in temporary
impairment.

DEFINITIONS
Mental Illness refers collectively to all diagnosable
mental health problems which become “clinical,”
requiring professional intervention and treatment.
Mental Disorders are health conditions characterized
by alteration in thinking, mood or behavior (or some
combination thereof) associated with distress/impaired
functioning.
Mental Distress that has not reached the level of a
diagnosable mental disorder can still be a source of
considerable suffering. Copyright @ 2017 WCG All rights reserved.

DEFINITIONS
Stress is a nonspecific response of the body to any
demand which results in symptoms such as rise in the
blood pressure, release of hormones, quickness of
breath, tightening of muscles, perspiration, and increased
cardiac activity.
Stress is not necessarily negative. Some stress keeps
us motivated and alert, while to little stress can create
other problems.Too much stress can trigger problems
with mental and physical health, over a prolonged period
of time. Copyright @ 2017 WCG All rights reserved.

DEFINITIONS
Job Stress is the harmful physical/emotional response
that occurs when job requirements don’t match the
capabilities, resources, or needs of the worker.
Job stress can lead to poor health and even injury. Long-
term exposure to job stress is linked to increased risk
of musculoskeletal disorders, depression, and job
burnout, and may contribute to a range of debilitating
diseases, ranging from cardiovascular disease to cancer.
Stressful working conditions interfered with employee’s
ability to work safely, contributing to injuries/illnesses.

DEFINITIONS
Anxiety is unpleasant feeling when worried, uneasy or
distressed about something that may/may not happen.
Agoraphobia Body Dysmorphic Disorder
Claustrophobia General Anxiety Disorder (GAD)
OCD Panic Attacks/Panic Disorder
Social Anxiety Post-Traumatic Stress Disorder
Social Phobia Disorder Health Anxiety
Phobias Fear of Flying
Depression is feelings of extreme sadness, despair or
inadequacy that last for a long time.

DEFINITIONS
Workplace bullying is repeated, unreasonable
behavior directed towards a person or group of
persons, which creates a risk to occupational health and
safety.
Unlawful harassment occurs when someone is made
to feel intimidated, insulted or humiliated because of
their race, color, national or ethnic origin; sex; disability;
sexual preference; or other characteristic. It can also
happen if someone is working in a hostile or intimidating
environment. Copyright @ 2017 WCG All rights reserved.

DEFINITIONS
Bipolar disorder is typically characterized by cycling
between elevated (manic) and depressed moods.
In a manic phase, employees may appear highly energetic
and creative, but actual productivity may suffer. During
full-blown mania, a person may become self-aggrandizing
or disruptive, flout workplace rules, be overly aggressive,
and make mistakes in judgment (overspending a budget).
During the depressive phase, an employee may exhibit
traditional depressive symptoms.Copyright @ 2017 WCG All rights reserved.

Worrying about these
pressures is NORMAL.
But feeling VERY sad,
hopeless or worthless might
be a sign of a mental health
problem.

MENTAL ILLNESS CAN OCCUR WHEN
THE BRAIN (OR PART OFTHE BRAIN)
IS NOT WORKING WELL OR IS
WORKING IN THE WRONG WAY.

When these symptoms
significantly disrupt a person’s life,
we say that the person has a
mental disorder
or a mental illness.

CONVERSATION ON MENTAL
HEALTH INTHE WORKPLACE?

Statistics Prove Mental
Illness Is More Prominent
Than You Think
 61,500,000 - Number of Americans who experience a
mental health disorder annually. That’s one in four adults.
 $100,000,000,000 - Estimated economic cost of
untreated mental illness (US). Includes unemployment,
unnecessary disability, substance abuse and more.
 70 - 90% - Percentage of individuals with mental illness
who saw improvement in their symptoms and quality of
life after participating in some form of treatment.

 800,000 – Estimated number of people globally who die
by suicide each year.
 25% - Amount of people with a mental illness who feel
that others are compassionate or understanding toward
those suffering from one of the disorders.
 350,000,000 - Number of people worldwide who are
affected by depression.
 79% - Percentage of all U.S. suicides committed by men.
Than You Think

 40,000,000 - Number of adults who suffer from anxiety
disorders in the U.S.
 22 - The (potentially underestimated) number of veterans
who die by suicide each day.
 3,500,000 - Number of Americans suffering from
schizophrenia. Disorder develops between ages 16 to 25.
 6,100,000 - Number of individuals in the U.S. who suffer
from some form of bipolar disorder.
Than You Think

 5,200,000 - Estimated number of adults who suffer from
post-traumatic stress disorder in a given year.
 7 - Number of people who die by suicide per hour in the
Americas.
 11% - Percentage of adolescents who have a depressive
disorder before the age of 18.
 90% - Percentage of people who die by suicide who also
had a mental health disorder.
Than You Think

Many mental illnesses begin
during childhood and
persist into adolescence
Some typical mental
illnesses include:
 Attention Deficit
Hyperactivity Disorder
(ADHD)
 Autism Spectrum Disorders
(ASD)
 Generalized Anxiety
Disorder (GAD
 Bipolar Disorder (Manic
Depressive Illness)

BUT… some illnesses begin
during adolescence
Illnesses that often begin
during adolescence include:
 Depression
 Disruptive Mood Disorders
 Schizophrenia
 Suicidal Thoughts
 Bipolar Disorder
 Borderline Personality Disorder
 Anxiety Disorder
 Eating Disorders
 ADHD, ADD, and ASD
 Autism
 Panic DisorderImage Credit: mohsen rasoulov

BUT… some illnesses begin
during adolescence
Illnesses that often begin
during adolescence include:
 Addiction and Substance Abuse
 Medications (antidepressants,
anti-anxiety, stimulants, mood
stabilizers, anti-psychotic drugs)
 Obsessive Compulsive Disorder
 Post-traumatic Stress Disorder
 Seasonal Affective Disorder
 Terrorisme (groups, religion,
etc.)
 Environnemental influence
 Complications of Brain TraumaticImage Credit: mohsen rasoulov

SO, WHAT ARE THE
CAUSES
OF MENTAL ILLNESS??
MENTAL HEALTH INTHE
WORKPLACE

OBSERVABLE CHANGES AT
WORK
 Decrease in personal hygiene
 Frequent complaints of fatigue or unexplained pains
 Confused or distracted appearance
 Expressions of strange or grandiose ideas
 Hyperactivity; excessive talkativeness.
 Displays of anger or blaming others
 Reported changes in patterns of eating or sleeping
 Avoidance of social interactions or public presentations
 Difficulty concentrating, making decisions, or remembering

OBSERVABLE CHANGES AT
WORK
 Flushed appearance; sweating
 Apparent daydreaming; blank stare
 Unsteady gait or slurred speech
 Red, watery eyes; pupils larger or smaller than usual
 Puffy face, blushing or paleness
 Smell of substance on breath, body or clothes
 Nausea, vomiting or excessive sweating
 Tremors or shaking of hands, feet or head
reserved.

CHANGES IN WORK
PERFORMANCE
 Frequent late arrivals
 Excess use of sick or
personal time
 Patterns in the days of
absence or ineffectual job
performance – e .g. on
Mondays or Fridays
 Decreased productivity
 Disorganization; untidy
workspace
reserved.

CHANGES IN WORK
PERFORMANCE
 Increased accidents or
safety problems
 Problems in work
relationships
 Increased errors and
missed deadlines
 Decreased interest or
involvement in work
 Decline in dependability
reserved.

FACES OF DEPRESSION
Bill Maruyama
Lawyer
Tuffy Sierra
Trauma and Recovery Specialist
Steve Lappen
Writer
reserved.

