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Bell Business Markets manager Sophie Watier based in Montreal has been trained to recognize mental illness symptoms and approach employees respectfully. The training, she says, puts employees at ease, too.Christinne Muschi/The Globe and Mail

The manager of a small manufacturing company in a Toronto suburb who oversees about 40 workers has dealt with the following employee issues in the past few years: depression, suicide attempt, alcohol addiction, harassment, arrest, fisticuffs and multiple meltdowns.

(What is a meltdown? As with pornography, you know it when you see it. And it's a rare and fortunate manager who hasn't seen an employee melt down.)

Managers will tell you it's not the work itself that they find stressful. It's not hiring or firing or scheduling or meeting deadlines or customer demands that make their workday difficult. It's the people problems that often arise out of mental illness.

And if there's one conversation managers don't want to initiate with employees who report to them, it's a conversation about mental health.

Employees aren't so eager to talk about it, either.

A Canadian Medical Association study in 2008 indicated that just 23 per cent of Canadians surveyed said they would feel comfortable talking to an employer about their mental illness.

"Managers and employees don't like to talk about behaviour problems," acknowledged Carolyn Dewa, health economist at the Centre for Addiction and Mental Health (CAMH) in Toronto. "It's really uncomfortable."

But with one out of five workers experiencing mental illness, and more education and openness about it, managers are increasingly expected to assume an active role on the front line of mental health in the workplace.

It's no longer a matter of leaving it to the human resources department.

Managers may be asked to be alert to symptoms, initiate the dreaded conversation, guide the employee to assistance programs, keep in touch during a leave-of-absence, and facilitate the employee's return to work.

Almost one in three managers surveyed recently by Ipsos-Reid reported that they'd been trained to identify and help employees with signs of depression.

Bell Canada, for example, has instituted "mandatory training for all our managers about mental health," said Mary Deacon, chairwoman of Bell's mental health initiative. Managers attend three-hour sessions, "face-to-face, in small groups of 15 to 20 people," facilitated by a mental health professional.

Sophie Watier, manager of client care at Bell Business Markets, was one of the first managers to be trained when the program was launched two years ago.

"It was a clear confirmation that it [awareness of mental health] is part of our job," said Ms. Watier, who supervises a team of seven managers and 170 employees in Vancouver, Toronto and Montreal.

"Employees feel safe," she explained, "because they know we're all trained and not biased. We are working from facts about mental health and that makes the perfect welcoming approach for employees to raise their hands and talk about these issues."

Becoming aware of facts and stats about mental health issues was an important part of the training, said Ms. Watier, who is based in Montreal.

Also, she said, "We were taught to recognize symptoms and how to act on that, how to discuss such a sensitive topic with employees. We were given tools on how to approach the conversation, how to do it so we are respectful."

Added Ms. Deacon, who initiated the Bell program: "This is an area where people don't know what to do. I don't believe for one minute that people don't want to do the right thing, but we Canadians are so polite, so fearful of saying the wrong thing, so we don't say anything."

Managers usually know what to do and say when an employee suffers a broken leg or a heart attack. However, when the illness is depression, anxiety, panic attacks or posttraumatic stress syndrome – which together account for 95 per cent of mental illness in the workplace – managers may be at a loss.

But they don't need to get stressed and anxious about employees' mental health or lack thereof, said Mary Ann Baynton, a consultant on mental health in the workplace and co-author of Preventing Workplace Meltdown: An Employer's Guide to Maintaining a Psychologically Safe Workplace.

"Dealing with psychological health and safety in the workplace is similar to dealing with physical health and safety," she said. "It's not as much of a burden as people might anticipate. It comes down to the way we treat people."

However, she emphasized, "It's not about being nice to employees and expecting nothing of them."

In fact, treating people as if they're not able to perform can provoke a poor relationship with co-workers.

"It's often viewed as special treatment," Dr. Dewa cautioned. Especially if the employee hasn't been really productive, it may seem as if the manager is favouring that employee, she said.

It also may mean a small business owner won't be able to meet goals if an employee isn't productive and could even jeopardize the business.

If a person with mental illness is able to work, he or she should be encouraged to do so.

"The key question to ask is,'What is it you need to stay productive?'" Ms. Baynton advised. The answer is as "unique as the individual," she said.

What may be required: clear communication, more structure or more flexibility, enhancing the ability to focus by minimizing distractions including conflict, multitasking and pressure.

"Many of the accommodations are not really costly," Dr. Dewa said. But it's imperative that they evolve out of a discussion between the manager and the employee, she said.

"Sometimes employees don't really know what to ask for." And so, the discussion may involve some brainstorming.

It may be that the employee is not comfortable leading a meeting that has been part of his or her responsibilities, she suggested.

"Sometimes it's noise," she said, for example, "If a person's desk is near the printer and everybody is always around the printer."

She added that it may be difficult to make changes without raising questions in the workplace. "Trying to find that balance, it's useful for the manager to ask the employee, 'Would you be comfortable if I did this?'"

"If someone was qualified and capable to do a task before depression or anxiety-related disorders became a problem," said Ms. Baynton, "in a majority of cases, you can do the task even when you're not well, with the right kinds of support."

She noted that she is referring to cases of moderate depression and anxiety disorder and not psychosis.

For all the responsibilities managers may be expected to take on regarding mental health in the workplace, "They should never try to diagnose, treat or counsel," Ms. Baynton cautioned.

Even expecting a manager to identify if an employee is experiencing mental illness, she said, "is not fair and not their role. It is their job to discuss behaviours in the workplace, and workplace issues and how that may be impacting performance."

As well, she emphasized, "It's not the manager's job to make employees tell them about their personal health. For some people, health issues are personal."

On the other hand, she said, "You don't need to shut people down who wish to talk about it – and talk about it and talk about it and talk about it."

Sometimes, said Ms. Watier, "It's not clear during these discussions that we're talking about mental illness. It can go from performance issues to personal issues."

She attributed that progression to "a safe environment. They know they can trust us because we were trained to deal with this."

The big change, said Ms. Watier, "is that we are really proactive. We're not just waiting for a mental illness problem to come up. All the time we're educating, facilitating, encouraging employees to participate in seminars and read articles, so we're all always aware of mental health and tools for dealing with these issues."

Another advantage, she said, is that employees can extend "what we're sharing with them to family and friends."

As a manager, she said, "I'm so proud to work for a company that cares."

As someone with a close family member who is living with mental illness, she said, "It is an initiative that is deep in my heart."

'Not all mental health issues are disabilities'

Before she went back to school in the 1990s and became a consultant about workplace mental health, Mary Ann Baynton had a brokerage business with eight employees.

"Four had mental health issues," she recalled, although she didn't realize that when she hired them. "I just hired the best and brightest people I could find."

At the time, she said, "I had that ignorant stereotype that people living with mental illness must be crazy."

One employee was living with bipolar disorder, another with posttraumatic stress disorder, another with depression and another experienced panic attacks.

(The other four employees had issues, too. "We all had issues," Ms. Baynton cheerfully said.)

"In my ignorance, I asked them what they needed. And they told me."

After she made accommodations for them, they were so productive and so effective, she explained, that she was able to sell the business, return to school and change careers.

"What they taught me is, first of all, that not all mental health issues are disabilities. Some are just conditions that you live with and manage."

Secondly, she said, "Even with mental health issues, there are ways to stay productive and contribute 100 per cent."

What accommodations did Ms. Baynton make that were so effective?

"The person with bipolar disorder said she found the very complex files were overwhelming for her. The person who experienced panic attacks said she was worried about having one in front of a client.

"So they switched tasks and both stayed productive and neither had to take time off."