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Bay Street litigator Lindsay Hill, whose life has been put on hold since 2007 when bipolar disorder left her unable to work, poses for a photo with her husband Jean-Pierre (JP) Boutros in Toronto on December 29, 2014. "Even when things are impossibly difficult my son and husband have made it worthwhile. Mostly now when things are really, really dark, I hang onto the fact that I can give them a hug and everything will be ok" she says.Michelle Siu/The Globe and Mail

Adrian Wall has worked as an adviser and manager at Fisheries and Oceans Canada for three decades, managing up to 100 people at a time.

It's been a tough few years for his department, with budget cuts and layoffs leaving fewer people to do more work.

Regulating a finite natural resource inherently produces conflict, and at times his employees have been threatened – "some staff have been faced with rifles, been shot at," he notes.

Concerned over how best he could support increasingly stressed staff, Wall, now in Kamloops, signed on for training from the Canadian Mental Health Association.

It was transformative. He learned how common it is to have a mental illness and that work-life balance is critical to keeping people healthy.

He learned to observe whether anyone is being excluded in teams. He now shares articles and speaks on mental health in staff meetings. Higher turnover and heavy workloads were stressing staff out, so at times he has let his own bosses know to ease up on the pressure.

"I need to make sure people are aware there's only so much people can do. We can be as productive as possible and trim the fat … but there is a point when productivity is going to decline because you're affecting someone's ability to manage their workload, their mental health – that's when you start seeing people go on sick leave."

Mental illness takes a staggering toll on individuals, families, communities and the country, costing the Canadian economy $52-billion a year in lost productivity (affecting retention, engagement and absenteeism), health-care costs and income supports.

One in five people will experience a mental illness in their lifetime, meaning virtually everyone is, or knows someone who is, affected. It also accounts for nearly a third of all disability claims.

In any given week, half a million employed Canadians are unable to work due to mental-health problems.

Even those who are at work, and coping with anxiety, depression or other illnesses, may not be fully present – having trouble concentrating, collaborating or making decisions. Many struggle alone, without telling their employer for fear they'll jeopardize a promotion, lose responsibilities or even their job. Some never receive the treatment they need; some never fully participate in the work force.

Lost labour-force participation alone due to mental illness costs Canada $20.7-billion annually, a level that will grow in the coming decade, according to a 2012 Conference Board of Canada estimate.

A Centre for Addiction and Mental Health (CAMH) survey in December showed a jump in self-rated poor mental health in Ontario – to 7.1 per cent in 2013 or 716,000 people, from 4.7 per cent a decade earlier, led by a surge among young adults.

Colum Bastable, chairman at Cushman & Wakefield and former chief executive officer of Royal LePage, doesn't mince words for business leaders who may not be taking the issue seriously.

"You have a responsibility to your people to look after them. They're one of your assets, whether they are the business or they are part of the business. It's in the corporation's interest and the shareholder's interest to have a healthy work force."


In Canada, programming and funding around the issue lags. Only 7 per cent of all health dollars are spent on mental health, among the lowest in the developed world, compared with 10 to 12 per cent in other countries such as the Netherlands, says Louise Bradley, president and chief executive of the Mental Health Commission of Canada (MHCC).

More and more, the workplace has become the front line. Whether the motivation is legal, moral or economic, employers are examining how best to prevent mental-health problems, support staff and smooth the way back to work. In 2013, the MHCC set out a national, voluntary "standard" for employers, with guidelines, tools and resources to help promote mental health and prevent psychological harm at work. It's the first of its kind in the world and a greater-than-expected 42 employers – from Carleton University to Enbridge Inc. – signed on for a three-year study that will analyze its impact and share best practices.

Also, in the past two years, 30,000 people have participated in mental-health first-aid courses, a Mental Health Commission program that teaches managers and workers how to recognize the symptoms of mental illness and refer people for support. Hundreds of courses have already been delivered, the commission says.


It's 9 a.m. on a Tuesday morning and a group of 20 managers are sitting in an elegant, wood-panelled room at Toronto's Royal York hotel. They're from both the private and public sectors, and work in areas ranging from police and schools to mining and retail firms. They're here for Leading a Mentally Healthy Workplace, a Queen's University-certified training program run by Morneau Shepell.

"Is it possible that someone could come in to work, but not show any of these signs – that on the inside they're suffering?" Dr. Cole Cohen asks. Heads nod.

