Ep. 64: Mental Health: The Other Pandemic with Craig Kramer

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Corporations around the world are confronting flagging mental health among their employees. The world’s largest wellness company, Johnson & Johnson, has since 2016 had a mental-health ambassador, Craig Kramer, who has spurred incredible changes within and without his employer. In conversation with Medcan’s chief people and growth officer, Bronwen Evans, Kramer describes the crisis of mental health in the pandemic, and the opportunity to create long-term change in the way employers manage the mental wellness of their employees.

LINKS

Video: TEDxJnJ talk about Kramer’s mental wellness journey.

Article: My First Two Years as J&J’s Global Mental Health Ambassador

Other podcasts featuring Kramer: On a podcast called Global Health Pursuit, Kramer argued that we need a militant mindset to drive change for global health care. Listen on Spotify or Apple Podcasts. 

Video: “The Mental Health Moment”, a talk for the U.S. Health Action Council. 

Resource: The World Economic Forum has compiled a list of articles and research to arm people looking for statistics and best practices to encourage mental wellness in workplaces. Check it out. 

Medcan provides mental health-promoting services for clients featuring appointments with a team of psychologists led by Dr. Jack Muskat. Learn more. 

INSIGHTS

File under best practices: Consider creating an employee resource group for those living with mental illness. When Kramer first began advocating to improve mental health care, he gave a talk about what he was doing for J&J employees and included an appeal for volunteers. Soon he had 400 of them — about 390 more than he had expected to get. Kramer believes it may have been one of the first employee resource groups created within a company for people who live with mental illness (which is one out of four people, Kramer says), or for those who are acting as caregivers to those who live with mental illness (about two out of four people, Kramer says). The group’s also become the fastest-growing employee resource group in J&J history, featuring representation from 79 countries around the world. Other employers have picked up the idea and now there’s a fraternity of these groups working together to address workplace mental health. (Time code 7:00)

Silver linings: There’s a positive side to the mental health struggles people are experiencing through the pandemic: “Before the epidemic hit, we were getting a lot of traction, a lot of openness to talk about this,” Kramer says, “but there were still a lot of people who didn't get it or, or thought that it was, you know, something that was really just about people being weak in character and not really having an illness of any kind.” The pandemic has opened the eyes of the people who didn’t get it, according to Kramer. Now, he says, “it's hard to find somebody who doesn't understand that their own mental health can really fluctuate based on the external environment, but also on your own internal genetic and family history. It's made this conversation a lot easier to have. And as we compete for resources, to address mental health, we are getting a lot more traction.” (12:25)

Argument: For employers, Kramer believes caring for employee mental wellness is smart business. “Numerous studies from the World Bank and others have shown that every dollar you spend on mental health promotion in the workplace leads to five to 10, maybe more, dollars of return, because mental illness is the leading cause of disability worldwide,” Kramer says. In the workplace, according to Kramer, this manifests as absenteeism, turnover, disability, short-term disability, long-term disability and something called presenteeism — when you show up to work but your head is not really in the game. “I can tell you,” Kramer says, “in the thick of my daughter's struggles… it's hard to go to work and really focus when you're worried that your loved one might not make the day or you're worried that the care they're getting is not really appropriate.” (13:23)

Thought-provoking metaphor: Kramer’s dad recently had cancer. He’s survived, and in the experience, Kramer was struck by the difference between what exists for those with cancer, and the way mental illness is treated. “The primary care doctor knew a lot about [the cancer] and stayed with us on the journey,” Kramer says. “[He] actually joined phone calls with the specialists, the oncologist, the radiologist, the surgeon. There were decades of studies of this particular kind of cancer. And we were able to get first, and second, and third opinions that all kind of lined up and gave us a good sense of where we were.” Mental health is very different, says Kramer. “Primary care doctors know very little about mental health,” he says. “And so they're reluctant to help you on the journey, or unable to help you in the journey. A lot of the specialists are freelancing, and using their own approaches, some of which work and some of which don't. It's not driven by data and rigorous clinical studies by and large. So as a consumer, it's hard to know where to start.” Kramer believes that the world that we want to create is one where mental health is treated just like cancer, or heart disease. (19:00)

