If you're diagnosed with a mental illness – as about one in four Canadians will be – it's likely that you'll be holding down a job. It is less likely, however, that you'll hustle off to human resources to report what's wrong the way you might if you had some physical ailment.
"It's uncomfortable talking about it," says Carl Vendette, a senior manager in Ottawa with the Conference Board of Canada who has battled depression, "because, at the end of day, I am talking about my faults and my flaws, and the more I talk about it, the smaller I become."
Such awkwardness wasn't really a factor for Kim Mik-Girard, a manager with American Express in Montreal: Her descent into psychosis was painfully public.
During a comedy routine for a talent show at a March, 2005, company conference in Florida, she suddenly began to tell off-colour jokes about colleagues who were in the room.
She thought she was hilarious, but then, she says, she also thought she could fly. You could almost hear her career shattering in the resounding silence.
Yet, within a year, she was back full-time – and still being treated for the bipolar disorder. There were setbacks – she first tried within months of the disastrous conference, only to postpone even part-time work until the fall – but eventually, she was back and looking at a promotion.
Now 33, she recalls that "I had literally thought my career was over. I was talking about moving back to my parents' farm in Alberta to raise pigs."
Not long ago, that might have been her fate. Her illness was severe, and there was no hiding it from her boss. Having listened to her ramble on during the trip home from the conference, he had called human resources and arranged an immediate leave. She was able to return largely because she received treatment so quickly and because she had an open-minded workplace.
A long-standing issue, creating healthy workplaces has become increasingly urgent as awareness of mental illness has grown and stress leels have risen. The Canadian Mental Health Commission is soon to release voluntary standards for psychological health and safety in the workplace.
The benefits are clear: After all, a knowledge economy relies on healthy minds. According to the Toronto-based Centre for Addiction and Mental Health, mental illness costs Canada $51-billion a year, about one-third of it in lost productivity. Aware of the toll (and potential legal implications of not handling mental illness properly), "all companies are looking for answers," says Carolyn Dewa, a CAMH researcher who studies the workplace.
For example, a recent pilot project at CAMH had participating companies cover the cost of having a psychiatrist on call to assist employees' family doctors, who are rarely trained to deal with mental illness. "The program saved money, people came back sooner and were less likely to go on long-term disability," Dr. Dewa says, suggesting it could easily go into widespread use.
But the main challenge remains creating an environment that encourages people to seek treatment quickly. Dr. Dewa's research estimates that 40 per cent of Canadians who undergo severe depression get no help.
Mr. Vendette, 48, recalls trying to get his depression under control so that he could put on a brave face while being interviewed last year for the job at the Conference Board (he researches better ways to provide health programs). "I did not want to be seen as someone who was less than others," he says. "I was convinced I could create the image that everything was okay and, once I was better, I wouldn't have to share with anyone."
At the same time, he felt people like him must "pony up" – to promote openness and make others less afraid to admit they need help – so last fall he gave a speech detailing his own story.
Now, while feeling better, he knows that he must monitor his mental health carefully. "It's almost as if it's in the background." But what helps, he says, in addition to feeling challenged at work, is knowing that he has the support of his employer. "Having a job you feel good about is very therapeutic."
If having a strong support network of family and friends is important, so is the sense of worth that comes from being able to resume a career.
"One of the worst things in our society is joblessness," says David Albert Newman, 35, an auditor with the Province of Manitoba. "If you don't have a job, you don't have that social inclusion of financial independence."
Mr. Newman struggles almost daily with schizophrenia, working full-time even as he nears completion of a master's degree in business administration. Sometimes he also thinks he can communicate telepathically, or that people around him may not exist. "You just catch yourself and say, 'Well, that was an odd thought. Maybe I will just package that up for a while.'"
After a serious psychotic episode in 2005, he says, a psychiatrist told him that he would "probably need to be institutionalized" for the rest of his life.
