mental health – Page 2

October 4, 2019June 29, 2023

The Past and Present of Mental Health Treatment

My most recent Workforce print feature story is about mental health parity, and that’s one of the topics I love writing about as a benefits reporter: the need for quality, accessible, affordable mental health coverage.

My preliminary research steered me to a new book, “Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness.” It explores scientists’ ultimately unsuccessful attempts to figure out the cause of mental illness.

The argument is that even though ideas or theories in psychiatry have prevailed in certain moments of history, all of them have been proven inadequate or outright wrong. And we’re still uncertain about both the cause of mental illness and why treatments work on some people but not others.

This sounds cynical, but I love a book that rationally explores the highs and lows of a scientific goal (in this case, to pin down the cause of mental illness). This isn’t discouraging as much as it is proof that people will constantly try to progress their understanding of the world in order to help people with a disorder. It’s more promising to me to see people admit their miscalculations and be determined to move forward than to see people stubbornly hold on to ideas from the past.

There are a few reasons I want to write about this book. The history of mental health treatment and theory is simultaneously fascinating, inspiring and upsetting. Especially in this context, history gives us many examples of how some of the mental health trends we’re now seeing in the workplace may not be exactly new.

I’ve gotten press releases about how people are more depressed or anxious now than ever before — especially millennials (or whatever young generation is being picked apart at the moment). I’ve spoken to people about how prevalent mental illness is and how that has changed over time. I’ve always been skeptical about the idea that it’s more common than in the past. My theory is that it’s more talked about now, more diagnosed now and less stigmatized now, and so the numbers just seem higher. (Feel free to argue against me on this, of course!)

What interested me about “Mind Fixers” was the section about the Cold War Era and how it was seen as the “Age of Anxiety” at the time. Many people relied on the “minor tranquilizer” Miltown, a predecessor of Valium, to deal with that anxiety. Meanwhile, in the 1980s depression became “the common cold of psychiatry.”

Comments like this make me wonder how current trends compared to other periods of history. This isn’t to minimize the impact that mental illness has on people and communities in the present. I bring this up so that we don’t talk about the history of mental health in a way that romanticizes the past. People in the 1950s, the 1800s, and before that had mental disorders, too. The treatments just weren’t as advanced.

According to the National Institute of Health and the Centers for Disease Control & Prevention, 41.2 percent of adults with a mental illness have received mental health services. And, more importantly, this statistic is very gendered if you dissect the data further. While 47.6 percent of women have received this type of health care, only 34.8 percent of men have.

That’s a big gap. Why don’t men get mental health care as much?

There’s a lot written about this already (see the National Alliance on Mental Illness, National Institute of Mental Health and Psychology Today, for example), but here’s a historical angle that shows how deep this goes. “Mind Fixers” briefly explored a 20th century mental disorder known as hysteria.

It was “associated with women and weakness” and men did not receive this label. Fast forward to the 1970s, when people were talking about a new trendy topic called “stress.” It was thought that women were twice as likely to experience stress and depression than men.

This is just a snapshot. Still, it shows how deep these roots are that may tell men that they’re weak if they admit certain things.

Finally, “Mind Fixers” mentioned the unwillingness of insurance companies to cover psychiatric services in 1970s. Lack of benefits coverage of behavioral health is something that even today — after the passage of the Mental Health Parity and Addiction Equity Act in 2008 — is still sometimes an issue.

Also read: Mental Health Parity Law Successes and Challenges

According to “Workforce Attitudes Toward Behavioral Health,” a February 2019 survey from behavioral health company Ginger, 35 percent of the 1,214 U.S. employees surveyed reported that they had to pay directly for behavioral health services their benefits didn’t cover. Further, 85 percent of people said that behavioral health benefits are important when evaluating a job, and 81 percent of people said they face barriers in accessing behavioral health care. The most common barrier (28 percent) was that providers aren’t available in their benefits plan.

