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When It Hurts

When It Hurts

One in five. That’s how many Canadians will personally experience some form of mental illness in their lifetime.

It’s a staggering number, and one that cannot be ignored.

While society has taken great strides in raising awareness of mental health struggles, the stigma remains. Those affected still experience difficulty opening up about their illness—especially at work.

So what happens when you’re too unwell to work, when the burden is too heavy to bear, but your illness is still largely misunderstood?

I spoke with three members who shared their personal experiences with mental health struggles, and the pressures and lack of understanding they faced at work and also the healing they’ve found. Their stories offer hope and encouragement to those who are hurting.

I also spoke with Trish Douma, CLAC regional director in Chatham, Ontario, about the difficulties members sometimes face dealing with their employer when they have a mental health challenge. She provides insight into what they and the union can do to help them get the accommodation they need at work.

Chris Janzen
Local 501 and National Board member, chief steward

Resource worker

I’ve been a care aide at a home for the disabled in BC for 20 years. I experienced a depressive episode when one of my clients took a fall and succumbed to his injuries. I was the one who administered first aid to him, and I’d known him for 19 years and was very close to him.

After the incident, I buried my head in my work and continued on. The company I work for told me that if at some point I needed something, just let them know.

I thought, really? You’re not going to bring somebody in to have a conversation about what happened? This was a serious loss for me.

I felt an emptiness in my life, and after a few months, I realized something wasn’t right. I went out with a friend and we began talking about what was going on in our lives. All of a sudden, I just started to cry in front of him. All this stuff started spilling out of me, and I knew that I wasn’t emotionally or mentally healthy right then.

I saw my doctor and on his recommendation took three weeks sick leave. I reached out to CLAC for help, got counselling, and used mindfulness apps like Headspace.

I became more proactive about dealing with stress at work. In a job like mine, dealing with individuals who have outbursts and self-violent episodes is like having explosions going on all around you. In caring for them, you end up residually wearing some of that, and somehow you need to clean that off.

If you don’t deal with your stress, if you try to brush it off and walk away, you can become hardened and lose the ability to express compassion. You can end up with compassion fatigue, which can lead to a depressive episode or more serious mental illness.

That’s where stress management comes in. It’s also part of the reason why I became more involved with the union at the National Board level—I really want people in our field to be good healthy workers, and I want to raise this issue from a place of more authority.

In the healthcare industry, we need active momentum by employers to promote mindfulness and stress-relieving tactics. It reflects better on clientele in the long run. People burn out and the company brings in new staff who soon burn out too. And on and on it continues.

For those of us who stay in the job for long periods of time, we reach down and find another gear and keep going. But eventually, we lose that compassionate edge and the ability to be a good care aide.

When I told people that I was on stress leave because of an emotional breakdown, they looked at me like I was a leper or a china doll. But I was able to push through that initial weirdness, and I’m not afraid to tell my story and share it with some of my coworkers who may be going through the same thing.

As a steward, I haven’t had many members approach me about their mental health. People generally hide their mental health struggles. They don’t like to let out their “dirty” little secret.

I had a member who used a health claim on her back, but it turned out that she was not mentally well. People are more comfortable hiding their mental health issues than coming out and talking about them. But people need to talk about them, because they’re serious issues and, if left untreated, they can lead to family breakdown, alcoholism and drug addiction, or suicide.

My advice for people who are struggling is know that you’re not alone. Know that there are so many other people going through the same thing. And know that with help you can win.

Jacquie Baker
Local 501 member, steward

Personal care aide

I had my first panic attack about a year and a half ago. I didn’t know what was happening and I ended up in the emergency room. I felt nauseated and I had butterflies in my stomach, and I wasn’t in control of my thoughts anymore. My chest was tight, and I couldn’t breathe properly.

The doctors put me on some medication to get me through the next couple of days until I could talk to my doctor. We tried a bunch of different medications to find the right fit. Some made my anxiety worse, some made me nauseous, and some made me sleep all day. It was challenging trying to figure out what would work best for me, and the whole time I was having to go to work and function as normal.

