Workplace Stress Costs the Economy Billions

Life is hard. You work in a "fabric-covered box," as Dilbert puts it. Some troll in the IT department monitors your every keystroke. Lunch is a greasy slab of pizza al desko, eaten under heavy email fire. Your eyesight is shot, you're going to flab, you've vowed to make this just a 50-hour week because your spouse - toiling in another cubicle across town - needs every night and the weekend to meet her ridiculous deadline. It's 4:59 p.m., and if you're late again the daycare's gonna dump the kid on the street and call Children's Aid. Grab the cell. Grab the BlackBerry. You just know the boss is going to tug your electronic leash if he sees you leaving this early. Yeah, yeah, life is hard.

It's, you know, stressful. Whatever that means.

Stress is part of an explosion in workplace mental health issues now costing the Canadian economy an estimated $33 billion a year in lost productivity, as well as billions more in medical costs. It's become a political priority for Prime Minister Stephen Harper, who recently announced a new Mental Health Commission of Canada. With almost one million Canadians suffering from a mental health disorder, "it's now the fastest-growing category of disability insurance claims in Canada," Harper said. The cause is unclear. "Some blame the hectic pace of modern life, the trend to smaller and fragmented families, often separated by great distances, or the mass migration from small stable communities to huge, impersonal cities," he said. If there was a false note in his speech, it was his optimistic view of society's comprehension of the issue. "We now understand," he said, "that mental illness is not a supernatural phenomenon, or a character flaw."

Well, maybe. Such understanding is hardly universal in the workplace, where, as Harper noted, "stress or worse" exacts a heavy toll. It's as likely that stress-related maladies will be viewed with a combination of cynicism, incomprehension, and a skepticism bordering on hostility. To critics - a field that includes many employers, some academics, and co-workers resentful at picking up the slack - stress is the new whiplash, except bigger, more expensive, harder to define, and even more difficult to prove. Or to disprove.

"Stress," says U.S. author and workplace counsellor Scott Sheperd, "is probably the most overused and misused word in the English language - with the possible exception of love." It means everything and nothing. It is, he argues in Attacking the Stress Myth, "The Great Excuse." Look at the numbers: stress leaves are off the charts and some of the zombies who do show up accomplish little more than draining the company coffee pot.

The cause of this growing hit on productivity is indeed a mystery. Did the world get harder, or did people get softer? Or are employers stuck with an addled labour force of their own creation? It's not as if today's children will be sent to work in the mines. Women aren't struggling to raise six kids, while mourning several more who died in infancy. Men aren't spending 12 hours a day plowing fields behind a mule, or sweating over some mechanical monster of the Industrial Revolution, waiting for an arm or a leg to be dragged into its innards. No, odds are you've got indoor work, no heavy lifting, a 40-hour week (in theory), holiday time, and a big-screen TV waiting at home. How hard can life be?

Well, one person's dream job can be another's nightmare.

Nights, weekends, Janie Toivanen, an employee on the Burnaby campus of video game giant Electronic Arts (Canada) Ltd., gave her all to her job. She was part of the team producing EA's wildly popular NHL game series. EA prides itself on being a work-hard/play-hard kind of place. The complex looks like a workers' paradise, complete with a sand-covered beach volleyball court, an artificial turf soccer pitch, a full-on fitness centre, massage, yoga classes and a steam room. There's a gourmet cafeteria, and an employee concierge service to look after such mundanities as dry cleaning and car washing. In exchange, EA expects a huge degree of worker commitment.

Toivanen, an employee since 1996, earned strong performance ratings in her early years, regular bonuses and stock options. She rose through the ranks, often using what downtime she had to catch up on her sleep. "Ms. Toivanen's career was her life," says a decision last year by the British Columbia Human Rights Tribunal. But life caught up with her. By 2002, at age 47, she was carrying a heavy load, and looming deadlines preyed on her mind and ruined her sleep. Dealings with co-workers were strained, questions from supervisors were met with tears or anger.

She resisted her doctor's urging to take stress leave, fearing it would hurt her career. Finally, on the edge of a breakdown in September 2002, she handed her doctor's note to a supervisor and requested leave, only to be told EA had already decided to fire her. Big mistake. The failure to investigate her deteriorating condition or to accommodate her medical condition violated the provincial human rights code, the tribunal concluded. "She thought that EA was a company that prided itself on looking after employees," it said. "Instead of investing any time and energy in bringing her back, healthy, to her workplace, it fired her." She spiralled into depression and was placed on long-term disability by her former employer's insurer. At the time of the ruling in 2006 she was still on paid disability. The tribunal ordered EA to pay almost $150,000 in costs, severance, stock option losses and damages, "for injury to her dignity, feelings and self-respect."

Employers neglect the work environment at their peril, warns Bill Wilkerson, a former insurance company president and now CEO of the Global Business and Economic Roundtable on Addiction and Mental Health. "Chronic job stress has emerged in what you might call epidemic terms," he says. He co-founded the group 10 years ago, as private insurers grew alarmed at the runaway impact of mental health issues.

