“I have a very particular set of skills, skills I have acquired over a very long career.”
Liam Neeson’s menacing advice to the villain in the film Taken could just as well apply to the goal of workplace mental health support: to give at-risk employees or family members the particular set of skills they need to overcome the villains they face in their mental and emotional health.
Those “villains” may range from painful stressors to clinical anxiety, depression, bipolar disorder and schizophrenia, and other challenges. As in the movie, the plotline in battling mental illness can be highly unpredictable. It takes the right counseling and medical support, as well as social understanding and acceptance, to help individuals build the skills they need to manage mental illness better and achieve stronger mental and emotional health.
Why should employers care? Look around you. One in four people will experience a mental health challenge in their lifetime, according to both the World Health Organization and a recent study by Teladoc Health on “the mental health crisis in the workplace.”
Employers increasingly recognize that employees bring their whole selves to work. That includes employees’ personal challenges or their worries about family members with physical and mental health issues – not to mention the stigma of admitting to a mental health issue of their own. Putting mental health on par with physical well-being helped drive expanded employer health benefits. These benefits now address mental illness as a disease every bit as in need of care – and perhaps even more prevalent and painful – than many more visible physical conditions.
Simply put, benefits and policies need to support the well-being of the whole person. That’s because unsupported and untreated mental illness can result in a host of downstream impacts for the organization:
Employers who “get it” know they need to step up mental health support for their workforce. Initiatives range from parity in medical benefits coverage to stigma reduction campaigns that make it okay to talk to others and to ask for help. “It’s okay” is a message some employers send literally, with education to help co-workers and managers be open and supportive about the topic, so affected employees become more willing to learn about and use available counseling and related resources.
Employers need to take notice of mental health issues. The U.S. workforce continues to experience a high burden of chronic conditions, including workplace stress and poor mental health. Approximately two in three employees report work as a significant source of stress, and depressive illnesses affect one in five U.S. adults. Routine stress, including job strain and long working hours, may contribute to serious health problems, including elevated risk for heart disease and stroke and experiencing depression for the first time. Annual total expenditures (2010) of work-related stress and poor mental health (depression and anxiety) have been estimated at $190 billion and $211 billion, respectively. Half of that is borne by employers, primarily due to lost productivity, including absenteeism and reduced engagement at work.
Businesses also need to pay attention to potential mental illness triggers or stressors and provide specific training to managers and employees on support. Research suggests that resilience training programs have a modest effect, comparable to other primary prevention programs such as mindfulness training and depression prevention programs. Future study is needed to better define resilience, measure it accurately, and understand the mechanisms through which resilience leads to health and work performance outcomes.
More evidence also is needed to understand which program elements best predict resilience as an outcome. Future research should evaluate the effectiveness of systemic or organizational-level policies and practices and determine the cost-effectiveness of resilience training compared to different types of interventions. As employers design and strengthen these training programs and organizational practices, we encourage them to develop evidence-informed programs, innovate where necessary, and publish results. These actions will help close the current knowledge gaps between research and practice.
In our focus groups with employees, we do hear that in some workplaces, mental health issues must remain hidden. Yet increasingly, we hear of successes where employees have managers who make accommodations to support their staff. In one example, an employee spoke glowingly about her manager’s flexibility in dealing with her agoraphobia (fear of leaving home or of crowds). Her manager recognized that on some days, the employee could be highly productive at home. A flexible work policy was important, but so was that manager’s sensitivity and encouragement.
For individuals, managing a mental illness requires skills such as coping mechanisms and new behaviors. Substance abuse issues can exacerbate these disorders. Organizations with campaigns such as Stamp Out Stigma offer tools to change perceptions, recognize the prevalence of mental illness, reeducate on the truths, and reduce stigma so that those who need help can find needed resources and feel comfortable getting the help: in short, learning new skills as well. Some employers use an internal social media approach to encourage employees to share their stories of challenge and triumph on a wide range of mental and emotional challenges. The results help encourage others to see that there is hope and to take advantage of the company’s resources to be more mentally well.
What can employers do to enhance resilience in the workforce? To begin, look at your corporate wellness strategy. It should include effective behavioral health, financial literacy, and well-being tools and programs. Employees should be aware of your employee assistance program (EAP), and any behavioral health supports available through the benefit plan and in the community. And of course, open communication and encouragement from management are vital, especially during unstable times.
But beyond these basics, employers can take positive steps to help employees become resilient:
Fortunately, needed skills often can be learned through self-care, resilience and mindfulness training, and even attentiveness to the basics of well-being: good nutrition, physical activity, and restorative sleep. As a comorbidity with mental health concerns, addiction can be targeted with new techniques. And the good news is options for finding and paying for resources are on the rise.
Intake support for initial treatment and potential guidance to an in-network, quality mental health provider can be as simple as a call to an employee assistance plan (EAP) for free in-person or phone-based support. A May 2019 National Business Group on Health survey found 99% of responding member employers offer an EAP, with the top reason (47%) to address stress and emotional well-being.
While trained psychologists and mental health experts are in short supply in some areas of the country, telehealth and technology solutions may help many individuals through convenient phone or online chat support, or even low-cost apps. While not all solutions are created equal, approaches include cognitive behavioral therapy (CBT) and acceptance commitment therapy (ACT), addressing an array of issues such as depression, eating disorders, PTSD, obsessive-compulsive disorder, and more.
Some health plans have validated some of these tools and offer them to patients at low or even no cost, reducing barriers to care.
With the 2020 COVID-19 pandemic triggering a range of medical and mental health concerns, employers should be especially attentive to helping employees take the actions within their power to feel more in control of their personal well-being. This can become more than just an exercise in teaching handwashing and social distancing techniques, as the Harvard Business Review points out – it can be a legal concern. In the U.K., employers “have a duty to assess the risk of stress-related ill health arising from work activities…” This includes mitigating the psychological burden on the employee.
We know this might seem extreme to some U.S. employers. But it’s not unreasonable to anticipate that the physical and financial stressors associated with an unprecedented outbreak or other health-threatening events will require creative steps by employers. It’s critical to support employee engagement and bolster the employees’ belief that their employer has their back.
Workplace change continues to outpace our employee’s ability to manage behavioral health consequences. That can leave workers bewildered and stressed. The time to focus on mental health at work is now – to build the “very particular set of skills” that will see them, and the business, through.