DEPRESSION DIFFERENT
IN MEN AND WOMEN
Depression signs and symptoms differ in men and women.
Men also use different coping skills — both healthy and
unhealthy — than women do.
It isn't clear why men and women may experience
depression differently. It likely involves a number of factors,
including brain chemistry, hormones and life experiences.
Other behaviors in men that could be signs of depression
include:
 Escapist behavior - spend a lot of time at work or sports
 Alcohol or drug abuse
 Controlling, violent or abusive behavior
 Irritability or inappropriate anger

PATERNAL AND MATERNAL
DEPRESSION
As many as 1 in 9 (11%) women
experience depression before, during, or
after pregnancy.
Women who experience a depressive
episode have a 25-50% chance of the
depression recurring
According to a 2010 study using data
from 1993 to 2007, about 4% of
fathers experience depression in the
first year after their child’s birth.
By a child’s 12th birthday, about 1 out
of 5 (20%) fathers will have experienced
one or more episodes of depression.

MALE DEPRESSION
Male depression often goes
undiagnosed:
 Failure to recognize depression
 Downplaying signs and
symptoms
 Reluctance to discuss
depression symptoms
 Resisting mental health
treatment

FEMALE DEPRESSION
About twice as many women as
men experience depression:
 Puberty
 Premenstrual problems
 Pregnancy
 Postpartum depression
 Perimenopause and menopause
 Life circumstances and culture
 Other conditions

MENTAL HEALTH IN THE
WORKPLACE
Sadness
Persistent sadness is one
hallmark trait of depression.
Anxiety goes hand in hand
with depression since anxious
thoughts can lead to
depression and depression can
lead to nervous thinking.
Thoughts of suicide are
common, according to the
Anxiety and Depression
Association of America.

WORKPLACE
Sleep Problems
Sleeping too much, or not
getting enough sleep, are both
potential symptoms of
depression, according to the
Mayo Clinic.
National Institute of Mental
Health points out that people
with depression may also
experience sleep
disturbances, when their
minds race and they feel
overwhelmed with
problems they must solve. Copyright @ 2017 WCG All rights reserved.

WORKPLACE
Appetite Changes
Depression can affect how
hungry people feel — either
stimulating their appetite or
suppressing, it according to
the National Alliance on
Mental Illness.
These changes in appetite can
cause physical problems
caused by extreme weight loss
or gain.

WORKPLACE
Loss of Energy
People with depression may
feel like they don’t have the
mental energy needed to get
through the day, and may
develop slower response
times, according to the
National Alliance on Mental
Illness.
Some also experience a loss of
focus -- such as having trouble
concentrating on a TV show
or newspaper article -- which
can effect their work
performance.

WORKPLACE
Physical Symptoms
Depression is well-known for
its mental symptoms, but the
condition presents an array of
physical symptoms including
stomach aches, headaches,
chest tightness, and chronic
pain according to the National
Institute of Mental Health.
Interestingly, physical exercise
can alleviate symptoms. Just
walking for 30 minutes a day
can help someone feel better,
according to Psychology
Today.

WORKPLACE
Hopelessness
People with depression often
feel a sense of hopelessness
and pessimism weighing them
down, as well as distorted
thoughts such as guilt/fault for
past failures even if they are
not to blame.

WORKPLACE
Loss of Interest
Losing interest in things that
once brought joy is a symptom
of depression. Hobbies, loved
ones -- even sex -- can lose
their appeal, according to the
National Institute of Mental
Health.

MENTAL HEALTH INTHE
WORKPLACE
 Ball State University analyzed National Health Interview
Survey (NHIS) data to determine if health and job security
were related.
 Results found that job insecure individuals in the US are
more likely to be male, racial minorities or multiracial adults
with less than a college degree and 45-64 years old.
 Males and females reported different health issues. Females
had higher rates of asthma, diabetes, work-life imbalance,
worsening general health and pain disorders - migraine and
neck pain. Males were more likely to miss more than two
weeks of work and suffer from severe chest pain, ulcers and
hypertension Copyright @ 2017 WCG All rights reserved.

STIGMA OF MENTAL HEALTH

MANAGEMENT APPROACHES
IMPACT MENTAL HEALTH
63% of managers and/or supervisors would like to receive better training to deal
with this type of situation and 43% would like to receive more support from senior
management and Human Resources (HR)

MENTAL HEALTH INTHE
WORKPLACE
 Functional disability:Any serious symptoms of mental
illness that severely interfered with life for the past year,
including limitations based on physical, sensory, and other
impairments.
 Work disability: Limitation in or inability to work as a
result of physical, mental, or emotional conditions.
 Perceived disability: Individuals who consider themselves
to have a disability or are considered by others to have one
 Disability program recipient: Anyone covered by Social
Security insurance, special education and/or a disability
pension.

THE CAUSES OF MENTAL ILLNESS ARE
COMPLICATED!!
Genetics Environment
+ →
Brain Disorder
WORKPLACE

MYTHS AND FACTS ABOUT
MENTAL HEALTH
Myth I: Mental illness is the same as mental
retardation
Facts: The two are distinct disorders.
A diagnosis of mental retardation is chiefly
characterized by limitation in intellectual functioning
as well as difficulties with certain daily living skills.
In contrast, among persons with psychiatric
disabilities, intellectual functioning varies as it does
across the general population

MENTAL HEALTH
Myth II: Recovery from mental illness isn’t possible
Facts: Long-term studies have shown that the
majority of people with mental illnesses show
genuine improvement over time and lead stable,
productive lives. For many decades mental illness
was thought to be permanent and untreatable.
People with mental illness were separated from the
rest of society through institutionalization in mental
hospitals. As medications were discovered, it
helped to alleviate the symptoms of mental illness.

MENTAL HEALTH
Myth III: Mentally ill and/or mentally restored
workers (term denotes when disorder is effectively
treated) tend to be second-rate workers.
Facts: Employers who hired these individuals
report higher than average in attendance and
punctuality and as good or better than other
employees in motivation, quality of work, and job
tenure.
Also, there were no differences in productivity
when compared to other employees.

MENTAL HEALTH
Myth IV: People with psychiatric disabilities cannot
tolerate stress on the job.
Facts: Workers with psychiatric disabilities vary in
their response to stressors on the job. In essence,
all jobs are stressful to some extent.
Productivity is maximized when there is a good
match between the employee’s needs and working
conditions, whether or not the individual has a
psychiatric disability.

MENTAL HEALTH
MythV: Mentally ill or mentally restored individuals
are unpredictable, violent, and dangerous
Facts: Vast majority of people are not dangerous
or violent. Upon learning that an applicant has a
mental illness, some employers may expect that the
individual is likely to become violent.
This myth is reinforced by portrayals in the media
of people with mental illnesses as frequently and
randomly violent.

MENTAL HEALTH
 MythVI: Exposure to chemicals can’t affect mental
and physical health, impair judgement or behavior
 Facts: Chemicals influencing CNS/PNS by: numbness,
confusion, slurred speech, impaired sight, memory
lapses, decreased muscle strength or coordination.
 Lead, cadmium, and mercury – Batteries and electronics
 Bisphenol A – polycarbonate plastics and epoxy resins
 Polybrominated diphenyl ether (PBDEs) – flame retardant
 Polychlorinated biphenyls (PCBs) – Coolants and lubricants
 Chlorpyrifos and DDT – pesticides
 Toluene – industrial solvent
 Tetrachloroethylene (PERC) – solvent/degreasing agent

MENTAL HEALTH AT WORK:
MAKING A DIFFERENCE

HOW MENTAL HEALTHY
IS YOUR BUSINESS?

Thinking
When the brain is not working
properly, one or more of its 6
functions will be disrupted
Perception
Emotion Signaling
Behavior
Physical
MENTAL HEALTH INTHE
WORKPLACE

Symptoms can include:
Sleep problemsExtreme emotional
highs and lows
Thinking difficulties
or problems
focusing attention
MENTAL HEALTH INTHE
WORKPLACE

MENTAL HEALTH INTHE
WORKPLACE
 Symptoms of mental illness
result from abnormal brain
function
 Mental illness is a brain
disorder
 Mental illness is rarely if ever
caused by stress alone

What do we know about the causes of mental
illness?

MENTAL HEALTH INTHE
WORKPLACE
 Not a consequence of bad
behavior
 Not a result of personal
weakness/deficits in personality
 Not a manifestation of
malevolent spiritual intent
 Only in exceptional cases is it
caused by nutritional factors
 Not caused by poverty
What do we know about the causes of mental
illness?
 Copyright @ 2017 WCG All rights reserved.