I saw my doctor once a week, and it took about three months before I was diagnosed with general anxiety disorder, panic attack disorder, and depression. During this time, I phoned in sick a few times. Some nights I didn’t sleep at all—during one of my lowest times, I hadn’t slept for two days. When I phoned in sick, I was pressured to still come in because they had nobody to cover my shift.

I work with people who are recovering from injuries at what’s called a transition home in BC. My clients are people who have had surgery, but they can’t go back to work yet.

When people are recovering from an injury, they go through a grieving process. A lot of my job involves talking to people and reassuring them, and that was very hard to do when I wasn’t feeling reassured myself, when I was sick myself. It was really difficult having to come into work when I hadn’t slept the night before, I was experiencing really bad anxiety, and I was having panic attacks. But the office staff at work would guilt me by telling me that I was abandoning my clients.

During one of many midnight ER visits, I snuck out of the hospital because I had a shift to get to. I felt I absolutely had to get to work, because at that point, I was very vulnerable. When my managers told me I had to go to work, I just did it.

If I had phoned my employer from the ER because I’d broken my leg, they would have given me time off—no questions asked—and sent me a get-well card. But because it’s my mental health, I was made to feel like I was inconveniencing everyone. They wanted me to deal with it later.

It was really hard balancing my work and mental health at the same time. I felt very alone, very isolated, and it got to the point where my mom had to come over every morning to help me get the kids ready for school because I couldn’t do it. I felt like I was losing.

I reached out to CLAC, and the union was there for me when I felt nobody else was. My representative was so supportive, and she got me in touch with our employee and family assistance program. I talked with a psychologist for over an hour and they set me up with a counsellor.

I’m much more stable now. I’ve found medication that works, I practice mindfulness every day, and I meditate every night before I go to sleep.

I understand what’s happening to me now, and I know my triggers, like the stress of not knowing what to expect going into work each day. I could be seeing a client with broken bones or a brain injury. Now, a coworker phones me before my shift and gives me a rundown of my day.

I’m more mindful of my sleep patterns and make sure I get enough sleep each night. I’ve also cut down my hours and refuse to work double shifts. I’ve gotten some grief from work, but I’ve found my voice and learned to speak up more and say no.

I have a supportive role at my workplace as a steward, encouraging my members to get help if they need it. I’m very open with them and share my story whenever I can, to offer hope.

I refuse to be embarrassed by my mental health. I let my coworkers know there’s nothing wrong with taking medication for their mental health, and I always give them the CLAC EFAP number because that was the biggest help for me in my darkest time, and it’s what got the ball rolling. It’s a very lonely place to be when you struggle with mental health, so if I can be there for someone, I will be.

Brady*
Local 920 member, former steward

Volunteer firefighter

*name changed

I was a corrections officer at a prison in Ontario, as well as a volunteer firefighter. Over the course of my employment, I have witnessed several suicides, attempted suicides, drug overdoses, assaults, stabbings, beatings, hostage takings, bombings, and large-scale inmate riots.

From 1998 to 2004, I was an active member of the Emergency Response Team [ERT] at the prison. During my tenure, I experienced several hostage takings, cell extractions, and clearing the institution of improvised explosive devices.

We had an inmate who was an explosives expert, and he had planted bombs throughout the institution and then committed suicide. The ERT was tasked with clearing the institution of suspicious articles, with the assistance of the OPP Explosive Division Unit. I’d go to work every day looking for bombs. Unfortunately, one of those devices detonated beside me, causing permanent hearing loss in both ears.

In 2009, I was diagnosed with chronic PTSD. I took just over nine months off, and management at the prison were not supportive. In that work environment, mental health issues are seen as a weakness, that you’re not fit to do your job.

When I eventually returned to work, a middle manager harassed me. Coworkers who I thought were my friends turned their backs on me, refused to work with me, and even stopped speaking to me.

At this time, I would often call my union, which was not CLAC, but they weren’t very helpful. I received much more assistance through CLAC, my union for when I was a volunteer firefighter.

In 2016, I had a reoccurrence of PTSD and have since been diagnosed with panic attacks, obsessive-compulsive personality disorder, general anxiety disorder, functional neurological symptom disorder with a psychogenic stutter, and chronic pain. I’m currently not working as I’ve been deemed too psychologically compromised for employment in any capacity, and I’m not sure at this time if I’ll ever return to work.

