Breakdown: Canada’s Mental HealthCrisis a Continuing Series

He switched on the light – then fell into darkness To cap a long,
high-powered career, Bill Wilkerson led a campaign to transform the way
corporate Canada saw mental illness in the workplace. Then as he reveals
here for the first time the professional crisis manager unexpectedly slipped
into crisis himself.

Tavia Grant
Globe and Mail, February 21, 2009

Bill Wilkerson woke up early in his Halifax hotel room one Tuesday morning
last August.
A busy day loomed as usual – at 8 a.m., he was supposed to deliver a
one-hour keynote
address to more than 1,000 people. He was well-rehearsed. There was just one
snag:
He wasn’t sure he could get out of bed.

“There was a fuzziness behind my eyes. My arms felt limp.” He felt heavy and
frightened
for no apparent reason. The man who for a decade had been giving speeches
around
the world and lobbying for political action as one of Canada’s top
mental-health
experts was now, himself, battling depression.

Desperate to fight the feeling, he did sit-ups, spoke out loud just to hear
his own
voice, shadow-boxed and swung an imaginary baseball bat – “anything to get
to a point
where I could get back to a physical presence,” he recalls. “Because if I
stepped
in front of the mirror, I wasn’t sure if I would see anybody.”

Ultimately he made it to the conference. He spoke. He urged businesses to
make mental
health a priority. He joked (giving a Top 10 list of “management practices
now driving
us crazy”). And the crowd gave him a standing ovation.

When Mr. Wilkerson gathered together a host of prominent Canadians 10 years
ago to
address the social and economic effects of mental illness, he wasn’t
motivated by
personal problems.

But along the way, as head of the Global Business and Economic Roundtable on
Addiction
and Mental Health – whether because of his own makeup, stress, frustration
or some
mix of causes – his own mental and emotional state began to fray. Tensions
grew between
his public and private personae.

“There’s such a surrealism to it,” he says now, sitting in the sun-drenched
dining
room of his century home in Port Hope, Ont. “It’s like … there is Bill,
this person,
and there is Bill, the other person” – the effusive, approachable Bill who
was at
home in any social situation and the inner, angry Bill who saw health-care
bureaucracies
and indifferent employers cause so much misery for people in need of help.

“I had to leave that Bill behind.”

Today, he is also leaving the Roundtable, winding the organization down
after hitting
the one-decade mark. He doubts he could have found a replacement, as he
wasn’t drawing
a salary for much of that time. In any case, other groups and individuals
are now
carrying the torch.

As he prepares to write a book on the Roundtable experience, this skilled
professional
crisis manager is finally willing to reveal his own crisis to the public.
It’s a struggle he kept private for three years, telling no one but his
wife, Olga,
of his diagnosis. He never wanted to make his crusade personal – he wanted
to present
“bulletproof” research to employers and policy-makers to persuade them, with
hard-nosed
logic, to take the mental-health issue seriously.

“If I’d declared my illness earlier,” he says, “I would have become another
voice
who got religion because they went through it. I got religion long before I
had any
notion of being affected by it.”

But he is willing to reveal himself as he steps down, in the hope that his
story
will underscore one of his main messages: Mental illness is part of the
mainstream
in Canada – and it does not spell an end to meaningful work.

Changing the agenda
Mr. Wilkerson is widely credited with moving the conscience of corporate
Canada by
sparking groundbreaking discussions on mental health among senior
executives, scientists
and government policy-makers in North America and Europe.

“Ten years ago, this wasn’t on anyone’s agenda. Now, it is,” says Michael
Wilson,
the former finance minister and current Canadian ambassador to the United
States,
a leading advocate for mental health since his own son’s depression-related
1995
suicide. “You need a unique character to do that, and Bill is one.”

Mental illness will strike one in every five Canadians at some point in
their lives.
Depression and anxiety represent up to 90 per cent of such illnesses and
cause up
to 35 million lost workdays a year in Canada. Mental illness costs Canadian
employers
$51-billion a year (chiefly in lost productivity) and is the leading
disability claim
for insurers.

It’s daunting stuff, but Mr. Wilkerson keeps his focus squarely on
solutions. “He
respects science, he understands the needs of the business community and he
is relentlessly
optimistic that we can all make a difference if we work together,” says Tom
Insel,
director of the National Institute of Mental Health in the U.S. It may help
that Mr. Wilkerson typically asks his influential contacts not for money but
for their time. Fundraising has not been a priority – which explains why
both he and long-time administrator Donna Montgomery have worked for
stretches without pay.

The Roundtable’s partners have included the big banks, not traditionally the
most
nimble of institutions. Rob MacLellan, chief investment officer at TD Bank,
says
Mr. Wilkerson persuaded the “big names” to get involved by deploying the
plain facts
on lost productivity and the links between mental and physical illnesses.

