June 6, 2019 09:30
Karine The Beer | Photo : Denis Méthot
Mental illness causes more damage in the workplace and leads to a marked increase in absenteeism. In 2016, nearly 10 % of québec workers have taken leave due to a mental health problem. They missed by an average of 11.9 days per year, compared to 9.5 days elsewhere in Canada. It now represents one of the main sources of short-term disability in companies.
Absenteeism caused by mental illness, especially depression, is increasing for the past 16 years. In the year 2000, 6.3% of employees were absent from school for this reason. This percentage increased to 9.7 % three years ago, said Karine The Beer, senior manager of Biron Health during the congress training course organized by Segic, in Quebec city.
According to the figures it has provided, the complaints related to mental health account for 30 % of claims in the short-term disability, but they have between 56 and 70 % of the costs. The total cost average per employee amounted to $ 18,000. It is a large bill that employers are seeking to reduce.
In 2012, the depression would have cost Canada $ 51 billion. Close to 42.5 million antidepressant prescriptions were issued in Canada in 2012, 9 % of Canadians are expected to take an antidepressant in their life and 16% of Quebecers are taking medication for mental health.
The causes of increased depression are multifactorial : the individual himself, his or her work environment (mergers, internal reorganisation, lack of recognition of the employer, etc), the individualisation of society, the need of the performance and the effects of globalization are part of it. The system of health lack of time, resources, sometimes of knowledge and a support structure and support almost non-existent also weigh heavily in the balance.
An approach to overcoming the problem is needed, ” said Karine The Beer. It is necessary to accompany the people and businesses in the reduction of disability due to mental health.
It is not easy to diagnose depression
But is this enough to easily find the correct remedy ? Diagnosing depression is not an easy task. It is difficult to have access to objective testing. Doctors lack the time and often expertise. The average time of a medical consultation varies between 12 and 18 minutes. It often takes several consultations to get the right diagnosis and the right treatment plan.
Despite this, the rate of wrong diagnosis is more than 65 %, 30 to 40% of patients are receiving care not consistent with their condition and, even worse, 20% to 25% of care provided is not needed or even worse, are potentially harmful. For their part, patients make the mistake of waiting for a miracle solution.
Barriers to the treatment plan
The obstacles to clinical treatment plan in the field of mental health are also very numerous : it is difficult to get the right diagnosis and the right treatment suitable to our state, non-adherence to the treatment varies from 40 % to 75 %, several interrupt by lack of training or lack of adverse side effects, 38 % of patients do not respond well to SSRI antidepressants because of their genetics and it is difficult to get good follow-up. One person left to itself, especially in the first year, will often lose the time before you react to the difficulties that she lives.
However, the first two months are crucial for preventing the risk of chronicity. After six months, the risk of chronicisation increases dramatically. More optimal treatment is reached quickly, the better is the prognosis. The strategy, said the representative of Biron-Health in his lecture, is to reach and eliminate the unexpected by implementing the treating physician, the employee and the manager.
The objective is summed up in four words : for, the just care, just-in-time. It is necessary to prevent, detect risk factors, identify the problem, establish the right diagnosis and the right support to ensure the proper treatment and do proper follow-up. The mental health of workers, highlighted Karine The Beer, is a shared responsibility between each person and his / her employer. In the Face of the depression of an employee, a manager may play a role as trigger him or her to visit.
The importance of coaching
It is important, says Karine The Beer, take the time to do a comprehensive assessment of the situation using various tools and make a diagnosis suitable while requiring a follow-up by specialty. Attention, 50 % of the people who suffer from sleep apnea have symptoms of depression that could be interpreted as a depression, whereas this is not the case.
The accompaniment of the person from the beginning of the absence is extremely important. Initially, the patient is deprived, there is a lack of resources and energy to make the right choices. It has obtained little information of the treating doctor and needs to better understand his illness and the treatment prescribed. Antidepressant is there to control the symptoms. If it does not, it is not able to work on the root cause. As long as the symptoms are there, we will not resolve the problem, she insists.
A better framing is used to optimize the adhesion and retention in treatment. It will be necessary to intervene at all stages of the treatment plan. The follow-up call from a nurse involved in the three weeks brings a greater improvement in depressive symptoms in patients. For patients with major depression in newly diagnosed, for which treatment telephone follow-up, nurse monthly, there is more of remission after 24 months, 74 % vs. 41 %. This support strategy is paying off. The return-to-work in health leads to a decrease of relapses.
“The way we will interact with the employee that it will create a bond of trust with him, summarizes Karine The Beer. This link makes all the difference on the satisfaction of the employee in the process of his disease. He feels that his employer has not forgotten, that it was well taken care of and this will have a significant impact in the future. “