I’d strongly recommend this book to anyone interested in the science behind mental health. It brings up a lot of interesting talking points like, How much has stigma improved in the past 200 years, and where is there still room for improvement? Which issues still exist that caused people problems all those years ago as well?

While this isn’t a book about the workplace, you’ll read about certain historical trends and movements that sound a lot like some of the “innovative” solutions you’re hearing about now. Maybe you’ll learn a couple lessons from history.

October 4, 2019June 29, 2023

By the Numbers: Mental Health in the Workplace

Mental illness is an obstacle that impacts many individuals, communities and places of work. The Human Capital Media research department gathered national and international data to explore how prevalent mental illness is, how often people get help and how much mental illness impacts the global economy.

Also in By the Numbers: Diversity in the Workplace

Also in By the Numbers: The Latest Statistics on Public Sector Employees

September 16, 2019

Mental Health Parity Law Successes and Challenges

The Mental Health Parity and Addiction Equity Act of 2008 was passed to ensure that insurers and health plans offer mental health and substance abuse benefits comparable to coverage of medical and surgical care. It has heralded some positive trends, but there are still areas in need of improvement, experts say.

Other than the 2008 act and its precursor in 1996, there has been no legislation in America regarding mental health care, said Mary Kay O’Neill, partner at Mercer.

Also read: The Mental Health Parity Challenge

Until recently, “We didn’t have the resources or cultural language to talk about this,” she said. “How we talk about behavioral health now is completely different than seven year ago.”

Tom Sondergold, vice president, global HRIS, Benefits and Mobility at Walgreens Boots Alliance, said that while his organization has always strived for parity, having the law on their side has helped a lot. The Mental Health Parity Act has highlighted that there aren’t enough providers, he said.

“The parity law has allowed us to have a little bit more weight in working with our carrier partners to make sure they strive to secure more providers,” he added.

Employers should not assume that their insurers or plan administrators are in compliance with parity, said Henry Harbin, a psychiatrist with over 40 years of experience in the behavioral health field.

Employers that have been sued for parity non-compliance include Microsoft Corporation, Marriott International, Indiana University and Boeing Corporation.

Self-insured employers are regulated under the parity law and a liability target. Financial and quantitative requirements — for example, that behavioral health copays must be comparable to medical copays — have been reasonably in compliance with health plans and employers, he said. But non-quantitative requirements are where most litigation is happening for failing to comply with the law because there aren’t numbers or data to directly compare, putting self-insured employers at risk.

These non-quantitative treatment limitations include areas like reimbursement rates and admissions standards to the provider network. While it’s generally clear if the health plan is complying with the quantitative parity requirements, with non-quantitative requirements, it’s harder to tell if the health plan is complying with the law.

August 1, 2019February 25, 2022

7 Tips for Managers to Help Employees De-Stress

The CareerCast stress report analyzes 11 factors that represent the most common stressors including deadlines, public scrutiny and physical demands.

In companies both large and small, workers can be heard talking about how they need a break or how they need to have a mental health day.

According to a 2017 report from the American Psychological Association, work stress is the third most common stressor in Americans’ lives. What’s contributing most to that work stress, according to a 2017 Paychex study, is missing out on time spent at home.

Employees are stressed for a multitude of reasons including workload, lack of support, lack of control in decision-making processes, unclear performance expectations, ineffective time management skills, and failure to implement boundaries on time away from work and use vacation time granted to them.

There are many ways managers can help employees cope with such stresses, though. Here are seven tips to get them started:

Look and Listen. As a manager it is important to pay attention to your employees. When you observe your employees in action, do they appear to be overwhelmed? Are they agitated when speaking with you? Do they express concern or anxiety over a project or deadline? What words are they using to describe their workload? Has their demeanor changed?

If you notice that an employee’s mood has changed and he or she appears more stressed than usual, it’s time to initiate a conversation on how you can help.