Instead, he worked hard to recover, and was eventually hired by the province. Because he is open about his illness, "people can be apprehensive," and it can be hard to distinguish between legitimate concerns about his work performance and stigma caused by his condition.
When Ms. Mik-Girard returned to her American Express job, her boss made great efforts to accommodate her, allowing her to travel less. She worked from home, but felt a need for more interaction with co-workers, so space was found for her at the office – and the details of her illness remained confidential, until she chose to disclose them.
She has since left to start a family, but still speaks to companies about mental illness, and plans to return to the corporate world when her kids are in daycare.
"If you were successful before a mental illness," she says, "you can be successful afterward."
What a (smart) boss can do to help
It takes more than a fitness centre to make a healthy workplace. In 2010, one in four working Canadians said they were highly stressed – especially those who were managers and professionals earning no less than $80,000 a year.
Graham Lowe, an emeritus professor of sociology at the University of Calgary, advises companies on how to improve their workplace culture. He often begins by asking employees to list tasks they must do that are not essential to their jobs – from attending meetings that lack a clear agenda to requiring a superior's approval for something that doesn't really warrant it.
"One of the most obvious ways that people are stressed," he says, "is that they are asked to do too many things in too short a time."
Dr. Lowe focuses on results more than process, preferring to set out responsibilities then let employees decide how best to meet them – even if it means holding meetings at Starbucks.
For example, Vancouver City Savings, the largest credit union in English-speaking Canada, allows "care" time. As a result, Vancity's largely female workers don't have to book a whole day off just to take a child or aging parent to a doctor's appointment.
Flexibility can go both ways, Dr. Lowe says. For example, a healthy workplace doesn't rule out bedtime BlackBerry checks.
Last month, German auto maker Volkswagen responded to charges that it was forcing workers to do "electronic overtime" by halting all messages sent after hours. But Dr. Lowe says many employees consider such messages an asset, not an imposition. "We are in a knowledge-based economy. "We have skilled and talented employees – we should use them more effectively."
Clearly, there is room for improvement. A survey of 1,000 workers (including nearly 500 front-line managers) conducted last year by the Conference Board of Canada found that only 46 per cent of respondents felt that their workplaces promoted mental health. They said employers must do a better job of educating people and encourage those who need help to come forward.
And this goes beyond productivity – it's now a major legal matter for companies, says Martin Shain, a specialist in employment law at the University of Toronto and co-author of Preventing Workplace Meltdown. In particular, courts have cracked down on work conditions that cause chronic stress, excessive demands or bullying behaviour by managers, and unpaid overtime that takes a mental toll.
"The legal hassles are getting worse every year," says Dr. Shain, who is helping to develop standards so employers can avoid potential threats to mental health. "This is the equivalent of 150 years ago: We started having factory laws to protect people's physical well-being; now, we are trying to protect people's psychological well-being."
But the big hurdle remains persuading employees who need treatment to seek it. "Most people will keep that to themselves until the seams burst in some incident at work that is disruptive," he says. "And yet ... we could have prevented it."
Attitudes about mental illness and the workplace
54 Percentage of respondents to a Conference Board of Canada survey who said their chances of promotion would suffer if their bosses learned they had a mental-health problem.
27 Yet only half as many who have faced mental illness and told the boss feel they've lost promotions and pay raises as a result.
59 Percentage who feel that their immediate supervisor cares about their mental well-being.
34 Not nearly so many believe that their employers have policies to promote mental health (33 per cent disagreed; the final 33 per cent were unsure)
81 Percentage of managers who say they would feel comfortable discussing a mental-health issue with an employee.
48 Far fewer respondents believe proper accommodations are made for staff with mental-health issues (the figure plummets for those who have actually required such accommodations).
59 Respondents who believe their employers actively support staff who return to work after a mental illness.
Source: Building Mentally Healthy Workplaces, a 2011 report by the Conference Board of Canada
Erin Anderssen is a Globe and Mail feature writer.