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The Mental Health Continuum: A Slippery Slope

Dec 07, 2015
Photo of Charles Boyer Charles Boyer
Research Associate
Workplace Health and Wellness Research
Photo of Bill Howatt Dr. Bill Howatt
Chief Research and Development Officer, Workforce Productivity
Morneau Shepell Ltd.

Each day, 500,000 Canadians miss work due to a mental health issue. The Center for Addiction and Mental Health also reports that mental health is the leading cause of disability in Canada. A Conference Board of Canada study in 2012 estimated that mental illness costs Canada $20.7 billion annually and also forecasted that this cost will grow to $29.1 billion by 2030.

People under chronic distress (i.e., perceived stress that is painful or unwanted) without relief or coping skills are at increased risk for developing mental and physical illnesses/issues. How a person copes with stress can have a positive or negative impact on their physical and mental health.

Difference Between Mental Health and Mental Illness

Today, one in five Canadians is experiencing some degree of a mental illness or mental health issue that is having a negative impact on their quality of life at home and work. But it is important to recognize the clear distinction between mental health and mental illness. The Mayo Clinic recognizes mental illness as “a wide range of mental health conditions—disorders that affect your mood, thinking, and behaviour. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders, and addictive behaviours.” For people living with a mental illness, treatment plans, pharmaceuticals, and psychological counselling may improve their quality of life.

Mental health is a spectrum, just like physical health. From day to day, individuals can experience positive or poor mental health. The World Health Organization defines mental health as “a state of well-being 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 Mental Health Continuum

The Mental Health Continuum (see “Mental Health Continuum” and Table 1) identifies five individual categories on a linear continuum that individuals under stress tend to move back and forth on. These states include: Happy; OK; Frustrated; At risk; Illness/health issue. An interesting observation regarding the continuum is that it is common for an individual in the OK category to take action every day to focus on what they can do to avoid entering the Frustrated category, rather than focusing on what they can do to enter the Happy category. Why? These individuals are focused on avoiding stress versus seeking happiness. Individuals with a mental illness or mental health issue can move back and forth on the continuum with the appropriate therapy, counselling, pharmaceuticals, or other treatment plans.


Your Life at Work research, conducted through The Globe and Mail, found that 60 per cent of employees in Canada were slipping toward the Frustrated, At risk, and Mental illness/health issue categories of the continuum. To employers, The Globe and Mail’s findings may not be surprising, as mental health issues/illnesses is a leading cause of disability in Canada.

Can We Reverse This Trend?

We know that workplace environments can help an employee maintain or improve his or her mental health, but workplaces can also exacerbate a mental illness or mental health issue. New research conducted by the Conference Board’s Workplace Health and Wellness Research Group, to be released later in 2016 as part of the Healthy Brains at Work series, will highlight effective mental health strategies, programs, and practices in Canadian organizations.

But employees also have a role to play in supporting their own mental health and that of their colleagues. Three possible areas that can help employees move toward the left of the mental health continuum are awareness, accountability, and action.

  • Awareness: refers to self-evaluation and self-knowledge.
  • Accountability: an employee’s realization that they can take charge of next steps; there is something they can change.
  • Action: there may be external supports that employees can access to direct them to make healthier changes. These external supports could be talking to a trusted peer, a doctor, or accessing the employee and family assistance program (EFAP).

Related Webinars

Healthy Brains at Work
Louise Chénier, Manager for the Workplace Health and Wellness Research and Greg Sutherland, Principal Economist for the Canadian Alliance for Sustainable Health Care (CASHC), The Conference Board of Canada, October 22, 2015.

The Coping Crisis: Building Psychologically Safe Workplaces
Dr. Bill Howatt, Chief Research and Development Officer, Workforce Productivity, Morneau Shepell Ltd., September 30, 2015

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