Provide Clarity. Managers have a broad view of the department’s productivity and goals, as well as what each employee is working on at any given time. Managers can plan projects and set appropriate deadlines for work.

Keep in mind that employees may need guidance on reassessing to-do lists and understanding priorities, direction on how the work is to be completed, and what assistance is available to get work done. Don’t be afraid to get in the trenches with your employees and work side-by-side to complete an important task.

Foster Partnership. Personality conflicts can be a contributor to stress, and managers play a significant role in fostering teamwork and mediating disputes. It is critical that managers address conflicts both timely and effectively to avoid escalation. HR can provide tools and guidance on how to properly investigate, document, and coach employees to resolve their discord.

Acknowledge Humanity. Employees are people. They have responsibilities and stressors outside of their work. It is critical for employees to recharge after the workday and workweek.

Enable employees to have a healthy work-life balance by providing them the opportunity to connect with family and friends and to rest and take care of themselves. Managers should encourage employees to limit checking emails after business hours and to take earned vacation time. Supervisors should also be trained in managing employee leaves of absence, knowing what leaves employees are entitled and supporting employees to take leaves to care for themselves or family members.

Encourage Exercise. Urge employees to take their breaks, stretch and move around for a few minutes several times a day. A change of scenery can help employees gain a fresh perspective on the task at hand and clear their minds for more creative thinking. Physical activity can aid in alleviating tension and increasing blood flow. Even better, have employees take a break together to foster teambuilding and comradery.

Also read: Consider Fresh Air and Relaxed Hikes to Combat Work Stress

Provide Training. Empower your employees with access to resources that enable resiliency. Employees themselves can be trained on stress management, time management and conflict resolution to hopefully minimize the incidence of anxiety and depression.

Promote Benefits. Managers should be the raving fans of the company’s benefits programs, especially those related to mental and physical well-being.

An employee assistance program is a useful tool for employees experiencing stress or needing to cope with difficult situations. Managers are not professional counselors and should not act as such.

Additionally, ensure that the medical plans provided to employees include access to outpatient and inpatient mental health treatment, medication and counseling. Many medical insurance companies are now offering teledoctors for individuals who have difficulty seeing a physician face-to-face, as well as perks and discounts to gyms and fitness-related services that employees may not be aware of.

Which Mental Health Service Does the FMLA Not Cover?

Recently I discussed our national mental health crisis, and the important role employers play in removing barriers to employees receiving the help they need.

Then, I came across this post on LinkedIn, discussing a massive barrier that the FMLA institutionally imposes.

An individual suffering with a mental health issue has various treatment and therapy options available to them. For medication, one can see a psychiatrist, a primary care physician or a nurse practitioner. For assessment and therapy, one can see a psychologist, a clinical social worker or a licensed professional counselor.

Amazingly, however, the FMLA does not recognize one of these licensed mental health professionals as a “health care provider.”

I won’t leave you in suspense. The answer is licensed professional counselors (unless an employer’s group health plan covers licensed professional counselors). The FMLA’s regulations specifically itemize all of the other categories of mental health professionals as “health care providers,” and specifically omits licensed professional counselors from its list. This omission is important, because an employee’s mental condition cannot qualify for FMLA leave as a “serious health condition” if, for outpatient treatment, the employee is not under “continuing treatment by a health care provider.”

As a matter of policy, however, the FMLA absolutely should cover licensed professional counselors as health care providers. According to a recent study by the National Council for Behavioral Health, the leading cause of our country’s mental health crisis is a lack of access to mental health services. We should not be erecting any barriers to mental health services, let alone one ingrained in the federal law that protects employees’ jobs when they take time off for health reasons, including their mental health. By refusing to recognize licensed professional counselors as FMLA-covered health care providers, the FMLA is deterring employees from seeking critical mental health treatment, or at least forcing them to choose between treatment and their jobs if a licensed professional counselor is the only available help. Many who can’t afford to live without their jobs will choose their paycheck over their health, exacerbating their mental health issues.

