module 4 workplace solutions...

ENCOMPASS WORKPLACE MENTAL HEALTHWORKPLACE SOLUTIONS WORKBOOK

Copyright eMETA Learning Solutions 2012 1

INTRODUCTIONINTRODUCTIONINTRODUCTIONINTRODUCTION

© 2012 eMeta Learning Solutions



ENCOMPASS MISSION

To provide employers with expert training and consulting for early identification and

remediation of mental health issues in the workplace.

WORKPLACE

SOLUTIONS FOR…

Healthy People

and

Healthy Organizations

MODULE IV

GOAL

To provide employers with practical and effective

solutionsfor addressing mental health issues in the

workplace



UPON COMPLETIONYOU WILL:� Be aware of solutions available to you to create

a mental health receptive workplace

� Understand the purpose of each solution

� Become familiar with how other organizations have utilized these solutions

� Know how to choose, customize, and implement these solutions in your organization

END OF INTRODUCTIONEND OF INTRODUCTIONEND OF INTRODUCTIONEND OF INTRODUCTION

SECTION 1SECTION 1SECTION 1SECTION 1



UNDERSTANDING

MENTAL HEALTH

PROBLEMS IN THE

WORKPLACE

MENTAL HEALTH CONDITIONS

IN THE WORKPLACE ARE:

MENTAL HEALTH CONDITIONS MENTAL HEALTH CONDITIONS MENTAL HEALTH CONDITIONS MENTAL HEALTH CONDITIONS

ARE VERY COMMONARE VERY COMMONARE VERY COMMONARE VERY COMMON

In a typical office of 20 people, chances are that 4

will suffer from a mental health condition this year

National Institute for Mental Health



FROM ALL WALKS OF LIFE

MH CONDITIONS

ARE A HUGE

COST TO SOCIETY

� Account for over 15%

of the burden of disease

� The leading cause of disability in the U.S. & Canada for ages 15-44

National Institute of Mental Heath, 2007

Archives of General Psychiatry, 2005 Jun;62(6):617-27

World Economic Forum's photostream

PHYSICAL HEALTH

47%

29%

MENTAL HEALTH

CONDITIONS COST MORE

THAN PHYSICAL

MENTAL HEALTH



LOST ANNUAL EARNINGS

Mental Illness Costs U.S. Billions ; 5/8/2008

COMMON MENTAL HEALTH

CONDITIONS FACED BY

WORKERS TODAY

� MOOD DISORDERS

• Depression

• Bipolar Disorder

� ANXIETY DISORDERS

TREATMENT VS WORKPLACE

COSTS

COSTS FOR DEPRESSION

Greensberg P, et al. Clinical Psychiatry. 2003 Dec; 64:1465-75

Treatm

ent

Cost

s -

-31.4

%

Workplace Costs 62%



� Untreated depression costs a business more than the treatment

� People with untreated mental health Conditions use more general health services than those who seek mental health care when they need it

Mental Health Cost to Businesses

RECAP

TAKE AWAY

� Depression is the #1 cause of disability in developed countries

� By the year 2020 depression will rank as the 2nd

leading causeof worldwidedisability

Global Burden of Disease study

BUILDING THE BUSINESS CASE FOR

MENTAL HEALTH RECEPTIVE

WORKPLACES



WHAT IS A MH RECEPTIVE

WORKPLACE?� Supervisors and staff are trained on identifying

possible mental health related behaviors

� Supervisors know how to speak to employees about mental health concerns

� Employees are not afraid to disclose personal mental health concerns and seek help

� Supervisors and employees know where and how to access help

� Confidentiality is safeguarded

� Management emphasizes problem solving and accommodations

The behavioral problems

associated with mental

health conditions result in

real, significant, and

measurable

financial losses

SUCH AS…

Turnover

RevenueProductivity

CostsCustomer Complaints



There is a compelling

business case for a

positive, all-encompassing

approach to mental health

conditions in the

workplace

COMPELLING BUSINESS

CASE

Health Insurance Costs

Absenteeism

Diversity

Productivity

Retention

Presenteeism

CONNECTING THE DOTS

Create a Mental Health

Receptive Workplace

?

