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The working wounded

Mental illness is costing the Canadian economy a staggering $51-billion a year, and each day 500,000 people miss work because of psychiatric problems. What are employers doing about it? Not much.

From Monday's Globe and Mail

GATINEAU, QUE. — The day Sylvie Giasson lost her job at the National Gallery of Canada – a victim of restructuring – it was as if a black hole opened up to swallow her.

The Gatineau, Que., translator began stuttering and crying. The tears wouldn't stop. She couldn't sleep. Suicidal thoughts overwhelmed her.

It took all the energy Ms. Giasson could muster to get herself to hospital, where she was diagnosed with severe depression and anxiety disorder. She spent seven months in the Royal Ottawa Hospital, being treated with medication, counselling and electroconvulsive therapy. And she endured it all virtually alone.

“Nobody wants to visit a loved one in a mental hospital,” Ms. Giasson said. There were no flowers or get-well-soon cards. No one called.

Society's silence about mental health is deafening. When you are diagnosed, you disappear. Yet the vast majority of Canadians suffering from mental illness – such severe conditions as depression, bipolar disorder and schizophrenia – are not in hospital but in the community and at work.

Mental illness accounts for a stunning 40 per cent of disability claims and sick leaves in Canada. While employees jest about “mental-health days,” they are no joke. Every day, 500,000 Canadians are absent from work due to psychiatric problems; the most recent estimate pegged the annual economic burden of mental illness at a staggering $51-billion. The World Health Organization estimates that by 2020, depression will be the leading cause of disability on the planet.

“Depression is a colossus,” said Bill Wilkerson, CEO of the Global Business and Economic Roundtable on Addiction and Mental Health. “It's one of the biggest killers and one of the biggest disablers.”

And it carries a cruel stigma. “There's this attitude out there that if you come back from cancer, you're a hero, but if you come back from depression, you're damaged goods,” Mr. Wilkerson said.

Most people do return to work after bouts of mental illness. Yet few employers are accommodating, and fewer still reach out to help staffers before they descend into crisis.

“We can't afford to be tossing any workers overboard,” Mr. Wilkerson said. “We have a brain economy and we can't let all these brains go to waste.” The situation, he added, is a “national calamity.”

Ms. Giasson, now 51, was one of those who clawed her way back. Doctors discovered the combination of medications that controlled her symptoms, including antidepressants and the Pill to deal with the violent mood swings linked to her menstrual cycle.

She left hospital with $35 to her name. After a stint on welfare, she found employment, first as a temp, then doing contractual work and finally landing a full-time government job. Since 1992, Ms. Giasson has risen steadily through the ranks of the civil service, where she now works in employee assistance services at Health Canada. Over that time, she has had two bouts of severe depression, each necessitating a few months off.

“Depression was not part of my career plan,” she said wryly.

While she does not consider herself any different from workers with chronic illnesses like diabetes or heart disease, she knows she faces far different perceptions.

“In terms of dealing with an individual with mental illness,” Ms. Giasson said, “we're still in the Stone Age.”


There is no doubting the scale of the problem. A poll commissioned by the Great-West Life Centre for Mental Health in the Workplace found that 18 per cent of workers in Canada had, at one point, a diagnosis of clinical depression. At any given time, about 8 per cent of those on the job are taking drugs for a mental-health condition, and 6 per cent are under the care of a physician.

And because mental illnesses tend to afflict people in their prime working years, they have a huge economic impact.

The estimated $51-billion in annual cost to Canada was the conclusion of a study by Dr. Carolyn Dewa of the Centre for Addiction and Mental Health in Toronto. The study estimated direct medical costs at $5-billion, while loss of productivity due to long-term disability came to $8.5-billion a year and short-term sick leaves rang in at $9.3-billion annually. The balance, about $28-billion, was attributed to “reductions in health-related quality of life” – a method used to put a dollar figure on pain and suffering.

Phil Upshall, national executive director of the Mood Disorders Society of Canada, can rhyme off these stats with alacrity. He believes the figures are essential to understanding the scope of mental illness and the folly of not dealing with it.

“I have to use the numbers. They're all I have. I don't have a Timmy,” Mr. Upshall said, referring to the way causes like breast cancer and muscular dystrophy capture the public imagination by putting a human face on the conditions. But mental-illness sufferers are reluctant to come forward because they fear the stigma.

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