Another thought-provoking metaphor: Kramer believes the drive for marriage equality forms a template for how things may proceed for the drive to improve mental health care. ”For a long time, our society did not support [marriage equality],” says Kramer. “But there came a point where enough of us knew somebody we loved, who couldn’t marry the person they loved, [so] that almost overnight” things changed. “And you know, we're using the same strategy for mental health, we want to raise these voices.” Kramer believes we face an enormous opportunity now. “Some people call this the mental health moment,” he says. “Now is the time. All the pieces are aligned in the right place for us to make a lot of progress, but we've got to push. I think if you wait, other things will crowd out this issue.” (24:45)

Mental Health: The Other Pandemic transcript

Christopher Shulgan: Christopher Shulgan here, executive producer of Eat Move Think. Episode 64 falls at the beginning of Mental Health Week here in Canada. We could start with some statistics about the way mental health has suffered during the pandemic—but do we really need numbers? Because we've all experienced it firsthand. Maybe it's that flat feeling of languishing, where you find it hard to get excited about anything. Or maybe you or a loved one is experiencing a more serious struggle.

Christopher Shulgan: Craig Kramer is farther along on the journey than most of us. He's the mental health ambassador for the world's largest wellness company, Johnson & Johnson, and he's held that role since 2016. A few years previous, a family emergency provided him with firsthand experience of the toll that mental illness can take. At the time, he was Johnson & Johnson's vice president of international government relations. He convinced the company to switch jobs. He devoted his life to improving care for mental health—and he did it in a really smart way, by focusing on challenging employers to care for the mental wellness of the people who work for them.

Christopher Shulgan: Is Kramer worried about mental health amid the pandemic? Of course. But he also sees an opportunity. For years, few people talked about things like depression, anxiety, addiction issues, or any of the other mental maladies. The pandemic has brought such issues to the forefront of our public consciousness, and Kramer believes that employers have the potential today to create lasting change. And he has a list of things that corporations can do to start. In this episode, Kramer is in conversation with Medcan's Chief People and Growth Officer, Bronwen Evans, herself a passionate advocate for mental wellness. Here's their conversation.

Bronwen Evans: Hi, I'm Bronwen Evans, Medcan's Chief People and Growth Officer, and my guest today is Craig Kramer, the mental health ambassador for Johnson & Johnson. Craig, I'm calling you from Toronto. Where are you, and how are you today?

Craig Kramer: Hi, Bronwen. I'm in Denver, Colorado, up near the Rocky Mountains enjoying a burst of spring.

Bronwen Evans: That sounds lovely. Since 2016, you've been a mental health ambassador for Johnson & Johnson. We'll get to what that means in a minute, but can you start by talking about what happened to make you want to pursue such a role?

Craig Kramer: Yeah, my career and my life took a turn when I got a phone call on New Year's Day, 2013. And it was from my daughter's phone. And I greeted her very exuberantly, like all dorky fathers do. And only to be greeted by the voice of a man who told me that he was from the police department, and my daughter had tried to take her life. And he was taking her to the hospital, and we needed to get up there right away. She was in Boston, we were down south of New York City. And as we drove up to Boston, we thought of her 10-year struggle with an eating disorder, and we knew that she had become exhausted and lost hope that it was ever going to get better.

Craig Kramer: But we also knew we'd been through just a very difficult process of trying to get her help. You would wait months to meet a psychiatrist, only to find out that they didn't have what you needed. Oftentimes, in my country, the United States, insurance didn't cover basic mental health services. You know, people don't talk about mental illness. It's so stigmatized. You know, other parents would try to keep their daughter away from our daughter, afraid that they were going to somehow catch this mental illness from her, which is not how it happens. And, you know, I also work for the largest health care company in the world, and so I was aware of how we can use the health system to change things.

Craig Kramer: But I was struck by how underfunded and fragmented the mental health care was. I later learned it wasn't just eating disorders, it's depression, anxiety, addiction, post-partum, post-traumatic, OCD, bipolar, schizophrenia and other disorders. And I learned it wasn't just my country. The World Health Organization now says when it comes to mental illness, every country's a developing country. Canada and Australia are the leaders in this space, but your mental health commission with whom I've met, Louise Bradley and others, will tell you that you're not that far ahead of everybody else. There's very difficult cultural and system changes that are required. So all of that background led me to go back to my leadership and say, "Look, I think there's an opportunity for us to make a difference in mental health, and can I take a run at that?" And that's what I've been doing the last four years.

