Absence management

Early Identification leads to Early Intervention

Is your Early Intervention truly early? When should the clock start ticking on intervention? It’s great to preach Early Intervention and promote early return to work, but if employers miss the key signals of employees who may be at risk, they miss their chance to intervene early.

Most employers understand why and how to intervene early in an absence when the absence is related to a physical problem. Until recently, efforts to reintegrate absent employees to the workplace have focused primarily on resolving physical impairments and seeking opportunities to modify the employee’s job tasks or work hours to bring him or her back to work sooner. These well-intentioned efforts to return the employee to productivity should be applauded; however, the challenges facing employers today are not related to physical ailments. The challenges are related to mental health issues.

Plan members at risk

Among employees at work, there are those who are at risk. Statistics Canada reports that in 2004, one-third of our working population reported days “quite a bit stressful” to “extremely stressful,” and 10% contacted mental health services for support[i]. These workers may be attending the workplace and functioning well enough to get the job done, but the risk of succumbing to work-life pressures is great. Workplace absence may be just around the corner.

In 2004, Statistics Canada surveyed household population aged 15 and over in Canada (excluding its territories) and found the following among Canadians aged 25 – 64[ii]:

All	Men	Women	Experienced:
5.1%	5.0%	5.2%	Dissatisfied or very dissatisfied with life
33.7%	31.8%	35.6%	Days quite a bit stressful to extremely stressful
7.1%	6.4%	7.8%	Fair or poor self-rated mental health
10.4%	9.4%	11.4%	Any measured disorder or substance dependence
0.8%	0.3%	1.2%	Agoraphobia
1.7%	1.2%	2.2%	Panic Disorder
3.0%	2.7%	3.4%	Social Phobia (Social Anxiety Disorder)
5.0%	3.8%	6.3%	Major Depressive Episode
10.7%	7.5%	13.9%	Contact with services and support for problems concerning emotions, mental health or use of alcohol or drugs

Statistics Canada reports a 17% increase in workdays lost per Canadian worker from 1998 (7.8 days) to 2003 (9.1 days)[iii]. In the same period, the number of days missed for personal or family responsibility has increased by a half-day (1.2 to 1.7 days) and days lost due to illness or disability has risen steadily from 6.6 to 7.4[iv].

Mental health claims

The 2002/2003 Staying@Work™ survey found that 79 percent of the organizations surveyed report depression, anxiety and other mental health-related conditions to be the leading cause of their short-term disability claims. These same psychological conditions are also reported to be the leading cause of long-term disability claims by 73 percent of survey participants[v]. In its Roadmap to mental disability management in 2004/2005, the Global Business and Economic Roundtable on Addiction and Mental Health estimates problems arising from mental health issues are either the primary or secondary issue in 60 to 65 percent of all disability insurance claims in Canada[vi].

Early Identification

The key to Early Intervention in employee absences related to Psychiatric illness is Early Identification. It is critical to understand when and how to intervene to avoid unnecessary delays in return to work when the issues are psychological or psychiatric in nature.

Do you know who is at risk in your work force? How do you react when an employee’s behaviour or performance changes? Are you able to recognize when the cause of the change is related to psychiatric illness? What do you do when you recognize someone is in distress? Do your workplace health, absence management or disability management programs support you and your front line managers in identifying people at risk? Where does your responsibility as an employer lie in sorting out these complex employee situations?

Managers and supervisors can help

It is the supervisor’s role to help ensure the productivity of the work unit is maintained. Identification of a change in an employee’s behaviour or performance requires supervisors to be vigilant in performance management. Vigilance allows the supervisor to recognize when a change occurs, which in turn offers the opportunity for the supervisor to consider the appropriate management techniques to address the change in behaviour or performance.

This does not mean that the supervisor should try to diagnose the cause of the behaviour, but the employee needs to be made aware that his or her change in performance is having an effect on the work unit’s productivity*.

It’s very important for all employees to be aware of the workplace support resources available to them and how to access these services. It’s also crucial that supervisors have this information readily available. This way, they can assist an employee who comes to them with a problem by providing information on programs such as the Employee Assistance Program (EAP), Occupational Health, Extended Health Benefits, and corporate policies for leaves of absence to obtain any required health care. The supervisor should also be able to point the employee to sources of information such as pamphlets, phone numbers or online educational and supportive services that are available within the workplace.

The supervisor should caution any employee at risk that he or she is not obligated to share details of a health problem with the supervisor. However, any medically imposed limitations or restrictions that need to be considered within the workplace should be communicated to the supervisor so the employee can be supported in remaining at, or returning to work, since employers have a duty to accommodate employees with health issues.

The benefits of Early Intervention

The Roadmap to mental disability management in 2004/2005 says that the longer an employee is off work, the less likely it is that he or she will return. While three quarters of workers return to work after 12-weeks of absence, only 2 percent return after an absence of a year[vii]. In the case of mental health issues, the British Columbia Partners for Mental Health and Addictions Information say early and appropriate treatment will greatly improve the symptoms of the illness while reducing the likelihood of a long-term psychiatric disability[viii]. This is especially true when the illness involves psychosis. According to the Canadian Mental Health Association, some of the benefits of early treatment of psychosis include less disruption of normal activities, a quicker and more complete recovery, improved ability to maintain the course of one’s life and reduced disability with better resistance to future episodes[ix].

An employee who receives help early and is able to remain in the workforce while experiencing a mental health episode, or is able to return to work sooner than if he or she never received help early, will have a better chance of remaining an active and productive member of both your company and the community. As an employer, you can provide crucial support by encouraging open and regular communication between managers and employees, and by making it easy for your employees to access appropriate help early.

*This article is not intended to provide employment advice. Employers should seek their own counsel for issues regarding employment law.

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