Gene Scalia has been nominated to replace Alex Acosta as Secretary of Labor. I implore him to close this dangerous loophole by amending the FMLA’s regulations to make it clear and explicit that licensed professional counselors qualify as health care providers in all cases, and not just those in which an employer has made the choice that its group health plan covers their services.

July 23, 2019June 29, 2023

HR History: Mental Health in the 1950s

From Personnel to Workforce, Workforce Magazine; HR History

The workplace has changed a lot since 1922. That year The Journal of Personnel Research debuted, rebranded later as Personnel Journal and finally Workforce. Now in our 97th year, we take a look back at what was on the minds of past generations of people managers.

A Nuanced Approach to Mental Handicaps, September 1957

The concept of “normal” means different things to different people, according to researcher and writer Silas L. Warner in the article “Spotting the Neurotic and Helping the Maladjusted.” This article was sympathetic toward the plight of employees who are emotionally or mentally ill.

Warner used war-taught lessons to make the argument that people formerly excluded from the workforce can become valuable workers. World War II required that women do manual labor previously done by men and, in some cases, that people recovering from strokes work with different machines. If the stroke impacted the right side of their body, they could depend on left-hand operated machines. If physical handicaps can be overcome this way, so can emotional handicaps, Warner argued.

Let’s first acknowledge that obviously being a woman isn’t a physical handicap. Overlooking that, his argument is pretty progressive. He highlighted a few types of mental or emotional handicaps: paranoia, neuroticism, alcoholism and depression.

As long as the “paranoid” person in question is ultimately harmless, there’s “no psychiatric reason why this person’s job should be taken from him,” Warner wrote. Further, certain jobs require a certain degree of skepticism.

Warner also had a nuanced approach to “neurotics.” Contrary to popular beliefs, he wrote, “[They] are not spoiled weaklings who can’t stand up to what you and I do, but are unhappy individuals, most of whom are productively working.”

Finally, he stressed how much of a medical emergency depression can be, due to the dangers of suicide. He noted that serious depressions occur most frequently in one’s 40s and 50s. That’s a very different narrative than what we hear about now, which is that young people are more likely to experience mental health problems.

— Andie Burjek

The New Workforce, January 1998

From the mid-1920s until December 1997, this publication was known as Personnel Journal. That all changed with the January 1998 issue as the first edition of Workforce rolled off the presses. And like any good publication would in its first appearance, the writers, editors and a series of distinguished panelists made a splash with some bold predictions as they gazed upon 2008.

Panelists ranging from longtime HR tech analyst Jac Fitz-Enz to University of Michigan professor Dave Ulrich to then-McDonald’s Corp. HR director Bob Wilner offered their thoughts in “60 HR Predictions for 2008.” Under the header “Work and Society” – “Just as defined-contribution plans have begun to take over from Social Security, companies will take on responsibility for elder care, long-term care and other social needs through cafeteria-style benefits programs.” In “Definition of Jobs” – “Organizations won’t pay for the value of the job but the value of the person.” And under “Strategic Role of HR” – “Leading change will become HR’s greatest contribution to the corporation.”

One last forecast many wish would come true: “We can all expect to attend fewer meetings in the future.”

Maybe by 2028?

— Rick Bell

Also in “From Personnel to Workforce”:

‘Reskilling’ in the Great Depression (June 1935)

Rosie Returns Home (October 1945)

Hold My Beer — And Don’t Give It Back (June 1965)

April 10, 2019June 29, 2023

Expanding Employee Access to Mental Health Care

Last week the U.S. Department of Labor announced that it’s launched a new toolkit for employers to help them understand mental health issues and create a supportive work culture.

The EARN Mental Health toolkit — created by the DOL’s Office of Disability Employment Policy and its Employee Assistance and Resource Network on Disability Inclusion, or EARN — includes an educational framework and a list of case studies of successful programs at organizations of various sizes.