What do we know about
people with mental illnesses?
Most people with mental disorders live
productive and positive lives while receiving
treatments for their mental illness.
Some people have severe and persistent
mental disorders which respond poorly to
current treatments (as in all other illnesses)
Mental illness does not respect any boundaries
of race, class or geography.
The majority of people have a friend,
acquaintance or family member who has or has
had a mental disorder.
Image Credit: Paulo Correa aka Nookiez -
http://www.sxc.hu/profile/nookiez
MENTAL HEALTH INTHE
WORKPLACE

Do you ever…Do you ever…
• Often feel very angry or very worried?
• Do reckless things that could harm you or others?
• Feel very sad or grieve a long time after a loss or a death?
• Think your mind is controlled or out of control?
• Use alcohol or drugs?
• Exercise, diet and/or binge-eat obsessively?
• Hurt other people or destroy property?
If you feel any of these things, it
might help to talk to a friend, clergy,
crisis counselor, psychiatrist,
psychologist or your primary
physician

Mental health problems can beMental health problems can be
treated!treated!
More Americans have access to
insurance and treatment increased,
as healthcare reform has reduced
the rates of uninsured adults. 19%
of adults remain uninsured in
states that did not expand
Medicaid. 13% of adults remain
uninsured in states that did expand
Medicaid. Copyright @ 2017 WCG All rights reserved.

Mental health problems can beMental health problems can be
treated!treated!
But most Americans still lack
access to care.
56% of American adults with a
mental illness did not receive
treatment. Even in Vermont, the
state with the best access, 43% of
adults with a mental illness did
not receive treatment.

There is a serious mental healthThere is a serious mental health
workforce shortage.workforce shortage.
In states with the lowest
workforce, there's only one (1)
mental health professional per
1,000 individuals.
This includes psychiatrists,
psychologists, social workers,
counselors, and psychiatric nurses
combined.

STATES WITH MOST MENTALSTATES WITH MOST MENTAL
HEALTH PROFESSIONALSHEALTH PROFESSIONALS

SIGNS OF MENTAL HEALTHSIGNS OF MENTAL HEALTH
ISSUES INTHE WORKPLACEISSUES INTHE WORKPLACE

WHAT IS A PSYCHOLOGICAL
DISORDER?
"...a syndrome characterized by clinically significant disturbance in an
individual's cognitive skills, emotion regulation, or behavior that reflects
a dysfunction in the psychological, biological, or developmental process
underlying mental functioning. Mental disorders are usually associated
with significant distress in social, occupational, or other important
activities.“ (American Psychiatric Association)
reserved.

MENTAL HEALTH INTHE
WORKPLACE
 Stress
 Common medical health conditions
 Mental health disablement
 Absenteeism, withdrawn behavior, greater risk of injury/illness
 Returning to work, strain from fatigue, burnout and anxiety
 Conflict, turnover, loss of productivity, increased costs
 Other medical health conditions
 Learning disability, dementia
 Severe and enduring mental health illness
 Medications including illegal drugs and alcohol
 Physical illness Copyright @ 2017 WCG All rights
reserved.

EFFECTS ON WORKPLACE
ENVIRONMENT
Presence of mental health problems can affect
the work environment in many ways:
Negative impact on team work and co-operation
Heavier workloads for coworkers
Distraction of coworkers
Problems with morale
Increase in workplace errors, accidents and injuries
Illegal activities at work including drinking and selling illicit
drugs compromise other employees
reserved.

ANNUAL DIRECT AND INDIRECT
COST OF MENTAL ILLNESS
Total costs associated with
serious mental illness,
those disorders that are
severely debilitating and
affect about 6% of the adult
population, to be in excess
of $300 billion per year.
reserved.

COST OF MENTAL ILLNESS FOR
ALL AMERICANS
Among all Americans,
36.2 million people
paid for mental health
services totaling $57.5
billion (2006). This
means the average
expenditure per person
was $1,591.

TOTAL EXPENSE FOR MOST
COSTLY MEDICAL CONDITIONS
This places mental
health care
expenditures as the
third most costly
medical condition,
behind heart
conditions and trauma
and tied with cancer.

COST OF MENTAL ILLNESS FOR
ALL AMERICANS (1996-2006)
Over this 10 year period,
the number of Americans
paying for mental health
services increased
87.6% and total
expenditures on mental
health services
increased 63.4%.

CALCULATED COST OF STRESS
AND MENTAL HEALTH
 Matteson and Ivancevich (1987) and Rosch (2001) calculated the annual
cost of workplace stress to the US economy was US $300B
 Hoel et al. (2001) estimated that 30% of sickness absence is directly caused
by stress
 Leymann (1990) estimated that USA mobbing (harassment) costs
organizations between US $30,000 - $100,000 per victim
 Greenberg and colleagues (2003) calculated the cost of depression in the
USA was US $83.1B. Figure comprised medical costs (US $26.1B), suicide-
related mortality costs (US $5.4B) and workplace costs (US $51.5B)
 Besides depression, additional costs associated are cardiovascular disease,
diabetes, and musculoskeletal disorders
reserved.

CALCULATED COST OF STRESS
AND MENTAL HEALTH
Presenteeism Cost Business 10X MoreThan Absenteeism
On average, employees cost businesses the equivalent of three (3)
months per year in lost productivity (Global Corporate Challenge)
Presenteeism – the phenomenon where employees show up for work
but don’t perform at full capacity – included nearly 2,000 employees and
validated against the WHO’s Workplace Health and Productivity
Questionnaire (HPQ).
The cost of presenteeism to businesses is 10 times higher than
absenteeism. Absent workers cost employers around $150 billion
USD per year, but those who came to work and were not fully
productive cost $1.5 trillion USD per year.
reserved.

PREVALENCE OF MENTAL
HEALTH INTHE WORKPLACE
Data Source: CDC. Behavioral Risk Factor Surveillance System, 2003-
Behavioral Risk Factor Surveillance System (BRFSS)-Appalachian and the Mississippi Valley
regions have high/increasing FMD and upper Midwest had low/decreasing FMD
prevalence
FMD – Frequency of
Mental Distress

Behavioral Risk Factor Surveillance System, United States, 2006
Prevalence of serious psychological distress among adults aged ≥18 years, by state
quartile

Prevalence of depression* among adults aged ≥18 years, by state quartile

Mean number of mentally unhealthy days during past 30 days among adults
aged ≥18 years, by state quartile

WHERE ISTHE LEVEL OF
MENTAL ILLNESS HIGHEST?
Depression estimates generally are highest in the Southeastern states (e.g.,
13.7% in Mississippi and West Virginia vs. 4.3% in North Dakota).

LET’STALK ABOUT MENTAL
HEALTH
Sometimes it is as simple as
asking “how are you?”

WHY IS MONITORING MENTAL
ILLNESS IMPORTANT?
 According toWHO, mental illnesses account for more disability in
developed countries than any other illness, including cancer and
heart disease
 About 25% of all U.S. adults have mental illness and nearly 50% of
U.S. adults will develop at least one mental illness in their lifetime
 Mental illness is associated with increased occurrence of chronic
diseases such as cardiovascular disease, diabetes, obesity, asthma,
epilepsy, and cancer
 Mental illness is associated with lower use of medical care,
reduced adherence to treatment therapies for chronic diseases,
and higher risks of adverse health outcomes
 Mental illness is associated with use of tobacco products and
abuse of alcohol

WHY IS MONITORING MENTAL
ILLNESS IMPORTANT?
 Rates for both intentional (e.g., homicide, suicide) and
unintentional (e.g., motor vehicle) injuries are 2-6 times higher
among people with a mental illness than the overall population
 Population-based surveys and surveillance provide evidence
needed to guide effective mental health promotion, mental illness
prevention, and treatment programs
 Provide organizations the data they need to assess the need for
mental and behavioral health services
 Many mental illnesses can be managed successfully, and increasing
access to and use of mental health treatment services
 Many chronic illnesses are associated with mental illnesses

COMMON SIGNS AND
SYMPTOMS OF ANXIETY

COMMON SIGNS AND
SYMPTOMS OF DEPRESSION
reserved.

