Canada has a Mental Health Framework called “The Standard”?!
Developed by Mental Health Commission of Canada.
https://www.mentalhealthcommission.ca/English/national-standard
Recently, the UK Government released a report on mental health issues due to work stressors. This report, called the ‘ Thriving at work — The Stevenson / Farmer review of mental health and employers’, estimated that the cost of poor mental health to the UK economy as a whole is a staggering £99 billion per year.
Interestingly, the report mentioned that Canada has a Mental Health Framework called “The Standard”.
This was news to me!
Apparently “Canada has a structured framework for workplace mental health. The framework, called ‘the Standard’ provides a comprehensive framework to help organizations of all types improve their workplace mental health offer to provide the best return on investment.”
It further states that apparently “The Mental Health Commission of Canada has developed a variety of resources to help organizations implement the Standard.”
My Immediate thoughts:
- How is it that none of the health professions’ system leaders and front-line workforce know anything about this framework and the resources developed?
- Should the system leaders not be made accountable for this?
- This obviates that the most critical of all the recommendations: The importance of leadership role and transparency.
Facts and figures from the Mental Health Commission of Canada.
- The total cost from mental health problems to the Canadian economy exceeds $50 billion annually.
- In 2011, mental health problems and illnesses among working adults in Canada cost employers more than $6 billion in lost productivity from absenteeism, presenteeism and turnover.
- 70% of Canadian employees are concerned about the psychological health and safety of their workplace.
- 14% don’t think theirs is healthy or safe at all.
- About 30 per cent of short- and long-term disability claims in Canada are attributed to mental health problems and illnesses.
Background to Health Professions Burnout Epidemic.
The quality of health care systems and patient safety depend heavily on high-functioning health care professionals.
Recent studies, however, have revealed, what was already informally known — an alarmingly high prevalence of burnout, emotional exhaustion, interpersonal disengagement, and a low sense of personal accomplishment amongst the health care professions.
Many recent publications are warning about the continual rising levels of burnout rates amongst health care professions — having reached an “epidemic” level already.
With compelling evidence now available, there is a real sense of urgency for our leaders to realize that burnout is having devastating consequences for those affected, their colleagues, patients, and the healthcare system as a whole.
Burnout is defined as “prolonged response to chronic emotional and interpersonal stressors on the job”. It comprises of symptoms such as:
- Emotional exhaustion
- Depersonalization
- Diminished satisfaction with one’s work
Burnout has been documented since 1981. But despite several studies indicating to a growing crisis since then, little or no effort has been spent in dealing with this issue, now an epidemic.
Burnout has been linked to:
- Diminished professionalism
- Increased medical errors
- Poorer patient outcomes
- Worse health care economics
- Depression in those affected
- Alcohol misuse
- Substance misuse
- Suicidal ideation — and tragically increasing number of actual suicides
- Poor family dynamics / relationship breakdowns
Despite these known facts, little or nothing has been done to address the core issue at hand — what is leading these bright minds to be affected in such a manner or to even understand the factors, often systemic or institutional, that are contributing to this epidemic.
We are now seeing a sudden increase of studies coming out reporting the scale — still under-reported in many people’s opinion — of burnout amongst many specialities in health care. While the system continues to put up intense resistance, many are buoyed by the availability of social media and other web-based modalities in reaching out to audience globally.
The importance of professional culture and the working environment is now being recognized as a critical factor leading to burnout amongst professional. For example, burnout is viewed by some as an “inevitable consequence of the “hidden curriculum” in medical education, where learners witness and adopt their teachers’ maladaptive behaviours, which are often reinforced throughout their careers.”
Poor learning environments in medical institutes, such as disorganized rotations and inadequate supervision, are also associated with learner burnout.
Chaotic clinic settings with bottlenecks to patient flow, lost charts, collection of meaningless administrative data in the garb of “patient and health care outcomes”, are just some of the most basic examples of what can lead to physician burnout, as well as medical errors.
Doctors are often seen struggling to maintain performance standards in a chaotic and unpredictable work environment by “using adaptability, flexibility, interpersonal skills, and humour to diffuse stress.”
Definition of Good Mental Health.
The World Health Organization defines good mental health as
“A state of wellbeing in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community.”
The Way Forward.
Any attempts to produce better patient care and health care quality outcomes are utterly and totally futile unless we deal with the core issues leading to a burnt-out workforce, unable to deliver on right care and patient safety.
Appropriateness in health is inappropriate without including health professions wellbeing.
In times when efforts to employ concept of ‘appropriateness’ in health for system sustainability is a priority for health care leaders and government alike — workable solutions and quality improvement initiatives must include health care professions wellness and wellbeing as an essential quality and patient safety indicator.
Accountability of Health care organizations and leaders is of paramount importance.
Health care organizations & leaders must embrace their responsibility and be made accountable in building an efficient, supportive, open workplace environment — to foster a culture of wellness & openness, while also supporting health professions’ efforts to improve their own health & wellbeing.
We must realize and accept the role of behavioural insights & design-thinking in co-developing workable solutions.
To guide the development of appropriate policies and decision-making processes in order to foster health care professions wellness and wellbeing.
Personalization of Initiatives.
Personalization of health professions lifelong learning / professional development initiatives — including leadership development — can help foster ownership within the health care professions, thereby increasing value and joy in personal lives, as well as practice. Urgent help is needed in supporting such initiatives. Although, care must be taken to ensure that any personalized initiatives launched are not just “token” programs. Fundamental concept of all such initiatives must be to move the paradigm in health care system from “what’s the matter with you” — To “what matters to you”.