TO



QUIZ:

Do you believe that your senior management understands the need for a mental health receptive workplace?

Yes or No

Buy-in from senior management is a critical factor in establishing a mental health receptive

workplace.

END OF SECTION 1END OF SECTION 1END OF SECTION 1END OF SECTION 1




LET’S CONNECT THE

DOTS

CONNECTING THE DOTS

Create a Mental Health

Receptive Workplace



BROAD ARRAY OF EFFECTIVE

AND PRACTICAL SOLUTIONS

PolicyRevisions

ResourcesExpertiseTraining

CulturalShifting

EEEEXPERTISE

� Disability Management

� Change Management

� Effective Communication

� Mental Health Conditions

PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

Expertise in Disability

Management



THE BROAD PRACTICE OF

DISABILITY MANAGEMENT

� Assessment and Monitoring

� Prevention and Early Intervention

� Reasonable Accommodations

� Rapid Return-to-Work

� Vocational Rehabilitation

ASSESSMENTS

Vocational

� Assessment of the individual’s abilities, capacity, goals and preferences in relation to occupation

Worksite

� Assessment through observation of the individual undertaking tasks associated with their job

PREVENTION AND EARLY

INTERVENTION DO

MAKE A DIFFERENCE



REASONABLE

ACCOMMODATIONS

Modification of the:

� Work schedule

� Job

� Work environment

vieux bandit's photostream

Allowing a worker:

� To shift schedulesearlier or later

� To use paid or unpaid leave for appointments related to their mental health problems

� To work part-time temporarily

SCHEDULE

MODIFICATION

R. Berteig's photostream

JOB MODIFICATION

� Arranging for job sharing

� Reassigning some tasksamong workers



MODIFICATIONS TO THE

PHYSICAL ENVIRONMENT

� Providing anenclosed office

� Providing partitionsor room dividers

� Soundproofing and visual barriers between workspaces

archie4oz's photostream

JOB COACHING

� To plan and prioritize job tasks

� To perform job tasks to the employer's specifications

mattieb's photostream

Training by an approved specialist:

ASSISTIVE TECHNOLOGY

� A portable computer to enable anemployee to work athome or at unusualhours

� Software that allows the worker to structure time and receive prompts throughout the work day

DeclanTM's photostream



SUPERVISORY TECHNIQUES

� Offering additionalsupervisory sessions

� Offering additionaltraining or instruction on new procedures or information

RAPID RETURN TO WORK

Once away on leave

� Strong relationship maintained by supervisor

� Supervisor remains actively engage with employee

� Develop a return to work plan

VOCATIONAL

REHABILITATION� Associated with disabling conditions

� A process

� Strengths based and rehabilitative approach

� Employment and self-sufficiency are the goals

� Can be in concert with physical rehabilitation



Disability Management

Recap:� There are reasonable

accommodations for people with mental health conditions

� Early assessment, treatment, and planning are critical elements to a rapid return to work





EEEEXPERTISE





PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

EXPERTISE IN

CHANGE

MANAGEMENT

CHANGE MANAGEMENT

Managing the People side

� Top management commitment and support

� Communication

� Change Team

Managing the Project side

� Identifying the activities

� Creating an action plan



GETTING STARTED

� Where are you now?

� Where are you going?

� How will you get there?

THE TRANSITION MODEL

The Current State

The Transition(What & How)

The Future State

Do your employees seek MH care when they need it?

Do your employees know where to get help?

What does absenteeism & presenteeism cost you?

What are your• Productivity rates?• Turnover rates?• FMLA costs?• Mental Health related

prescription drug costs?

What does your mental health care coverage look like?

How does Mental Health Parity Act impact you?

Expertise

Policy Revisions

Accessing Resources

Cultural Change

Training

A Mental Health receptive workplace

• Increased Morale

• Lower FMLA costs

• Lower Workers Comp costs

• Lower turnover

• Contained Health Care costs

• Increased Productivity

• Decreased Absenteeism

• Decreased Presenteeism

The Current StateDo your employees seek mental health care when they need it?

Do your employees know where to get help?


What are your• Productivity rates?• Turnover rates?• FMLA costs?• Mental Health related prescription drug costs?


How does Mental Health/Substance Abuse Parity Act impact you?