Bronwen Evans: Wow. I can't imagine as a parent, how difficult it was to receive that call. And I'm sure that it's been a challenging journey. How's Catherine doing now?

Craig Kramer: Yeah, thanks for asking. She actually just sent me a text yesterday. She's in grad school down in Florida. She changed her career from public relations to mental health. She's getting a master's in social work. And yesterday, she texted me saying that for the first time in years, she feels that she's not only surviving, but she's thriving. And that is the goal of all of us. And it just really made us all feel great that she's at a place where she's managing her illness. This is a chronic set of illnesses for her. But she's able to keep herself balanced and unleash her energy and power, which is just phenomenal. So thanks for asking.

Bronwen Evans: Yeah, that's really wonderful to hear. I know that journeys as they relate to mental health can be ones with setbacks, and so it's wonderful to hear that Catherine is doing well. And it seems like, from that phone call, from that moment, you've made mental wellness your life's cause. Can you talk about why something like a mental health ambassador is necessary at a company?

Craig Kramer: Well, you know, it's interesting. At the time I was vice president of international government relations for J & J. So as I mentioned, I was working on all these other diseases, I went to 14 different countries to find out what was going on the ground on HIV so that we could play a constructive role in that effort, and as you know, in our lifetime, we've changed HIV from a death sentence to a chronic disease. And now we're working on a vaccine that would make it preventable. I thought that we would work externally to try to bring the same partnerships and networks to bear on mental health.

Craig Kramer: So the initial idea of mental health ambassador was to work externally with other partners, with advocates, with scientists, with governments, with business leaders and with celebrities and others, people who are passionate about this issue. But one of the things we stumbled into was that our employees were very much interested in helping in this effort. I gave a little talk within our company about my experience and what we were planning to do. I asked for volunteers, and by the end of the month I had 400 volunteers, which was about 390 more than I thought I was going to get. And so we ended up deciding as a group to form the first employee group in the world as far as we're aware for employees who live with mental illness either as a patient themselves—which is one out of four people—or as a caregiver, which the Mental Health Commission of Canada says is two out of four people. So it's basically all of us.

Craig Kramer: And we formed this group, it's become the fastest growing new employee group in J & J history. We just did a global activation and covered 79 countries of our employees around the world. And we've gone out to other companies and employers—not just companies, but governments, and encouraged them to form these groups. And now there's a whole, you know, fraternity of these groups that help each other get better at addressing workplace mental health from the employee perspective.

Craig Kramer: And on top of that, we've also tried to emulate companies like Bell Canada, to look at the benefits that we provide and to create the kind of supportive internal environment that can allow people like my daughter to thrive in the workplace while they live with these very common mental health challenges.

Bronwen Evans: As chief people officer at Medcan, I'm curious to know how forming these groups has changed the culture of the company, and whether it's had a positive impact in terms of reduced stigma around mental health?

Craig Kramer: We are much more open about when we're having a bad mental health day, or are more willing to take short-term disability when that's required, just like we would if we had problems with our heart or our liver or whatever it might be. We are in the process of rolling out supervisor training now so that we have a uniform understanding, because it's still somewhat based on whether you've heard about the mental health program we have or not. So we're going to try to require that all supervisors have this kind of mental training. And, you know, this past year—we activate every fall around World Mental Health Day, that's our big global activation, October 10. And this past year, every single member of our Executive Committee, which are the top dozen or so people who run our company of 135,000 total employees, every single member of the Executive Committee signed a pledge to support mental health in the workplace, which is something that we could not have imagined a couple years ago.

Craig Kramer: But we didn't have to twist arms, they voluntarily came forward and said, "Yes, I want to do this." And we're also starting to see now when we roll out new products and services or we create new philanthropic partnerships, for example, during COVID now we've taken the lead with frontline health workers to help support them, making sure they get personal protective equipment, but also to make sure that they support their own mental wellbeing in a time of great stress and crisis. And that kind of fusion of mental health, or infusion of mental health into everything that we do is becoming more natural, not just for our employees, but as I say, for every aspect of our enterprise, which is pretty exciting to see. So that's the evidence we have that the culture has changed.

