Regular readers of my blog know that I have many criticisms about our current approach to workplace disability caused by stress.

The problem is enormous and costly.  Recent surveys in Canada reveal that approximately a quarter of the current workforce is either “quite” or “extremely” stressed.  The majority of that stress is related to work.

We also know that stressed workers are more likely to be absent from work for psychologically reasons.  As the length of their disability increases, their corresponding probability of successfully returning to their job decreases.  One figure reveals that, after one year of absence, fewer that 2% ever return.

Recently, considerable effort and emotional appeal have promulgated the idea that mental health issues, things like depression or stress, should not be stigmatized either in society or in the workplace.   As part of a prestigious roundtable contemplating mental health in the workplace, Michael Wilson, the former Finance Minister, has urged companies to adopt what has been called the “Wilson Principle” by expanding their success in physical health and safety to mental health. The goal involves  “fusing physical and mental disorders into a distinctive construct that eliminates the stigma and segregation of mental health problems…”

Despite the lofty goals of reduced stigmatization and segregation, in my experience, the process of “medicalization” brings its own problems.

Let me explain.

Before the worker is ever seen by a doctor, the formative stages of a stress-related burnout begin with some nocive interaction between the worker and some aspect of the job.  The details vary from case to case but often, it is the worker’s personality, working style or performance that negatively interacts with either a critical boss, poorly defined goals or lack of a meaningful reward system in the organization.

During this formative period, a good Human Resources specialist can usually list the factors either within the worker or the job context that are causing the problem.  However, as time goes on these factors are often obscured by the myriad physical and psychological symptoms of stress that reflect a failure of coping.

At a certain critical moment, the worker makes a tacit decision to seek relief or escape with a financial cushion of a medical leave.  From that moment on, once the worker X job interaction problem has been pronounced to be “medical,” a quantum change occurs.

Firstly, the focus shifts away from job factors to focus on the person who has now become sick.  The stressed or angry worker, who is now a patient, becomes encased in a protective wall of secrecy.    If a boss does not need to know the results of a tumor biopsy, then by extension that supervisor need not know about the details of the psychological problem.

To quote from Michael Wilson’s Roundtable:

“Employers do not need to know the nature of the diagnosis of the disabling illness that is involved in any given case, this information is private and confidential.”

The physician’s note demanding time off for stress effectively places the worker is a modern day equivalent to an ecclesiastical sanctuary.

(to be continued)