I had to resign my position as a volunteer firefighter due to being very symptomatic, and I wouldn’t want to put my fellow firefighters at risk. I’m an honorary firefighter—I don’t respond to calls anymore, but I’ll occasionally attend training nights.

I’m on an approved WSIB claim and following the treatment plan that was recommended: cognitive behavioural therapy, exposure therapy, psychological education, and speech therapy. I’m on medications that help me sleep and lessen the severity of panic attacks. I’m also training my silver lab to be my service dog. All of these things help me get by, day by day.

My hope is that if I can help just one person get help when they need it, then my story is well worth being told. It takes a lot of strength and courage for someone to say, “I have a problem and I need help.”

If anyone reading this is suffering in silence with their mental health, I urge you to get help as quickly as you can! Don’t bottle up those feelings and hope they go away. The human brain is an amazing organ—if you don’t get help, your brain will take over in strange ways, such as physical pain, anger at the smallest things, and not being able to find happiness in anything.

The only way the stigma surrounding mental health will be eliminated is by educating yourself and others. With the Internet, there’s a wealth of information that can be accessed. Use the resources you have at work—most employers have some sort of employee assistance program. Find a therapist you’re comfortable with. You may have to see several therapists before you find one who is the right fit. Be honest with yourself, your family, friends, and healthcare providers. I’m open with my family and they’ve been an incredible support system for me.

And be patient. A mental health issue doesn’t happen overnight, and it can’t be fixed overnight. Absolutely do not try to self-medicate. The use of alcohol or illicit drugs will only add to your problems, and often make your symptoms worse. Become your own advocate. Don’t suffer in silence.

The journey through mental health struggles is not a pleasant one, but there is always hope.

Trish Douma
Chatham, Ontario, Regional Director

CLAC representative

As someone who represents many workers in the healthcare sector, both in hospitals and long term care, I am often in contact with members who encounter mental health challenges. But when they come to me, they use the word stress. I think it’s because stress is a more socially acceptable word and easier than admitting, “I’m feeling depressed,” or “I think I have anxiety.”

Working in healthcare is a very difficult job. The nature of the work is that you have to put a smile on your face every day and pretend everything is fine, even if it’s not. In long term care facilities, you’re essentially working in someone’s home, and you have to create a lovely experience for them.

The workload, the volume, the pressure, the mental health of the residents—it can all become too much. Caregivers’ minds are always working overtime. Did I chart that? Did I write that down? Did I give the right meds? Even when they’re not physically at work, their heads are.

Unfortunately, employers are not always understanding, especially when an employee mentions that they’re stressed. I’ll hear from a member, or through their steward, that they’re not coping well at work and want to take a stress leave. I always advise against using this word because most employers will take the position that stress is not an illness, and then they will not get paid.

I lay out two options for the member.

Go to your doctor and describe all of your symptoms. Let your doctor know that for you to take a medical leave from work because of your mental health, you will need a diagnosis under DSM-V [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which is published by the American Psychiatric Association and serves as a universal authority for psychiatric diagnoses].

Or go to your doctor and have him or her prescribe a medical leave for your physical symptoms—migraines, digestive upset, and any others.

I also tell members that they absolutely have the right to take a medical leave for mental health issues, but that their doctor may not write the word stress anywhere on their paperwork. That will get their medical leave denied immediately, and we will have to fight it.

Because these members are already burnt out and exhausted, almost everyone chooses the second option. They don’t have it in them to fight.

And therein lies part of the issue with mental health accommodation—the employer is asking people who are in a fragile mental state to make very strategic and important decisions. When someone has anxiety or depression, you shouldn’t expect them to wrap their heads around very complex legal issues and make proper decisions for themselves.

There’s so much mistrust around mental health, and there’s so much that’s unknown. Employers tend to err on the side of caution and ask their employees for lots of information and documentation, which creates a hurdle most people in that vulnerable state aren’t willing to jump over.

From the employer’s viewpoint, one of the easier things to accommodate is substance-related mental health issues, because that’s something you can quantify. But other mental health issues are hard to figure out and hard to quantify.