SEVEN (7) REASONSTO DISPEL
MENTAL HEALTH CONCERNS
 Alleged corruption by the
pharmaceutical industry
 Invalid diagnosis of mental illnesses and
disorders
 Scientifically unreliable diagnoses
 Biochemical (serotonin) imbalance
 Pseudoscientific drug effectiveness
research
 Psychotropic drug hypocrisy
 Diversion from societal, cultural and
political misery

PERSONAL RISK FACTORS
 Personal or family history of anxiety/depression
 Divorce or separation
 Financial stress
 Traumatic event
 Physical health problems
 Abuse of alcohol or drugs
 Loneliness or isolation
 Caring for loved one who is unwell
 Death of a loved one
reserved.

PERSONAL PROTECTIVE
FACTORS
 Support from family and friends
 Exercise
 Eating well
 Good sleep patterns
 Financial stability
 Hobbies
 Sense of self worth and/or achievement
reserved.

WORKPLACE MENTAL HEALTH:
A MANAGER’S PERSPECTIVE

PERSONAL RISK FACTORS
Physical and mental health are a complex interplay
between many individual and environmental
factors:
Family history of illness and disease/genetics
Lifestyle/health behaviors (smoking, exercise, substance use)
Levels of personal and workplace stress
Exposure to toxins
Exposure to trauma
Personal life circumstances and history
Access to supports (e.g., timely healthcare, social supports)
Coping skills Copyright @ 2017 WCG All rights
reserved.

WORKPLACE RISK FACTORS
Examples of job control stressors include:
Lack of control over your work
Lack of recognition for work done
Job insecurity and fear of layoffs
Harassment
Lack of respect from supervisors
Racism and Sexism
Age discrimination
Inadequate pay or compensation
Isolation from fellow employees either physically/psychologically and
Lack of promotion opportunities
reserved.

WORKPLACE RISK FACTORS
Examples of job demand stressors include:
Contracting out work
Fragmentation/job declassification
Poor ventilation, heating, and/or lighting
Forced overtime – fatigue, personal stress
Shift-work – fatigue, mental cognition
Speed-ups – physical and mental demands
Conflicting job demands
Physical danger – workplace violence, bullying, fatigue
Fear of accident or even death on the job
Poor computer workstation design
Monitoring (e.g.,AWT standards)
Lack of training specific to the job task/operation, and
Unnecessary paperwork Copyright @ 2017 WCG All rights

STRESS INTHE WORKPLACE
 Characteristics of healthy work organizations
 Work organization interventions to promote safe and healthy
working conditions
 Surveillance of the changing nature of work
 Work organization interventions to reduce MSDs among
office operators
 Work schedule designs protect the health and well-being of
workers
reserved.

 The effects of new organizational policies and practices on
worker health and safety
 Changing worker demographics (race, ethnicity, gender, and
age) and worker safety and healt
 Work organization, cardiovascular disease, depression,
hypertension, infertility and irregular menstrual cycles, trouble
concentrating, digestive problems, anxiety, appetite, sexual
dysfunction, short-term memory loss, insomnia and fatigue,
and stroke
 Psychological violence in the workplace
reserved.

SIGNS OF PSYCHOLOGICAL
STRESS
 Physical - fatigue, body aches and pains, nausea, headache, rapid
heart rate, sweats and chills, and muscle twitching
 Cognitive - confusion, disorientation, poor concentration or
alertness, memory problems, sleep disturbances, and nightmares
 Emotional – anxiety, fear, irritability, anger, depression, sense of
failure, helplessness, feeling overwhelmed
 Behavioral – denial, distrust, blame, withdrawal, inability to relax,
excessive worry, substance abuse
Both physical and psychosocial hazards combined had a stronger effect
on Musculoskeletal Disorders (MSDs) than separately.
reserved.

MANIFESTATION OF
PSYCHOLOGICAL STRESS
 Mild, Transient Distress
 Acute Stress Disorder
2 to 28 days after event
 Post-Traumatic Stress Disorder
More than 4 weeks after
event
 Depression
Persistence over 2 months
after event
reserved.

JOB CONDITIONSTHAT MAY
LEADTO STRESS
The Design of Tasks. Heavy workload, infrequent rest breaks, long work hours and
shiftwork; hectic and routine tasks that have little inherent meaning, do not utilize
workers' skills, and provide little sense of control.
Example: David works to the point of exhaustion. Theresa is tied to the computer,
allowing little room for flexibility, self-initiative, or rest.
reserved.

LEADTO STRESS
Management Style. Lack of participation by workers in decision- making, poor
communication in the organization, lack of family-friendly policies.
Example: Theresa needs to get the boss's approval for everything, and the
company is insensitive to her family needs.
Interpersonal Relationships. Poor social environment and lack of support or
help from coworkers and supervisors.
Example: Theresa's physical isolation reduces her opportunities to interact
with other workers or receive help from them.
Work Roles. Conflicting or uncertain job expectations, too much responsibility,
too many "hats to wear."
Example: Theresa is often caught in a difficult situation trying to satisfy both
the customer's needs and the company's expectations.
reserved.

LEADTO STRESS
Career Concerns. Job insecurity and lack of opportunity for growth,
advancement, or promotion; rapid changes for which workers are unprepared.
Example: Since the reorganization at David's plant, everyone is worried about
their future with the company and what will happen next.
Environmental Conditions. Unpleasant or dangerous physical conditions such
as crowding, noise, air pollution, or ergonomic problems.
Example: David is exposed to constant noise at work.
reserved.

EARLY WARNING SIGNS OF JOB
STRESS
Cardiovascular Disease -
Many studies suggest that psychologically demanding jobs that allow employees little
control over the work process increase the risk of cardiovascular disease.
Musculoskeletal Disorders -
On the basis of research by NIOSH and many other organizations, it is widely
believed that job stress increases the risk for development of back and upper-
extremity musculoskeletal disorders.
Psychological Disorders -
Several studies suggest that differences in rates of mental health problems (such as
depression and burnout) for various occupations are due partly to differences in job
stress levels. (Economic and lifestyle differences between occupations may also
contribute to some of these problems.)

EARLY WARNING SIGNS OF JOB
STRESS
Workplace Injury -
Although more study is needed, there is a growing concern that stressful working
conditions interfere with safe work practices and set the stage for injuries at work.
Suicide, Cancer, Ulcers, and Impaired Immune Function -
Some studies suggest a relationship between stressful working conditions and these
health problems. However, more research is needed before firm conclusions can be
drawn.
reserved.

PSYCHOLOGICAL COST OF
UNSAFE WORKPLACE
High demand, low control, high effort and low reward
jobs are more likely to suffer adverse consequences.
POTENTIAL HEALTH COSTS POTENTIAL PERFORMANCE COSTS
 3× Heart problems  Reduced adaptability
 3× Back pain  Reduced ability to cope with change
 5× Certain types of cancer  Impaired learning
 2-3× Injuries of all types  Increased helplessness
 2-3× Infections  Increase passivity/aggression/conflict
 2-3× Conflicts
 2-3× Mental health problems
 2-3× Substance abuse

At a minimum, construct a stress prevention program
should include the following:
Building general awareness about job stress (causes, costs, and
control)
Securing top management commitment and support for the
program
Incorporating employee input and involvement in all phases of
the program
Establishing the technical capacity to conduct the program
(e.g., specialized training for in-house staff or use of job stress
consultants)
PREVENT STRESS AT WORK: A
COMPREHENSIVE APPROACH
reserved.

 Pace yourself
 Take frequent rest breaks
 Mental fatigue increases risk of injury
 Take breaks away from work areas
 Try to maintain a normal schedule
 Regular eating and sleeping times
 Drink plenty of water
 Avoid the use of caffeine when possible
 Eat a variety of foods
 Increase intake of complex carbs
REDUCING PSYCHOLOGICAL
STRESS - EMERGENCIES
reserved.

