Mental health and mental illness are not interchangeable

Man with head in hand, sitting on a couch

This op-ed was originally posted by Canadian HR Reporter on October 1, 2019 and was written by Dr. Bill Howatt of the Conference Board of Canada.


What comes to mind when you think of mental health? Many think of it through a mental illness lens.

Employers play a major role in supporting employees’ mental health, but they must be clear on what mental health is and how it links to mental illness. To have the most impact, they must also be clear on how mental health differs from mental illness.

Stats Canada estimates that one in five Canadians—a significant percentage of the population—will experience a mental illness in their lifetime. This statistic is leading many employers, human resources professionals and employees to use the words mental health and mental illness interchangeably.

It’s common for a person when asked about mental health to think about conditions such as anxiety, depression and addiction that are described in detail by the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).

A person experiencing symptoms can only be sure if they have a mental illness by seeking support from a qualified mental health provider who can evaluate their condition, determine whether it meets the criteria for a mental illness, and recommend appropriate intervention or treatment.

While many organizations focus on supporting employees suffering from mental illness, their efforts could be short-sighted, because 100 per cent of the workforce at any point in time may be challenged with mental health issues.

Stigma about mental health continues to be a major challenge in many organizations. Attempting to support employees at risk for a mental illness may be a part of the challenge. It can be helpful to provide employees information on anxiety or train them on ways to support a person dealing with anxiety.

While many organizations focus on supporting employees suffering from mental illness, their efforts could be short-sighted, because 100 per cent of the workforce at any point in time may be challenged with mental health issues.

Consider what percentage of your workforce could be impacted by just one of the following factors on a typical day:

  • 48 per cent of Canadians have lost sleep over financial worries.
  • 28 per cent of Canadians are experiencing loneliness.
  • 30 per cent of Canadians go to work feeling fatigued.
  • 58 per cent of Canadians report feeling job-related stress daily.
  • 19 per cent of Canadians report themselves as heavy drinkers.

Notice I didn’t include commuting, elder care, relationship conflict, parenting, and dealing with a divorce—additional factors that can result in stress that can negatively impact employees’ mental health.

Expand the conversation

The above statistics are just a few examples that point out why it’s of value to expand the conversation beyond mental illness and to focus more on mental health.

Many employees simply don’t have context as to how to evaluate their mental health. One way to help them is to provide contrast and compare mental health to physical health. Both are influenced by the environment as well as by individual daily micro decisions and behaviours.

Changing the conversation moves us away from talking about just the one in five who may be at risk to about the five in five.

Since all employees’ mental health can, like physical health, fall on a continuum from excellent to at-risk,  the key to expanding the conversation is to focus on what the employer can do to help employees understand the difference between mental health and mental illness, as well as the benefits of proactively focusing on their mental health daily.

Tips for expanding the conversation

Don’t assume employees know what mental health is

To expand the conversation requires educating employees on mental health. Most have a frame of reference as to what they can do to improve their physical health, such as increasing their physical activity, and improving their diet, hydration and sleep.

Most employees also know that body weight and waist size are key metrics for personal monitoring of their physical health before they go to a doctor who can provide much more detail through blood work.

Employers need to be aware that impacting employees’ mental health can be as or more challenging than influencing their physical health. Regardless of the challenge, the first step is to educate employees on what positive mental health looks like. Keyes has created a user-friendly model that shows how mental illness and mental health fall on two separate continuums. Mental health ranges from languishing to flourishing. A person can move back and forth on this continuum based on their perceived stress and coping skills. The longer an employee stays in the languishing sector, the greater their risk for developing a mental illness such as anxiety or depression. They may engage in at-risk behaviours such as drinking to cope with their feelings of distress.

They key lesson is that mental health doesn’t just happen. We each play a role in influencing it through our daily actions.

Promote mental fitness

The next step is teaching employees what they can do to influence their mental health daily.

Providing context through specific actions creates an opportunity for employees to know exactly what they can do. One activity that promotes mental fitness is developing resiliency. Employers need to keep in mind that there are things both they and their employees can do to promote resiliency. Employers can create psychologically safe workplaces and employees can develop and practice coping skills.

They key lesson for employees is to learn what they can do to promote their mental health and reduce their risk for mental illness, much like those who take care of their physical health can reduce their risk for chronic diseases like diabetes.

Dr. Bill Howatt

Dr. Bill Howatt

Chief of Research, Workforce Productivity

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