Psychologist Carmen Bellows is on a mission to make it easier for Canadians to travel what she calls the “mental health roadmap.” As a Director of Mental Health Solutions for Sun Life, she knows firsthand the huge difference that employers can make. Take 5’s conversation with Bellows yielded the following five key takeaways to help employers with their own roadmap for a mentally healthy workforce.
The face of mental illness
Anxiety and depression are the most diagnosed forms of mental illness. The COVID-19 pandemic increased the incidence of both—but more so for anxiety and stress-related disorders, especially among working-age adults. “Historically we saw more mood disorders, most often depression, in the workplace,” says Bellows.
While both conditions can affect productivity, “employers will want to better understand that their employees with mental illness are expressing less of a tearful sadness and more of an anxious, overwhelmed feeling that they can’t cope,” she notes.
Genetic predisposition is less of a factor and first-time diagnoses have increased. “The pandemic really stripped away coping mechanisms for everybody,” explains Bellows, adding that women and younger people are more at risk. “Half of disability claims for people under 44 are for mental disorders and that number is rising.”
Finally, treatment and recovery may be a lifelong journey. “Anxiety and depression are often relapsing, remitting conditions. Understanding that complexity is really important to help destigmatize mental illness and to really reflect on how untreated mental illness can negatively impact your business.”
The upshot? Early detection and timely, convenient access to care is more important than ever. “We want people to have the psychological skills to manage their mental health when they’re at risk and when they’re doing well,” summarizes Bellows.
Vital role of employers
Employers can play an essential role in supporting mental health, in part because private health benefits plans fill gaps in the public healthcare system. “Access to publicly funded services and wait times differ from province to province. The pandemic really highlighted that,” says Bellows.
While federal and provincial governments have recently announced new funding and commitments to do more, it will likely be years before systemic improvements take hold.
In addition to health benefits, psychologically healthy and safe workplaces can dramatically boost employees’ ability to manage their mental health by removing stigma and enabling all levels of staff to know when and how to get help.
Despite the potentially vital role of employers, research to date has consistently found that more than half of those experiencing mental disorders are not receiving treatment or social supports. The key barriers are costs and knowing where to go, says Bellows.
Top actions for employers
The first step for employers is a mental health strategy to guide decisions. “The biggest thing is developing a strategy within your organization to talk about mental illness in the same way that we talk about physical health and safety,” states Bellows.
Two pillars of a mental health strategy are a robust benefits package and a psychologically healthy work environment. The third pillar, gaining more attention, is navigation support.
Within extended health benefits, the Canadian Psychological Association recommends mental health coverage of $3,500 to $4,000 annually. This provides for 15 to 20 sessions with a licenced mental health practitioner, which may be necessary to achieve optimal therapeutic outcomes for people experiencing depression or anxiety.
Most plans currently fall well short of the recommended maximum. In Sun Life’s book of business, four out of five offer $500 or less, notes Bellows.
When it comes to navigation support, proactive outreach is key. For example, Sun Life’s Mental Health Coach service, provided by CloudMD, engages plan members at risk of mental health issues. It nudges individuals by email to take advantage of an online self-assessment of their mental health, and from there connect with a mental health coach if they’d like.
The coach, a licensed healthcare practitioner, helps build a personalized action plan, guides plan members to resources and regularly checks on progress. If needed, the coach can recommend other care providers.
An evaluation of participating plan members assessed in May 2021 and again in December 2022 found that 90 percent reported at least one improvement in their mental health since working with their mental health coach. Seventy-three percent reported improvements in their anxiety symptoms, 68 percent in their depression symptoms and 69 percent were sleeping better.
Further analysis in the disability space found that 50 percent fewer claims transitioned from short-term to long-term disability, and those on short-term disability returned to work at least five weeks sooner, adds Bellows.
Help from carriers and advisors
Most insurance carriers today offer a suite of mental-health resources for both plan sponsors and plan members. At least some are available at no cost, such as Sun Life’s Mental Health Strategy toolkit and Lumino Health, an online platform to source and book the services of a wide range of vetted local healthcare providers.
For a psychologically safe and healthy work environment, the Mental Health Commission of Canada’s National Standard has become the go-to guide and your insurance carrier’s staff and/or experts at health organizations such as the Canadian Association for Mental Health can help with implementation.
Your benefits advisor can also be an essential partner to manage the initial workload of a mental health strategy, working with your carrier and other providers. As a member firm of Benefits Alliance, your advisor has access to the Benefits Alliance Mental Health Resource Guide, a compilation of regional resources that can be mobilized to cost-effectively execute your mental health strategy. Finally, your advisor can help communicate group benefits and services to employees.
Educating physicians
An important part of her job is peer education on how private insurance works, and its essential role in funding health care. “Unfortunately, psychology training programs place little to no emphasis on how clinicians can best navigate these systems to meet the needs of their clients,” wrote Bellows as a co-guest editor of a recent issue of Psynopsis, the professional journal produced by the Canadian Psychological Association (CPA), which was dedicated to the topic of working more effectively with insurers.
CPA also recently collaborated with the Canadian Life and Health Insurance Association to produce online resources for clinicians, including recommended best practices, on how to navigate extended health benefit plans.
This article is brought to you by Sun Life, a Platinum Preferred Solutions Provider for members of Benefits Alliance.