 Communicate with loved ones
 Choose your own comfort level
 Avoid substance abuse
 Practice stress/relaxation
techniques
 Accept what you cannot change
 Formal mental health support
REDUCING PSYCHOLOGICAL
STRESS
reserved.
(Photo courtesy of Thomas J Ratke)

 Be aware of psychological stress
factors
 Monitor levels of stress
 Yourself
 Other co-workers
 Seek assistance
 Severe psychological disorder
 Contact a health professional
immediately
PREVENTING PSYCHOLOGICAL
STRESS
reserved.
(Photo courtesy of Thomas J Ratke)

IMPACT OF MENTAL HEALTH IN
THE WORKPLACE
Impact on the individual:
 Increased number of days off
 Reduced personal finances (if worker has no sick
leave)
 Reduced quality of life
Impact on the workplace:
 Lower team morale
 Increased workload and reduced team productivity
reserved.

WORKPLACE RELATED
RISK FACTORS
 High workload, or not enough work
 Tight deadlines
 Bullying
 Conflict at work
 Job insecurity/redundancy/job loss
 Lack of support
 Poor work-life balance
 Unclear work role
 Workplace violence
reserved.

WORKPLACE RELATED
RISK FACTORS
reserved.

WHAT WORKERS SAY ABOUT
 One-fourth of employees view their jobs as the number one
stressor in their lives.
-Northwestern National Life
 Three-fourths of employees believe the worker has more on-
the-job stress than a generation ago.
-Princeton Survey Research Associates
 Problems at work are more strongly associated with health
complaints than are any other life stressor - more so than
even financial problems or family problems.
-St. Paul Fire and Marine Insurance Co
reserved.

WORKPLACE RELATED
PROTECTIVE FACTORS
 Effective mental health policies and programs
 Good leadership
 Strong team morale
 Involvement in decision-making
 Flexible working conditions
 Social activities
 Access to support at work
 Effective training
reserved.

THINGSTO DO AND
NOT DO AT WORK
DO
 Talk to them in a quiet place
 Break the ice by talking about something neutral
 Listen without judgment
 Encourage the person to take action and succeed expectations
 Motivate, build self-esteem, and encourage team success
DON’T
 Ignore or avoid the person
 Try to fix their problems
 Talk about your own problems
DON’T SAY
 “Harden up”;“Get over it, you’ll be fine”
 “It’s not my problem, I don’t want to get involved”
 “You’re worrying about nothing”

FIVE WARNING SIGNS OF
ESCALATING BEHAVIOR
 Confusion
 Frustration
 Blame
 Anger
 Hostility

OSHA WORKPLACEVIOLENCE
INFORMATION

WORKPLACEVIOLENCE
INFORMATION
Reality in the Modern Workplace
Every organization is vulnerable to workplace violence
Workplace violence is devastating to the organization
Employee
Safety
Employee
Morale
Employee
Retention
Employer
Reputation

WORKPLACEVIOLENCE
INFORMATION
Problem Cannot Be Ignored
Murders
 11 persons each workday worldwide, including two a day in US
 Assaults and Threats
 More than half a million at work annually in North American
 Workplace Violence as an Occupational Hazard
 Third (3rd
) leading cause of death at work
 Cost to Business
 $70B annually (US) - $64.4B lost in productivity (U. of Georgia)

WITH SUPPORT PEOPLE CAN…
 Recover from anxiety and depression
 Continue to work effectively and be productive
 Have fulfilling and meaningful lives
Work plays a vital role in an
individual’s recovery

MENTAL HEALTH INTHE
WORKPLACE
TheValue ofWell-Being
Mental health concerns are not only related to workers but
leadership style, behavior and culture.
Physical injury/illness may require medical help just like
psychological/emotional injury or illness

SIX CRITERIATO DETERMINE
NORMAL FUNCTION
 Efficient perception of reality (events and personal ability)
 Self knowledge and self-awareness (understanding one’s own
behavior and motivation)
 Ability to exercise voluntary control over behavior (control of
compulsivity)
 Self esteem and acceptance (feeling of self worth)
 Ability to form affectionate and meaningful relationships
(empathy with autonomy)
 Productivity (energy, motivation, and focus)
reserved.

MENTAL HEALTH INTHE
WORKPLACE
Signs of a potential problem
 Appearance – unkempt, inappropriate clothing, hygiene
 Mood swings – elation/depression, nervous, suspicious,
extreme sensitivity, irritability, withdrawn, sickness/death
 Behavior/Actions – argumentative, physically threatening,
overly talkative, resist change, outburst, personal calling,
and frequent complaining – blaming others
 Absenteeism – excessive sick leave, frequent pattern of
absences/unscheduled time off, improper reporting
absence, improbable excuses, on-the-job absenteeism
reserved.

MENTAL HEALTH INTHE
WORKPLACE
Signs of a potential problem
 Performance/Production – missed deadlines, mistakes, poor
judgement, forgetfulness, periods of highs/lows, carelessness,
decreased ability to perform complex tasks, work left
undone, complaints about work, growing disorganization
 Relationships at Work – communication breakdowns,
overreaction to real/imaged criticism, frequent criticism of
work or co-workers, abrasiveness, inappropriate behavior,
persistent transfer request, borrowing money
 Mishaps/Near Misses – accidents on- and off-the-job,
physical complaints on the job.
reserved.

MENTAL HEALTH INTHE
WORKPLACE
Common Mental Health Issues
 Depression
 Anxiety/Panic
 Substance Abuse
 Personality Disorders
 Paranoia/Thought Disorders
 Psychosis
 Bipolar Disorder
reserved.

HAZARD ANALYSIS FOR MENTAL
HEALTH
Sources of information for hazard and risk evaluation for
the psychosocial work environment include:
Health and safety committee reports, minutes and/or
suggestions
Workplace health committee reports, minutes and/or
suggestions
Worker concerns and complaints during workplace inspections
Worker behavior change, performance reviews or exit
interviews
Previous workplace risk assessments
Change reviews for increase production, profits, and
performance

HAZARD ANALYSIS FOR MENTAL
HEALTH
Sources of information for hazard and risk evaluation
for the psychosocial work environment include:
Incident investigations (if probes are deep enough into root
causes)
Absenteeism, short- and long-term disability claim data
Surveys for work-life balance, perception or employee
engagement
Data regarding the nature of health benefit claims and EAP
usage
Postings on social media, emails, or other communications

WHY MENTAL HEALTH
MATTERS INTHE WORKPLACE
Occupational Setting:
 Personal factors
 Social influences
 Environmental influences
Strain = consequences of stress:
 Behavioral – alcohol/drug abuse
 Psychological – burnout
 Physical – cardiovascular, ulcers
 Work-related – absenteeism

SIGNS AND SYMPTOMS OF
DISTRESS INTHE WORKPLACE
 When untreated or poorly treated – what emotional
distress or mental illness looks like relative to work
performance and productivity.

WHY MENTAL HEALTH
Job Stressors Examples
Factors unique
to the job
• Workload (overload and underload)
• Pace/variety/meaningfulness of work
• Autonomy (e.g. the ability to make your own
decisions
about your own job or about specific tasks)
• Shiftwork/hours of work
• Physical environment (noise, air quality, etc.)
Role in the
organization
• Role conflict (conflicting job demands, multiple
supervisors/managers)
• Role ambiguity (lack of clarity about responsibilities,
expectations, etc.)
• Level of responsibility

WHY MENTAL HEALTH
Job Stressors Examples
Career
Development
• Under/over-promotion
• Job security (fear of redundancy either from
economy,
or a lack of tasks or work to do)
• Career development opportunities
• Overall job satisfaction
Relationships
at Work
• Supervisors; coworkers; subordinates
• Threat of violence, harassment, etc. (threats to
personal safety)
Organizational
structure and
climate
• Participation or non-participation in decision-making
• Management style
• Communication patterns

WHY MENTAL HEALTH

WHY MENTAL HEALTH
Accommodating mental health problems at work makes
good business sense:
 Costs for providing accommodations are fairly low; usually
well under $500
 For those who get treatment, the employer can save
between $5,000 to $10,000 per employee per year in the
cost of prescription drugs, sick leave, and average wage
replacement
 Employees diagnosed with depression and take appropriate
medication will save their employer an average 11 days a
year in prevented absenteeism
reserved.