The Future State









• Lower turnover

The Transition

ExpertiseExperience and knowledge combined to ensure successful utilization of:

Policy Revisions• To establish a solid framework for positive behavioral

change

Resource Awareness• To leverage both your internal and external resources

Cultural Shifting• The process of creating a environment that supports

healthy people and a healthy organization

Training• A core element to get the right message to the right

people at the right time

BEGIN WITH THE END IN MIND

The Current State

The Transition(What & How)

The Future State

Do your employees seek MH care when they need it?

Do you employees know where to get help?


What are your• Productivity rates?• Turnover rates?• FMLA costs?• Mental Health related

prescription drug costs?


How will Mental Health Parity Act impact you?

Expertise

Policy Revisions

Accessing Resources

Cultural Change

Training





• Lower turnover







QUIZ:

Describe the three stages of the change management process

The answer is:

� Current state – describes your current business reality

� Transitional state – the changes that you need to make in your business to move to the desired outcome

� Future state- describes your desired outcomes

EEEEXPERTISE





PolicyRevisions

Training

CulturalShifting

ResourcesExpertise



Expertise in

Communication

Key Elements of Effective

Communication:

�Reflective Listening

� Emotional Intelligence

REFLECTIVE LISTENING

The key elements of reflective listening are:

� Encourage the other person to speak without interruption.

� Paraphrase what the speaker says at appropriate intervals

� Reflect feelings Video: Communicating with Your Employee



ELEMENTS OF EMOTIONAL

INTELLIGENCE� Confidence

� Curiosity

� Intentionality

� Self-control

� Relatedness

� Capacity to Communicate

� Cooperativeness

Elements of Emotional Intelligence

EEEEXPERTISE





PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

Understanding Common

Mental Health Conditions

� Mood Disorders

• Depression

• Bipolar Disorder

� Anxiety Disorders

• Panic

• General

• PTSD

• OCD

• Phobias



Sidebar

Mental Health Parity and the Health Care Reform Bill

WHAT IS THE MH PARITY?

Rep. Keith Ellison's photostream

Mental Healthand

Substance AbuseBenefits

ON PAR WITH

medical/surgicalbenefits.

MENTAL HEALTH PARITY IS

HERE

� The Unknowns• Increase in utilization• Lack of managed care

� The Predictions• Costs to go up .1% to .6%• Promoting early treatment will

minimize increases

Health & Benefits PerspectiveLEADING THROUGH UNPRECEDENTED TIMES



MENTAL HEALTH PARITY 2012

� Regulatory action has stalled since 2010

� President Obama remains supportive

� The final rule that would provide clarity to employers has not yet been issued

� There remains uncertainty and confusion over what an employer must cover and when parity applies

FEARS WERE UNFOUNDED

7 Federal Employee Health plans offered parity benefits to 8.5 million employees

without any significant increase

in costs

Behavioral Health Insurance Parity for Federal Employers, H.H. Goldman et al., March 30, 2006,

IBM REDUCES OUTPATIENT

COSTS

MENTAL HEALTH

PHYSICAL/ SURGICAL

DISEASE MANAGEMENT

EMPLOYEE ASSISTANCE

PROGRAM

The integration of

saved IBM $500,000 in outpatient costs in one year



PHYSICAL AND

SURGICAL

MENTAL HEALTH

BENEFITS

Medical Clinics of North America

TAKE AWAY

“We can pay for mental health

problems/substance abuse up front

we can pay down the line in increased medical/

disability costs, absenteeism, and

Presenteeism

Either way, we will have to pay.”

or…





ENCOMPASSING

SOLUTIONS…

POLICY REVISIONS

PPPPOLICY REVISIONS

� Stigma Busting

� Safeguarding Confidentiality

� Employee Assistance Programs

� Employee Health-wellness/Work-life

Balance

PolicyRevisions

Training

CulturalShifting

ResourcesExpertise



STIGMA BUSTING POLICIES

� Provide guidelines for business conduct

• Address bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance

� Develop standards for use of re-boarding

• Welcoming employees back from disability leave

SAFEGUARDING

CONFIDENTIALITY

EMPLOYEE HEALTH -

WELLNESS/WORK-LIFE BALANCE

LollyKnit's photostream



Said they believed productivity losses from depression are more costly than treatment 78%

Promoted Screenings 11%

WE NEED TO DO MORE

83%Said they had taken steps to create a supportive

environment for depressed employees

37%Conducted depression education programs

University of Michigan Depression Center

In a survey, human resource professionals:

FOOD FOR THOUGHT

Do you feel that the policies and procedures in your organization support a mental health receptive workplace?

