Psychological health and safety in the workplace: Discussion paper

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Abbreviations list
COHSR
The Canada Occupational Health and Safety Regulations
HPP
Hazard Prevention Program
MHCC
Mental Health Commission of Canada
OHS
Occupational Health and Safety
PHS
Psychological Health and Safety

Section 1: Introduction

Issue

Psychological health and safety in the workplace is a growing concern in Canada. The Mental Health Commission of Canada (MHCC) estimates that 500,000 Canadian employees are unable to work each week due to a mental health issue. This results in the Canadian economy losing an estimated $6 billion per year in productivity from the following:

The MHCC also estimates that 1 in 3 workplace disability claims in Canada are related to mental illness. Additionally, 70% of short-term and long-term disability costs are attributed to mental illness.

Mandate letter commitment

To address the impact that psychological injuries and illnesses are having on the health of federally regulated workers and on productivity in their workplaces, the Honourable Filomena Tassi, Minister of Labour, has a mandate commitment to improve labour protections in the Canada Labour Code (Code) by:

Several of Minister Tassi’s colleagues also have mandate commitments to take action to support Canadians’ mental health. Most notably, the Minister of Health has been tasked with the development of a national standard for access and support to mental health services for Canadians. The Minister of Health is working with the following Ministers to meet this commitment:

Also, the Minister for Indigenous Services has been tasked with developing a distinctions-based mental health and wellness strategy to better support Indigenous communities.

These mandate commitments are particularly timely due to the impact that the COVID-19 pandemic is having on the mental health of Canadians. Recent data shows a decrease in the number of persons who describe their mental health as being very good or excellent. For example, in May 2020, 48% of Canadians reported excellent or very good mental health compared to 68% in 2018Footnote 1.

Purpose of the discussion paper

This discussion paper is intended to elicit the views and perspectives of the following parties on psychological health and safety in the workplace:

The responses we receive will inform policy proposals to ensure that they are responsive to the diverse needs of federal jurisdiction workplaces.

Responding to this paper

Questions asked in this discussion paper aim at guiding and facilitating your input. We invite you to comment on all or some of these questions, or on any other related issues that you find relevant.

You can send written responses and questions or comments on this topic via email to: edsc.santementale-mentalhealth.esdc@labour-travail.gc.ca

Section 2: Background and prevalence

Definition of psychological health and safety

The World Health Organization defines “mental health” broadly as a:

“State of well-being where every individual realizes his or her own potential, can cope with the normal stresses of life, work productively, and is able to make a positive contribution to her or his community.”

The term mental health encompasses a broad spectrum of factors that may affect an individual’s well-being. Mental health initiatives in the workplace typically focus on promoting mental health as part of an overall state of well-being.

“Psychological safety” refers to efforts taken to reduce the risk of psychological injury, often in a workplace setting. Prevention helps achieve the minimization of this risk. While psychological health and psychological safety are equally important, ensuring safety through prevention is often a prerequisite to promoting health. For example, the CSA Group suggests that a psychological health and safety system should assess needs and address gaps in psychological safety before implementing health promotion activities. Further, the National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) notes that the strategic pillars of a psychological health and safety system are:

Consequently, in the context of occupational health and safety (OHS), what is generally understood as mental health is most often referred to as “psychological health.” This interpretation is the result of recent court decisions referring to “psychological health and safety” as an implied element of OHS obligations and regulations. Beyond the legal uptake, experts have also adopted the use of the term ‘psychological’ when referring to or describing mental health illnesses injuries or hazards that occur in or are linked to the workplace.

Accordingly, while mental health is used throughout this paper in a broader sense, the term psychological health and safety (PHS) is used for this policy issue, along with related terms like:

Benefits of psychologically healthy and safe workplaces

In Canada, the significant impact of mental health problems and illnesses can be felt in the labour force and the workplace. Before the COVID-19 pandemic, the MHCC estimated that in any given week, 500,000 Canadians were unable to work due to psychological illness, which has negative personal, workplace and economic effects.

