A New Paradigm for Approaching Mental Health in the Workplace

September 21, 2017

If you have a stake in your employees’ health (and most HR, benefits, and people managers do), you’ve probably already realized that poor mental health among your employees is a massive and complex problem. And the larger your company, the more people who are likely affected by it (we’ll look at some numbers a bit later).

Poor mental health clearly comes at a tremendous cost to the employee who is suffering, but also to your company as well.

Yet because of the complexity of this topic, it can be challenging to address mental health issues in a timely and effective manner. In a recent webinar, we covered this topic in detail. If you’d like to dive right in, you can watch the on-demand recording here. In this post, we’ll discuss the barriers to addressing mental health in the workplace and offer a new paradigm for overcoming these barriers.

Employee mental health: a quick overview

Two of the most common mental health issues are Generalized Anxiety Disorder and Major Depressive Disorder. According to a recent meta-analysis by the American Psychological Association, an average of 18% of American adults suffer from a diagnosed Generalized Anxiety Disorder. This can manifest itself in employees who struggle to feel at peace or at ease during the day and night, whose stress has led to burnout, and who constantly feel overwhelmed and not in control.

Major Depressive Disorder, which affects on average 7.5% of your employee population, often leads to employees feeling completely alone, experiencing little to no joy in their lives, their work, or their relationships, and feeling detached from joy and passion. On the cost side, you’ve likely experienced both very high healthcare costs—think psychiatrist bills, medications, and hospital visits, and a higher number of disability work days lost than the averages taken for issues related to obesity, diabetes, or hypertension.

Taken together, the percent of your population that is facing a diagnosed mental health issue is 22%, or more than 1 in 5 people.

What are the barriers to addressing mental health?

This issue is complex, and there are many reasons why mental health is not addressed, but for the sake of brevity we’ll focus on four of the major barriers: utilization, stigma, access, and cost.

Utilization refers to the challenge of employees using the existing mental health services that are already made available to them by you, their employer. Stigma refers to the fact  that, depending on an employee’s upbringing, culture, or personal experience, they may not feel comfortable addressing their mental health challenges. Access isn’t just about “does an employee have something available to them,” but how easy is it to get the help they need, of high quality and quickly. And cost refers to how employers can afford to address these mental health challenges in a way that they can trust will be both cost-effective and deliver a return on investment within a reasonable time period.

The 5 tiers of mental health

One of the other challenges when considering mental health is the fact that it’s often seen as binary—either a person is suffering from a mental health challenge or they’re not.

The reality is: mental health is more accurately represented as a continuum of no less than five tiers.

Tier 1 is where the majority of people sit in any given year. In this state, people are occasionally sad, occasionally lonely, sometimes lower energy, and generally with a fair level of life satisfaction.

Tier 2 generally comes about when an employee experiences a mild trauma like a breakup, divorce, natural disaster, or death of a loved one.

Tier 3 is when mental health challenges can start to be quantified using diagnosis tools. This is the tier in which an employee is experiencing prolonged sadness, prolonged loneliness, at least 8 weeks of chronic worry, chronic stress they can’t turn off, or chronic anxiety.

Tier 4 is absolutely where much of the human and financial cost of mental health challenges takes its toll.

Tier 5 is when a person can often end up in the emergency room, the intensive psychiatry sessions that come with heavy medications, and potentially utilizing outpatient or even residential psychiatric facilities.

When you look at the average employer, based on national statistics, the prevalence of each stage looks like this: 80% of all employees are at least Tier 1, at least 45% will experience Tier 2 in any given year, 18.5% will touch Tier 3 within a given year, 5% will experience Tier 4, and .4% will experience Tier 5.

The problem employers and employees face is that the earlier tiers are not utilized even though the access is easy and the cost is light. On the other hand, utilization is higher as costs expand.

The new paradigm: the Wide Net solution

You can consider the traditional mental health approach to be like using a fishing pole. You share with your employees that you have mental health services available, and you say to them, “Hey, if you need help, we have some great people to talk to,” and oftentimes that is where things are left.

The new paradigm we’d like to introduce is the Wide Net solution to mental health. When you cast a large net into the ocean, and you pull all of the fish in at once and together, the reason it is so effective is because 90% of the fish do not even know they are “caught.” The opportunity with mental health at your company is simple but profound: Engage the majority of your population with a soft-touch, primary prevention program that opens up the thinking and the conversation around mental health, without even calling it a mental health program, and you will see a complete reversal of the four barriers.

To learn more about the Wide Net solution and how to put it in place, check out the on-demand version of the webinar.

Photo by Caleb George on Unsplash
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