The RIGHT care, at the RIGHT time, for the RIGHT outcome©.

ACHIEVING ABILITYProven Strategies to Help Employers

Effectively Manage Mental Health Claims

and Return to Work

Liz R. Scott, PhD

Principal / CEO

Organizational Solutions Inc.

www.orgsoln.com

info@orgsoln.com

• Over 130 employees

• Services provided in both official languages

• Over 1,000 corporate clients across Canada

• Regulated healthcare professionals & Paralegals

• High level of experience in the Disability Management and Workers’ Compensation field

• Invited Speakers & Authors of publications in the field

• Committed to the Power of DM to reduce human and financial cost through the provision of “the RIGHT care, at the RIGHT time, for the RIGHToutcome©”

Organizational Solutions Inc. offices

Organizational Solutions Inc.

• Organizational Solutions Inc – Nationwide Workers’ Compensation & Disability Management (DM) firm –with over 130 highly qualified staff

• Significant and positive experience in all sectors

• Over 25 years of experience in the field, education includes PhD, MEng, MBA, MSc, RN, teach University of Guelph, Ryerson and McGill, vibrantly lead OSI’s matrix

• Significant and positive experience in all sectors

• Committed to the Power of DM to reduce human and financial cost through the provision of “the Right care, at the Right time, for the Right outcome© OSI”

Agenda

• Complexity of Mental Health Claims

• Recognizing an Employee whose Mental Health impacts their work

• Importance of objective medical, the right diagnosis and the right treatment

• Effective return to work planning

• Duty to Accommodate

Business Challenges Concerning Disability / Absence Management

Current Disability / Absence Management Context in Canada

Rising Costs of Disability and Benefits

Current State of Health Care in Canada

The Duty to Accommodate

Current Context in Canada

• Time lost for disability and person absences increased by 60% from 1997 to 2007(1)

• Aging population

• Increasing incidence of mental health

• Escalating work-life conflict

• CSA Standard - Psychological Health and Safety in the Workplace

• More generous sick and family leave benefits

• Many organizations are still not aware of the cost drivers and reasons for absences

• Lack of policies, processes, roles and responsibilities

(1) Statistics Canada

Changing Legislative Environment

• Quebec allows “mental disorders”

• BC now allowing “mental disorders”

• Human Rights Commission Paper

• CSA standard

ABSENCE RATES BY PROVINCE

Stats Canada, 2011

Drivers of Disability

Source: Human Resources Leadership Survey: Workplace Health Strategies in Canadian Organizations (2011).

Almost half of all respondents indicated Mental Health as their number one driver of STD

Current State of Health Care in Canada

• Shortage of family physicians;

• Limited patient time with physicians;

• Long referral waiting times (for specialists);

• Increased reliance on drugs

Health Care in Canada - Trends

Median Wait in 2012 increased by 129% compared to 1993.

Median Wait for an Orthopaedic Surgeon in 2012 increased by 147% compared to 1993.

Health Care in Canada - Trends

Complexity of Mental Health

• No lab, no physical, few objective tests

• Collection of symptoms equate to a diagnosis

• Takes 1.7 times longer

• Not a fatal condition - don’t die soon

• Massive reserves - $250,000

• Media promotes “self diagnosing”

• Psychological diagnosis often gets interpreted as disability – perceived disabled once labeled

Trends in Mental Health

It is estimated that between compensation and lost productivity, mental health issues cost the Canadian economy $51 billion a year, of which $20 billion alone would be lost productivity.

The total loss represents 4% of GDP

(Towers Watson, 2012)

Factors that InfluenceMental Wellbeing

Social Factors;Previous learningCultural factorsPatient role – what’s Expected of us / asked of usModeling

Genetic Factors;Predisposed to waysof responding to / copingwith stress

Psychological Factors;Anxiety, stress, fear, tension

Family Factors;Observed experience ofillness as child; waysParental models soughthelp when ill

Health Beliefs;Extent of internal locus of controlPersonal coping styleBeliefs, expectations communicatedby professionalsHarrison & Hart, 2006

Most Frequent Mental Health Conditions

50%

19%

19%

5%

3% 2%1%1%

Depression

Adjustment Disorder

Anxiety

Alcoholism

Acute Stress Disorder

Bipolar Disorder

PTSD

Withdrawal

Delivering Excellence in Disability Management

An integrated systematic process of

returning people to functioning lifestyles following an event

of disability by ensuring that they are in active treatment

and return to work as soon as possible…

Injury/Illness TreatmentReturn to

Work

DISABILITY MANAGEMENT IS:

Evidence Says…

• Recognize signs and symptoms early

• Workplace awareness

• Separate mental illness from life events / workplace issues

• Objective medical – the right diagnosis

• Appropriate treatment promptly

• Return to work!

