Why Mental Health Matters
By Steven T. Hunt, Fawn Fitter, Lauren Park | 12 min read
Tom (not his real name) has struggled with depression and anxiety for much of his life. As an athletic kid, he loved to practice with his baseball team, but taking the field for an actual game in front of spectators made him physically ill. When he was in his 20s, insomnia and panic attacks about the demands of his dream job forced him to switch to a related but slower-paced field. Now in his 60s, he has a thriving career, in no small part because he’s found ways to effectively manage his mental health challenges with the support of an employer that has allowed him to work from home for several years.
When COVID-19 hit and Tom’s company shifted to remote work, many of his colleagues started to experience challenges similar to those that Tom already had learned to navigate: struggling to get things done in an environment of increased anxiety and depression that hampered their ability to function.
“It’s not that I feel better while other people are suffering,” Tom explains. “It’s that the way everyone is feeling right now is the way I feel all the time. We now have this shared experience of having times when you function better and times when you don’t, and it’s not always under your control.”
The pandemic may be a forced experiment in giving employees greater flexibility, but it’s opened business leaders’ eyes to the benefits – to the point that more than 70% of companies in a Mercer poll intend to prioritize flexible work in the future.
This conversation about creating a radically more humane workplace that works better for more people is long overdue, but there’s no time like the present to start it.
Massive stress reveals systemic fault lines – and opportunity
Mental health has become an important topic of discussion in the workplace as COVID-19 has erased the line between work and home. The pandemic has made workdays longer and driven millions of predominantly female employees out of the workforce under the burden of juggling work and unpaid care, all while requiring some employees to continue to endanger themselves to protect others.
“There’s never been a work/life collision like this, ever, in the history of the modern working world,” says Jennifer K. Dimoff, assistant professor of organizational behavior and human resource management, Telfer School of Management, University of Ottawa. “You’ve got people working on one side of their kitchen table while their kids are on the other side going to virtual school. Job insecurity is a huge stressor, especially now, and it can be the straw that breaks the camel’s back.”
Many of the changes that companies have made because of the pandemic could help address people’s mental health challenges.
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There is no doubt that our collective mental health has suffered since the pandemic started. In a Boston Consulting Group (BCG) survey of professionals in the United States, Germany, and India, an unprecedented number (40%) were working remotely for the first time, and 29% said the pandemic is making their mental health worse. The U.S. Centers for Disease Control (CDC) corroborates this with a report that 31% of American adults experienced symptoms of anxiety disorder and depressive disorder in the second quarter (Q2) of 2020, almost four times as many as in Q2 of 2019. In fact, 11% of the general public – and 22% of front-line workers – told the CDC that they had seriously contemplated suicide in the previous 30 days. And while a Gallup poll in early May found that the percentage of American employees who were “engaged” (highly involved in, enthusiastic about, and committed to their work and workplace) was the highest it had ever been since Gallup began tracking that metric in 2000, it plummeted the following month.
In an interesting coincidence, though, many of the changes that companies have been forced to make could help address some of the mental health challenges people are facing.
Companies have had to restructure job roles and redesign the workplace to ensure that employees can remain safe and still do what they need to do when they need to do it. By adopting more flexible work models, businesses can also make it easier to tailor working conditions to accommodate mental health concerns. And by providing that support, they can expand their talent pool, diversify their workforce, and tap into capabilities, skills, and energy in employees that they – and possibly the employees themselves – didn’t know were there.
“Being able to work at a time of my own choosing, having scheduling flexibility, and socializing with colleagues in a more controlled way all lighten my cognitive load,” Tom points out. “I can think more about work and less about my depression and anxiety.”
While there is no one-size-fits-all environment to ensure optimal employee performance, including employees’ mental and emotional well-being in strategic planning is a business imperative. Doing anything less is essentially a deliberate choice to squander valuable talent.
Seeing potential instead of liability
Roughly 75% of adults never experience depression or anxiety. But that means that about 25% do. Most of these people are skilled and capable as long as they receive the occasional support they need. For example, someone whose medication affects their sleep cycle might ask to start work at 11 a.m. instead of 9 a.m. Someone who has days when too much eye contact triggers a panic attack may prefer to hold meetings by teleconferencing with the option of switching off their camera. Someone who has a hard time retaining information given to them verbally may ask for written guidance and feedback.
These kinds of accommodations deliver a high ROI to employers who provide them. The Job Accommodation Network (JAN), which is funded by the U.S. Department of Labor’s Office of Disability Employment Policy (ODEP), has found that employee accommodations cost 56% of employers nothing, while another 39% of employers incur only a one-time expense with a median cost of just $500. Yet these interventions significantly improve retention and increase productivity, which reduce the costs of recruiting and training replacement hires.
When it comes to mental well-being, accommodating employees’ needs can lead to increased productivity and higher retention.
A workplace that only works for 75% of employees is a workplace that doesn’t work well. An employer willing to invest in supporting employees when they need help enables the full potential of those who may need that support, which in turn expands the productivity of the employees who work with them.
Building an environment that helps every employee perform at their best is an investment in the future as well as the present. Although studies of changes in public opinion about mental health are inconsistent, anecdotal evidence suggests that many workers no longer stigmatize mental health issues, thinking of therapy and medication as ordinary and unremarkable. These employees will decide who to work for based in part on how much potential employers respect their needs.