He cites statistics on the prevalence of mental-health disorders, that half of people who don't show up for work don't because of mental health and that just one-third of people are getting proper treatment. This is "unimaginable" for other health problems, such as cancer or a broken leg. "So how come we're still at this appalling statistic?" And, he asks, why is that no one celebrates the stories when someone successfully returns to work?

Managers raise their hands. Because of stigma, they say. Fear of losing your job. Fear of what others will think. Fear you won't get promoted, or that others won't take you seriously. One woman from a smaller town says that access to treatment is an issue – wait-lists for psychiatrists are eight months long.

Cohen drops another statistic: When doctors get the diagnosis and treatment plan right, the success rate is 85 per cent.

An early adopter of new mental-health standards, Bell Canada has implemented anti-stigma campaigns, research support, focus groups, surveys and has been changing workplace practices for its 55,000 staffers. (Bell is owned by BCE Inc., which also owns 15 per cent of The Globe and Mail.) Every "people leader" at the company receives mandatory mental-health training – more than 6,000 managers have been trained, and the training is being expanded to others, such as union and health-and-safety reps, on a voluntary basis.


In Surrey, B.C., Lyne Moussa, manager of wellness, safety and disability for Coast Capital Savings Credit Union, says workplace mental-health training has had a "huge" impact on how she does her job.

She has learned to be more open-minded about what may be triggering stress in workers. She's learned to stay in touch with people while they're on leaves – and keep including them in company events. At times, her company has temporarily lightened workloads, altered schedules or reallocated some job functions.

At Bell, short-term disability cases relating to mental illness have fallen 17 per cent since the program was introduced in 2010, says Bernard le Duc, executive vice-president of corporate services. And employee engagement has grown. "It has helped us to reduce the number of cases, shorten the time people are away and reduce the relapse rate," he says. "It provides a positive return on investment."

New CAMH research on the cost-effectiveness of anti-stigma programs demonstrates that the programs can pay for themselves, even with minimal decreases in mental-illness-related short-term disability claims. It's too early to assess many of the new initiatives employers are embracing.

On an individual level, increased awareness of how pervasive mental illnesses are can have a profound impact.

"I'm capable now of feeling hope. And that is the most miraculous thing," says Lindsay Hill. She was a successful Bay Street litigator, often logging 100-hour work weeks, starting at 5 a.m. so that she could leave by dinnertime to see her son, now 10. She was happy and fulfilled – until, suddenly, in 2007, "the wheels fell off."

Within days, she was in the emergency ward, convinced she was a burden to friends and family, and profoundly suicidal. "I went from being me, to being someone I didn't recognize."

For years, she thought hard work and sheer will would pull her out of her slump. With the help of family, friends and doctors, she began to realize she had an illness, now diagnosed as bipolar disorder. She says her employer was empathetic – but seemed utterly unsure how to navigate her situation. "People see mental illnesses as somehow different than physical illnesses. There's still a stigma around them and a desire not to talk."

Stigma, says Bradley of the Mental Health Commission, is "the biggest challenge we still face."


Despite all the efforts employers take, little can overcome the anxiety created by uncertain economic conditions, which erode workers' resiliency.

"When there's job insecurity, there's an increase in stress. And we know there's been an increase in work-related stress, just because of the economy, in the last five years," says Dr. Carolyn Dewa, a senior scientist at CAMH.

Janice Rubin, a Toronto employment lawyer, says the impact of the 2008 recession was enormous. "So many people lost their jobs, and for many of the people left, the stressors of working in this new workplace have become harder."

It's a realityWall, in Kamloops, knows all too well. "There are things you can control and things you can't. I want people to understand they need to take care of their health, their mental health. I don't want to see people get to the point where they're sick and can't come to work."


A year ago, Globe Careers and Howatt HR Consulting launched Your Life at Work, a voluntary, online, English survey. Nearly 7,300 Globe and Mail readers have responded. Here's what they said:

59 % feel stressed out, unable to manage the pressure they're under, and as a result are less satisfied with work, less productive and less healthy

67 % say their current job expectations are too demanding

60 % report little trust between employees and management

56 % think their workplace doesn't have a positive culture

The survey is still active. Full results are online (, along with tools for companies to calculate the cost of ignoring the health of their employees, and see how they fare according to Mental Health Canada's 13 factors of workplace psychological health. – Gillian Livingston

Editor's note: Janice Rubin's name was spelled incorrectly in the original version of this article. This article has been corrected.