Fighting depression: How a Canadian is driving science and business to find a cure
Bill Wilkerson heads up a global roundtable on depression and work stress. P
Photograph by: Julie Oliver , Ottawa Citizen
European mental health experts have turned to Canada to help lead a campaign targeting depression in the workplace that is snowballing into an international movement to find a cure.
On Oct. 8, Canada’s High Commissioner to the United Kingdom, Gordon Campbell, will host a reception in London for 75 business leaders from among the European Union’s corporate giants, kicking off the European Business Leadership Forum that will lead the charge to make workplaces more “brain healthy.”
At the same time, businessman Bill Wilkerson, one of Canada’s most outspoken mental health advocates, is stitching together what he calls a “business and science alliance” to broaden the campaign against depression at work into a major “rethink” of how mental illness is studied and approached.
He hopes the two initiatives will morph into a partnership of business and science throughout Europe, Canada and the United States, with pilot projects and clinical trials in workplaces.
“We are going to spell out that our objective is the cure for depression,” Wilkerson, who heads Mental Health International, told the Citizen.
These initiatives will be rolled out from Canada. Leading the way is Wilkerson, 72, who, with Michael Wilson, Canada’s former ambassador to the U.S. and senior cabinet minister for the Mulroney government, founded the Global Business and Economic Roundtable on Addictions and Mental Health.
Wilkerson’s new goals are ambitious and controversial.
He wants to set a 10-year deadline to reduce the number of disability claims for depression and anxiety to 10 per cent of all claims – compared to between 35 and 45 per cent today.
He is also asking companies to allow pilot projects with their employees, trying the variety of tools, programs, policies and approaches that have been developed to manage, reduce and prevent depression in the workplace.
These projects will be “scientifically validated” to determine what works and can be turned into a “best practices” guide for employers around the world.
Corporate heavyweights have shown some interest. Some, such as Unilever, Shell Europe, Ford Europe, British Telecom, Barclays Financial, the Royal Mail – headed by Canadian Moya Greene, former CEO of Canada Post – and Deutsche Post DHL plan to sign a business charter to help reduce stresses in the workplace that contribute to depression. Four have already signed up for pilot projects.
The big leap in the EU anti-depression campaign is the consortium of scientists Wilkerson and Dr. Anthony Phillips, chief of neuroscience at Canadian Institutes of Health Research, is assembling to collaborate on research projects to crack the mystery of the brain.
Some of the world’s top brain scientists – including Thomas Insel, director of the influential U.S. National Institute of Mental Health – are backing the plan for a “business and science” alliance to accelerate discoveries, diagnosis and treatment around mental illness.
They are betting on a “quiet neuroscience revolution,” which, with the right mix of entrepreneurial investment and scientific collaboration, can accelerate recent breakthroughs.
Not everyone shares Wilkerson’s optimism.
“There is no question in academic and community circles I find myself in … that the words ‘cure’ and ‘depression’ are not often found in the same sentence and if you say it, people step back and think you have misspoke. It does jolt people,” said Dr. Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto.
But, he says, “They did it with AIDS because of multi-lateral partnerships and urgency.” Science, McIntyre says, is “positioning us to have the word ‘cure’ in sight, not in our grasp yet – but in sight.”
One of Wilkerson’s key strategies is recruiting employers – including governments – to allow their employees to volunteer for clinical trials on depression, which would reduce the cost and time of testing and bringing new therapies to market. The aim is to encourage scientists to share unpublished data and intellectual property rather than compete with each other. The initiative also aims to attract drug companies, which have all but abandoned the costly development of mental health medications, back into the market.
How did Canada become a driving force in an international battle against depression?
The key, according to Wilson, was the Global Business and Economic Roundtable on Addictions and Mental Health. “They (the Europeans) called Bill to see how it all started. He went over to see them and has built this into something quite significant,” said Wilson.
Barclays chairman, and former Finance Minister Michael Wilson at his offices on Bay and Adelaide streets in Toronto, ON. Wilson co-founded the Global Business and Economic Roundtable on addiction and Mental Health.
Dr. Peter Hongaard Andersen, director of the Danish National Innovation Foundation and former senior vice-president of Lundbeck, a Danish pharmaceutical giant that specializes in brain illness, was impressed by the roundtable’s work and Canada’s commitment to mental health through the creation of the Mental Health Commission, which is supportive of Wilkerson. Andersen convinced Wilkerson to come to Europe.
“We don’t have anything close in Europe. Canada is so much more advanced,” said Andersen. “I encouraged Bill, saying he couldn’t be satisfied with what he had achieved when there was more to do.”
Wilkerson’s Europe initiative draws heavily on the roundtable, which he and Wilson founded 15 years ago to tackle the stigma around depression in the workplace.
“What the roundtable did was reach into the ranks of senior executives and make them aware of the existence of mental illness and addiction in their workplace, the cost of this, and about identifying how to work with it and help people get treatment, and once they are ready, get people back into the job,” Wilson summarized.
Roger S McIntyre M.D., FRCPC a professor of Psychiatry and Pharmacology with the University of Toronto and head of mood disorders Pychopharmacology Unit at the University Health Network on Bathurst street in Toronto, ON.
Through the exercise, they got the ear of corporate Canada, and are credited with putting depression in the workplace on the national agenda as an economic issue.
As they make the same push in the EU, there’s a critical twist: adding science as an ally.
The roundtable wound up in 2011 with a final report calling for an international “business and science” partnership. A forum of Canadian and U.S. business leaders and scientists endorsed the approach last year, as did a prominent group of neuroscientists at a summit in Munich – co-chaired by Andersen and Canada’s Phillips.