Among Mr. Wilkerson’s breakthroughs was the creation of the Great-West Life
savings
and insurance company’s Centre for Mental Health in the Workplace. He helped
to make
workplace issues a top priority when the federal Mental Health Commission of
Canada
started in 2007. He has also influenced curriculum, designing the first-ever
compulsory
academic program dealing with mental health for students at the McGill
University
school of management. And he has made sure that some of the individuals who
have been hurt by
Government or corporate bureaucracy get a chance to share their stories with
senior
decision-makers.

“Despite the often highly distressing nature of the narratives, Bill always
manages
to pull out a little ray of hope,” says Ron Kessler, a professor of
health-care policy
at Harvard medical school.

For one thing, he speaks about cures: If we can dream about a cure for
cancer, why
not for depression or schizophrenia? He also emphasizes that depression is
as normal
as any other illness or injury. But he doesn’t mince words about employers’
duty
to accommodate (by adjusting work hours, for example) and the health
profession’s
need to make treatment more accessible.

“I’ve seen him be dead honest with business leaders,” says Rod Phillips,
president
and chief executive officer of Shepell·fgi, the largest provider of
employee-assistance
programs in Canada: “‘You say one thing, but you are not living up to your
obligations
as an employer.'”

But Mr. Wilkerson hasn’t lavished his attention only on bigwigs. Tanya, a
Canada
Post employee with a bipolar disorder (she asked that her last name be
withheld),
went to Mr. Wilkerson for advice on returning to work after a leave. He
didn’t just
offer platitudes, but called Canada Post’s president. “It made me feel good
to have
someone on my side,” she says.

Tom Regehr was a successful Toronto-based consultant before alcohol and drug
abuse
left him sleeping on the streets. At the age of 37, he was starting to get
clean,
but was scared he could go off the rails at any moment. Mr. Wilkerson
offered advice,
encouragement and his candid opinions.

“There’s no bullshit with Bill,” says Mr. Reghr, who is now a workplace
consultant.
>From failure to Fixer

William Edward Wilkerson was born nearly 67 years ago in Niagara Falls,
Ont., the
last of five kids for an Ontario Hydro generator operator and an
American-born, stay-at-home
mom.

In high school, he played guard on the basketball team. But he didn’t quite
sink
the shot when it came to graduation – he was kicked out on the last day of
Grade
12 after an unfortunate incident involving a water bomb and his math
teacher.
His mother was horrified, convinced her son would become a hardened
criminal. So
that very day, he set out in the family Plymouth to find a job. He landed
one as
a court reporter for the Tribune in nearby Welland, earning $45 a week.

The young Mr. Wilkerson turned out to be a fine reporter, landing stories
about corruption
at the Niagara Parks Commission (where perks included “hookers, lots of
booze and
very expensive food”), the root cause of the 1965 Northeast Blackout (human
error
in Ontario) and unguarded comments a bishop made while watching a church
burn (“holy
smokes”). (You can detect the former headline writer in him in all the
phrases he has coined
in speeches over the years – for instance, “hurried and worried” as an apt
description
for a typical worker; the message that most mental illnesses are “treatable
and beatable”;
and “social climate change,” the process by which stress can melt
resilience, drop
by drop.)

At 26, however, he heard the call of Liberal politics and left reporting to
begin
speechwriting for various politicians. Eventually he served as chief of
staff and
campaign manager for Toronto mayor Art Eggleton.

His career since then has spanned the public and private spectrum, mostly in
situations
of turmoil. He was spokesman and adviser for the National Hockey League
during the
1992 strike. He was the “crisis” president of the Toronto Symphony
Orchestra, which
at one point in his 2001-02 tenure was hours away from collapsing. (He and
then-chairman
Bob Rae kept it afloat, barely, with a new marketing strategy and new
staff.)
It was as director of communications at the CBC in the early 1980s that he
met Olga
Cwiek, then a human-resources executive there. They were married in 1987 and
now
live in a historic home in Port Hope; they have no children, but are
surrounded by
books, trees and a much-loved dog and cat.

Mr. Wilkerson’s last corporate job was as the transitional chief executive
of Liberty
Health. It was there that the story behind the Roundtable began,
surprisingly springing
from a business conundrum, rather than any quest for a social cause.

Insurers’ drug claims for pain relief, sleeplessness, tension – afflictions
with
imprecise diagnoses – had spiked in the mid-1990s, especially among young
men and
women with full-time jobs. No one knew why. Mr. Wilkerson suspected it may
have to
do with rising rates of depression.

After his contract at Liberty Health ended, he set out to investigate
further as
a consultant to Homewood Health Centre, a Guelph, Ont., health-care provider
that
specializes in addiction and mental-illness treatments. That investigation
unexpectedly
catapulted him into the mental-health field.

