According to the National Institute of Mental Health (NIMH), mental disorders are the leading cause of disability in both U.S. and Canada for people between the ages 15 and 44.

Since mental disorders can affect us at any time through our working years, they can play a major role in our economy, due to their impact on costs from decreased productivity at work, increased absenteeism, sick leave, and short-term and long-term disability. 

With about 10% of the working population being diagnosed with a mental disorder each year, productivity losses to mental illnesses are estimated to be approximately $17.7 billion each year in Canada.

Ensuring the mental health of workers is essential. Providing effective interventions and supportive reintegration to work are key ingredients towards recovery.  

Effective treatments for mental disorders do exist. However, one major problem lies within the delivery of such treatments. Fragmentation between different types of health care providers is one of the major barriers to accessing effective treatment according to Dr. Carolyn Dewa, head of the Work and Well-being Research and Evaluation Program at the Centre for Addiction and Mental Health (CAMH). 

Dr. Dewa has stated that when people suffer from a mental health problem, they often go to their primary care physician who might refer them to a mental health specialist. However, collaboration may not occur among the health care providers, resulting in fragmentation of care. This latter major problem that we are facing led Dr. Dewa and team to examine whether a collaborative care model could make a difference. 

The study from CAMH, published in the Canadian Journal of Psychiatry in June 2009 by Dr. Dewa and her team, examined both the clinical and cost effectiveness of a Collaborative Mental Health Care (CMHC) program for people on short-term disability leave for psychiatric disorders.

This is the first Canadian study looking at the cost-effectiveness evaluations of a CMHC model for people on short-term disability leave for psychiatric disorders. The CMHC program worked on extending the availability of specialty mental health resources in primary care settings, increasing communication among health care providers, and promoting continuity of care and follow-up care. 

Three major objectives of the CMHC program were:

• To increase the number of workers who return to work
• To decrease the number of workers who transition to long-term disability care
• And to decrease the length of short-term disability episode.

The results of the study showed that the CMHC models of disability management based on the Canadian data may be a very good investment in helping individuals who are on short-term disability leave for psychiatric disorder to receive adequate health care treatment. 

Specifically, the findings of the study indicated that for every 100 people on short-term disability leave to psychiatric disorder, there could be:

• $50,000 in savings related to disability benefits ($503 per person x 100 people)
• more people returning to work (n=23)
• fewer people transitioning from short-term disability to long term disability leave (n=24)
• 1,600 more workdays (16 fewer short-term disability days x 100 people).  

Ongoing collaboration and regular contact among mental health specialists and primary care physicians were stated as being the key challenges to the success of the CMHC program.  

“Employer investment in high quality mental health care produces better outcomes and cost-savings than traditional disability management approaches” according to Dr. Ash Bender, Clinic Head of the Work, Stress and Health Program at CAMH.

The 4th Annual Canadian Congress for Research on Mental Health and Addiction in the Workplace will occur on October 28-30 at the Westin Harbour Castle, Toronto, and will explore both policy and practical interventions that employers can use to ensure the wellness of their employees. It is the leading Canadian forum dedicated to exchanging scientific evidence to improve the working environment and the mental health of workers.

It is by working together that we are contributing to mental health in the workplace.