What does someone do when they’re extremely stressed out, but their whole job is stressful? Sometimes, they don’t even know their own triggers. They could just wake up panicked and have no idea why.

Every disease is different for each person, and recovery or functionality is different for each person. When someone breaks their leg, we know that it takes six to eight weeks to recover. But when someone has anxiety, how are they supposed to know when they feel well enough to work again?

The biggest thing members should do is get themselves educated. Take a mental health first-aid course. Read articles and watch videos on the topic.

As union representatives, we need to continue to educate ourselves and raise the issue with employers. I tell my members that I will protect them with everything I can, and I won’t shy away from having difficult conversations with their employer.

The stigma surrounding mental health is still huge. We’re in a messy world where there are almost no guidelines on mental health accommodation. We need clear guidelines so that employees get help and employers don’t feel like they’re opening the floodgates. In the meantime, we’ll continue to advocate for our members and offer our assistance when they need help.

Mind Your Mind
Mindfulness can be an effective coping mechanism when you’re struggling with a mental health issue. According to Jon Katab-Zinn, founder of Mindfulness-Based Stress Reduction, mindfulness is “awareness that arises through paying attention, on purpose, in the present moment, nonjudgmentally. It’s about knowing what is on your mind.”

5 Ways to Practice Mindfulness
1. Set aside some time. It could be a scheduled five minutes on your break or whenever you feel your thoughts spiralling out of control.
2. Observe the present moment as is. The goal of mindfulness isn’t quieting the mind or trying to achieve eternal calm. It’s simply paying attention to the present moment, without judgment.
3. Let your judgments roll by. When you notice judgments arising, such as “everything is awful right now,” or “this is a bad moment,” simply make a mental note and let them pass.
4. Return to observing the present moment. Our minds often get carried away with our negative thoughts. Mindfulness is the practice of returning, again and again, to observing the present moment.
5. Be kind to your wandering mind. Even if you keep having negative thoughts, don’t judge yourself for them. Recognize when your mind has wandered, and kindly bring it back to the present.
Source: mindful.org

Know Your Rights
In Canada, by law, you don’t have to tell your employer what is causing your disability (mental illness is considered a disability). But to be accommodated, you need to tell your employer that you’re experiencing health challenges and state what you need to work well. Your employer may need information from your healthcare provider about your abilities and difficulties, but they don’t need and can’t ask for your diagnosis.

Employers have to try to look at reasonable accommodations for anyone who experiences a disability. These accommodations can include

• Flexible scheduling
• Changes in supervision
• Modifying job duties
• Changes in training
• Using technology
• Modifying workspace or changing location
• Mental health assistance
Source: cmha.ca

How to Get Help
If you are experiencing a mental health challenge that’s affecting your ability to work, you can get the support you need.

• For emergencies, always call 911 and then contact your family doctor.
• Contact your CLAC representative, who is a labour relations professional trained in mental health first aid.
• Get immediate, free, and confidential help through your workplace employee and family assistance program.
• Get connected with a Canadian Mental Health Association facility by visiting cmha.ca.
• Find resources, crisis hotlines, support groups, and mental health facilities in your area at ementalhealth.ca.

PTSD’s Four-Legged Helper
Brady, a former corrections officer and volunteer firefighter, is currently training his silver lab, Augustina (Gus), to be his service dog. Having trained narcotics dogs in the early ‘90s, he feels he has the skills needed to train his puppy at eight weeks old, despite the incredible amount of training that’s required to get her working as a service dog.

“Right now, she’s being socialized and getting a lot of obedience training,” says Brady. “Service dogs are not just for the blind; they’re also a very reliable resource for those suffering from PTSD.

“Dogs just know intuitively when their humans are having a bad day. Some are trained to wake you up when you begin to have a nightmare or flashback. They’re also trained to sense when their handlers are about to have a panic attack, and act as a physical barrier to you while out in public if you experience anxiety.

“Gus is helping me feel comfortable out in public, and live my life in a fairly normal way. She’s always happy to see me, and it gives me a sense of comfort knowing she’s always there for me. She already knows when I’m having a bad day and lies on my feet to calm me down.”

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