Rethinking traditional leadership approaches
If the massive disruptions currently shaking the business world have anything remotely resembling a silver lining, it’s that business is recognizing that the old way of doing things isn’t necessarily the best way. According to Gallup, nearly two-thirds of people who have been working from home would prefer to keep doing so as much as possible even after public health restrictions are lifted. And while organizations may have had this increased flexibility forced on them by circumstance, they’re seeing proof that it’s working out well, with a majority of the respondents in the BCG survey reporting that their productivity stayed the same or even increased through the first few months of the pandemic.
Accelerating change and disruption are likely to keep increasing employee distress even after the pandemic passes. In the future, managers will likely have to spend more time actively listening to employees’ needs and concerns, being transparent about what’s happening in the business and why, and expressing empathy about and interest in how the resulting changes are affecting employee well-being. These three approaches to leadership are becoming increasingly important:
- Shifting from a culture of evaluation to a culture of coaching: Managers need to prioritize how people can improve over how they fall short and make it clear to employees that adaptability is as important as productivity.
- Encouraging “supportive supervisory behavior”: Managers aren’t counselors, but they need to show that they understand that everyone struggles and that they struggle sometimes, too. Otherwise, instead of having effective conversations with employees, they’ll spend time trying to convince employees that they don’t have to be defensive or apprehensive about needing help.
- Making resources readily available without stigma: For example, using chat technology or AI-driven bots to connect employees with Employee Assistance Program (EAP)-style services is an affordable, accessible, low-stress way to ease them into getting help. BCG also suggests that employers provide and fund therapy and bring in mental health experts to educate employees and managers about mental health and well-being.
Embracing these approaches means an organization can support employees’ differentiated needs. Everyone’s needs deserve equal concern, but everyone’s needs are different and require different types of support, says Dimoff. “The person/job fit, which is so predictive of psychological and work outcomes, may need to be adjusted because what you’re doing and how you’re doing it is so different now,” she points out.
Some of those adjustments might include:
- Greater comfort in the physical environment: for example, accommodating employees who can’t work in a loud, distracting office or under fluorescent lighting that gives them migraines.
- Adjusting an employee’s work schedule as necessary: for example, accommodating an employee like Tom, who recently disclosed to his manager that he takes medication that interferes with his sleep cycle. “I explained that I can’t really function before 10 a.m. but that I was happy to have meetings at 6 or 7 p.m. to make up for it since we work with people in other time zones,” he says. “He was fine with that.”
- Suggestions for support at the company-wide level: for example, creating a childcare cooperative through HR so employees have one less stressor to worry about or increasing the availability of mental health support. “To be honest, what I’m really looking for at the organizational level is to move toward more inclusive, socially supportive work environments and increases in insurance coverage for mental healthcare,” Dimoff says. “I would love to see companies double or triple the amount of mental healthcare their employees can access, maybe by reallocating the money they’re saving by moving out of their offices. That would let them prioritize mental health and provide better access to preventative and supportive mental healthcare in a very tangible way.”
A work environment that works for everyone
One thing the COVID-19 crisis has made inescapably clear is that a lot of our ideas about what work is and how it should be done are fundamentally outdated. The notion that work can only be done during set hours, in person, in a shared environment is a fallacy keeping people from performing their best and even forcing them out of organizations.
We now have months of proof that work doesn’t necessarily have to take place between 9 a.m. and 5 p.m., that colleagues don’t have to be in the same room to get things done, and that managers don’t, in fact, need their direct reports to be right in front of them to manage them.
It’s also time to jettison the assumption that employees should be able to set aside and ignore during working hours the things that affect them the rest of the time. Mental health issues don’t work that way, as anyone who was coping with them before the pandemic can testify. If companies are willing to provide whatever support their employees need to keep performing at their best during an especially difficult time for everyone, it makes sense for them to continue to do so for the subset of employees whose stress won’t go away when COVID-19 does.
In the United States, the 1990 Americans with Disabilities Act (ADA) defined mental illness as a disability that required accommodation by law. Nonprofits and academic organizations have been working ever since to help people with mental health conditions succeed in the workplace. The first book about the topic – Working in the Dark: Keeping Your Job While Dealing with Depression by Fawn Fitter and Beth Gulas – came out in 2002, telling individuals how to recognize their depression manifesting itself at work, acknowledging that work conditions themselves are sometimes the cause or a contributing factor, and walking them through the steps of determining whether the law protects them and how it can help them. Yet in all that time, managers have had very little equivalent guidance.
In 2012, Jennifer K. Dimoff developed a protocol for managers to identify and intervene with employees struggling with their mental health and to reduce the stigma around mental health issues in workplace contexts. This Mental Health Awareness Training (MHAT) protocol now seems to be evolving into the standard.
The MHAT is a three-hour, one-session training program designed for anyone who has at least one direct report. It starts by giving managers a high-level overview of mental health issues, including depression, anxiety, substance addiction, strain, burnout, and suicidality. It then discusses how these issues intersect with health, safety, and performance. It also provides a Signs of Struggle (SOS) scale, a checklist of 20 items that describe how mental health issues can manifest in the workplace. Managers learn how to use these to assess changes in their employees’ behaviors (for example, changes in social interactions, attendance, personal hygiene, performance, and signs of emotional distress) that might suggest their mental health is deteriorating.
Although an employee’s score on the SOS scale can predict whether they will go on disability leave, Dimoff says, “We’re not saying this is a diagnostic tool, and we’re definitely not teaching managers to be counselors. We’re just saying that these are the warning signs that someone is not doing well and that managers need to be paying attention to them, and not in a disciplinary way.”
The MHAT training then helps managers develop action steps tailored to their specific organization, including what support they can offer directly, what help the company offers through HR department resources such as insurance, an employee assistance program, and other formal policies, and finally, how they can best help an employee access all the forms of support available to them.
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