Increasingly employer organisations, trade unions and government policy makers are realising that the social and economic costs of mental health problems at work cannot be ignored!
Mental health is not in itself a readily defined concept but rather refers to a continuum that includes emotional wellbeing, mental health conditions and mental illness. Mental health like physical health can fluctuate. It is this which can be tricky for employers to navigate!
With World Mental Health Day recognised on 10 October 2018, is time to pause and reflect on what can be done to turn the tide on the prevailing stigma on hiding, rather than acknowledging that you (employers and employees alike) have mental illness in our society?
Taking stock of what workplaces are doing or not, to overcome the impact that mental health episodes are having on the workplace is worth the reflection. An estimated R 3 billion is lost to the corporate sector annually as a result of untreated mental health conditions and other stress related illness.
Globally more than 300 million people suffer from depression, the leading cause of disability. The World Health Organisation (WHO) recent study estimated that depression and anxiety cost the global economy US $ 1 trillion each year in lost productivity. Depression contributes 69% of indirect costs such as loss of productivity, absenteeism and disability (South African Federation Mental Health – SAFMA). Around 16.5% of the South African adult population suffers from mental illness (SADAG). So if you are employed by a large organisation chances are you are working with someone who has one of a range of mental illnesses; and 80% of employees diagnosed with depression continue to work during their episode of depression!
Many factors contribute to this in South Africa: work-related stress, disease, poverty, abuse, sexual violence, as well as the decay of the traditional value system, according to a study conducted by the Mental Health and Poverty research Program. Mental illness has a large genetic component to it, and while these factors may act as triggers, mental illness is very often chronic, and even though managed by medication and therapy, still a life long condition for the majority of people.
Unfortunately, mental illnesses still carries a heavy stigma, mostly due to a lack of understanding and poor education. So it’s no surprise then that many sufferers keep their mental illness secret, and some are indeed easier to hide than others.
What is a mental illness?
In South Africa, the definition of mental illness varies depending where you read it, but in the work place it is classified as a disability, and therefore the one that is used is that from the Employment Equity Act. It describes people with disabilities as those who have “a long-term or recurring physical, including sensory, or mental impairment which substantially limits their prospect of entry into or advancement in employment.”
While many people have mental health concerns from time to time, it only becomes a diagnosable mental illness when the signs and symptoms are ongoing and cause regular stress and negatively impacts the individual’s ability to function in society or the workplace.
The South African situation
A study by the Mental Health and Poverty Project (MHaPP), based at the department of psychiatry and mental health at UCT, found that public attitudes toward mental health and treatment are generally negative, and that despite a supportive and progressive policy framework for mental health, this area is not given the priority it needs in South Africa.
Many South Africans still hold the traditional belief that mental illness results from a demonic possession. Katherine Eyal, who facilitates a support group for students at UCT who have mental illnesses, says “This is tricky, because while mental illness isn’t a well-known concept in many African communities, that doesn’t mean those cultures are ignorant. In many cultures around the world, mental illness is not a thing – it’s shameful, or as a result of witchcraft – so this is a common thing in many cultures.” Operations Director at SADAG Cassey Chambers says, “In Zulu, there is not even a word for ‘depression, it’s basically not deemed a real illness in the African culture.” Most mental illnesses lack obvious physical symptoms, so are considered “not ‘real’, a figment of the imagination”! (extract from an interview with the South African College of Applied Psychology (SACAP).
It is interesting to note that 45% of the black patients who attended a community mental health clinic had consulted a Traditional Healer, while 26% also simultaneously seek treatment from both traditional healers and psychiatrists.
Eyal clarifies this by explaining “To say someone is hearing voices and should take anti psychotics to get rid of them, might be trumping a very strong traditional belief about being called by one’s ancestors, for example. So that means actually a synthesis is important – Western and traditional medicine working together.
The costs of mental illness
Recent studies have found that it costs South Africa more to not treat mental illness than to address it. The expense includes costs at work, such as reduced productivity, absenteeism, staff turnover and loss of talented employees. Effectively, it costs more to replace a mentally ill employee than it does to assist them, yet employers underestimate the financial impact of mental illness on their business’ earning potential. Often choosing to exit an employee rather than supporting them through the illness (If supported this usually has the benefit of ensuring employee loyalty).
There is also a strong correlation between mental health disorders and substance abuse. The South African Association of Social Workers in Private Practice estimates that 50% of workplace accidents are related to substance abuse, and an undetected substance abuser can cost the employer 25% of that person’s wages: a significant cost risk.
Investing in an Employee Wellness Program, de-stigmatising mental illness and encouraging employees to disclose their diagnosis therefore has a direct impact on the bottom line.
Employee Assistance Programmes
Many larger companies already have established Employee Assistance Programmes (EAPs) to support their employees whose mental health may impact their work performance.
The workplace EAP is also a valuable preventative tool that can address issues fuelling stress and impacting mental health at the workplace. It’s no secret that healthy workers are more motivated, more productive and more engaged with their work. Companies with effective EAPs also save costs, by ensuring better attendance and reducing staff turnover.
There are many South African organisations which can assist companies in making improvements in their management of mental health in the workplace. Here are a few resources we suggest:
The South African Federation for Mental Health (SAFMA) offers presentations and workshops on mental health in the workplace and assists companies in developing strategies to improve the mental health of employees and the reasonable accommodation of persons with mental illness in the workplace.
The South African Depression and Anxiety Group (SADAG) supplies leaflets for distribution on the workplace, which aim to promote understanding and minimise stigma.
Finally, the Constitution (Act 108 of 1996) prohibits against the unfair discrimination of people with mental disorders, and as such doing so is illegal and those who struggle with mental illness have legal protection and recourse for unfair dismissal or workplace discrimination in South Africa.
The World Economic Forum (WEF) suggest a 3 pronged approach:
Protect mental health by reducing work related risk factors
Promote mental health by developing the positive aspects of work and strengths of employees
Address mental health problems regardless of cause