Bronwen Evans: That's fantastic. You mentioned COVID. Everybody's very much aware of COVID and its various impacts that it's having in terms of long-term isolation, and increases in calls to crisis lines, anxiety, depression. How, from your perspective, has a pandemic changed the mental wellbeing of workforces?

Craig Kramer: The United Nations Secretary General says that mental health is a crisis within the crisis. I think most observers believe we had a mental health pandemic before this pandemic came along, and this is clearly exacerbated because of the stress not only from fear of getting the virus or from loss of life, but all the economic dislocation, the social isolation, especially for our young people having to stay at home from school and not being able to participate with their peers in normal developmental and educational activities. So all that stress is making people more vulnerable to anxiety, depression, suicidal ideation, addiction.

Craig Kramer: And, you know, the clinicians—and I should actually clarify that I'm not a clinician, I'm really just a dad who does healthcare policy, so I have an ability to make a difference here. But the clinicians said the long-term effect is where we're going to really see the difference. Just like with any natural disaster, you can go back in and put the buildings back together, but it's those broken lives that have long-term impacts from, you know, broken families, anxiety, suicide and the like. The clinicians are telling me we're going to see this kind of impact extend over time beyond when we get clear of this infectious disease that’s at the heart of the pandemic.

Craig Kramer: So that's the negative side of it. The positive side is that everybody's aware that mental health is something we all have. You know, before the epidemic hit, I think we were getting a lot of traction, a lot of openness to talk about this, but there were still a lot of people who didn't get it or thought that it was something that was really just about people being weak in character and not really having an illness of any kind. But the pandemic has put all of us in the spotlight, all of us into the pressure cooker. And, you know, within our company and outside, it's hard to find somebody who doesn't understand that their own mental health can really fluctuate based on the external environment, but also on your own internal genetic and family history. So it's made this conversation a lot easier to have. And as we try to compete for resources to address mental health in a more systemic way, we're getting a lot more traction, which is great to see.

Bronwen Evans: So do you think that corporations have a role in responding to this crisis? Do employers have a responsibility to promote mental health among their workforce?

Craig Kramer: Well, employers broadly, so private sector, government sector, nonprofits all have not only responsibility but, you know, we say it's actually good business to address this in the workplace. There have been numerous studies from the World Bank and others that have shown that every dollar you spend on mental health promotion in the workplace leads to five to 10 maybe even more dollars of return, because mental illness is the leading cause of disability worldwide. And in the workplace, this manifests as absenteeism, turnover, short-term disability, long-term disability. And the biggest cost driver is something that the academics call presenteeism. That's when you show up to work but your head is not really in the game.

Craig Kramer: And I can tell you that in the thick of my daughter's struggles, and my daughter's not the only one, my family has mental health challenges. So it's the thick of that struggle for you and your family. You know, it's hard to go to work and really focus when you're worried that your loved one might not make it through the day, or you're worried that the care they're getting is not really appropriate. So employers have every reason to do this from a financial standpoint, from a productivity, from an engagement standpoint. And so we found that it's not only smart dollars and cents point of view, but also it really energizes your workforce to support your mission, your overall mission.

Bronwen Evans: We talk about dollars and cents oftentimes in terms of productivity, the cost to benefits, but also it sounds like creating that openness or reducing stigma around mental health in the workplace is also a good way to attract and keep employees, if they believe that they're working somewhere where the organization cares about them, and if they have an issue that concerns their their mental wellbeing or the mental wellbeing a family member, that they're comfortable about coming forward and not worrying about losing their job over it. So as employers over the next few months to a year think about coming out the other side of the pandemic, in addition to being open and supportive of their employee population around mental wellbeing, what other programs or initiatives could employers put in place to help in that regard?

Craig Kramer: There's a couple of things that I think most companies or employers are doing now. One is raising awareness, just teaching people the fundamentals of mental health, what it is, so we all have a common vocabulary. What are the signs to look for? How to have a conversation with somebody. And then how to be supportive. What is your role?