The EARN Mental Health Toolkit hinges on “4 A’s”:

Awareness: Build awareness and a supportive culture.
Accommodation: Provide accommodations to employees.
Assistance: Offer employee assistance.
Access: Ensure Access to treatment.

I want to focus on access for now, because no matter how much you try to create a disability-friendly culture, if employees can’t access or afford medication, therapy or whatever medical assistance they need to treat their mental illness on a regular basis, then a huge piece of the treatment puzzle is missing.

APA Publishing, a division of the American Psychiatric Association, recently published an informative article on this issue of access. The article covers a February 2019 panel discussion hosted by the New York Academy of Medicine, the New York County Psychiatric Society, and the New York State Psychiatric Association.

There are a lot of points I find valuable in this panel discussion of several people in the medical community. First, one of the panelists noted how Aetna recently settled a lawsuit in Massachusetts after an investigation found that the insurer violated state law with its “inaccurate and deceptive provider directories and inadequate provider networks.” Basically, this means that patients couldn’t access timely behavioral health care because listed providers weren’t accepting new patients or had retired.

This isn’t necessarily an anomaly, the article noted. For example, it cited a very comprehensive report that’s worth a read for anyone interested in this.

The 2017 research report by Milliman Inc. found that compared to medical/surgical care, people seeking behavioral health care more often have to access an out-of-network provider. While in-network care generally has lower co-pays for patients, when they must seek out-of-network care that means more out-of-pocket costs and more expensive behavioral health care.

Also, the report stated, “Some patients may want to avoid the higher costs and delay seeking needed services from behavioral health care providers, which can lead to less effective care.”

The article also stated the employer’s role in this. An excerpt:

Schwartz said that the business community is a strong ally in improving access to behavioral health care given the high cost of not addressing these issues in productivity loss, lower employee retention, high rates of disability, and higher overall employee costs. “While employers are paying for benefits, they are not getting what they paid for when employees cannot access behavioral health care,” he said. “Businesses are well positioned to ask health plans for data on provider networks and to examine disparities to improve accountability.”

Also noteworthy was a list of actionable items that presenters believe could help improve access to care. For example, a suggestion from the National Alliance and the Center for Workplace Mental Health is that “employers obtain quantitative assessments from third-party administrators on how well their employees are accessing mental health and substance use benefits.”

Again, I don’t want to suggest that environmental factors in the workplace don’t impact people’s general well-being. But offering free yoga classes in your building or teaching employees how to use mindfulness to reduce stress are NOT the medical equivalent of seeing a therapist or accessing an outpatient center.

Self-care is not medical care. If your organization has a deluge of trendy perks to help employees de-stress but doesn’t have a sufficient behavioral health provider network, how much of a difference could that really make?

February 7, 2019June 29, 2023

Eating Disorders Belong in Your Workplace Behavioral Health Strategy

A while back a source mentioned to me that many people have a limited view on mental illness. It’s depression; it’s anxiety; or maybe it’s PTSD. But there are many more mental illness conditions to address. Like eating disorders.

Eating disorders account for the highest mortality rates of all mental illnesses, with someone dying every 62 minutes as a direct result of an eating disorder. The National Alliance of Healthcare Purchaser Coalitions hosted a webinar a few weeks ago on the topic — perfect timing to educate employers for Eating Disorders Awareness Month in February.

The alliance referred to eating disorders as a “hidden health crisis” in email communications about the webinar and, I have to say, to me this sounds like an accurate way to describe it. I had no idea that they accounted for so many deaths! I also fell victim to the stereotype that the demographic most likely to develop an eating disorder are young, white, rich girls. Really, it cuts across gender, ethnicity and socioeconomics at pretty much the same rates.

