The following is an excerpt of a presentation delivered at the 2006 Top Employers Conference by John Cardella, Ceridian Canada’s Chief People Officer and Estelle Morrison, Director – Strategic Solutions for LifeWorks, Ceridian's market-leading Employee Assistance Program.

Historically, employee health focused on employee behaviours, but research now demonstrates that health is much more complex and contextual than previously believed. Within our work lives, the drive to become more efficient by doing more with less has contributed to rising health care costs by way of absenteeism, presenteeism, turnover, illness, higher rates of prescription drug use, and more. Stress and depression are now recognized as significant strains on health care services.

As a result, organizations have begun to identify employee health as a critical business issue. With the understanding that mental health is fast becoming a principle, if not THE principle issue in disability, loss of productivity, turnover, and health care costs, supportive workplace behaviours and programs can inoculate your workforce against the overwhelming predictions of declining mental performance.

Why focus on mental health at work?

More than ever, the success of business is reliant on the human mind. This is a knowledge economy and mental performance is critical. The importance of a fully present and functioning mind is evident when you consider the valuable skill sets of the 21st century workforce – creativity and innovation, people management and relationship skills, organizational and multi-tasking skills. In the face of these demands, our workforce is facing more challenges to optimal mental health than ever before.

Employees are changing and as a result, their relationship to their workplace has gone through tremendous transition. The baby boomers, working at the rate of 1.5 full-time equivalents, are planning their retirement; our population growth has slowed, and Generation X and Y workers have greater boundaries between work and home. These younger employees are not prepared to work at the same rate as their Baby Boomer predecessors, resulting in increased pressure on the workforce, and little need to tolerate increased demands since competition for talent will be high.

There is a rise in mental illness, particularly amongst the younger generations who are now entering the workforce. More Canadians are suffering from mental illness, yet the Global Business and Economic Roundtable on Addictions and Mental Health found that only 25% who had symptoms of a mental health condition sought help from a professional and only a quarter of those actually received appropriate care.

Presenteeism: There in body, but not in mind

Presenteeism is a term used with greater frequency and understanding. It stemmed from the downsizing/restructuring efforts that plagued the 1990s. Employees are putting in long hours (or at least appearing to do so) and showing up for work ill or compromised in some way. Graham Lowe, a renowned Canadian researcher in the area of health and work refers to a study out of Florida that analyzed 17 diseases and found that lost productivity from presenteeism was 7.5 times greater than productivity loss from absenteeism.

Essentially, presenteeism is an employee’s effort to make it look as though things are better than they actually are – a particularly enticing thought when you are trying to hide a stigmatizing illness such as depression.

What is the impact of workforce changes to business?

Human capital has become extremely precious and vulnerable. Organizations must be prepared to provide supportive environments, as social environment stressors take a cumulative toll. The more sources of stress there are in the work environment, the less likely employees are to rate their health as excellent.

In their examination of the factors that influence wellness, Shehadeh and Shain found that stress due to the social environment at work impacts health by influencing employees’ feelings of control over their work and their health. Stress arising from each individual aspect of the social environment increases the likelihood that employees will rate their health as only average or worse. The greater the number of sources of stress within the social environment at work, the greater the likelihood that employees perceive their health as only average or worse.

Employees experiencing stress as a result of difficult interpersonal relations and poor management practices are also less likely to rate their health as excellent. Poor management practices such as lack of feedback, lack of fair treatment, harassment, and discrimination are associated with poorer health perceptions.

Job demands and stresses such as feeling physically and mentally tired constitute two more sources of stress accompanied by poorer health perceptions. Employees reporting excessive job demands are less likely to rate their health as excellent. Lack of personal control over one’s job follows a similar pattern. Job-related change, however, has a somewhat different relationship to health. Employees reporting excess stress due to jobrelated change are about as likely as other employees to rate their health as excellent.

Unlike job demands and lack of job control, some job changes such as a promotion may result in increased perceptions of control over one’s own health, thereby positively influencing health perceptions.

How should business respond?

Organizations can employ many effective strategies to help bolster the mental health of the workforce, from manager development and employee resiliency training, to targeted health promotion programs and policies, comprehensive benefit plans, Employee Assistance Programs, stress-prevention conflict resolution techniques, and more.

In this article, as an example, we’ll explore nine strategies that harness management’s influence to foster employee health. Research has shown a strong relationship between manager behaviours and employee health, and both front line and senior-level leaders can exert great influence by implementing programs and practices that support work-life balance.

1. Rewards, acknowledgment – Reward programs can help to minimize impact of high effort, low reward positions. Data shows that people working with high demands and low control, when compared to workers who have a high level of control, experience significantly higher rates of heart and cardiovascular disease, anxiety, depression, alcohol abuse, infectious diseases, back pain and repetitive strain injuries (RSIs).

2. Workloads and limitations – Managers must examine workload expectations, both explicit and implicit; send clear messages with respect to hours of work, overtime, vacation time, and sick time; and make considerable efforts to support work-life balance. A recent study estimated that the health care related costs caused by role overload (having too much to do in too little time) amounts to roughly $6 billion per year, while the medical treatment sought by employees burdened by high levels of caregiver strain costs about $5 billion.

3. Managing technology – Managers must set realistic expectations and boundaries related to use of technology to support work-life balance. In a competitive environment that is continually being reshaped by the Web, we're tempted to rebalance our work on a monthly, weekly, even hourly basis. Unchecked, this frantic approach is a recipe for dissatisfaction and despair. The real challenge is not managing time but maintaining focus.

4. Communication – Open, honest and ongoing communication helps establish trust and sets appropriate expectations, while contributing to the destigmatization of the use of programs and supports. Communication related to policy is critical.

5. Flexible hours – Flexible scheduling tends to increase employee satisfaction and lessen the conflict between work and family. When the work schedule fits poorly with an employee's preferences, burnout is more likely to occur. Flexible work hours can offset the disruption of increased workloads, help to balance work-life challenges, recognize individual needs and establish them as important, and set the tone for message about culture.

6. Mobile work – Mobile work can be a friend or foe as it can allow for freedom of movement of the employee, and greater work-life balance. But, the program must be clearly defined to allow for reasonable expectations.

7. Openness – Employees must feel comfortable in approaching managers without fear of retribution. Organizations must recognize the importance of both positive and negative feedback on employee surveys, and use the information gathered to address issues.

8. Job construction – Organizations must be prepared to form job committees that consider the importance of decision-making and control in one’s job. Managers must always consider workload, supports, expectations, and boundaries.

9. Fostering social connectedness – Having social support at work from coworkers or supervisors can help eradicate the effects of high demand and low control. Employees who report supportive, friendly relationships with their coworkers are more satisfied with their jobs and more able to maintain the appropriate work/personal life balance. Forming a Social Committee, and making known the acceptability of talking, laughing and developing friendships at work, can help support a social environment.

According to a 2004 Mercer study and a 2005 Watson Wyatt survey, while businesses may be aware of the rise in mental illness disability claims at work and the impact on productivity and presenteeism, few are prepared to respond to them. In addition, while many HR departments and organizations are convinced of the importance of optimal mental health and wellness, most are unaware of how to establish and maintain such a healthy workforce. As an employer or HR professional, your role in providing a supporting environment is critical. Remember: generous benefits and perks may attract employees, but it's the workplace culture that keeps them and keeps them productive.

To learn more about presenteeism:
http://www.webmd.com/content/article/86/98895.htm?action=related_link http://www.grahamlowe.ca/documents/26/2002-12-02-Lowe.pdf

This article first appeared in Ceridian Canada’s e-newsletter, The Specialist, July 2006 issue.

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