Population health is key to facilitating mental health in the workplace

EDITOR’S NOTE: “Solving the Puzzle: How to Facilitate Psychological Safety in the Workplace” is a monthly series published by OHS Canada and Talent Canada, in partnership with Dr. Bill Howatt of Howatt HR Consulting in Ottawa.


A growing interest in mental health in the workplace is the desire for more evidence-based outcomes. In concrete terms, this is proof that dollars invested in mental health in the workplace have an impact.

The most important success metrics for boards, CEOs, COOs, HR directors, and CFOs are attraction, retention, disability costs, and productivity. A Mental Fitness Index study demonstrated a positive causal relationship between thriving employees and better results on the above measures. More and more employers are realizing and understanding the potential benefits of protecting and supporting the mental health of workers.

The connection between population health realities and the achievement of targeted mental health outcomes in the workplace may not be clearly understood. To have an impact on mental health in the workplace, it is beneficial for those charged with facilitating workplace mental health initiatives to have a fundamental understanding of the connection between population health and worker productivity.

A key lesson in population health is the financial power that small improvements can have. Small changes matter, even 1-3% changes in a range of population health issues, including mental health. Population health can be affected by mental health at work by increasing the percentage of thriving versus sluggish workforce and decreasing the number of workers with anxiety or depression. There is no magic formula. Mental illness, obesity and diabetes continue to have a negative financial impact on the global economy.

How small percentage changes in population health matter

Like any other country, Canada has population health profiles for many common diseases and conditions. There is extensive research on the prevalence rates of each condition in the general population represented in the average workforce. For each condition, there are reliable assumptions about associated costs such as drugs, treatments, absenteeism and presenteeism. Here are five examples found in every workforce with just two guesses.

To help understand the math, let’s start with an example from Company ABC with 1,000 employees at an average salary, including benefits, of $100,000 for 240 days of service per year.

Looking at the depression in the following table, it is not difficult to estimate the costs for 11 FTEs at six lost work days at a cost of $2,500 per FTE equals $27,500. For presenteeism, assuming full productivity is 90% (90%-82%) per FTE, this represents a loss of 8% (11 x $100,000) of total paid time which equals $88,000. The sum of these two factors for 11 FTEs with depression can be estimated at $115,000.

This calculation does not include all of the other potential costs mentioned above. Most senior leaders do not receive reports on the actual costs associated with the health of their staff.

Illness/Condition Prevalence rate Absenteeism (additional lost working days) Presenteeism (percentage productivity rate)
1. Chronic pain 20.5% 6.12 82.5%
2. Depression 11.0% 9.22 92.4%
3. Diabetes 6.4% 3.32 96.0%
4. Obesity 24.5% 1.3[13] 95.8%
5. Smoking 12.4% 2.0[18] 90.5%
6. Anxiety Disorder (GAD) 8.2% 1.02 96.1%

To make matters more complex, the reality is that some workers have more than one of the conditions above, and many other conditions are not on this list of examples. The good news for employers is that it’s not difficult to get a reasonably accurate understanding of the costs of inaction when it comes to chronic diseases in the workplace. A user-friendly tool that I participated in the development of Health Solutions by Shoppers Drug Mart estimates chronic disease costs based on the size of the workforce and current employee benefits spending.

Key considerations for achieving evidence-based results

  • A positive impact on workplace mental health will occur by positively influencing the psychological health and safety of the culture. It also requires helping workers develop positive habits to improve their mental and physical health.
  • Consider comorbidity related to mental illness. For example, which comes first in workers, obesity or depression? The correct answer is bi-directional, which means that one condition can influence the other. One of the most effective actions employers can take to impact mental health in the workplace is to have evidence-based programs that facilitate emotional well-being and mental health. Programs can include establishing psychologically safe workplaces and enabling employees to develop and master their resilience.
  • Employers should set realistic expectations for any program or support. Consider the six conditions in the table above for 2000 lives. Small may not sound appealing, but the calculations are compelling when done year after year. If only a 1% improvement were made in each of the six conditions, what would be the financial benefit? Now imagine if that was done year after year for five years. The cost-benefit ratio is compelling, provided workplace mental health enablers have realistic measures of success that can demonstrate the financial value of small changes.
  • Research shows that in addition to enabling employers to create a psychologically safe workplace, helping workers improve their lifestyle choices and habits by strengthening their mental (behavioral) health can have a positive impact on their physiological health and overall psychology. Such actions also have a positive impact on the outcome measures desired by employers.
  • Design program evaluation to include population health to provide decision makers with evidence of how small changes in population health can pay off time and time again.
  • Population health requires taking the long view and staying focused on a Plan-Do-Check-Act model with the goal of continuous improvement and seeking evidence that programs improve population health and outcomes. key performance measures of mental health in the workplace.

The Psychologically Safe Workplace Awards (PSWAs) are an annual, evidence-based, national competition that measures employee experience with mental health in the workplace.

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