The Health Case

How do psychosocial risk factors in the workplace affect employee health?

There is strong evidence that certain features of the workplace can affect employees’ mental and physical health. Workplace risk factors increase the likelihood that an individual will experience increased stress, which in turn increases the likelihood of developing or worsening a mental disorder.

Does work cause mental disorders?

There is no simple answer to this question. The answer hinges on: what we mean by saying a disorder is "caused" by a situational trigger; where we draw the line between mental distress and mental disorders; and, our emerging knowledge concerning the relationship between factors in a person’s life and the development of mental health problems. But there are a few things we can state with some confidence:

• With the exception of psychological trauma related to an extremely stressful event such as being robbed or assaulted on the job, we can rarely draw a direct link between a person’s work situation and their developing a mental disorder.
• Workplace factors may increase the likelihood of the occurrence of a mental disorder, make an existing disorder worse, and impede effective treatment and rehabilitation.
• Workplace factors may contribute directly to mental distress (demoralization, depressed mood, anxiety, burnout, etc.). Mental distress may not reach the level of a diagnosable mental disorder, and yet be a source of considerable suffering for the employee, productivity loss for the employer, and legal consequences if "toxic work conditions" are judged to have contributed to an employee’s suffering and disability.
• A supportive work environment can reduce the onset, severity, impact and duration of a mental health disorder.
• Organizations that make the effort to identify psychosocial risks and to create a psychologically healthy workplace reap benefits in productivity, sustainability and growth.

What is the prevalence of mental disorders?

It is estimated that 1 out of 10 Canadians suffer from a diagnosable mental disorder within any given year - 1 out of 5 people will experience a mental disorder over the course of their lifetime. These can include very serious but uncommon conditions, such as schizophrenia, but are more likely to include conditions such as depression, anxiety or substance use. These figures increase sharply if we include the range of psychological distress that can be a precursor to a diagnosable disorder. Mental disorders touch all of us, whether we face direct challenges ourselves, or are impacted through our families, friends, or colleagues.

More than half of people with a psychological health condition do not receive a diagnosis, and of those diagnosed, less than half receive treatment that meets the expected standards of practice. There are a number of reasons for this, including lack of public awareness of the signs of mental distress, the shortage of mental health specialists and services, and failure to recognize mental health problems that accompany physical health conditions. Over 15% of Canadian health care expenditures can be attributed to mental disorders, but less than 4% of research funding is dedicated to mental health. Canada is the only G8 nation without a national mental health strategy. Another major barrier is the stigma associated with mental disorders. It prevents individuals, family members or concerned others from accessing care, thus increasing and extending undue suffering.

As Canadians, employers and business owners understandably share the national concern about the economic and personal impact of mental disorders. They recognize the need to improve our understanding and care for our fellow citizens with these disorders. However, they may not realize the impact that mental disorders have on Canadian public and private organizations. A 1998 study estimated the annual cost of mental health problems to the Canadian economy at $14.8 billion; more recent estimates put the cost as high as $35 billion. One-third of these costs related to the provision of public health services; the remaining two-thirds were borne by employers. Mental health problems are the fastest-rising cause of short- and long-term disabilities, with costs borne by private and public sector insurance, employers and taxpayers. Mental health problems are expected to be the source of more than 50% of all disability claims administered over the next five years, exceeding even heart disease.