The recommendations of the roundtable’s final report, which weren’t acted upon in Canada, were sitting there “ready to be implemented,” said Andersen.
But the European campaign has to make that next leap, said Wilson. Mental health must be tackled as an international problem like energy, the environment or security. He argues that it is the only way to speed up brain research and find new treatments.
“We’re going at it this way because scientists need help getting their science into pills and treatment for people. They need power, clout – and business leaders can bring that into the fray,” said Wilkerson.
The timing couldn’t have been better when Wilkerson began crisscrossing Europe to drum up interest.
The world was awakening to the economic burden of mental illness as a growing public health issue. It took the spotlight at this year’s World Economic Forum meetings in Davos, whose study concluded mental disorders are the largest health cost to the economy, with global projections of $6 trillion by 2030 – more than diabetes, cancer and pulmonary diseases combined.
As Canada and Europe negotiated over trade, Wilkerson tapped into the “spirit of free trade”: Canada’s ambassadors set up meetings with business leaders in Copenhagen, London and Rome to discuss a partnership plan for “brain health in a brain economy.”
Wilkerson also got the backing of the International Labor Organization and the European Agency for Health and Safety in the Workplace.
Others were also focusing on brain research. The Obama administration gave US$100 million toward a new initiative to help develop brain technologies. The European Union announced a similar 10-year investment in neurosciences to build a simulation of the human brain.
In Canada, the Conservative government committed to $100 million through the not-for-profit Brain Canada, the first public-private partnership for brain research.
Employers have already seen what mental illness and the stigma around it do to productivity. It drives up absenteeism and presenteeism – employees going to work ill and disengaged. It’s a barrier to development in “emerging economies” and a huge cost on health care systems. It will hit one in four of us during any working year.
Sharpening the issue now is the changing nature of work.
The report that will be presented to EU business leaders in London – Breaking Through: Brain Health in the Brain Economy – focuses on the 21st-century economy as brain-based and the world’s workforce as the “brain capital” critical for success. Today, 85 per cent of all new jobs in North America and Europe demand cerebral, not manual, skills. Mental health is critical.
The London School of Economics calls depression more than a brain disorder, with spillover effects on the entire body. It is closely entwined or co-occurs with major chronic diseases such as cancer, heart disease, diabetes and obesity. Depression makes the heart work harder, the blood stickier and increases the risk of stroke among women.
The U.S. National Institute of Mental Health recently estimated mental disorders and addictions were reducing life expectancy by up to 25 years, more than smoking – eroding the gains in life expectancy of the past 50 years.
“We have arrived at place in history where senior leaders in business and science across Canada, the U.S. and Europe believe it is important for both sectors to become close allies in the discovery of scientific info and development of new treatments,” Wilkerson said.
“It’s a great opportunity we can’t let pass us by.”
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Depression: What is it?
An illness that causes prolonged feelings of sadness, hopelessness, anxiety and loss of interest that interferes with everyday life – the ability to work, concentrate, eat, sleep or make decisions.
What causes depression?
Scientists believe it is caused by a combination of genetic, biological, environmental and psychological factors. Depression and other mental illnesses are considered disorders of the brain, which has researchers looking for the root causes of those disorders so they can develop better ways to treat, prevent and manage them.
Who is hardest hit?
It’s prevalent among all Canadians, with about 40 per cent suffering depression and/or anxiety disorders some time in their life. It hits the young and those among the 19.2 million Canadians who are in their working years the hardest.
Depression and suicide
Worldwide, suicide is one of the three leading causes of death among young people aged 15 to 24 years. Depression is present in about 90 per cent of all suicides.
Depression and the workplace
Depression is estimated to afflict 18 per cent to 25 per cent of employees in Canada and the U.S. in any given year. It’s the largest and fastest-growing cause of disability on the job.
Depression and the general population
The general incidence in Canada and the U.S. is between 20 per cent and 25 per cent over the a lifetime and 30 per cent in Europe.
In any given week, at least 500,000 working Canadians don’t go to work because of mental health problems. Of those, 355,000 are on disability and 175,000 have called in sick.
Cost of depression, anxiety and addiction in the workplace
$51 billion in Canada per year – that is, four per cent of GDP – including health-care costs, lost productivity and reductions in health-related quality of life.
Overall cost of depression in the European Union and North America
More than $1 trillion a year.
– Sources: Mental Health International and Global Business and Economic Roundtable on Addictions and Mental Health, Centre for Addiction and Mental Health.
One man’s description:
“Depression is a terrible name to put on this brain disorder because it doesn’t begin to capture what this experience is like. It actually has nothing to do with sadness. When you’re depressed you hope you can feel sad; that would be an improvement.
“There is a sense of real anguish or severe anxiety that comes with it. For many people, it’s a feeling of deadness, it’s a complete lack of feeling. And perhaps the description that most people give as falling into a dark place, falling down a well … Andrew Sullivan, who has probably written the best book on depression, called Noon Day Demon, talks about a great oak tree covered in vines, so much so that you can’t see through the vines. It’s like the tree is dying and it’s just the vines, which is this terrible illness, keeping you up. That is sort of what depression feels like. There is nothing left of you.
– Dr. Thomas Insel, director of the National Institute of Mental Health, the world’s biggest funder of brain research, at Mental Health International’s fifth U.S./Canada Forum on Mental Health and Productivity, Nov. 20, 2013, in Toronto.