Yes or No

ENCOMPASSING

SOLUTIONS…

RESOURCE AWARENESS



RESOURCES

� Connecting with:

• EAP services– Virtual Counseling

• National and local Support groups

� Selecting mental health screening tools

� Securing sources of mental health information for employees

PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

EMPLOYEE ASSISTANCE

PROGRAMS (EAP) CAN

PROVIDE RAPID RESULTS

� If your company doesn’t already have an EAP, consider getting one

� Choosing an EAP

• THE EAP BUYER’S GUIDE

CHARACTERISTICS OF

VIRTUAL COUNSELING

� Convenience

� Privacy

� Comfort

� Lower cost

� Flexibility

� Options



quinn.anya's photostream

SCREENINGS CREATE

AWARENESS

Depression Test 15 questions, 10 min

At times, everybody gets down in the dumps. But if life is consistently getting you down and your lows are making it hard to function, you may be depressed. Find out whether your slump is critical with the Depression Test. This test is designed to determine whether you presently have, or are at risk for developing a depressive disorder. Examine the following statements and indicate how well they describe you or how often you feel that way. After finishing the abridged version of the Depression Test, you will receive a brief interpretation of your score that includes diagrams, information on the test topic and tips.

Pamphlets, Flyers, Posters,

Newsletters



Health & Wellness Fairs

health fair

Celebrate

MilitaryHealth's photostream

EDUCATION IS CRUCIAL

Paycheck Messages can be useful



RESOURCES AT YOUR RESOURCES AT YOUR RESOURCES AT YOUR RESOURCES AT YOUR

FINGERTIPSFINGERTIPSFINGERTIPSFINGERTIPS

� Substance Abuse & Mental Health Services Administration(www.samhsa.gov)

� The Partnership for Workplace Mental Health (www.workplacementalhealth.org)

� Mental Health Works(www.mentalhealthworks.ca)

APPS For Mental Health for

iPads/Phones and Androids

� Mobilyze

� Let Panic Go

� Mindfulness Meditation

� Freedom From Stress

� Buddhist Meditation Trainer

Duke Integrative Medicine

of Duke University

� Developed Mindfulness Based Stress Reduction Program

� Developed Integrative Health Coach Professional Training



THERE ARE MANY SOURCES

OF PROFESSIONAL HELP

� Physicians

� Mental health specialists

� Employee assistance programs

� Mental Health Literacy Trainers

� Community mental health centers

� University or medical school affiliated programs

� Family service/social agencies

QUIZ:

True or False:

The most important resource that a company can have to address mental health issues in the workplace is an EAP.

If you answered “True”

You are correct! EAP’s are a company’s first line of defense in addressing mental health conditions in the work place. The challenge is to encourage your employees to use your EAP at the first signs of distress.





ENCOMPASSING

SOLUTIONS…

CULTURAL SHIFTING



CCCCULTURAL

SHIFTING

� Creating a Culture of:

• Awareness

• Knowledge

• Understanding

• Open Communication

PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

Employee develops a mental health condition

Employee takes a leave from work

There is minimal acknowledgement

Workplace conversations are hushed

No communication, flowers, or cards

Recovery is compromised

Employee does not

return to work

WHEN THE

WORKPLACE

IS NOT MH

RECEPTIVE

Employee develops a mental health condition

Supervisor expresses concern

Supervisor provides support, resources

and reasonable accommodations

If Employee takes time off to recover

Supervisor stays in touch

Colleagues stay in touch according to

wishes

Employee is welcomed back

WHEN THE

WORKPLACE

IS MH

RECEPTIVE

Inno'vision's photostream



FEAR OF DISCLOSURE IS A

SERIOUS BARRIER

� Diagnosis

� Treatment

� Acceptance in the Workplace

Fe

ar o

f Dis

clo

su

reF

ea

r of D

isc

los

ure

Fe

ar o

f Dis

clo

su

reF

ea

r of D

isc

los

ure

STIGMA

MENTAL HEALTH

CONDITIONS

REDUCED PRODUCTIVITY

INCREASED COSTS

LOWER MORALE

A NEGATIVE DYNAMIC IS

SET IN MOTION

PEOPLE WITH MENTAL

HEALTH CONDITIONS DO NOT:

