Features | From Pivot Magazine

The real cost of the global mental health crisis

Companies, and countries, need to act fast to preserve our most valuable resource: people

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Portrait of PwC's Becky WilsonBecky Wilson (Photograph courtesy of PwC)

Two summers ago, Becky Wilson was driving back to Toronto after a weekend away when she started to feel light-headed, and noticed her heart was racing for no discernible reason. Worried she was about to faint, she pulled over to the side of the highway and called her parents to come pick her up.

Wilson, a CPA and then an associate at PwC, had experienced depression and anxiety on and off since high school, but this was her first panic attack. Her mother, who’d had one herself when she was younger, suggested it may have been brought on by stress. 

After a night’s sleep, Wilson set out to the office Monday morning. “And then I had a panic attack on the subway,” the 26-year-old, now a senior associate, remembers. “I made it to work and tried to spend the morning there, but ultimately had to go home.”

When things didn’t get better after a week, Wilson decided to speak to her work coach, the person at the firm assigned to help her plan her career and look out for her well-being. “I remember saying to her, ‘I hope this doesn’t make me look bad.’ ” Wilson was especially worried because she’d just been put on an important project.

Wilson’s coach reassured her that during this time, she wouldn’t allow anyone to express criticism of Wilson’s performance that was directly connected to her mental health issues. She also brought in a PwC partner who’s known as a champion for well-being at the firm. “They said, ‘What do you need in order to be successful? We want you to be here.’ ” [See My depression was so acute I tried to resign. Now, I’m KPMG’s chief mental health officer]

One in four people worldwide will suffer from a mental health disorder at some point

The compassionate reception that Wilson experienced isn’t always the case, however—and that gap in support has proven to be a destructive force for workers and economies across the globe. The World Health Organization estimates that one in four people worldwide will suffer from a mental health disorder at some point in their lives, and that the global economy loses about US$1 trillion a year in productivity due to depression and anxiety. 

And yet governments are not adequately investing in prevention and treatment. In a 2018 report, the medical journal The Lancet estimated the cost of our “collective failure to respond to this global health crisis” will have reached US$16 trillion in the period between 2010 and 2030—and that 13.5 million deaths could be avoided each year if the crisis were properly addressed.

According to Toronto’s Centre for Addiction and Mental Health, about 500,000 Canadians miss work each week due to a mental health illness. As those numbers pile up week after week—and the unattended problems lead to longer-term disability claims—health care costs and lost productivity add up to a $51-billion-a-year burden to the economy. Meanwhile, more than 4,000 Canadians die each year from suicide. 

In Ontario, about 10 per cent of the burden of disease is related to mental illness, yet it only accounts for seven per cent of the province’s health care budget—a shortfall of almost $1.5 billion. 

Like PwC, many companies in Canada did the math and realized that the human value of supporting employees struggling with mental health issues also yields economic benefits. A recent Deloitte study found that, among Canadian companies that had implemented mental health programs, the median annual ROI was $1.62 for each dollar invested. The longer the program was in effect, the higher that return.

Last year, a survey of 251 accountants conducted by the Chartered Accountants’ Benevolent Association—which provides support to accountants in England and Wales—found that one in three respondents feels stress on a daily basis. And indeed, the high-pressure nature of the job makes it especially important for every CPA to keep an eye on their wellbeing—whether they believe they have a mental health issue or not.

“We all experience mental health issues in some way,” says Ed Mantler, vice-president of programs and priorities at the Mental Health Commission of Canada (MHCC). “People often think you’re either perfectly fine or you have a diagnosable illness, but there’s a continuum.”

“…The stigma around mental health illnesses is as bad or worse than the symptoms themselves.”

Mantler suggests taking proactive, preventative measures—getting enough sleep, eating a healthy diet and exercising regularly. While he adds that going to work is among the list of things that can actually improve our state of mind—“it can give us a sense of purpose and a regular feeling of accomplishment”—our jobs can also sometimes exacerbate underlying problems. 

He points to the National Standard of Canada for Psychological Health and Safety in the Workplace, launched in 2013 by the MHCC in partnership with the Canadian Standards Association Group, as a useful guide for employers and staff to understand what helps and hurts. The Standard, which professional accountants helped develop, discusses everything from the most effective wellness policies and benefits to more subtle things like the importance of an employee knowing what is expected of them at work, and an understanding of how their role contributes to the company’s mission. 

For those who are in the midst of a pressing mental health concern, Mantler suggests contacting your local branch of the Canadian Mental Health Association, and to check if your company has an employee assistance program. “One place you can always start is with your family physician,” he adds.

Of course, making the move to find help can be easier said than done. “Many people tell us that the stigma around mental health illnesses is as bad or worse than the symptoms themselves,” says Mantler. Early intervention is important, but according to Mantler, only 30 per cent of people reach out for help early on—and it can take some people many years or decades to seek assistance. He hopes that as workplace well-being is increasingly discussed at more companies, people will be more comfortable speaking about their own mental health.

In Wilson’s case, she was able to get six free sessions with a counsellor through Morneau Shepell, which administers PwC’s employee assistance program. The program then connected her with a psychiatrist. As she adjusted to the medications that help ease her anxiety and depression, she kept her team updated when she was having an off day. Now, if she’s had a run of long hours on a high-stress project, she makes sure to take a day off, if possible, once the deadline has passed. 

Wilson, who has become one of two Greater Toronto Area leads in PwC’s Differently Abled Wellness Network (DAWN), encourages her colleagues to speak up if they’re in trouble. Far from hampering her career prospects, she says being open has helped her to be productive. “I just feel like I can come to work and be more of myself,” she says. “It’s one less thing to worry about, and that lets me focus on my job.”


Organizations are recognizing their success includes taking care of their workforce. Find out how members of the Canadian Chapter of The Prince of Wales’s A4S project are integrating Social and Human Capital considerations into their practices.