Stick it to stigma: How to deal effectively with workplace depression

Dealing with depression in the workplace the right way can make all the difference to your employees - and to your company's bottom line.

It was only when Arnie Cader found himself checking into the psychiatric ward of Toronto’s Centre for Addiction and Mental Health 20 years ago that he realized he had a problem. “I had been working harder and harder, and I just started being less efficient,” recalls the former executive vice-president of the Four Seasons Hotels and Resorts chain. “One day I just came to the end of my rope.”

A severe bout of depression landed Cader in hospital for seven days, followed by months of psychiatric treatment. His worst fear: the office fallout. “I was thinking, what would the impact be on the company, what would people say,” he says. “The stigma was huge.”

It is stigma that prevents many employees suffering from depression from seeking help–and managers from helping them. According to the Global Business and Economic Roundtable on Addiction and Mental Health, a non-profit think-tank established in 1998 to study mental health in the workplace, depression and anxiety cost the Canadian economy $33 billion annually. That’s because of the roughly three million depressed Canadians, 70% are in the workforce, according to the Roundtable. Studies show that a single case of depression typically leads an employee to take between 40 and 90 days off. The Roundtable estimates a depressed employee can cost an employer $10,000.

Depression is certainly taking a bite out of productivity. It represents 35% to 40% of disability insurance claims of large employers, according to Colleen McKinnell, who works with the Group and Health Care division of Watson Wyatt Worldwide in Vancouver. Long-term disability costs, she adds, have jumped 27% over the past two years. “We’re seeing that Canada is lagging behind in the productivity statistics on a global basis,” McKinnell says.

Given the hit to the bottom line, you’d think employers would be taking action. Not so. According to Toronto-based Bill Wilkerson, co-founder and CEO of the Roundtable, at an average company you won’t find any innovative approaches to dealing with depressed employees. “There’s an instinctive reaction that I’m somehow intruding on someone’s privacy,” he says. “That’s always a legitimate concern. But if someone walked into your room and they had a big gash on their face, wouldn’t you say, ‘Geez–can I help?'”

Paula Allen, vice-president of health solutions and product development at FGI World, an employee-assistance program provider based in Thornhill, Ont., agrees managers tend to treat depressed employees at arm’s length. “I think a lot of managers suspect when it’s a mental illness,” she says. “And unfortunately, they act a lot differently and don’t communicate.”

Cader was lucky: his manager was sympathetic, allowing him to take time off to recuperate. He said the experience ended up being a positive one, despite initial fears about job security and public perception. “I didn’t have the huge fear most people would have of disclosing what would be perceived as a weakness.”

So what’s a manager to do? Head to depression school–an educational module designed by the National Quality Institute, the Roundtable and the Homewood Centre for Organizational Health. Slated to launch at the end of 2006, the program–which allows managers to attend sessions at a time and location of their choosing–will provide training on how to identify depressed employees, help them seek treatment, and reintegrate them back into the workplace following an absence.

Wilkerson says the module will initially be targeted at CEOs and other senior executives, building a top-down approach to dealing with workplace depression. He says it will focus on “the semantics, the language, the discourse” necessary to initiate a dialogue with a depressed employee. “It’s a very fine line between doing it right and doing it wrong,” Wilkerson explains. “You have to be careful not to be judgmental, not to be presumptuous, and to phrase questions and frame comments with appropriate language.”

The first step for managers is to identify a distressed employee–someone who is coming in later than usual, overreacting to everyday events, and perhaps not fulfilling their job obligations. But, Wilkerson stresses, managers cannot use the D-word when addressing an employee in a confidential meeting. He suggests a non-specific discussion about the change in an individual’s work habits, along with questions about its root causes. As well, a company’s employee assistance provider should be cited as a place to turn to for help.

If an employee decides to seek counselling, then it’s up to a manager to show support–maintaining the person’s privacy, allowing for time off or a more flexible work schedule and welcoming them back to the office after treatment.

But if an employee refuses to admit there’s a problem, and three or four meetings have yielded nothing, the issue becomes strictly performance-focused, Wilkerson says. “I’ve seen some people reach a stage of resisting it to the degree that they become a liability to the company. That’s a slippery slope–either severance or firing. You’re not firing them because they have depression; you’re firing them because they can’t do their job.”

Make sure, however, that you’ve explored the issue with an employee–or you could have a lawsuit to contend with, warns Allen. “If you take punitive action against somebody without going through proper due diligence–to understand whether they have a health issue or not–the organization could be liable,” he says.

Taking appropriate action is what Wilkerson wants to see more of. And he feels that if action isn’t taken now, Canadian businesses will continue to pick up the rising costs. “The effects of depression are hitting business hard in the pocketbook, in the talent pool and in their productive capacity,” he says. “By not doing this, we are handicapping our managers in their ability to meet their responsibilities.”

How to help

1. Look for performance change: does an employee seem irritable, sad, confrontational, noticeably less productive?

2. In a private room, mention that you’ve noticed a change in the person’s behaviour. Ask what you can do to help and whether they wish to obtain professional advice to find out what may be affecting their performance.

3. Never refer to depression or seem judgmental. All initial conversations should focus on the availability of help rather than work performance.

4. Keep the matter private. Tell others the individual will be off work for some time and that assignments may have to be juggled.

5. Following treatment and recovery, welcome them back. Work out with the employee how duties can be modified to make sure recovery continues. But don’t isolate them.