Craig Kramer: You know, fortunately for a global company like us, there's a global curriculum called Mental Health First Aid training. And that's available in every country. It started in Australia, but now it's been picked up everywhere. Raising awareness is number one. Getting everybody up to speed. And, you know, we had one of our factory workers who took the training and wrote me an email afterwards and said it had changed his life because he didn't really understand mental health. And he said, "I have an uncle who I haven't talked to in 20 years and the family kind of ostracized him because he was a little bit crazy." And he says, "Now I understand this was not a choice he was making. And I'm going to reach out to him and repair that relationship. And I also understand, you know, on the shop floor, that our daily mental health status can affect safety, safety of each other and also our productivity."

Craig Kramer: So that kind of just basic fundamental awareness is something we all need to keep bringing to the workplace. A second thing is telling our stories. We actually train our employees who want to tell their stories. Not everybody does and not everybody should, but for those who feel comfortable, we help them tell a compelling and effective story. And that means you don't spend your whole time talking about how bad it is. You need to talk about some of that, but you spend a lot of your time talking about the context. This is very common, it's one out of four people, it's really almost everybody. Every family is touched by this. And the current treatments work, especially if they are applied early in the disease progression.

Craig Kramer: And then, as I say, you got to back up with the system. So you have to have supervisors who understand and know how to support. You got to have insurance coverage, whether that's government provided or private depending on your marketplace or your country. You got to have enough providers. In most countries, there aren't enough psychiatrists and therapists. So then you have to work with the local governments and others to try to build more capacity at the high end, but also just frontline health workers. There are a number of ways that employers can and should get involved in advancing this.

Bronwen Evans: Yeah, you mentioned advocacy in terms of speaking to government about what's covered. And obviously, insurance being an important part of that in terms of what employers offer in the way of benefits. What are some of the best practices that you have seen from corporations, whether in Canada or in the US?

Craig Kramer: Well, maybe I can talk about what the world should look like, and then we can work back from there and see how we measure up.

Bronwen Evans: That sounds good.

Craig Kramer: Yeah. I mean, my dad recently had cancer and he survived, but it was not one of the good kinds of cancer where you know right away you're going to be okay. You have to really work at it. But everybody knew the basic vocabulary. The primary care doctor knew a lot about it and stayed with us on the journey, actually joined phone calls with the specialists, the oncologist, the radiologist, the surgeon. There had been decades of studies of this particular kind of cancer. And we were able to get first and second and third opinions that all kind of lined up and gave us a good sense of where we were. And, you know, we knew that if the existing treatments didn't work, there were clinical trials in the background going on that were driven by science and data.

Craig Kramer: Then I think about our experience with my daughter and other family members. You know, mental health is very different. A lot of people don't have the basic vocabulary. Primary care doctors know very little about mental health, and so they're reluctant to help you on the journey, or unable to help you in the journey. A lot of the specialists are really freelancing and using their own approaches, some of which works and some of which don't, but a lot of it's anecdotal, it's not driven by data and rigorous clinical studies by and large. So as a consumer, it's hard to know where to start.

Craig Kramer: And then, you know, there's not always a rigorous first line treatment, second line treatment, third line treatment. You know, whether that's talk therapy, or medicine or electrical stimulation or other types of approaches. And there's not a lot of money going into the science to try to learn more about that. And so the world we want to create is one where mental health is treated just like cancers or heart disease or whatever other ailment there is. There's rigorous clinical trials, studies, funding and research, common understanding. Primary care should be right at the centre of this, but they need to be better educated. So that's where we need to get. And if you're an employer, you know, you're the tail wagging the dog here. Your specialty is not putting together health systems, you're just trying to get your employees to engage with that.

Craig Kramer: So, you know, one of the things that we've done and a lot of companies are doing, a lot of employers are doing is banding together and talking with these health systems about what this world that we want to try to create together, and using our purchasing power, or our spending power to help influence and guide those decisions. But you're trying to change very ingrained institutions and incentive structures and behaviours. So you need that kind of critical mass of support. So that's something else that employers can do.

