Health Benefits and Types of Leave
Counselling is an essential part of mental health treatment. Many benefit plans include it, but at completely inadequate rates. With counselling sessions costing $120 to $250 an hour, many plans don’t cover enough sessions or enough of the fees to be truly helpful.
Given the cost, and how critically important counselling is for mental health treatment and recovery, unions should negotiate this as a separate benefit. A member facing a long-term mental health issue will need far more support than the small number of sessions covered by an EAP.
It’s also important to look at what kinds of counsellors are covered. Psychologists usually are, but there is a wide range of other kinds of counsellors too. Having a range of accredited counsellors covered by your health plan can provide the widest choice and range of support for your members.
Consider bargaining coverage for psychologists, social workers, masters of counselling and any other kind of recognized counsellors that your members may need.
There are a few key points to bargain when it comes to mental health coverage:
- Are members entitled to a certain number of appointments, regardless of cost per appointment?
- Is the full fee per appointment covered, or a percentage?
- Or is there simply a maximum annual dollar amount?
- Try to increase the total number of appointments covered. And if your plan covers a percentage of fees or a total maximum, can you bargain an increase to those benefits?
- Are in-person counselling appointments – not just phone or online counselling – covered?
Are drugs for mental illnesses like depression or anxiety medications covered?
Most mental health care is on an outpatient basis, but sometimes members will find themselves needing in-patient treatment.
- What coverage does your plan provide for the costs associated with hospitalization?
Types of Leave
Treatment and support for mental health often involve needing leave for members and their families. Taking care of our mental health involves appointments with doctors, therapists, and other professionals. During a critical period, a member may need to see a doctor or counsellor every few days. At other times, appointments may be less frequent.
It’s important to have time off for these and other kinds of appointments built into the collective agreement.
- Does your agreement have paid or unpaid leave for health appointments?
- Is this leave available to people who require care only? Are members caring for someone in their family able to take leave to help them get to appointments?
- How much sick leave are members entitled to?
- Do they need a doctor’s note? If they do, who pays for the note?
Short-term and long-term disability
Mental illness is often episodic. People can cycle through periods of being well, followed by episodes in which they may need care or time off. Sick leave and short-term disability are essential provisions for members with mental illness.
Look at your collective agreement’s provisions for short-term and long-term disability and consider what you can improve in bargaining:
- Is short-term disability easily accessible for mental health reasons?
- Does your contract include long-term disability coverage? If you take long-term leave, what percentage of your earnings do you maintain? Can you bargain an increase?
Long-term disability plans often change their definition of disability after two years. With most plans in the first 2 years, in order to receive LTD benefits, a worker must be disabled from doing their own job. After two years, most LTD plans often use a broader definition of disability, and a member would have to be disabled from doing any job in order to continue receiving benefits, not just their own job. Sometimes as a result of this change in definition of disability, members are cut off from LTD before they are ready to return to their own job.
- Does your long-term disability coverage guarantee any wage level for any other job your members might be able to do, to move to, or be retrained for?
Employment Insurance Sickness Benefits / Compassionate Leave Top-up
Under Employment Insurance (EI), workers can take maternity or parental leave for a percentage of their salary. Many collective agreements top up this amount.
- Does your contract provide a top-up for members on EI sickness benefits?
- Does it top up the salaries of workers taking compassionate care leave for a family member with mental illness?