By Michael Kary
In recent years, there has been significant media attention focused on the issue of worker injury rates in the health care sector, especially around the issue of violence and aggression and long-term care. While this media attention may be well-deserved – as these injuries rates are high and only slowly decreasing – often neglected are matters relating to the mental health or wellness of workers. In particular, the burden and stigma of mental health problems is becoming increasingly apparent in today’s society, including in BC’s health and continuing care sectors.
Each year, one in five Canadians will experience a mental health or related substance use problem, and in some areas, it is as high as one in four.[i] It is important to note that the actual rates are likely even higher as they reflect only those who have been diagnosed with a mental health condition or substance use issue. A recent survey, for example, revealed that two-thirds (66 per cent) of employees who took time off work for a mental health issue did not report it. The same survey also found that only one-third (31 per cent) of employers said support for mental wellness in their organization has improved over the last two to three years, compared to 62 per cent who said it had stayed the same or worsened.[ii] Likewise, almost 60 percent (57%) of Canadian workplaces have no mental health strategy.[iii]
Overall, mental health issues are a major cause of absenteeism and lost productivity in the workplace. It is estimated that stress claims account for an estimated $77 million every five years in British Columbia.[iv] According to the Mental Health Commission of Canada the economic burden of mental illness in Canada is estimated at $51 billion per year, which includes more than $6.6 billion lost in British Columbia alone.[v] This includes health care costs, lost productivity, and reductions in health-related quality of life. [vi]
The impacts are equally as important in health and continuing care. A National Population Health Study, for example, revealed that 11% of nursing assistants sought healthcare attention for mental health reasons compared to 7% of other Canadian workers. The same study found that registered nurses, nursing assistants, orderlies, and nursing attendants had proportionally higher levels of distress due to psychological job demands, job insecurity, and low social support than Canadians in other occupations.[vii]
Likewise, Care Aides, who provide about 80 percent of the direct care received by older Canadians living in long term care or their homes, face similar mental health challenges.[viii] In particular, over 60 percent of frontline workers reported that they experience burnout, depression, anxiety and irritability in response to work stressors.[ix] According to WorkSafeBC data, stress also costs the continuing care sector almost $3 million dollars every five years, though it may also be a contributing factor in many more injury claims.
Although greater attention has been given by the media and others to mental health it is still underfunded to some degree. Currently, the most recent estimates show that provincial and territorial governments spend only about 7 per cent of total public health spending on mental health and addictions.[x] A recent analysis from the Mental Health Commission of Canada suggests that overall funding for mental health should be increased from 7 to 9 per cent of total public health spending.[xi]
Community approaches to care, including services for continuing care workers, are not only essential to people in recovery but are also the key to reducing or avoiding the major service system costs associated with acute care admissions as well as various social costs. Despite strong evidence of providing various health benefits, the uptake of evidence-based community programs and supports across Canada has been slow as the vast majority of mental health funding goes to acute care.[xii]
As noted by the Canadian Alliance on Mental Illness and Mental Health (CAMIMH) the resulting failure to invest in effective programs and supports in the community has also ironically resulted in steadily escalating pressures on acute care. The consequences are emergency department overcrowding, revolving door psychiatric admissions and discharges and high and increasing demands on police and social services. The high economic costs associated with insufficient investment in effective, community-based services are also in addition to the enormous personal and social costs associated with the failure to provide effective, community-based and recovery-oriented treatment and support.[xiii]
As such to help foster greater discussion on mental health issues in the workplace, on November 17, 2016 the BC Care Providers Association (BCCPA) will be co-hosting a Care to Chat event with SafeCare BC, whose mandate is to reduce worker injury rates in the continuing care sector. The event includes well known CKNW Radio host Jon McComb, as well as an expert panel with representatives from the continuing care sector, health authorities, labour and academia. The panel in particular will discuss issues such as the prevalence of mental health issues among workers in the continuing sector, including what can be done both at an organizational and system wide level to deal with such concerns. Along with outlining some of the potential challenges and solutions, the panel will discuss best practices being undertaken in Canada and abroad to deal with mental health issues and stress in the workforce.
Most importantly, the hope is that this Care to Chat event will help dispel some of the myths and stigmas on mental health while also increasing public awareness on this important issue effecting BC’s continuing care sector. In particular, building on some of the discussions at the Inaugural BC Continuing Care Collaborative last September, the BCCPA and SafeCare BC hopes this will begin an even greater dialogue and further discussions on mental health issues in the workforce.
[i] Smetanin et al (2011). The life and economic impact of major mental illnesses in Canada: 2011-2041. Prepared for the Mental Health Commission of Canada. Toronto: RiskAnalytica.
[ii] Benefits Canada. 66% of employees with mental health issues don’t report it. Jennifer Patterson. January 27, 2016. Accessed at: http://www.benefitscanada.com/uncategorized/66-of-employees-with-mental-health-issues-dont-report-it-76352
[iii] Chenier, L., & Boyer, C. (2016). Healthy Brains at Work: Employer-Sponsored Mental Health Benefits and Programs. Conference Board of Canada, Briefing (2)
[iv] WorkSafeBC, Injury Safety Information Centre, 2015.
[v] Ministry of Health Services, Ministry of Children and Family Development. Healthy Minds, Healthy People – A Ten-Year Plan to Address Mental Health and Substance Use in British Columbia. November 1, 2010. Accessed at: http://www.health.gov.bc.ca/library/publications/year/2010/healthy_minds_healthy_people.pdf
[vi] Smetanin et al (2011). The life and economic impact of major mental illnesses in Canada: 2011-2041. Prepared for the Mental Health Commission of Canada. Toronto: RiskAnalytica.
[vii] BC Provincial Health Services Authority. Changing the Workplace: Improving Mental Health among hospital workers. March 2007. Accessed at: http://www.phsa.ca/Documents/Occupational-Health-Safety/FactSheetChangingtheWorkplaceImprovingMentalHealth.pdf
[viii] Whitney Berta, Audrey Laporte, Raisa Deber, Andrea Baumann and Brenda Gamble, “The evolving role of health care aides in the long-term care and home and community care sectors in Canada,” Human Resources for Health 2013, 11:25 at 1.
[ix] BC Provincial Health Services Authority. Changing the Workplace: Improving Mental Health among hospital workers. March 2007. Accessed at: http://www.phsa.ca/Documents/Occupational-Health-Safety/FactSheetChangingtheWorkplaceImprovingMentalHealth.pdf
[x] Institute of Health Economics. The Cost of Mental Health and Substance Abuse Services in Canada. June 2010, page 15.
[xi] Mental Health Commission of Canada. Making the Case for Investing in Mental Health in Canada. 2013.
[xii] Canadian Mental Health Association, British Columbia. Community-Base Supports for Mental Health and Substance Use Care: 2015 Budget Consultation, 2014.
[xiii] Canadian Alliance on Mental Illness and Mental Health. Mental Health Now! Mental Health Now! Advancing the Mental Health of Canadians: The Federal Role. September 2016. Accessed at: http://www.psrrpscanada.ca/clientuploads/News/CAMIMH_MHN_EN_Final_small.pdf