The direct and indirect costs associated with mental and/or psychological health problems are expected to be a burden for most economies, including Canada’s, if action is not taken soon. For instance, of the estimated $51 billion economic cost of mental illness in Canada annually, some $6 billion a year is related to lost productivity. This amount is expected to increase and cost Canadian businesses approximately $198 billion over the next 30 years. Further, a report prepared for the MHCC before the pandemic estimated that the cumulative cost of mental illness will be $2.5 trillion by 2041.

Studies exploring the benefits of psychologically healthy workplaces reveal that such environments are likely to:

Employers can also benefit from having a psychologically healthy workplace as this enables them to:

Finally, according to a 2019 report by Deloitte Insights, Canadian companies saw an average return of investment of $1.62 for every dollar invested in mental health initiatives for 1 year. The findings revealed that organizations with initiatives in place for 3 years or more were able to double that return of investment. It also showed that mentally healthy workplaces have been proven to attract top talent and keep great employees in the workforce.

Individuals affected by the issue

Psychological injuries and illnesses can affect any worker, regardless of their age, gender, economic status or any other factor. However, there are certain segments of the working population that are disproportionately impacted by the issue.

Research indicates that women are up to 2 times more likely to experience anxiety and depression than men. In addition, societal pressures surrounding gender expectations, including work, family responsibilities and, lately, the COVID-19 pandemic, may present increased stressors for women, which can then be carried into the workplace. Concurrently, women are also more likely than men to self-identify mental health issues, seek and use support services.

Mental illnesses have similar symptoms across cultures. However, the ways people manifest, describe, and interpret symptoms as well as where they seek help varies among vulnerable populations, including:

According to the research literature, workers who face work-related racial/ethnic discrimination experience various negative mental health impacts. This can include:

In addition, racially charged workplace discrimination and bullying can be linked to increased sick leave, as well as decreased productivity and workplace withdrawal. Other types of discriminatory behaviour may also lead to similar negative impacts for other marginalized groups.

Certain type of work or industries are at a heightened risk for psychological injuries and illnesses. As we will explore in Section 4, various psychosocial risk factors can impact employees’ psychological responses to work and potentially cause psychological injury or illness. These can vary tremendously from one type of employment, or from one sector, to another. They include:

Prevalence in the federal jurisdiction

Available statistics related to psychological health and safety in the workplace do not distinguish between federally and provincially regulated workplaces.

While the Labour Program has access to reliable data on the prevalence of physical injuries and illnesses in federally regulated workplaces, it is not the case for psychological health and safety issues. This can partly be explained by the lack of regulatory requirements to specifically report on psychological injuries and illnesses.

Questions

  1. Have you seen or noticed an increase in the number of workers experiencing psychological health issues that stem from the workplace? If so, are there any factors that could explain this increase (for example, greater awareness of the issue, reduced stigmatization, etc.)?
  2. Do you agree with the benefits identified above? Are there any other benefits of having a psychologically healthy and safe workplace?
  3. Are certain types of workers more prone to experiencing psychological injuries and illnesses? If so, who are they and are there any specific considerations that your organization has taken into account to better protect them or considerations that you think should be taken into account?

Section 3: Existing approach and tools

Existing approach in the federal jurisdiction

The Labour Program is responsible for administering and enforcing Part II of the Code, which governs occupational health and safety in the federal jurisdiction. The Code requires that employers protect the health and safety of all their employees at work.

Part II (Occupational Health and Safety) of the Canada Labour Code

The purpose of Part II of the Code is to prevent workplace related accidents and injuries, including occupational diseases. It applies to:

Part II of the Code sets out the employers’ obligations and responsibilities with regards to occupational health and safety.

Employers are currently bound by both a general and more specific duties to protect the health and safety of every person employed by the employer (see sections 124 and 125). However, there is no specific or prescriptive obligation for employers to protect the psychological health and safety of their employees.

It is also important to note that amendments to the Code made through Bill C-65 (An Act to amend the Canada Labour Code (harassment and violence), the Parliamentary Employment and Staff Relations Act and the Budget Implementation Act, 2017, No. 1) will come into force on January 1, 2021. When they do, the purpose statement of Part II of the Code will be amended to include “psychological injuries and illnesses”:

“122.1 The purpose of this Part is to prevent accidents, occurrences of harassment and violence and physical or psychological injuries and illnesses arising out of, linked with or occurring in the course of employment to which this Part applies.”