Craig Kramer: On the day-to-day basis, there are levers you can pull. Again, you know, no one's done this better than Bell Canada in my experience, but really looking at your employee assistance plans, your supervisor training, your internal discussions, the cultures of awareness and inclusion. And then, you know, for cases that are a little more critical: short-term disability, return-to-work policies, and then more macroscopically is, you know, how are you organizing your work environment. There are things we can do to lighten the load, even the load for employees, that can make a big difference in the stress levels they feel and the mental health issues they encounter downstream from that.

Craig Kramer: And, you know, we're seeing this now with all these Zoom calls and kids in the background that are trying to go school. What we've done with that is we've just tried to be very understanding and tell our employees that family comes first. You also come first. You have to take care of your mental and physical health so you can be there for your family. And then, you know, we're going to work with you to be as effective as you can in the workplace, and prioritizing things that really, really matter during the crisis, because these are unusual times and we just can't act like it's business as usual.

Bronwen Evans: Absolutely. And it is interesting with these Zoom calls and what have you with family in the background, we're suddenly getting these peeks and views into people's private lives that we wouldn't have had in the past. And, you know, I'm often on calls where there's a little one tugging on mother or father's or leg to do something while they're trying to make a presentation or what have you. Because with the pandemic, we don't necessarily have the benefit of childcare either. So do you think this glimpse that's a bit unusual compared to a normal—what we would experience in a normal workday, will make people more sympathetic to work-life balance, employers more sympathetic to work-life balance, and a recognition that employees' lives extend beyond the office. And that there needs to be support there to ensure people are given the time to be with their families, to recharge. So do you think that will influence employers' views at all?

Craig Kramer: I think it can, but we can't take it for granted. And that's why we are—and our employee group in particular is continuing to beat the drum of how important this issue is, and how far we have to go. We've come a nice long way, but we've got a long way to go. You know, anecdotally, there are more people who get this, but there are still a lot of people who either don't get it or they don't care about this. It's not a priority for them, they think that this is not really that big a struggle, or it's not as big a struggle as some other thing. So you're never going to win everybody over to the view that mental health should be treated differently. You also can't just take it for granted that people are going to understand it. You got to go out and advocate and educate.

Craig Kramer: You know, I often talk about the experience we had in the United States around marriage equality, or it used to be called gay marriage. But, you know, for a long time, our society did not support that. But there came a point where enough of us knew somebody we loved who couldn't marry the person they loved, that we—you know, almost overnight in the United States, this issue changed, where we went from majority opposed to majority supporting marriage equality. And, you know, we're using the same strategy for mental health. We want to raise these voices, enable these voices.

Craig Kramer: So now is the time. You know, some people call this "The mental health moment." Now is the time. All the pieces are aligned in the right place for us to make a lot of progress, but we've got to push. I think if you wait, other things will crowd out this issue in favour of other things that are maybe not as important. You know, the World Economic Forum looked at all health care issues, and they assessed that mental health is almost half of the economic cost of all illnesses worldwide. It's bigger than the combination of cancer, diabetes and asthma, other chronic respiratory diseases. It's enormous, but because of the shame and the stigma and the dysfunctional systems and the underfunding, it doesn't get the attention it deserves. And so, as I said, we can't take it for granted, we've got to take advantage of this mental health moment to really push hard and get our voices out there.

Bronwen Evans: Yeah, so it certainly does feel like a moment. And it sounds like we are going to really have to push to ensure that the moment lives up to its potential. And you talked about how employers can get together, advocate for change. Do you see that as the most important thing that employers can do in terms of creating lasting change?

Craig Kramer: I think we've covered a lot of what employers can do. I do want to highlight one other thing is that the biggest driver of this is going to be young people. And employers who do not get ready for this next wave of employees, or the current wave that is coming in now, are going to find themselves really behind the eight-ball in appealing to young employees. These young people, like my children are growing up in schools, universities, online communities where they're talking more openly about mental health than ever in history. And, you know, they're frankly a little nervous that when they go into the workforce that they're going to have to go back in the closet, to again borrow a phrase from our LGBTQ friends.

