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When Donna Hardaker, the co-founder of Toronto’s Mental Health Works, sits down with employers to discuss how they can assist workers living with a mental illness, she's not speaking solely as a representative of the award-winning initiative—she’s also speaking from experience.
Almost a decade ago, Hardaker waged her own personal battle with depression that left her dealing with personality changes, reduced productivity and severe psychological distress; at one point she considered suicide daily. Luckily, she endured and went on to use her experience to inform the creation of Mental Health Works (MHW).
Established in 2001 as a research partnership with the Canadian Mental Health Association (CMHA), the innovative program has grown into a practical initiative that educates employers and employees on the best ways to approach, and deal with, mental illness issues in the workplace. It does this through workshops, and publications that help people return to work and support their ongoing recovery, with minimal disruption of the workplace.
“A huge part of the work we do is just to help people feel connected to someone who has a mental illness,” says Hardaker. “As opposed to seeing people as a problem or weak, or as someone to get rid of.”
The cost of ignoring the issue in the workplace cannot be understated. Mental health and addiction problems are estimated to cost the Canadian economy nearly $30 billion a year in lost productivity and other indirect costs, according to a 2001 study commissioned by the Public Health Agency of Canada.
And a 2007 survey conducted by consulting firm Watson Wyatt concluded that mental health issues were the leading cause of disability claims in Canada—making up 72% of short-term claims and 82% of long-term ones.
The figures may seem shocking, but they come as no surprise to anyone in the mental health field. The CMHA estimates that one in four Canadians will suffer some kind of mental illness at some point in their lives. Which means that Mental Health Works is poised to fill a huge need.
“We're teaching people how to manage differently,” says Mary Ann Bayton, MHW’s director and co-founder of. “It improves the bottom line at the same time as improving working lives.”
It’s an approach that Hardaker, one of MHW’s 40 trainers, wishes was around nine years ago.
It was 2000, and Hardaker was working as an events organizer at a healthcare company in Toronto. After suffering whiplash in a car accident, she began to experience signs of depression during her recovery.
“I became extremely irritable at work,” she says. Her attentiveness to detail—a necessary part of her job—started to tip over into obsession. She became increasingly angry when others made mistakes, and began interpreting their errors as personal affronts. She also lost her ability to concentrate and forgot things people told her; but was embarrassed to ask for the information again.
The resulting reactions only intensified her condition. Hardaker's co-workers began to avoid her, which served to reinforce her feelings of isolation and alienation. Plagued with insomnia, she began having panic attacks and crying jags at work. She often had to leave her desk for extended periods of time because she couldn't cope. Eventually, she realized that she might be suffering from depression and asked her family doctor to check her for the illness. She was prescribed a medication which helped her cope, but did little to repair her frayed relationships.
“It was very effective for me, for a lot of the symptoms I was having, but it didn't help me with my interpersonal relationships at work.”
It all came to a head when she took eight weeks of sick leave, most of which was spent in bed. She says, by the time she felt well enough to return to work “the situation was so toxic that my manager literally didn't speak to me for a full year… My colleagues didn't know what to do. They saw me as a bad person, a weak person, not a team player.”
The resulting workplace environment edged her into a darker place. One where she contemplated suicide every day as her subway passed over Toronto’s Bloor Street Viaduct (which for years ranked second only to San Francisco’s Golden Gate Bridge in terms of frequency of suicides).
“I knew I had to get out of [my job] if I was going to survive,” Hardaker says.
Now almost a decade later, she understands that it must have been extremely difficult for her manager to understand her change in behaviour.
“She just didn't know what to do,” she says “[So] she isolated the person who seemed to be hurting everyone else.”
Mental Health Works assumes that most managers have little if any training on how to have effective conversations with employees who may be mentally ill. Their training sessions address this, as well as helping to break down the stigma associated with mental illness by stimulating an open discussion of the issues. MHW also advises employers about an employees' legal rights, and about the types of accommodation they can make that help their workers be more productive.
For instance, says Hardaker, someone suffering from anxiety and panic attacks as she did might need an office with a door that closes and is quieter than a cubicle in a large room—an accommodation that is usually not difficult for an employer to make.
“The best thing to do is to speak to the employee about what they need,” says Hardaker.
The City of Hamilton, which employs about 8,000 people, is one of the larger organizations that employs Mental Health Works’ training several times a year.
“It shows (our) commitment to a healthy workplace and to providing support to employees,” says Lisa Gilmour, a healthy workplace specialist with the city. “It's not training managers and supervisors to be someone's therapist or to be able to do a diagnosis, it's just giving them some tools in terms of how to have a conversation, and to be attentive to any problems that arise.”
Most of the 500 or more managers and supervisors who have taken the session not only find it positive, they ask for further training says Gilmour, something the city is committed to providing in the coming year.
Although the program is aimed at prevention, not at an immediate reduction in disability claims, the City of Hamilton's disability claims are in fact lower than the national average. Only about a third of its disability claims are for mental illness, compared to the 72- and 82-percent national figures that the Watson Wyatt study cites. The city has been offering the training since 2006.
Mary Agro, a human resources manager in Hamilton, first took the training in 2007.
''They had really solid strategies for returning people to work, and really understood that it's an illness, but not a condition that prevents people from coming back to work,” says Agro.
One of the strategies Agro found most helpful was a three-step model that MHW gives managers to help them open a conversation with an employee. It begins by having a manager point out, in a non-judgmental way, something they have noticed. Then they move on to saying that they are concerned about the employee. It finishes by having the manager say ‘Let's focus on solutions at work.’
The manager and employee can then draft specific solutions, sometimes writing them down as a contract. Those solutions can be as simple as ensuring that an employee who is having trouble remembering things gets written instructions, perhaps via email, for example.
“At the end of the day, you still have to manage the workflow and be accountable for the productivity in your unit,” says Agro. “CMHA says folks who are struggling still need structure and accountability, so you're really trying to focus your efforts on solutions at work, instead of being caught up in any potential drama.”
Since taking the training, Agro has used it in dealing with an employee who is extremely sensitive to negative feedback and who has an underlying depressive illness.
Mental Health Works has given Agro a better understanding of the dynamics involved in her employee's behaviour, and of the underlying condition. She no longer assumes there is simply an attitude problem.
The training also helps managers become aware of their own issues, since they are equally vulnerable to mental illness, Agro points out.
Hardaker wishes her previous employer had access to the kind of practical information and solutions that Mental Health Works provides. The stakes are high, she points out – not just for an employers' bottom line, but for an employees return to health.
“If you can have someone who has peaceful discussions at work about issues, and who is able to have a flexible schedule or changes to workplace processes, they may never have to go on short-term or long-term disability,” she says.
“All the literature says that being employed is an essential component of recovery.”