Our April 20, 2020 op-ed entitled “The next pandemic? A mental health crisis?” warned corporate leaders and public health officials that the Covid-19 pandemic would take an even deeper toll on Americans’ mental health than on their physical health.
Sadly, we were right. The toll on mental health is staggering. Nearly one third of Americans are experiencing symptoms of clinical depression or anxiety; 150,000 additional deaths tied to the social isolation and economic stressors associated with COVID-19 are expected; deaths by overdose have skyrocketed. As Scientific American noted, we shouldn’t have had to pick between physical and mental health.
Even though the CARES act made digital mental health therapy more accessible and billable, public response has been lagging. We had hoped that the Biden Administration would focus on rebuilding the country’s human infrastructure. But nearly $6 trillion in stimulus and policy spending later, we have very few direct investments and no coherent national strategy.
The burden of dealing with Covid-19’s toll on the mental health of workers fell on the private sector.
As a result, like diversity and inclusion (D&I), mental health is suddenly a strategic imperative for companies around the country. However, most employers’ responses to these imperatives have thus far been reactive, emotional and predictable.
If mental health is indeed a strategic issue, it deserves to be treated as such. If we have all been mentally impacted by the all the events of the year, we need to adjust how we work and what we demand of others. Corporate initiatives should be clear about the problem and potential solutions. They should address the sources of stress at work, not just its consequences.
Workers hurting in plain sight
One of the good things to come out of the pandemic so far is that it started to rip off the veil of stigma that created a Trillion-Dollar Taboo — the cost of mental health issues at work.
This focus also laid bare how deeply our businesses have neglected mental health over the course of decades. Most environmental, social, and corporate governance (ESG)-focused investments and corporate social responsibility initiatives have assessed the firm’s impact on the environment and society. Few have measured the company’s impact on the mental health of its employees, of those of suppliers whose margins they squeezed, and of customers whose fragility they exploited.
Suddenly, leaders are fretting that employee engagement is low, even though an Employee Engagement Index published in 2006 by the Gallup Management Journal revealed that less than a third of respondents reported active engagement with their job. Around half were described as “mentally checked-out” or “sleepwalking through their workday and putting time — but not passion — into their work.” [i] This had remained steady.
This means that even in the best of times, society bears the brunt of the externalities of bad management through mental health disorders. Research suggests that sustained stress at work changes our personalities. In a pandemic that has rendered employees increasingly psychologically and economically vulnerable, poor management and policies are a recipe for deep distress, poor productivity, and loss of life.
Barking up the wrong tree
According to the New York Times, the average budget for well-being programs are up nearly 40% since 2019, to $4.9 million. A few very lucky employees received home “ergonomic evaluations, home-office equipment, free child care, free pet care, stipends sizable enough to purchase Pelotons and digital personal trainers, professional coaching, teletherapy, meditation apps.”
Most of us got emails encouraging self-care, telling us to keep perspective and optimize work/life integration — as if they were not integrated enough. We got free access to mental health apps we will probably only briefly use if at all, and whose clinical value might be unproven. Wellness has become synonymous with productivity and self-optimization. But wellness isn’t something that can be downloaded and consumed.
Then there are the stress management seminars which we attend while stressing about the work left undone. Piling on deliverables as if nothing had changed while encouraging “self-care” can feel a bit like being told to take swim classes to improve your stroke — when you are drowning. Our already poor sleep quality has worsened in the pandemic — for some from worrying about the work to be done and the inability to shut ourselves off. Yet sleep has emerged as one of the pillars of total health.
Meanwhile, many workers are working longer hours, in more stressful ways on Zoom and dealing with home issues, and making less. A quarter of us are thinking about changing jobs. The same is true of healthcare workers. Over 50% of nurses report being overwhelmed and 93% of U.S. healthcare workers report experiencing stress, 76% report exhaustion and burnout. And then we see young Goldman Sachs bankers ask for an 80-hour week cap.