The first indicator was the spiralling costs of prescription drugs for maladies that were "imprecise in their nature," says Wilkerson, who also now serves as chairman of the workplace advisory board of the Canadian Mental Health Commission. Depression, insomnia, hypertension were all part of the mix. "As a business guy I was focused on how we tackled these as costs," he says. After a decade immersed in the science, Wilkerson has no doubt stress is a trigger for mental health issues, and such physical ailments as hypertension and heart attack. But there remains, he concedes, skepticism in boardrooms and corner offices. "We have to talk tough love to business leaders all the time," he says. "Our job isn't to make a case for business, it's to make a business case for mental health."

Still, the skepticism remains. In the case of politicians, for example, some think stress leave is just an excuse to escape political problems. Consider some examples: veteran NDP MP Svend Robinson walked into a public auction in 2004 and stole an expensive ring. Days later, he turned himself in, held a tearful news conference and embarked on stress leave. He was subsequently diagnosed with a bipolar disorder. A year later, Conservative Gurmant Grewal, then an MP from Surrey, B.C., took stress leave after being embroiled in a scandal over secretly recording conversations with senior Liberal officials, among other bizarre incidents. "One of the things that makes me pretty cynical is when I hear a politician or a CEO who's gotten into trouble leave to spend more time with his family, or to take stress leave," says stress researcher Donna Lero of the University of Guelph.

Even when companies think they have clear evidence of malingering, they may find the courts decide otherwise. James Symington, a Halifax police officer and aspiring actor, left work June 11, 2001, citing an elbow injury. He was found fit for duty; instead, he booked off on stress leave. Months later, still on leave, Symington took his service dog to New York to help search for bodies after the terror attacks of Sept. 11. He also worked acting gigs. Symington was fired in early 2005, while still on leave, after the force said he wouldn't co-operate with attempts to get him back to work. This August, the Nova Scotia Court of Appeal cleared the way for Symington to sue the police for malicious prosecution for conducting a fraud investigation into his alleged misuse of stress leave. He's also suing his union, claiming it failed to protect him from a hostile work environment.

Understandably, many employers have become highly skeptical of complaints about excessive stress, and they vent their frustration to people like employment law specialist Howard Levitt, a Toronto-based lawyer for Lang Michener. He says stress issues have mushroomed during his 28 years in the field. "It's become for most employers the single biggest bugaboo in terms of workplace law issues," he says. Companies are "infuriated" by doctors who recommend stress leaves "without any real substantiation." For one thing, the family doctor isn't diagnosing the problem behind the alleged stress. Nor does the doctor know if there are other jobs in the workplace the patient is still capable of doing. The end result, ironically, is a more stressful workplace. "It's a bad motivation for other employees who see these employees getting away with it, and then have to work harder to pick up the slack," says Levitt. "So, often they say, 'Why shouldn't I participate in this scam?' And everybody works a little less hard."

A vocal minority of academics and others share a view that stress is a bogus concept. British author and former Fulbright Scholar Angela Patmore took on the "stress industry" in her 2006 book, The Truth About Stress. She doesn't buy that life in Britain is more stressful than it was, for instance, during the war years or the disease-ridden Victorian era. "The concept of mitigating stress is bollocks," she told Maclean's. "Everywhere in the West we see this message, 'you will drop dead, you will go mad, avoid negative emotions, avoid emotional situations.' None of our ancestors would have understood a word of this." She has an ally in Bob Briner, an occupational psychologist teaching at London University's Birkbeck College. He considers stress a meaningless concept; one that is creating a generation of "emotional hypochondriacs." As he writes, "One of the main explanations for the popularity of stress is that people like simple catch-all ways of 'explaining' why bad things happen, particularly illness."

Whether you believe stress is a real condition with debilitating effects, or the product of a generation of weak-minded workers, this much is indisputable: the costs are real, and spectacular. "Today, our estimate is that mental health conditions - with stress a risk factor - clearly cost the economy $33 billion per annum in lost industrial output," says Wilkerson. Those losses, he adds, "are excessively higher than the cost of health care associated with treating these conditions."

But one of the central problems with treating the apparent stress epidemic is that it remains exceptionally difficult to cure a problem that can't be easily defined. If you ask experts for a definition of stress, you often get a pause and then something like this: it is a highly individualistic, multi-faceted response to a set of circumstances that place a demand on physical or mental energy. There is "distress," a negative response to disturbing circumstances. And there is "eustress," so-called good stress. Eustress might come on the day you marry the love of your life. Distress might come on the day the love of your life marries someone else. Stress is a kind of personal weather system, ever changing, its components unique to the individual. It may consist of overwork and job insecurity, combined with colicky children and a sickly mother. It may be an unrealistic deadline, vague expectations and hostile co-workers. It may be the thing that gets you up in the morning, the challenge that makes work bearable, the risk of failure that makes success sweeter. Stress is bad. Stress is good. Stress is a mess. It is also a constantly moving target.