Even though the above amendment will not introduce prescriptive requirements on employers, it highlights the evolution of occupational health and safety and the need to recognize that it broadly includes a psychological aspect.

The Canada Occupational Health and Safety Regulations (COHSR)

The COHSR are made pursuant to Part II of the Code and apply to most federally regulated workplaces. They are divided into 20 parts, each dealing with a particular topic. While none of the parts of the COHSR deal specifically with psychological injuries and illnesses, 2 of them are implicitly related:

Part XIX – Hazard Prevention Program

Paragraph 125(1)(z.03) of the Code requires employers under federal jurisdiction “to develop, implement and monitor (…) a prescribed program for the prevention of hazards in the work place (…)”. Part XIX of the COHSR includes specific requirements associated with this paragraph.

Generally speaking, Part XIX requires employers to develop, implement and monitor a program to prevent hazards in the workplace. Employers are required to consult and work with the policy committee, workplace committee or health and safety representative to develop their hazard prevention program. Also, employers must identify and assess every hazard in the workplace and take preventative measures to mitigate the risks associated with each, following a hierarchy of controls.

Neither the Code, nor the COHSR defines the term “hazard”. However, one could argue that the prevention program under Part XIX aims at preventing all kinds of hazards including those that lead to psychological injuries or illnesses.

Part XX – Violence Prevention in the Work Place

Part XX of the COHSR, the Violence Prevention in the Work Place regulations, will be repealed on January 1, 2021 and replaced with the Work Place Harassment and Violence Prevention Regulations. These new regulations will:

These regulations are expected to have a positive impact on employees’ psychological health and safety by reducing occurrences of harassment and violence in the workplace. However, they are limited to dealing with a single cause of psychological injuries and illnesses.

Additionally, occurrences of harassment and violence in the workplace cannot be treated as any other hazardous occurrence in the workplace. They require a distinct process due to the sensitivity of the issue. The regulations will require that employers maintain a confidential process for complainants and alleged perpetrators during informal resolution processes or investigations. This process should encourage complainants to come forward.

National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard)

The Standard was launched in 2013 as a set of voluntary guidelines and tools that organizations can fully or partly implement to improve psychological health and safety in their workplaces. It was created to support businesses and organizations in recognizing and promoting the importance of psychological health in the workplace.

The Standard outlines a systematic approach to developing and sustaining a psychologically healthy and safe workplace. This is done through the identification, assessment, and control of risks of psychological injuries and illnesses in the workplace. It also promotes psychological health and safety in the workplace through culture change.

Due to its voluntary approach to implementation, many employers are aware of its existence, but few have fully implemented it. According to a 2018 study on awareness and implementation of the Standard, evidence from a survey of a sample of 1,010 Canadian organizations found that:

However, over half of the participating organizations reported they believed that elements of the Standard would be implemented within the next year.

The study noted that barriers to implement the Standard may include:

In contrast, the MHCC did not find that perceptions of mental health as irrelevant in the workplace was a barrier. In a 2014 to 2017 case study led by the MHCC, it was found that barriers to implementing the Standard included:

Questions

  1. Is the Hazard Prevention Program the proper vehicle to address psychological injuries and illnesses in the workplace?
  2. Are you aware of employers who use Part XIX of the COHSR to identify, assess and monitor psychological hazards in the workplace?
  3. Should incidents that cause psychological injuries or illnesses to an employee be reported to the Labour Program? If so, how and when?
  4. How much interplay should there be between the new Work Place Harassment and Violence Prevention Regulations and any new specific requirement to protect the psychological health and safety of employees?
  5. Has your business or organization adopted the Standard? If yes, what are the pros and cons of implementing it?
  6. Should the application of the Standard be mandatory and incorporated by reference in the Code or its regulations?

Section 4: Causes and barriers to addressing the issue

Cause of the issue

According to the MHCC, 47% of working Canadians classify work as the most stressful aspect of their daily lives. Similarly, a 2017 survey found that 71% of Canadian workers reported that the following workplace factors had significantly contributed to their mental health problems:

More particularly, 34% of respondents noted workplace stress as the primary cause of their mental health problems.