WHY MENTAL HEALTH
 Westinghouse: Prevalence rates for major depression
were 17% for women and 9% for men.
 Pacific Bell: Depression accounted for 11% of all days lost
from work during one year and resulted in half the total
time lost due to mental health problems.
 Wells Fargo Bank: Employee survey at revealed that 30% -
35% of respondents experienced depressive
symptoms. The incidence of clinical depression could be as
high as 12% to15%.
reserved.

MENTAL HEALTH INTHE
WORKPLACE
Why don’t people speak up when they see
others in distress?
 Fear of invading privacy
 Perception that it is not allowed or not businesslike to
reach out
 Lack of comfort and not knowing how
Why don’t people seek help on their own?
 Don’t want to admit that they are unwell.
 Afraid that it will adversely affect their work status
 Embarrassed due to stigma about emotional distress and
mental illness
 Feel alone Copyright @ 2017 WCG All rights
reserved.

WHY MENTAL HEALTH
Many people face mental health problems during their
prime working years:
 Depression will rank second only to heart disease as the
leading cause of disability worldwide by the year 2020
 Disability represents anywhere from 4% to 12% of payroll
costs in Canada; mental health claims (especially
depression) have overtaken cardiovascular disease as the
fastest growing category of disability costs in Canada
 In Great Britain, stress-related sickness absences from
work cost an estimated £4 Billion annually
 Stress, burnout and physical or mental health issues are the
main issues limiting productivity

WHY MENTAL HEALTH
High stress levels and mental health problems can cause
other health conditions
 Excessive stress has been linked to infectious disease and
cardiovascular problems, higher incidence of back pain,
repetitive strain injuries (RSIs), colorectal cancer
 Stress on the job can double the risk of heart attack
 Employees at three major American companies who
displayed chronic symptoms of depression were twice as
likely to miss work due to health reasons, and seven times
as likely to report missed workdays at the time of the
follow-up survey
reserved.

WHY MENTAL HEALTH
Early identification, intervention and treatment can be
important to successful recovery:
 When someone experiences a mental health problem and treatment is
given in first few months of their illness, early recovery is more likely;
early detection and treatment also reduces the likelihood of a chronic
mental health problem
 When short-term disability becomes long-term, there is a lesser chance
the person will be able to return to previous levels of proficiency
Stigma and discrimination can discourage people from
seeking help:
 In response to societal stigma and negative stereotypes about mental
illness, people often conceal symptoms and fail to seek treatment

WHY MENTAL HEALTH
Promoting mental health benefits workers and
organizations:
Husky Injection Molding systems estimates it has saved $8M in reduced
absenteeism, higher productivity, and better use of resources, from a $4M
investment in employee well-being and a healthy workplace environment,
With programs such as an on-site parent resource center and extended
benefits:
Absenteeism rates in were 2.25 days per Husky employee per year,
compared to the Canadian average of 5.7 days per year
Annual per employee drug costs for Husky’s workforce were $153 as
compared to $495 average for similar businesses
reserved.

WHY MENTAL HEALTH
 Viable, steady income contributes to stability and wellness
 If people are unemployed, very difficult to carry on and see a
purpose in life if older and prospects of finding work not good
 ‘Adjustment disorder’ is difficulty making change to a new status
not chosen such as moving from working to nonworking status.
 Hazards include:
 Depression and anxiety
 Worry and fatigue
 Increase in substance abuse/gambling
 Stressed family and interpersonal relationships
 Boredom, anger and sadness
 Poor self-esteem or self-image Copyright @ 2017 WCG All rights
reserved.

WHY MENTAL HEALTH
 Depression ranks among the top three workplace problems for
employee assistance professionals, following family crisis and stress.
 Leading mental health (medical) and disability cost is related to
depressive disorders.
 3% of total short-term disability days are due to depressive
disorders, and 76% of those cases are female workers.
 Annual economic cost of depression (1995) was $600/depressed
worker. Nearly 1/3 of the costs were for treatment and 72% of the
costs related to absenteeism and lost productivity at work.
 Almost 15% of those suffering from severe depression will commit
suicide.
reserved.

WHY MENTAL HEALTH
Employee Concern for Psychological Health and Safety
at Work
A 2012 survey completed by Ipsos Reid, with more than 6,600 employees,
indicates that 70% of Canadian employees report some degree of concern
with psychological health and safety in their workplace (Ipsos Reid, 2012)
14% of employees disagreed that their workplace was psychologically
healthy and safe. 30% report levels of concern that warrant serious attention
(Ipsos Reid, 2012)
Over 50% of employees reported experiencing frustration, exhaustion or
irritation sometimes or often in the previous month. About a quarter
reported experiencing anxiety, helplessness or depression (Ipsos Reid, 2012)
reserved.

WHY MENTAL HEALTH
at Work
Over 25% report feelings that no matter what they did, it would never be
enough to please their manager/employer (Ipsos Reid, 2012)
46% believe that economic uncertainty has had a negative impact on their
workplace and 22% worried about losing their job (Ipsos Reid, 2012)
60% of managers/supervisors say dealing with conflict is one of the most
stressful parts of their job (Ipsos Reid, 2012)
Frequently cited factors deemed very or fairly stressful included frustration
with poor management (54%), and not enough support from managers (47%)
(MindYouGov survey, 2014)
reserved.

WHY MENTAL HEALTH
at Work
Employees with a previous disability claim related to mental illness are
almost seven times more likely to have another disability claim related to
that illness than someone with no previous disability episode related to
mental illness (Dewa, Chau & Dermer, 2009)
One survey showed that 38.6% of respondents would not tell their current
manager if they were experiencing a mental health problem (Dewa, C.S.,
2014).
Psychologically healthy and safe work environments can be protective even
for those who are not seeking accommodation.
reserved.

WHY MENTAL HEALTH
Preventing Stress at Work: A Comprehensive
Approach

WHY MENTAL HEALTH
 Moderators of Stress:
 Individual’s characteristics – coping styles, personality, self-
esteem,Type A, B
 Social relationships – co-workers, bosses, clients, home-
life
 Environment – support from others
 Culture of the organization, trust, authority, discretion,
control
 These moderators may magnify, reduce or enable
strain

WHY MENTAL HEALTH
Promoting mental health benefits workers and
organizations:
In the US, psychiatric hospital admissions at Chrysler went down 12% in a
year, and their length of stay in hospitals dropped 22%, due to that company’s
efforts to achieve higher rates of earlier detection via better psychiatric
health benefit programs and greater success in matching diagnosis and
treatment methods
57% of graduating business students rate that maintaining a balance between
work and personal life as their primary career goal and a key to choosing
their first employer. Most believe a career and personal goals can be
developed in tandem, and say a working schedule that allows them to see
family and friends on a predictable basis is key to work-life balance
reserved.

MENTAL HEALTH MATTERS IN
THE WORKPLACE?

MENTAL HEALTH INTHE
WORKPLACE
Resources
 Employee Assistance Program (EAP)
 Fitness for Duty Evaluation
 Local Area Hospitals
 Crisis Hotlines and Bereavement Counselors
 Religious Leaders and Clergy
 Community Agencies
 Local Law Enforcement for Crisis Intervention
 Occupational Health Psychologists
 Certified Social Workers
 Psychologist and Psychiatrists

MENTAL HEALTH INTHE
WORKPLACE
Resources
 National Institute for Mental Health (NIMH)
 Anxiety and Depression Association of America
 Depression and Bipolar Support Alliance
 Mental Health America
 National Alliance on Mental Illness
Treatment andTherapies
 Meditation
 RelaxationTechniques
 Yoga for Health
 Classes for Health Mind and Body, Friendship. etc.

 There may be occasions where supervisors or managers are
worried a worker who may be in danger of either hurting
themselves or others. Workers may be under the influence of
drugs and/or alcohol.
 This could be related to mental illness, suicide attempts,
workplace or domestic violence, terrorism, and other stress.
 In these situations, whether the person has mental illness or not,
managers have an obligation to take action to try to prevent risks
to workplace health and safety.
 Contacting local authorities and seeking internal or outside
support for intervention strategies to reduce or eliminate the
situation.
MANAGERS: WHATTO DO FOR
WORKER HEALTH AND SAFETY
reserved.