"Is stress quantitatively growing, I don't know," says Shannon Wagner, a clinical psychologist and a specialist in workplace stress research at the University of Northern British Columbia. "What we do know is it is qualitatively changing." Jobs may not be as physically laborious as they were but they're more relentless, she says. "A lot of people now are identifying techno-stress and the 24/7 workday, which we didn't have even 10 or 15 years ago, this feeling of being constantly plugged in, of checking email 500 times a day."

There is ample evidence that people are working longer and harder, skimping on holidays, and paying a price. The work-life balance is out of whack, says Donna Lero, who holds the Jarislowsky Chair in Families and Work at the University of Guelph. She says the stresses today's families face are different, and come from all directions. Workdays are longer, and for most families, including three-quarters of those with children, both parents work. "What used to be three people's work is being done by two, with nobody home when the child is sick," she says. Families are smaller, but they're also scattered. The sandwich generation is often simultaneously handling both child and elder care. "At a time when employers and certainly individuals are voicing concerns about work-family conflict, we're seeing things go in the opposite direction we'd like them to."

Consider the impact on the federal public service. A newly released Treasury Board study of remuneration for some 351,000 public servants notes that disability claims for its two main insurance plans have more than doubled between 1990 and 2002. "Much of the increase," the report concludes, "resulted from growth in cases relating to depression and anxiety." In fact, more than 44 per cent of all new public service disability claims were for depression and anxiety - up from less than 24 per cent a decade earlier. Stress and mental health issues are now the leading reason for long-term disability claims, ahead of cancer. The problem seems to be especially acute in Quebec, where civil servants are off the job an average of 14 days a year, an increase of 33 per cent since 2001, according to a recent report.

Nationally, an estimated 35 million workdays are lost to mental conditions among our 10 million workers. A six-year-old Health Canada report estimates the annual cost of just depression and distress at $14.4 billion: $6.3 billion in treatment and $8.1 billion in lost productivity. And all that only measures the number of people who actually miss time at work. Just as serious may be "presenteeism" - the phenomenon of stressed-out workers who show up to work anyway and accomplish little. It's estimated to cost Canadian employers $22 billion a year. "It's the silent scourge of productivity," says Paul Hemp, who wrote a definitive article on the subject for The Harvard Business Review in 2004. A U.S. study of 29,000 adults calculated the total cost of presenteeism at more than US$150 billion.

So what is an enlightened, conscientious employer to do? That's a quandary: in some cases, a generous benefits plan actually increases the likelihood of workers booking off. A study on sick leave published last year by Statistics Canada found unionized workers with disability insurance are far more likely to take extended leaves. The recent federal public service pay study uncovered an interesting fact: prison guards, dockyard workers, heating plant operators and hospital service groups consistently used the most sick leave per capita during the 13-year period under examination. It's understandable that those in "difficult environments like penitentiaries or dockyards" would make more claims, the study notes. But their consistent use of leave over the years "suggests that cultural and management factors may also play a role in the level of demand for sick leave." Translation: some workers take stress leave simply because they can.

It seems the key is to strike a difficult balance between compassion and coddling. It's not easy, but for those who get it right, the results are dramatic. For example, the Vancouver City Savings Credit Union - Vancity - has been repeatedly ranked among Maclean's Top 100 employers, in part because of an ingrained employee assistance program and management training in spotting employee problems before they reach a crisis.

Few jobs are as stressful as front-line tellers, especially in Vancouver, with an average 237 bank robberies a year, about the highest rate in Canada. Ann Leckie, Vancity's director of human resources, concedes "one of the greatest negative situations we can face is robbery." Vancity set out in the mid-1980s to limit the personal and financial fallout by contracting Daniel Stone & Associates Inc., its employee assistance provider, to design a robbery recovery program. Branch employees who wish to gather after a robbery can meet with Stone, a clinical counsellor, and others of his staff. Those who wish can have one-on-one sessions later. All have access to a 24-hour help line. Managers keep watch for delayed signs of stress: absenteeism, increased mistakes or mood swings. These workers are urged to seek help.

If it all seems too touchy-feely, consider the results. In B.C., the average post-robbery absence per branch - as paid out by the Workers Compensation Board - is 62 days. "In Vancity [in 2005] 17 of our 19 robberies had no days absent," says Leckie. The other two robberies had an average absence of two days. Leckie does a quick calculation: "That's 1,054 days not lost," she says. "There's a big financial incentive to doing it right."

Doing it right means building mutual trust and respect between employer and employee. It means heading off problems in advance and believing in those employees who need help. "The sense that there are non-sick people obtaining benefits fraudulently is an urban myth," Leckie says. The Vancity program is much copied, but rarely duplicated. "I have seen the program fail," she says. "In a cynical organization you get comments like, 'Well, the only time I get to talk to anyone important is when I have a gun to my head.' "

Sometimes the gun is real, more often it's a metaphor. Maybe bad stress is exactly that: a robbery. It steals joy and purpose and health; and it takes from the bottom line. In that sense it is real, no matter how it is defined, or how cynically it is viewed.

Maclean's October 15, 2007