Karen Belanger

Substance Use and Mental Health Implications for the Workplace

Karen Belanger - 5 June 2020

 

As substance use and the availability of highly potent drugs increases globally, so too does comorbid substance use and mental health disorders.  According to the World Health Organization there was a 13% rise in mental health conditions and substance use disorders in the decade from 2007 to 2017.

 

Comorbidity is the occurrence of two or more disorders or illnesses within the same person either simultaneously or one following the other. Interactions between illnesses can exacerbate both. Comorbidity can be caused by a number of factors such as genetics, trauma, and adverse childhood experiences, to name a few.  For mental illness and substance use comorbidities, people using drugs to self-medicate may worsen their symptoms and progression of the illness.  Also, substance use and addiction can contribute to the onset of mental illness by provoking brain changes that elicit a vulnerability to a particular mental illness.

 

The European Monitoring Centre for Drugs and Drug Addiction identified that approximately 50% of substance users have comorbid substance use and mental health disorders. Furthermore, the National Institute on Drug Abuse (NIDA) population surveys have found that about half of those who experience a mental illness in their lives will also experience a substance use disorder and vice versa. The Centers for Disease Control and Prevention identified that in 2016, nearly 1 in 5 U.S. adults reported a mental illness. 71% of those surveyed reported at least one symptom of stress, such as a headache or feeling overwhelmed or anxious, symptoms that frequently occur in or as result of the workplace.

 

 

Impacts

 

Comorbid substance use and mental health disorders can have significant impacts on employees and the workplace. Both disorders can have a profound effect on a worker’s ability to remain focused on the job. For example, drugs and alcohol can alter the brain’s ability to function properly and can cause workplace accidents, absenteeism, and a reduction in productivity while mental illness, such as depression, is a leading cause of disability, absenteeism, and lost productivity. Other implications for the workplace include:

 

*  Approximately 80% of persons with depression reported some level of functional impairment because of their depression, and 27% reported serious difficulties in work and home life.

*  Research shows that rates of depression vary by occupation and industry type. Among full-time workers aged 18 to 64 years, the highest rates of workers experiencing a major depressive episode in the past year were found in the personal care and service occupations (10.8%) and the food preparation and serving related occupations (10.3%)

 

The ability to identify mental health or substance use disorders in the workplace is complicated due to employee concerns about confidentiality, stigma, and fear of employment repercussions. However, many times the employee’s adverse behavior related to substance use or mental illness can lead to employment counseling or other employment action that encourages them to get help.

 

 

Wellness Workplace Culture

 

Creating a culture of wellness, especially focused on health and safety, can provide both employees and employers with a wealth of benefits.  Here are some of the program components that employers should consider:

 

  1. Comprehensive drug-free workplace policies that discourage the use of drugs and alcohol in the workplace and support those in recovery from a substance use disorder.
  2. Prevention through information, education and training programs addressing alcohol and drug issues and mental health awareness, preferably as part of wider health promotion programs.
  3. Drug testing to identify substance use problems, which may arise informally through discussions around performance issues or as a result of formal assessments.
  4. Employee Assistance Programs or interventions to address problems that have been identified, including seeking assistance, referral for treatment, rehabilitation programs, and return to work.
  5. Employment support for employees who have sought mental health or substance use treatment and have returned to work.
  6. Implementing a variety of wellness and intervention programs as they have shown positive impacts on various mental health issues such as depression and anxiety.  These activities include: mindfulness training, yoga, stress management or stress reduction programs, work-focused cognitive behavioral therapy in combination with individual work support, mental health literacy, exercise, and team-based participatory intervention.

 

Benefits

 

Direct financial benefits to employers include:

* Reduced health benefit expenses

* Reduced insurance premiums

* Decreased absenteeism

* Increased worker productivity

 

Other benefits include:

* Improved employee morale

* Reduces stigma associated with substance abuse and mental health disorders

* Decreased disciplinary actions

* Demonstrated commitment to employee health and safety

* Decreased theft and property damage

 

* Benefits for the employee include:

* Personal health and wellness support

* Retention of job and benefits

* Company culture of caring

* Employer’s commitment to a safe and healthy work environment

 

 

Both employers and employees reap the many rewards of openly addressing the issue of comorbid substance use and mental health disorders in the workplace.

 

 

Has your workplace addressed employee substance abuse and mental health disorders, and if so how?  What benefits have been observed?   Are additional practices needed?