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Chapter I: Roundtable Process

  • Issued: October 2014
  • Content last reviewed: October 2014

Why a roundtable?

On September 28, 2012, the government of Ontario announced the launching of a roundtable to help workers who suffer from job-related post-traumatic mental stress.

The aim of the roundtable on job-related traumatic mental stress (TMS) was to help promote healthier, more productive workplaces across Ontario. The roundtable brought together employer and labour representatives from high-risk sectors, such as police, emergency medical services and transit services, where workers may, as a result of their job, be at risk of developing a TMS injury, such as post-traumatic stress disorder (PTSD). (See Appendix A for a full list of the organizations from which the members were drawn.)

The roundtable focus was on:

  • Finding the best ways to promote awareness, education and training initiatives.
  • Identifying and sharing approaches and best practices to deal with TMS in theworkplace through prevention, early diagnosis and intervention.

Mental health is a significant challenge across workplaces. The Canadian Mental Health Commission has reported that, in any given year, one in five people in Canada experiences a mental health problem or illness, with a cost to the economy of well in excess of 50 billion dollars.[1] Mental illness is responsible for a significant loss of potential labour supply, higher rates of unemployment, costs associated with disability insurance programs, as well as losses in productivity due to sickness and absence from work. Mental health problems and illnesses typically account for approximately 30 per cent of short- and long-term disability claims.[2]

The Ministry of Labour (MOL) is committed to encouraging workplace parties to work together to develop strong workplace practices to promote the prevention of workplace injuries and illnesses. This includes reducing the risk of workers developing traumatic mental stress.

Roundtable objectives

The roundtable on TMS was the MOL’s first initiative of its kind.

Several objectives were outlined in the Terms of Reference document that was shared with roundtable members:

  • To raise awareness of work-related TMS, which includes post-traumatic stress disorder (PTSD), as a workplace issue.
  • To facilitate knowledge exchange of best practices across sectors where workers may be at risk of developing work-related TMS injuries such as post-traumatic stress disorder.
  • To identify and explore best practices at the local, national and international levels.

The roundtable met six times over the course of approximately one year. It met for the first time on November 28, 2012, and the final meeting took place on September 25, 2013.

Shaping the dialogue: Topics identified by roundtable members

At the first meeting on November 28, 2012, roundtable members identified key topics of interest to them.

The topics identified generally fell under one or more of the following overarching categories or stages:

  • Prevention of work-related TMS disorders;
  • Response following work-related traumatic incidences; and
  • Follow-up and support in the workplace for workers who have suffered a workplace traumatic event.

What was also heard at the opening roundtable meeting was that it would be important in the roundtable discussions to consider the impact WSIB processes have on workers who have experienced a traumatic event, and to consider where there may be room for improvements, as well as the role of government, such as MOL’s role in supporting prevention.[3]

Roundtable members agreed that roundtable discussions would be guided by this overarching framework with a focus on the three stages along a continuum – prevention, response, and follow-up and support. The continuum for the multi-sector discussion on TMS is illustrated here:

Prevention > Response > Follow-up and support

Key areas of interest identified by roundtable members relating to the three stages of the continuum are presented below.

Prevention

  • Primary prevention
  • Understanding the range of causes of post-traumatic stress disorder
  • Educating employees early in career
  • Need for better statistics

Response

  • Early intervention and treatment after an event
  • Early diagnosis and continuum of injury
  • Access to psychiatrists
  • Intervention following a traumatic event

Follow-up and support

  • Return to work supports/recovery
  • Recurrence upon return to work
  • Spectrum of trauma related illnesses

Cross-cutting themes

Below are some cross-cutting themes or areas of interest relating to all three stages:

  • Leadership within organizations
  • Government leadership and role of government
  • Need to change the culture of organizations
  • Diversity of approaches (situational/occupational)
  • Knowledge exchange between organizations
  • Broader impact on individuals, families, economy, organizations, society
  • WSIB supports and opportunities for improvement
  • Barriers to support (e.g. geographical, smaller workplaces)

Roundtable members agreed on a number of key questions to explore under each of the three stages in the continuum. The process was not designed to arrive at a consensus on each question but instead the intention was to generate dialogue and ideas.

In addition to engaging in discussion, the roundtable members were also interested in hearing from mental health experts on TMS. In this regard, the roundtable was fortunate to have been able to draw on the expertise of Dr. Ash Bender and Dr. Rakesh Jetly for several of its meetings.[4]

Written report of the roundtable proceedings

The intent of the roundtable was to facilitate open and frank discussion on the issue of TMS. In this spirit, discussion groups on the various questions were not struck along any formal organizational lines, and the wide range of views and ideas that were expressed by individual members from workplaces, sectors and government during group discussions are presented in the following sections of this report, but are not attributed to specific members or organizations.

The purpose of this report is to reflect the ideas generated in the discussions that took place during the six roundtable meetings. As indicated above, the process was not intended to reach, and does not reflect, consensus. The report also does not evaluate or assess the feasibility of ideas discussed during the meetings, such as the effectiveness of peer support programs. The purpose of the report, therefore, is to capture the range of insights, experiences, and perspectives of the roundtable members.

The range of ideas generated through this open dialogue are provided for the consideration of interested individuals and organizations, and are intended to spark discussions and actions in the sectors and organizations that participated in the roundtable process, other sectors where traumatic mental stress incidences are likely to occur, as well as for consideration by government.

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[1] Smetanin, P., Stiff, D., Briante, C., Adair, C., Ahmad, S. & Khan, M. (2011). The life and economic impact of major mental illnesses in Canada: 2011 to 2041. RiskAnalytica, on behalf of the Mental Health Commission of Canada.

[2] Sairanen, S., Matzanke, D., & Smeall, D. (2011). The business case: Collaborating to help employees maintain their mental well-being. Healthcare Papers, 11, 78–84.

[3] The WSIB determines entitlement for individuals who have been clinically diagnosed as a result of a work-related traumatic event, subject to meeting certain criteria.

[4] Dr. Ash Bender, MD, FRCPC, is a staff psychiatrist and Clinic Head in the Work, Stress and Health Program at the Centre for Addiction and Mental Health in Toronto and is an Assistant Professor at the University of Toronto. Colonel Rakesh Jetly, OMM, CD, MD, FRCPC, is a Senior Psychiatrist and Mental Health Advisor with the Canadian Forces to the CF Surgeon General. He is also an associate professor of psychiatry at Dalhousie University, Queen's University, and the University of Ottawa.