The workplace has changed significantly over the past few decades. One of the main reasons is that more employees have shifted to working on virtual workplaces and platforms. In addition, employers are allowing greater levels of flexible work arrangements for their workers. However, the modern realities of life and work coupled with increased reliance on technology have created an environment where some workers feel unproductive. The COVID-19 pandemic exacerbated this feeling, and experts mentioned isolation and workload as psychosocial risk factors.

Literature on this issue indicates a growing consensus that psychosocial risk factors can lead to higher levels of chronic stress, depression and anxiety. Workplaces that do not attend to psychosocial risk factors are likely to make existing employee conditions worse, as well as impede efforts toward effective treatment and rehabilitation.

Psychosocial factors are elements within the influence and responsibility of employers that affect employees’ psychological responses to work and work conditions. While, the root causes of psychological health issues are complex and may not always be work related, psychosocial risk factors, including the way work is carried out (for example, deadlines, workload) and the context in which work occurs (for example relationships and interactions with managers and supervisors, colleagues and coworkers, and clients or customers), have an impact on employees’ psychological well-being.

Based on the above, the Standard lists 14 workplace factors including how to assess and address them. These are:

It is clear that understanding psychological health and safety in the workplace requires attention to psychosocial risk factors associated with a wide range of mental and physical health outcomes. However, some risks may be unique to particular organizations or occupations, and new risks may emerge as workplaces evolve.

Barriers to addressing the issue

Approximately 3/4 of working Canadians say they would either be reluctant to admit or would not admit to a boss or co-worker that they were experiencing a mental illness for fear of judgement or negative consequences, such as losing their job. In addition, more than two-thirds of people with mental illness and addiction report being disadvantaged at work due to their condition.

For employees to feel free to discuss mental health in the workplace and seek help, experts are clear that stigma must be reduced. This must be done by shifting workplace behaviours toward acceptance, respect, and fairness for those with mental health problems and illnesses. However, psychological health and safety is sometimes perceived as an individual’s personal issue that is brought to work rather than something that the workplace exacerbate.

Finally, many employers and workers find the subject overwhelming and complex. Whereas physical risk factors are well understood and have been a core aspect of occupational health and safety since its inception, psychosocial risk factors and their impact on an individual’s psychological well-being is a relatively newer concept that incorporates less tangible elements.

Questions

  1. What do you believe are the key risk factors of psychological injuries and illnesses in the workplace?
  2. The Standard identifies 14 psychosocial risk factors. Do you agree with them?
  3. In your opinion, what do you think are the main causes of psychological injuries and illnesses in your work place, industry or sector?
  4. What are the barriers that should be addressed in order to tackle this issue?
  5. Is there a stigma surrounding psychological injuries and illnesses in the workplace? If so, what is the best way to tackle it?
  6. In your opinion, how can the Government better ensure that these barriers are broken down?

Section 5: Impact of the COVID-19 pandemic

Mental health problems exist along a continuum from mild, time-limited distress to severe mental health conditions. Similar to other stressors, the COVID-19 pandemic is influencing where people are situated on that continuum. For instance, someone who previously coped well in either their personal or professional lives may now struggle due to the multiple stressors exacerbated by the pandemic. Further, individuals who have a pre-existing mental health condition may have less access to services they previously used, causing their condition to worsen.

Emerging trends suggest that COVID-19 stressors like financial uncertainty, isolation, job losses or reduced work hours are exacerbating pre-existing psychological distress, anxiety and even depression among Canadian workers.

Questions

  1. To what extent has the pandemic had an impact on workers’ psychological health and safety and what specific populations within your sectors are showing high degrees of COVID-19-related psychological distress?
  2. Are there best practices that have been implemented since the beginning of the pandemic that have had a positive impact on workers’ psychological health and safety?

Conclusion

The goal of this current engagement is to inform the Labour Program’s analysis of psychological health issues in the federally regulated sector. Drivers and barriers related to gender, identity, industry and occupation will be of particular interest.

This engagement will feed into proposed policy options and will inform a second round of engagement, which we expect to have in early 2021.

To provide written feedback to this discussion paper, or for any questions, please contact the Labour Program’s psychological health and safety team at edsc.santementale-mentalhealth.esdc@labour-travail.gc.ca

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Annex B: Federally Regulated Industries

List of federally regulated industries and workplaces

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