PROMOTING MENTAL HEALTH
INTHE WORKPLACE
 A psychologically safe and healthy
workplace is one that promotes
workers' mental well-being and
does not harm employee mental
health through negligent, reckless or
intentional ways
 A psychologically safe workplace
would be free of excessive fear or
chronic anxiety
 An organization's commitment has
to start at the top

INTHE WORKPLACE
Eight strategies employers can use to encourage
positive mental health:
Encourage active employee participation and decision making
Clearly define employees' duties and responsibilities
Promote work-life balance
Encourage respectful and non-derogatory behaviors
Manage workloads
Allow continuous learning
Have conflict resolution practices in place
Recognize employees' contributions effectively

INTHE WORKPLACE
Other strategies to encourage positive mental health:
Anger management and building self-esteem workshops
Assess psychological safety in the workplace and develop a
plan to address it
Develop a policy statement on mental health
Explicitly include mental health and psychological safety in
meetings, briefs, and discussions
Develop policies and practices for substance abuse and
workplace harassment, violence and bullying
Provide mental health education/training to everyone

PREVENT WORKPLACEVIOLENCE
A COMPREHENSIVE APPROACH
External Risks
 Don’t work late at night or early in the
morning
 Call for security escort if working late
 Carry mobile phone and report issues
 Redesign workspace to prevent
entrapment
 Train staff to diffuse violent behavior
 Use mirrors in hallways intersections
 Good lighting indoors and outdoors
 Control access to work areas
reserved.

PREVENT WORKPLACEVIOLENCE
Internal Risks
 Confidential survey of all employees
to uncover internal risk factors,
coupled with analysis of risk factors
 Share overall risk and gap analysis to
leadership, along with supporting facts
 Training at all levels of organization
 Sensitivity training for high-risk
employees, as necessary
 Follow-up survey to gauge impact of
training and management changesCopyright @ 2017 WCG All rights
reserved.

PREVENTING STRESS AT WORK:

Characteristics of a healthy and safe workplace:
Professional development is supported/encouraged
Obstacles are identified and removed
Diversity viewed as an organization advantage
Staff turnover and sick/stress leave is low
Staff loyalty is high
Workers are productive members of a team
Human performance, productivity, and prosperity are enhanced
HEALTHY AND SAFE WORKPLACE
PROACTIVE MEASURES
reserved.

Commitment to a strategy for creating a healthy
working environment…
Commitment from senior leadership to develop a healthy
working environment by mission statements, policies, and
enforcement
Managers demonstrating their commitment by implementing
the strategies and promote well-being
Make all staff aware of the managerial commitment to having a
healthy and safe working environment
Workplace surveys to evaluate working environment
PROACTIVE MEASURES
reserved.

Identify hazards, assess risks, and implement controls
Review of absences/tardiness to identify any patterns and trends
Review policies, including bullying and harassment, emergencies,
workplace health and safety and equal employment opportunity
Allow workers to provide feedback about their immediate reports
and management of the organization, such as:
 What they value about the organization
 What helps them within their role and the organization
 What changes they would like to happen
 What they find frustrating about their role or the organization and, if
appropriate, their manager
Audit to assess the risks related to mental health similarly to assess
the risks from chemicals or other safety risks
PROACTIVE MEASURES

Ways to create a healthy and safe workplace and
improve mental health:
Construct effective policies and procedures
Offer flexible working arrangements
Develop mentoring and peer support systems
Provide access to counselling services and/or support groups
Develop more understanding through education and training
on mental health, bullying, harassment, stress, communication, job
requirements, diversity, and worker disability
Ensure safe and healthy working conditions and environment
PROACTIVE MEASURES
reserved.

MANAGERIALTRAITS
OF BAD BOSSES
 Offers either unclear or immeasurable job expectations
 Harps on weaknesses/treats versus strengths/opportunities
 Micromanages the work task or job performance
 Provides bad direction or gives misleading information
 Lacks morale character and emotional support for workers
 Promotes idiots or persons less competent or qualified
 Doesn’t advocate for fair raises or worker compensation
 Employees overworked, overwhelmed, and underappreciated
 Doesn’t empower, engage or trust employee decisions
 Takes credit for jobs well done or blames others for bad jobs

MENTAL HEALTH
CONVERSATIONS AT WORK
reserved.

How to Change the Organization to Prevent Job Stress
Ensure workload is in line with workers' capabilities and resources.
Design jobs to provide meaning, stimulation, and opportunity for
workers to use their skills.
Clearly define workers' roles and responsibilities.
Give workers opportunities to participate in decisions and actions
affecting their jobs.
Improve communications - reduce uncertainty about career
development and future employment prospects.
Provide opportunities for social interaction among workers.
Establish work schedules compatible with demands and
responsibilities outside the job.

How to Identify Workplace Issues
Questions to ask before engaging the employee
 Do I have time to do this properly or am I pressuring myself to rush?
 Am I responding to hearsay or speaking about known facts?
 Am I in the right frame of mind or should I reschedule for another day?
 Am I considering my role in the situation or believing that I have no
need to improve?
 Approach the issue with a focus on solutions
 Am I looking for solutions or just rehashing the problem?
 Will this approach bring about new behavior or focus on old behavior?
 Will this approach bring about long-term improvement or only short-
term results?
reserved.

Explore Effect on the Employee and Co-Worker
 Am I seeing the bigger picture or just this particular situation?
 Will the potential solution provide energy for the employee or drain
them?
 Can I preserve the dignity of those involved or will someone feel
shamed or blamed?
 Does this approach encourage the employee to take control and
responsibility for their well-being and success or am I retaining all
control?
 Have I adequately addressed the fears and concerns of others or will I
create unease by ignoring them?
reserved.

Help the Employee Achieve Success at Work
 Can the employee and I develop a shared plan for success or will we
hold separate ideas of what success will look like?
 Am I helping my employee be successful on the job or am I focused
only on either personality issues or task concerns?
 Will I monitor and follow up or do I think one conversation will be the
end of it?
 Consider the Impact of Your Management Style
 How do you usually give direction? Do you know if your style works for
your employee?
 How do you usually give feedback? Do you know how your style
impacts your employee?
reserved.

COMPREHENSIVE WORKPLACE
HEALTH AND SAFETY PROGRAM
Four main components:
1.Occupational health and safety
(physical work environment)
2.Psychosocial work environment
(organizational culture and the
organization of work)
3.Workplace health promotion
(wellness)
4.Organizational community
involvement

What Science Says About Meditation

Meditation is a mind and body practice to
increase calmness and physical relaxation,
improving psychological balance, cope with
illness, and enhancing overall health and
well-being
Most types of meditation have four
elements in common: (a) quiet location
with few distractions; (2) specific,
comfortable position; (3) focus of
attention; and (4) an open attitude
reserved.

Meditation is generally considered to be safe for healthy
people
People with physical limitations may not be able to
participate in certain meditative practices with movement
People with physical health conditions should talk with
their health care providers before starting a meditative
practice, and make instructor aware of their condition
Few reports that could cause/worsen symptoms in people
with psychiatric problems like anxiety and depression

MENTAL HEALTH GUIDANCEMENTAL HEALTH GUIDANCE
DISCRIMINATIONDISCRIMINATION
 It’s illegal for employers to discriminate against an
individual because he or she has a mental health condition
 Employers should understand the exceptions for
individuals who pose a safety risk and for those who are
unable to perform their job duties
 Employer can’t rely on myths or stereotypes about a
mental health condition when making its decision but
instead must base its decision on objective evidence
reserved.