19%

22%

42%

74%

Mental Health Foundation,

Mention it on job application forms

Tell some family

Tell their partners

Tell their GP



WE CAN COUNTER STIGMA

� Learn and share the facts about mental health

� Treat people with mental health conditions as you wouldanybody else

� Avoid labeling

� Don’t discriminate

� Teach children aboutmental health

BAIA's photostream

Food for Thought:

Does your company have a “Don’t ask, don’t tell” culture for employees with

mental health conditions?

If you answered “yes”

It is important that your company understands the need for mental health

literacy training



SUCCESSFUL CULTURAL SHIFTING REQUIRES EFFECTIVE

CHANGE MANAGEMENT

PRODUCTIVITY IMPACT

MODELCalculating the Impact of Depression in the Workplace and the Benefits of Treatment

� Step 1 -- Size of workforce and industry category

� Step 2 -- Prevalence of depression

� Step 3 -- Treatment benefits

� Step 4 -- Cost of undiagnosedDepression Calculator

ENCOMPASSING

SOLUTIONS…TRAINING



TTTTRAINING

� Management

� Frontline Supervisors

� Workforce

PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

TTTTRAINING

� Mental HealthAwareness in the Workplace

� Understanding MoodDisorders

� Insights into Anxiety

� Practical Solutions for a MH Receptive Workplace

PolicyRevisions

Training

CulturalShifting

ResourcesExpertise

TRAIN YOUR FRONT-LINE

MANAGERS � Use respectful and reflective listening

techniques

� Be aware of what you can and cannot say to employees

� Be able to identify employee behaviors that may be associated with a mental health condition

� Recognize when an employee needs professional help



FEW SUPERVISORS ARE

TRAINED

Only 15% of supervisors are trained to recognize problem behaviors in the workplace Foreign and Commonwealth Office's photostream

DETECTING PROBLEM

BEHAVIORS

� Personality Changes

� Job Performance Issues

� Relationship Troubles

� Physical Problems

Jeffrey Beall's photostream

PROB LEM S

PERSONALITY CHANGES

� Melancholy/Quiet

� Indifferent attitude

� Crying

� Strange or grandiose ideas

� Displays of anger or rage



JOB PERFORMANCE ISSUES

� Consistent tardiness

� Frequent absenteeism

� Difficulty concentrating

� Working excessiveovertime for prolonged periods

� Unable to complete work or meet deadlines

� Increased accidents or safety problems

RELATIONSHIP TROUBLES

� Lack of cooperation

� Blaming others

� Disconnected from fellow employees

PHYSICAL PROBLEMS

� Expressed chronic pain

� Expressions of fatigue

� Poor physicalappearance



WHY SUPERVISORS OFTEN

DON'T RESPOND

� Fear of the consequences

� Lack of confidence in his/her own assessment

� Concerns about “interfering”

� Hope that the problem will just go away on its own

Relationship w/ supervisor

is strained

Coworkers feel confused &

assume responsibility for

the employee

Coworkers try to offer advice

Coworkers begin to feel

angry

Morale deteriorates

Everyone’s ability to function is

affected A NEGATIVE DYNAMIC IS

SET IN MOTION

AS AN EMPLOYER….

You can’t

� Diagnose a mentalhealth condition

� Ask an employee ifthey have a mentalhealth condition

business meets healthcare



BUT, AS AN EMPLOYER….

You can

� Use your skills to make the workplace feel safe and comfortable for all employees

� Discuss changes in work performance

� Listen to employee concerns

� Become familiar w/both internal and external resources

BUT, AS AN EMPLOYER….