Focus on what matters
The major workplace stressors have been known for decades: “workload (both excessive or insufficient work); lack of participation and control in the workplace; monotonous or unpleasant tasks; role ambiguity or conflict; lack of recognition at work; inequity; poor interpersonal relationships; poor working conditions; poor leadership and communication; and conflicting home and work demands.”[i]
They have all been made worse by COVID. So take them each in turn and ask yourself and colleagues: “What can we do address them at the root?” “What changes can be make in the way we manage and our company responds to our depressed, anxious new normal?” Below are some of our ideas.
Understand what actually causes stress to your workers. It is inadequate staffing, lack of support, and culture — core managerial tasks. And it is pay. (See Table). The adage is that people don’t leave companies, they leave managers. But there are limits to what a good boss can do, and people will leave companies that do not enable even good managers to address the main areas of stress. Instead of asking employees if they are stressed, can you ask them why and what would help them?
Balance the workload. If many of us are indeed suffering from mental health issues that prevent us from being fully engaged and productive, companies and managers need to adjust productivity expectations and redesign workload to manage a population that is cognitively impaired and perpetually distracted. How can you help address the pandemic upstream at the design-of-work level? What expectations need to be revised downward?
Guarantee more time off to heal. In 2019 one third of U.S. workers got 10 to 14 days of paid vacation after a year in their position; after a decade, a quarter still had so little and a third had 15 to 19 days, which is very little time to recharge, tend to anxious kids, and go to mental health appointments, for example. Exhausted staff will need more time to continue to function. Companies should also provide paid mental health or wellness days and expand their bereavement leaves and extend their application, for example after a miscarriage or to mourn the loss of close friends. How can time off today prevent more time off in the months and year to come?
Say it, mean it, and show it. Leaders sharing their struggles is important; more important is their sharing their solutions. If you want mental health you need to pay for it. If you do not, you will pay for it anyway some way through presenteeism (going through the motions at work but not being productive), absenteeism, and health expenses. How can you signal concretely to your people that they matter?
Personalize. We have five generations at work whose approach to mental health concerns and care vary widely. Then experts tell us that women, children, young adults and members of under-represented groups are at greater risk. Women in particular are shouldering more of the caregiving activities and reporting zoom fatigue. They are leaving the workforce. Yet most mental health “benefits” are one size fits all. We have “health” insurance, dental insurance, and vision insurance — why not have mental health insurance and benefits that employees could tailor to their needs and circumstances?
Get rewarded for your investments. In current accounting practice, investments made in programs to support employees are treated as a cost on the income statement. At the same time, liabilities that may result from failing to support employees’ economic and mental health (lost productivity, legal claims, cost of leaves, health expenses, etc.) are considered remote and go unrecognized on the balance sheet. Before the pandemic, in 2019, workers missing work or presenting tired, unwell and unfocused already cost employers $575 billion in 2019. Another good investment might be including sleep studies in benefits, given the connection between mental health disorders and sleep disorders. Finally, giving up the cult of “early bird gets the word” could make it ok for non-early risers to take early meetings at home before coming into the office. How would you change your approach if we accounted for investments in human infrastructure differently and Wall Street rewarded it?
Some employers will feel that they need to recover before implementing such ideas. Some employees, grateful to be employed, will need to feel that they can push employers to do more for workplace stressors to be addressed. For all parties, however, thinking differently about mental health is not just the right thing to do, but also more sustainable for all.
An Idea for Mental Health Awareness Month
May 1, Labor Day in many countries, will open Mental Health Awareness month. Many American adults will have had a shot at the vaccine by then. How about giving them a shot at healing emotionally, too, with concrete gestures? It could be anything from a voucher to spend on whatever activity would help their mental wellness — perhaps art therapy classes or a few safe nights out? — to the promise of adjusting work hour expectations to our new state of being, or like LinkedIn, give them a week off. Our collective recovery depends on it.
[i] Dan Crim and Gerard Seijts, “What Engages Employees the most or, the Ten C’s of Employee Engagement,” Ivey Business Journal, March/April 2006, http://iveybusinessjournal.com/topics/the-workplace/what-engages-employees-the-most-or-the-ten-cs-of-employee-engagement#.Uu_EGRAzTAI, accessed January 2014.