Through research and interviews, he found several shifts under way: The
transition
to a knowledge-based economy from manufacturing was bringing more chronic
stress;
more young people in the work force were being diagnosed with depression;
and scientists
were discovering links between stress, depression and heart disease.

In other words, it was no coincidence people were getting sick: The whole
nature
of work was changing. Chronic job stress – a frantic, relentless pace that
can bring sleeplessness, soon to be exacerbated by endless e-mails and
BlackBerrying – is a
trigger for depression. The World Health Organization projects that
depression and
heart disease will swell to become the top contributors to the global
disease burden
by 2020.

Job insecurity was another key factor. “The mass-layoff culture, in my
judgment,
was a trigger point, if not the cause of the unfolding epidemic of
depression which
has now taken hold 12 years later,” he says. “And it hasn’t gone away.”

On the other hand, he realized, an employer that could prevent even one
long-term
disability case would see benefits go directly to the bottom line. Mr.
Wilkerson,
a man with no medical or academic training, did what few others had: He
connected
the dots.

On Oct. 10, 1997, he gathered a group around a polished Bay Street boardroom
table
that included former Ontario premier Bill Davis, Michael Wilson (then
vice-chairman
of RBC Dominion Securities), Tim Price (then chairman of Trilon Financial
Corp.,
later Brascan) and Claude Lamoureux, then head of the Ontario Teachers’
Pension Plan.
That was the seed of the Global Business and Economic Roundtable on
Addiction and
Mental Health.

“Everybody around the room had a personal experience with mental illness – a
son,
daughter, brother, sister, wife, husband,” says Mr. Wilkerson, whose father
suffered
from bouts of paranoia and depression. “That was never the intention of the
meeting.
But of the 35 people in that room, there was not one from the business side
who didn’t
have a family experience or concern with it. And they wanted to learn about
it because,
back then, the subject was on no one’s agenda.”

Indeed, the topic was a complete taboo. It made people squeamish. As
Vancouver-based
philanthropist Edgar Kaiser puts it, it was like walking around in the dark
and banging
your shins. Mr. Wilkerson’s skill, he says, was in turning on the lights.
“He makes the subject non-threatening.”

That meeting led to a report, to a book Mr. Wilkerson co-wrote with Edgardo
Pérez
Entitled Mental Health: The Ultimate Productivity Weapon and to a series of
Roundtable meetings across North America.

There were failures. At his first speech at a global conference in Vancouver
a decade
ago, Mr. Wilkerson spoke in front of 150 empty chairs. But then came the
successes,
and now when he speaks to business leaders, rooms are overflowing. His
cheeky, boyish irreverence and love of a good yarn help to explain why – the
man has not worn a tie in seven years, his silver hair waves past his ears
and his
laughter booms.

But, of course, his audiences haven’t been privy to the days when the
laughter won’t
come.

Everyday people
The persistent stereotypes about the mentally ill drive Mr. Wilkerson to
distraction.
The typical person with a mental illness is not the guy on the street who
talks to
himself. It’s not the violent killer or the woman who stays hidden in her
parents’
basement. Those, he says, are the extremes, not the mainstream of this
crisis.

“It’s the mothers who get up and go to work every day and struggle. It’s
fathers
and brothers who fight uphill just to get routine things done. It’s the
heart patient
who’s having difficulty recovering and who’s about to have another [attack].
It’s
the female executive who can’t stop obsessively checking whether she turned
the tap
off, but she gets to work and does her job,” he says.

“It’s the lawyer who decides to take a year off to get well, and then
struggles to
explain why she took that year off. It’s the teacher who was told not to go
back
in the classroom after a depression because the school board and the
principal worry
he would somehow harm the children. And it’s the kid who, at three months
old, is
exhibiting stress symptoms but can’t get in to see a child psychiatrist
until they’re
much older.”

And it’s Bill Wilkerson himself. There had been some warning signs: For
decades,
he wrestled with coping with anger and disappointment. In his Roundtable
work, surrounded
by some of the world’s top neurologists and business leaders, he was anxious
about
lacking a university degree.

Over the past decade, his frustrations snowballed. His phone was ringing
non-stop
with people who were struggling. These were “logical and reasonable cases,
and they’re
being treated like damaged goods and thrown into isolation. And I began to
feel this
was a less hopeful cause than I’d thought.”

He often felt alone. “Rumination is a predictor of depression – and I
seethed a lot,”
he says. He never showed the inner side “because if you’re going to be an
effective
voice for anything or anyone, you can’t be an angry public person. I was
never that.
But my disappointments and frustrations got internalized.”

Inside, he would rage against the powers that be, and yet “to alienate them
would
lose the cause.”