You can

� Refer the employee to an EAP or other qualified provider

� Ensure confidentiality

� Learn about mental health conditions

� Recognize that an employee with a mental heath problem may need a reasonable job accommodation

RECAP:

It is critical to understand that mental health literacy training is an investment

rather than a cost.

Through an effective employee training program a company can mitigate many of

the costs of untreated mental health conditions in the workplace.



END OFSECTION 5END OFSECTION 5END OFSECTION 5END OFSECTION 5


ORGANIZATIONS THAT HAVE CONNECTED

THE DOTS



STRESS MANAGEMENT

PROGRAM INCREASES

PRODUCTIVITY

At a Motorola manufacturing facility, 93%

of employees had an increase in productivity as a

result of a stress management program

phylevn's photostream

FOCUSING ON

MENTAL HEALTH ISSUES

IMPROVING EMPLOYEE

ASSISTANCE USAGE

ELIMINATING UNNECESSARY SOURCES OF

STRESS

REDUCING BURNOUT

15% -25% REDUCTION

OF DISABILITY

RATES

+ + + =

AETNA

Research showed that:

� Depression was very common and rising in their member population

� Depression has a high impact on work abilities and on the progression of medical conditions

� Medical costs for individuals are much higher if depression is present and hospitalization rates are nearly double

� Depression increases the likelihood of reduced work performance, absence from work, and disability.



AETNA RESEARCH SHOWED

� Increased adherence to care improved outcomes of those with depression

� Efforts to better integrate behavioral and medical care resulted in

• enhanced early identification of depression

• increased access to integrated care

• ~ $1600 savings per treated individual/year

NET SAVINGS FOR EMPLOYEES NET SAVINGS FOR EMPLOYEES NET SAVINGS FOR EMPLOYEES NET SAVINGS FOR EMPLOYEES

EFFECTIVELY TREATED FOR EFFECTIVELY TREATED FOR EFFECTIVELY TREATED FOR EFFECTIVELY TREATED FOR

DEPRESSIONDEPRESSIONDEPRESSIONDEPRESSION

COMPANY SIZE EMPLOYEES

AFFECTED

# EFFECTIVELY

TREATED

TOTAL

SAVINGS/YEAR

100 EMPLOYEES 13 10 $14,000

500 EMPLOYEES 63 50 $70,000

1000 EMPLOYEES 125 100 $140,000

10,000 EMPLOYEES 1250 1000 $1,400,000

Data extrapolated from “Cost of Lost Productive Work Time Among U.S. Workers with Depression” by W.F. Stewart, et.al, June 18, 2003, The Journal of the American Medical Association.

CITY OF COLORADO SPRINGS

ADDRESSES DEPRESSION

Reduced severity of depressive symptoms

Improved physical and

social functioning

Increased productivity

Reduced time away from work

Estimated savings of

$3,136/week

+ + + =

After 6 months:

http://www.workplacementalhealth.org



HOW DID THEY DO THIS?

Promoted Screenings

PHQ-9 depression screening tool.pdf

Contracted

Depression Care Management

Employee Assistance Program

DUPONT

� Telephonic screenings for mental health have been offered since 1998

� Each October, during Mental Health Screening Month, reminders to participate are issued

� At this time the screenings are limited to the USA and Canada but efforts to expand them are ongoing.

FORD MOTOR COMPANY

� The Ford Motor Company worked with the University of Michigan on health plan improvements for greater flexibility and choice for behavioral healthcare

� There was improved coordination and integration of care for chronic illnesses such as depression

� Health Navigators were provided to help steer plan members through the health care system Partnership for Workplace Mental Health



OTHER COMPANIES THAT HAVE

INTEGRATED BEHAVIORAL AND

PHYSICAL/SURGICAL HEALTHCARE

� American Airline

� Caterpillar

� IBM

� Cisco

� Pitney Bowes

� PPG IndustriesPartnership for Workplace Mental Health

What can I do in the next day or week to make my

organization a more mental health receptive workplace?

END OFSECTION 6END OFSECTION 6END OFSECTION 6END OFSECTION 6



Deborah Dutton Lambert, MBA, PC, [email protected]

Daina R. Dennis, MBA, [email protected]

Contact Information

www.encompasselearning.com

module 4 workplace solutions...

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