PRIVACY & CONFIDENTIALITYPRIVACY & CONFIDENTIALITY
Employees/applicants are entitled to keep their condition
private and employers can ask medical questions in four
situations only:
 When an individual asks for a reasonable accommodation;
 After a conditional job offer has been extended but before
employment begins (as long as all applicants in the same job
category are asked the same questions);
 For affirmative action purposes a response must be voluntary;
 If there is objective evidence that an employee may be unable
to do his/her job or may pose a safety risk because of a medical
condition
When medical information is disclosed, employers must
keep the information confidential—even from coworkers

JOB PERFORMANCEJOB PERFORMANCE
Reasonable accommodation is a change in the way things are
normally done at work and gives the following examples:
 Altered break and work schedules (e.g., scheduling
work around therapy appointments)
 Quiet office space or devices that create a quiet work
environment
 Changes in supervisory methods (e.g., written
instructions from a supervisor who does not usually
provide them)
 Specific shift assignments
 Telecommuting
reserved.

CONVERSATION ON MENTALCONVERSATION ON MENTAL
HEALTH INTHE WORKPLACEHEALTH INTHE WORKPLACE

ADA - SUBSTANTIALLYADA - SUBSTANTIALLY
LIMITING CONDITIONLIMITING CONDITION
 Under Americans with Disabilities Act (ADA), companies
should develop informal guidance for advising employees
of their legal rights in the workplace with regard to
depression, post-traumatic stress disorder (PTSD), and
other mental health conditions
 Condition does not need to be permanent or severe to
be substantially limiting under the ADA
 A condition that makes activities more difficult,
uncomfortable, or time-consuming to perform (when
compared to the general population) may be substantially
limiting
reserved.

ADA - REASONABLEADA - REASONABLE
ACCOMMODATIONACCOMMODATION
 Under ADA, employees may ask for reasonable
accommodation at any time but before any workplace
problems occur because employers are not required to
excuse poor job performance—even if it’s caused by a
medical condition or the side effects of medication.
 Employers may ask an employee to put an
accommodation request in writing and may ask for
documentation from the employee’s healthcare provider
about the medical condition and the need for
accommodation.
reserved.

ADA - REASONABLEADA - REASONABLE
ACCOMMODATIONACCOMMODATION
 Unpaid leave may be a reasonable accommodation if
the leave will help the employee get to a point where
he or she can perform a job’s essential functions
 If an employee is permanently unable to do his or her
regular job, the guidance explains that the employee
can request reassignment to another job if one is
available
 Employees bring to their medical appointment a copy
of the EEOC publication
reserved.

FAMILY AND MEDICAL LEAVEFAMILY AND MEDICAL LEAVE
ACT (FMLA)ACT (FMLA)
The Family and Medical Leave Act (FMLA) provides
employees with up to:
12 weeks unpaid leave within a 12 month period, during
which the workers’ jobs are protected.
Unless the employee is unable to perform the essential
functions of his or her job, employment is guaranteed.
However, if the position is filled, the employee can be
placed in a substantially equivalent job with the same pay
and benefits.
reserved.

EMPLOYEE ASSISTANCE PROGRAMSEMPLOYEE ASSISTANCE PROGRAMS
(EAPS)(EAPS)
 EAPs are company-sponsored programs designed to
alleviate and assist in eliminating workplace problems caused
by personal problems.
 Programs provide supportive, diagnostic, referral, and
counseling or treatment services.
 Many EAPs began as occupational alcoholism programs and
gradually evolved into broader-based efforts that could
intervene on negative job performance.
 EAPs offer a wide range of services for employees to
resolve personal and work-related problems.
reserved.

REASONS FOR DEVELOPING
MENTAL HEALTH STRATEGIES
Good for business:
Reducing costs associated with worker absence from work
and high worker turnover
Achieving greater staff loyalty and higher return on training
investment
Minimizing stress levels and improving morale
Avoiding litigation and fines for breaches of health and safety
and employment laws
Avoiding time and cost involved in discrimination claims
reserved.

Good for business:
Avoiding industrial disputes
Costs for reasonable mental health-related accommodations
are often fairly low
If individuals with a mental illness receive treatment early,
disability leave, which costs $18,000 on average per leave, may
be avoided
Mental health management programs in the workplace can
have a positive ROI from the employer perspective, but only
when they are based on best practices
reserved.

Good for business:
85% of survey respondents agree that employees with
mental health conditions can be just as productive as other
employees with access to the right supports.
Most mental illness begins before adulthood and often
continues through life.
Improving mental health early in life reduce inequalities,
improve physical health, reduce health-risk behavior and
increase life expectancy, economic productivity, social
functioning and quality of life.
reserved.

 Improves worker
productivity/morale
 Workplaces are very
diverse and create
many challenges and/or
opportunity for enable
workers to meet their
goals and objectives
 Mental illness can affect
anyone at any time
 It’s the law
reserved.

CASE STUDY: FORD MOTOR
COMPANY
 Ford Motor Company has more than 370,000 employees
worldwide.Total Health Program applied to 44,000 salaried
workers in the US and employed by the parent company.
 A comparable program was made available to Ford hourly
workers represented by the United Auto Workers through
the UAW-Ford Employee Support Services Program.
 Total Health Program is part of Ford’s major and ongoing
change in corporate culture.
 Changes have directly affected the work environment by
providing structure and support for workers so that they
have greater involvement in planning and decision-making.

COMPANY
 Ford Motor Company offers a health promotion program
including: health risk appraisal, hypertension and cholesterol
screening, education in nutrition, smoking cessation, exercise
and stress management. Average participation rates are 65%.
 Counseling is available 24 hours/day, 365 days/year. Strictly
voluntary, confidential, and no cost to employees and their
families.
 Mental health professionals provide training and assistance
to supervisors, managers and personnel representatives in
addressing unsatisfactory employee performance, which may
be related to employee personal problems
reserved.

COMPANY
 Ford offers lunchtime talks with counselors on mental
health topics (relating to holidays, relationships, and dealing
with difficult people) to help employees feel comfortable.
 Bulletins on mental health topics are distributed periodically
to all employees.Topics include:“Everyone feels down
sometimes” and “How many roles do you play?”
 Posters discuss depression and work-family relationships.
 Articles in newsletters talk about depression, transitions,
assertiveness, anger, parenting, substance abuse, and grief.
 In person presentations by counselors at company meetings
provide mainstream exposure for the program genesis.

OTHER COMPANY INITIATIVES
 First National Bank of Chicago developed an integrated
health data management system for its self-insured, self-
administered program. System includes data on health
claims, short-term disability, EAP utilization, health program
participation, nursing visits, health evaluations, etc.
 Pacific Bell uses its health data management system to
establish priorities, identify changes in its health program,
and provide standards to evaluate specific interventions.
 Owens Corning designed and implemented an integrated
information system to include medical, human resources,
payroll data, and data on safety and industrial hygiene topics.
reserved.

 Washington Business Group on Health (WBGH) is a
non-profit organization of approximately 300 employers.
 National Institute on Disability and Rehabilitation
Research (NIDRR) is a governmental organization which
works closely with WBGH.
 National Business and Disability Council (NBDC)
formerly the Industry-Labor Council, is the leading national
corporate resource on all issues related to the successful
employment and integration of individuals with disabilities
into the U.S. workforce.
RESOURCES
reserved.

 National Mental Health Association (NMHA) is a
nationwide network of mental health advocates seeking
reform for all people with mental and emotional disorders.
 National Alliance for the Mentally Ill (NAMI) is a self-
help support and advocacy organization of consumers and
families and friends of people with severe mental illnesses,
such as major depression, bipolar disorder, obsessive-
compulsive disorder, and schizophrenia.
 National Mental Illness Screening Project (NMISP) is
a nonprofit to coordinate nationwide mental health
screening programs and ensure cooperation, professionalism,
and accountability in mental illness screenings.
RESOURCES

 National Institute for Occupational Safety and
Health (NIOSH) Center for Disease Control and
Prevention
 Occupational Health and Safety Administration
(OSHA)
 Mental Health America Workplace Wellness
 Workplace Strategies for Mental Health
 Canadian Centre for Occupational Health and
Safety - Healthy Minds @ Work
RESOURCES
reserved.

CELEBRITIES WITH MENTAL
HEALTH ISSUES

Mental Health and Psychosocial Disorders in the Workplace

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