Now, he figures he should have sought help earlier. He felt he was losing
control,
he felt consistently generally unwell and daily routines – even getting a
glass of
water – seemed overwhelming.

Three years ago, he was officially diagnosed with depression. “It’s like the
energy
being taken away. It’s an absence, not a presence. It’s not a bad mood. It’s
almost
no mood. There’s also that physicality: my achy stuff – my scar, my baseball
shoulder
– got achier.”

He now takes antidepressants to keep the black dog at bay. It still sneaks
back every
few weeks or months, especially when he hasn’t been sleeping. “I kick it in
the teeth
and it goes away again.”

Rough road ahead
As the Roundtable winds up its work, Mr. Wilkerson has mixed emotions. For
all the
accolades its work has earned, he is frustrated he has not achieved more.

“I don’t see, after 10 years, the kind of change that I know has to happen,”
he says.
“If someone like me – a high-school fucking dropout – can become one of the
top experts
on this, you can see how bereft this field is.”

Did such disappointments bring about his mental illness? No. But “it’s had
to contribute
something. Nothing satisfies me.” Still, experiencing depression himself has
given
him more empathy, and added to his existing passion. And it has not remotely
slowed
him down – he continues to crisscross the country. He will devote the next
year to giving speeches, writing his book on the Roundtable’s
decade and advising the RCMP and the Canadian military on mental health.

Meanwhile, the sinking global economy is aggravating his concerns. In a
culture of
mass layoffs that treats workers as disposable commodities, he says, they
are even
more apt to stay quiet about depression, stress and anxiety, fearful of
stigma. Few
employers have moved beyond “wellness” programs to a hard commitment to help
prevent
mental illness and accommodate those who do fall ill and successfully
reintegrate
them back into the work force.

It’s easy to see why Mr. Wilkerson is apprehensive. Leaders such as Michael
Kirby,
first chair of the Mental Health Commission of Canada, predict that work
overload,
job insecurity and financial fears will spark a fresh wave of depression and
other
disorders. Psychiatrists across Canada are already reporting heavier
caseloads.

Mr. Wilkerson recalls being required to lay off 105 workers while he was at
Liberty
Health. It initially saved a few million dollars in overhead, but the
company wound
up having to rehire some because it couldn’t function without them.

“Job cuts as a measure to improve competitiveness are fool’s gold,” he says.
“When all was said and done, savings were minimal. It undermined and
probably devastated
our competitive advantage.” It’s a lesson he thinks of often in these days
of downsizing.

Yet Mr. Wilkerson also sees potential for the crisis to help motivate
Canadian workplaces
to become venues for mental-health education and prevention – for workplaces
to act
as communities and invest in human capital.

“The sanity to come out of this mess would be to rediscover the long-term
value of
people. We’ve got to get back to the basics of human decency.”

Still, sometimes his frustrations erupt into fury – as when an acquaintance
in dire
need of psychiatric help was recently placed on an 18-month waiting list.

“Maybe this is the source of why and how I wear down,” he says. “It’s not
the task
of helping individuals as best I can, but the awful realization of how
limited and
limiting is the mental-health care system we have allowed to exist in
Ontario and
in Canada for so goddamn long.”

It may be Olga who can most eloquently summarize the challenges her husband
has endured,
having seen him through the highs and lows of his crusade.
“What’s hard to do is to be a first. And he’s done 10 years of firsts,” she
says.
“He was the first to bring in businesses, to translate medical language into
laymen’s
terms, to hold Canada-U.S. forums. Nobody spoke of these things before. He
was the
first to bring it all out into the open. He’s a pioneer. But firsts are the
hardest
things to do because you’re usually alone.

“Most people do only one first. Billy has done 60.”

Tavia Grant is a Globe and Mail writer.

*****

Hurried and worried
In his speech in Halifax in the summer, Bill Wilkerson presented a set of
stress-inducing
workplace situations with a humorous twist: “With apologies to David
Letterman, let
me give you my Top 10 list of management practices now driving us crazy.”

  • 10. Treadmill effect. Got that done? Get this done.
  • 9. Lots of responsibility, not much discretion.
  • 8. Too much work, not enough resources? Join the club.
  • 7. Got something to say? E-mail me.
  • 6. What’s the priority? Everything.
  • 5. Not sure what’s expected of you? So what’s your point?
  • 4. Job fulfilment? What’s that? Besides, be glad you even have a job.
  • 3. Skills and job don’t match up? Not what you were hired to do? Too bad.
  • 2. That’s not fair, doesn’t make sense? Is it supposed to?
  • 1. Turned your cellphone off? Who told you to do that?

Reproduced from http://www.theglobeandmail.com/servlet/story/LAC.20090221.BILL21//TPStory/Comment