Craig Kramer: And they're afraid that if they have to do that, their mental health is going to suffer. And they have seen the generational consequences of people sweeping mental health under the rug. Some of them are very activist-minded, but a lot of us are, you know, we go along to get along. But this wave of employees is already landing inside of our workplaces. And, you know, when I have a CEO or a CHRO who isn't persuaded by the financial numbers, and they say, "Why should I care?" I say, "Well, you should care because it's already coming to your shores." And I can tell you, Johnson & Johnson is going out to universities. And just like we go to universities and we talk to the students about how if they're LGBTQ, or they're coming from a racial minority or religious minority, what have you, or they're from a veterans' group that you and I've worked with, you know, they can come to J & J and be their authentic selves, find a home, be a leader, make a difference. We are going out to these communities and saying, "If you're the one out of four people who has mental health yourself, or if you're the other two out of four who's caring for somebody at home, come to Johnson & Johnson, because we get this. You can be open about this. You can actively seek the help you and your family needs. And you can help make a difference in the world, because that's what we're trying to do."

Craig Kramer: So if you're an employer who's competing with us for talent, we've got a leg up on you right now, because we get this I think a little bit better than most.

Bronwen Evans: You've said that if you don't treat mental illness early, it gets worse. What do you have to say to people who are wondering whether to seek help? Can we finish with some words of affirmation for people who may be struggling themselves?

Craig Kramer: Well, I'll try to have words of affirmation, but you're exactly right. Like any condition, if you let something that's hurting you go untreated, it gets worse, right? Whether it's a cut on the arm or cancer. And mental illness is largely no different. You know, studies show that most people don't get treatment or support ever. And about the third who do, one-third who do get treatment, wait an average of eight to 10 years before they find care. And that was certainly true in my daughter's case. I think studies are clear that the sooner you begin engaging people on these conditions and treat them with the skills they need, and in the cases where medicine's appropriate or electrical stimulation or other types of inventions, you have better outcomes.

Craig Kramer: I don't know if those are words of affirmation, but the science is certainly there. And, you know, I can tell you that, as my daughter and I look back at our experience, and as we look forward to her new career in social work and therapy, our mantra is let's get to the people early on, because, you know, half of all mental illnesses start by the age of 14.

Bronwen Evans: Mm-hmm.

Craig Kramer: And another 25 percent—so 75 percent of all mental illness begins by the age of 24. And people by and large wait until later in life to start to address those conditions. And we can really not only bend the individual trajectory of those diseases, but really start to curtail the economic cost of mental health by engaging early. And that means in part, you know, working with our schoolchildren to learn as much about their mental health as they now learn about their dental health. What's the grade school equivalent of flossing and brushing for the brain? Our children need to be conversant. You know, every movement, every disease has a turning point. You know, I personally feel, I think we as a company feel that this is the time for mental health to go through that turning point where everybody can recognize how common this is, how we can engage our children and we can work with our scientists. You know, as a sign of this, when I am asked to give talks, I will ask people in the audience to raise their hand if they're affected by this. And almost every hand goes up now. A few years ago, that wasn't always the case. But I think people are more comfortable coming forward, and that's the first step. And then we have to keep telling our stories. Because that's what really at the end of the day drives that kind of change in engagement and changes in the system that we really need.

Bronwen Evans: Well put. Well, Craig, you've said a lot of things during our conversation that I find personally inspiring, including your own story, Catherine's story. And I know our listeners will find it inspiring as well. Thank you very much for this interview, as well as for the work you've been doing for these last few years on mental health. I'm sure you're making a tremendous difference.

Craig Kramer: Thank you, Bronwen. Good to talk to you again.

Christopher Shulgan: That was guest host Bronwen Evans, Medcan's chief people and growth officer, in conversation with Craig Kramer, the mental health ambassador for Johnson & Johnson.

Craig Kramer: I'm executive producer Christopher Shulgan. Find show notes, links and full episode transcripts at EatMoveThinkpodcast.com.

Craig Kramer: Eat Move Think is produced by Ghost Bureau. Senior producer is Russell Gragg. Special thanks for technical support to Shea Shackelford. Social media support from Emily Mannella.

Craig Kramer: Remember to rate and subscribe to Eat Move Think on your favourite podcast platform. Follow our host Shaun Francis on Twitter and Instagram @Shauncfrancis—that's Shaun with a U, and Medcan @medcanlivewell. We'll be back soon with a new episode examining the latest in health and wellness.

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