Recognizing Early Warning Signs

• lateness or frequent breaks away

from office

• excessive sick leave &

‘presenteeism’ (on the job

absenteeism)

• reduced quality of work

• high rate of accidents

• Withdrawal / avoidance

• employee errors

• missed deadlines

• changes in physical appearance

• confusion or forgetfulness

• employee conflict

• inappropriate behaviour, mood

swings, negative attitude

Psychological Health in the Workplace• Prevention

• Understand your organizational needs & identify potential and existing issues

• Develop prevention and management strategies for psychological health

• Educate staff on mental illness and coping skills• Remove stigma by education on the realities of mental illness

• Learn mental health coping strategies are strained by stress, burnout, conflict or life events

• Awareness of mental health resources

• On line tools, Peer support, posters, articles, newsletters, lunch & learns, etc.

• Manager training to identify and address workplace mental health issues• Effectively recognize and manage mental health related issues in the workplace

• Principles and practicalities to manage issues related to employee mental health in the workplace including communication

• Managing conflict, performance management, return to work etc.

• Early intervention and employee support• Prevention & crisis response

• Temporary accommodation

• Modified work and accommodation• Return to work process

• Accommodation ideas for mental health related situations

Workplace Solutions

• Establish programs that support positive mental health and focus on coping strategies

• Ensure workplace addresses and recognizes the key areas of positive mental health

• Differentiate between workplace / personal issues and disability

Organizational Support

Sometimes there is a Problem

• Work with the team through individual & group sessions on respectful communication and workplace behaviours

• Provide coaching to the manager

• Facilitate work team and manager training on wide range of topics

The Solutions….

APPROPRIATE CLAIM INITIATION

ELIMINATE THE CONFUSION BETWEEN ILLNESS AND CHOICE ISSUES!

• Appropriate paperwork

• Solid adjudication / determination of disability

• Appropriate treatment / intervention

• Focus on RTW / capability

Event

Appropriate Assessment

Treatment & Stay at Work

Coping Mechanisms

Recovery & Return to

Work

The SolutionAction Driven Case Management

"How heavy is this glass of water?”

The absolute weight doesn't matter.

It depends on how long I hold it.If I hold it for a minute, it's not a problem.

If I hold it for an hour, I'll have an ache in my arm.If I hold it for a day, my arm will feel numb and paralyzed.

In each case, the weight of the glass doesn't change, but the longer I hold it, the heavier it becomes.“

"The stresses and worries in life are like that glass of water.Think about them for a while and nothing happens.

Think about them a bit longer and they begin to hurt. And if you think about them all day long, you will feel paralyzed –

incapable of doing anything.

Remember to put the glass down!

Stay At Work / Return to Work Is Healthy

Diagnosing Mental Illness

• Subjective symptoms that strung together create a diagnosis

• A disturbance in thoughts, feelings and perceptions that has a direct

affect in day to day function

• May affect thinking, mood and behaviour; This is associated with

distress and or functional impairment with symptoms varying from

mild to severe

• Affects people of all ages, from all walks of life

• Impacts on a personal, social and financial level

• This is goal focused treatment that will resolve the condition and enable a return to work

• Psychological disability management is essential to resolve the increased number of psychological claims

Access to Appropriate Care

Treatment Plan

• Addresses specific mental health issues as it pertains to work

o Prepares employee to return to work

o Helps employee find new ways of thinking and behaving in the workplace

o OSI liaises with family doctor, mental health services

o Attendance & compliance

• Number of treatment sessions can vary

Goal needs to be very clearReturn to work is the Objective

Action Plan

Case Management

Effective Return to Work Plan

• Focus on abilities NOT disability

• Develop a clear plan

• Document

• Set Goals

• Timelines

• Progressive (Max 6-8 wks)

• Communicate with Stakeholders

• Manage resistance and relationship

Duty to Accommodate

• Obligation to accommodate up to undue hardship

• Mental illness is recognized under the Human Rights Code

• Return to work strategies

6 Months761

Claims

Average durations reduced from 35 days to 19

That’s 16 days saved per claim

Savings of 12,176 days (761 claims x 16 days)

Average Salary 40k ÷ 250 days = $160 cost / dayat 70% payout =$112

Daily cost $112 x 12,176 total days saved

WE SAVED OUR CLIENT $1.364 MILLION DOLLARS IN 6 MONTHS

Case StudyTHE ROI EQUATION

AnalysisPeriod

Claim Volume

Impact on Duration(Days Saved)

Impact on Payout

Potential Savings

A 4 to 1 Return on Investment

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Liz R. Scott

lscott@orgsoln.com

Principal / CEO

Please feel free to use and benefit from any of the materials provided. If you

do reproduce please give appropriate credit / reference to the originating

source / forum. Thanks.