Canadian HR Reporter

CANADIAN HR REPORTER JANUARY 2019 NEWS 7 Combating the rise of mental health claims Exclusive roundtable looks at challenges and potential solutions to disability management – or 'disability prevention' BY MARCEL VANDER WIER IN a world where mental health is- sues are becoming more prevalent in employment settings, employ- ers and HR professionals are striv- ing to find preventative solutions around disability management. In November, Canadian HR Reporter hosted an exclusive roundtable sponsored by Sun Life Financial that explored the issues behind the rise in mental health claims, including: What is driving the increase? Where can employ- ers and employees turn for help? And what solutions exist to pre- vent workers from going off the job, but also having them return quickly? What's behind the trend Societal and demographic factors such as an aging workforce are driving today's disability claims, according to Paula Allen, vice- president of research and integra- tive solutions at Morneau Shepell in Toronto. Reduced stigma surrounding mental health plays a role in in- creased claims, but so do risk fac- tors such as isolation, she said. "ere's more Canadians living alone now than have ever been in history," said Allen. "It's hard to feel validated when you're by yourself." "e last thing we want is for the workplace to exacerbate something that's already happen- ing and that we know to be quite damaging for health." e workplace is often the place where people find connection, though it can also be an issue for younger workers, according to Mike Aiken, assistant vice-pres- ident of disability operations at Sun Life Financial in Kitchener, Ont. "at is not the diagnosis, but it's the trigger point that is leading to that mental health issue — that absence," he said. Humans are social animals and isolation can have a harsh effect, said Tyler Amell, chief relation- ship officer at CoreHealth Tech- nologies in Calgary. "At the end of the day, work is essential for our good health and when we miss out on that interac- tion, that commonality, that sort of thing, it tends to feed into some negative feelings," he said. Also behind the increase in in- cidents and longer durations of employee leave is the coupling of a chronic disease with a mental health incident such as anxiety or depression, said Amell. "One of the things that we're seeing is that there are more co- morbidities or polymorbidities taking place," he said. "So, it's not just one particular incident that is driving an episode of temporary work disability." "is invariably leads to more incidents and longer durations, and more people are transition- ing from short-term disability to long-term disability plans." Employers need to shift to- wards an approach of disabil- ity prevention and investment in well-being, according to Allen. "e workplace does have an impact on how people manage their own health," she said. "Cultures of the workplace, self-care, resources that are avail- able, whether there's conflict that's poorly managed — all of these have impact on people's physi- cal well-being as well as mental well-being." "ere is an education as well for employees, because this is a joint accountability — it's employ- ees as well as employers — to sort of avail yourself of resources." Education needed Education on benefits program- ming would be a good start, said Aiken. "More and more, you're see- ing the younger generation, and they are not understanding their benefits program," he said. "ey don't even understand what their employers offer." In that respect, society has a ways to go in terms of mental health literacy, and understand- ing ailments such as depression, anxiety and bipolar disorder, said Allen. High-functioning mental disor- ders can be hidden behind a smile and continued work productivity, she said. "It doesn't necessarily show the same way in every person. One person might show anger; another person might show self-induced isolation," said Allen. "Without that understanding of the different ways that mental disorders can show themselves in people, then I think we end up missing a fair bit," she said. "Peo- ple hang on until they absolutely crash." Education is also needed around workplace accommoda- tion, said Stuart Rudner, employ- ment lawyer and founder of Rud- ner Law in Toronto. "It's critical that employers and employees understand what the law says about accommodation — what's required from both parties, because it should be a bilateral or two-way process," he said. "When it comes to requests for accom- modation, it's critical to have a very clear, defined process." "It doesn't matter what the issue is, there should be one process for accommodation which involves the employee, makes sure the employee knows that they need to provide appropriate information." Employers are not trying to catch employees in a lie, said Rudner. Rather, they are simply de- termining whether there is a le- gitimate need for accommoda- tion and how it can be provided — with the goal of having the employee return to work sooner through a modification of duties or other options, he said. Options available in medicine, tech, data Personalized medicine such as pharmacogenetics or pharma- cogenomics could prove to be a major benefit in the mental health space, according to Aiken. "We really need to actually con- tinue to tout that and get the gen- eral practitioners onboard with that," he said. "It sounds simple but it's very difficult to actually educate the general public on this trend." e practice consists of an oral swab test, after which DNA is sent to a lab and screened to un- derstand which drugs the patient would process best, said Amell. "It's relatively inexpensive when you compare it to the disability costs associated with wage-loss replacement and other things," he said. "It's a way to leapfrog to the final drug that's going to have the best indication for treatment for one particular person." "I foresee a time in the future where this will be part of our medi- care program — funded by the provinces eventually — because the efficacy is clearly supported. e research is clearly there that this does make perfect sense." Canada's public health-care system, while excellent, does have some drawbacks in terms of rapid resolution to mental health issues, said Rudner. "ere are flaws, including ex- cessive delays to see specialists, get tests done," he said. "It can be as simple as you've got someone who needs an MRI and you're waiting three months to have it done, and the employ- er's waiting three months to have them come back to work." Telemedicine and telehealth also play a role in ensuring quicker turnaround times for employees with mental health issues, said Allen. Cognitive behavioural therapy — delivered in an internet or digi- tal format — is a possible solution and effective alternative to tradi- tional face-to-face consultation, she said. SPONSORED BY From left, roundtable participants: Mike Aiken of Sun Life Financial, Stuart Rudner of Rudner Law, Paula Allen of Morneau Shepell, and Tyler Amell of CoreHealth Technologies. Credit: John Hryniuk HOLISTIC > pg. 8 "is is a joint accountability — it's employees as well as employers — to sort of avail yourself of resources."

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