Also, as someone whose been writing about benefits, wellness and health for 2 ½ years, this may have been the first time I’ve seen a pitch or an event about eating disorders. Panelist Craig Kramer, global mental health ambassador at Johnson & Johnson, cited some basic numbers on eating disorders:

30 million Americans suffer from eating disorders, including anorexia, bulimia and binge eating disorder. There are other problems that are still in the process of being officially defined as a disorder. To be clear: An eating disorder is different from dieting or occasionally consuming too much. It’s a clinically diagnosed mental health disorder.
Eating disorders are “the only chronic condition of the young,” with half of sufferers experiencing them by age 14 and 75 percent by age 24. Most people don’t receive treatment, for reasons like stigma and lack of access, and the longer they wait to treat it, the worse it gets. Although people often develop this at a young age, it’s possible for people to still have an eating disorder into old age.
The eating disorder community is underfunded, raising about $10 million per year. Kramer pointed out that an organization dedicated to autism, Autism Speaks, raises $50 million a year.

There are several reasons why this applies to the employer population. One, this is a major mental health consideration, and many employers are saying they want to address mental health issues. Two, employers are developing an affinity for employee health and wellness programs. As they focus on areas like exercise, diet, weight loss, healthy eating initiatives and body mass index, they should also acknowledge that eating disorders are a big deal. Three, people have eating disorders in the workforce but have never received treatment for it.

One of the interesting ideas that came from this webinar was the causation of eating disorders. Alliance President and CEO Mike Thompson brought up an organization that deals with childhood obesity. Through this organization, Thompson learned how sensitive one must be when they talk about weight with children. It’s possible to push a child in the direction of developing an eating disorder if you don’t communicate with them the right way.

This reminded me a Corporate Wellness magazine article about the impact of wellness programs with people suffering from eating disorders. This messaging could be sensitive to other people, not just developing children.

The National Eating Disorders Association was one of the organizations that, three years ago, opposed the EEOC’s “voluntary wellness rules” that allowed for incentives up to 30 percent. According to the association:

“There’s an increasing trend of tying these [wellness] programs to health insurance benefits, with penalties that can mean that the employee ends up paying more money for their health insurance. Additionally, these programs aren’t necessarily just harmless ways to encourage people to be healthier, they could also include office-wide, Biggest Loser-style group weight loss programs that can be triggering for people who struggle with disordered eating.”

The bottom line for employers: Don’t underestimate the impact of an eating disorder, even in a workforce full of adults. Think about eating disorders when you’re crafting messages for weight-loss programs.

When you’re thinking of your population, ask yourself, “How easy it is for them to find an in-network specialist provider who has adequate training, specifically treating this [eating disorder]?” said panelist Jenna Tregarthen, founder and CEO of Recovery Record.

And, as panelist Kristina Saffran, co-founder and CEO of Project Heal, said: “People are not quite sure where [eating disorders] belong. Although there’s a medical and a behavioral component, it is a mental health condition when it comes down to it. So, it should be a part of your behavioral health strategy.”

Other wellness topics on my mind …

Money and motivation: There’s an idea floating around that more money doesn’t motivate people; rather, other rewards like trips or non-cash prizes do. Every time I read or hear that, I have one major reaction, even though I don’t doubt there’s some truth in this. It makes perfect sense in certain contexts. Still, I hope companies don’t use this as an excuse not to give employees standard-of-living raises or to raise minimum wage. Financial wellness is more than just giving employees access to financial advisers or tips on how to save money. It’s also acknowledging that as the cost of living rises, appropriate compensation will help them with basic financial needs.

Hate crimes: Ever since the alleged hate crime against “Empire” actor Jussie Smollett, I’ve been seeing a lot online about the broader topic. For example, the number of hate crimes in Washington, D.C., have nearly doubled since 2016, with crimes based on sexual orientation accounting for half the city’s total hate crimes in 2018, according to the Washington Post. This is a major public policy and public health issue, but the workplace should take notice, too. I plead with employers — no matter what religion or morality your organization associates with — to think seriously about how your employees’ behavior and workplace policies impact LGBTQ people, especially now. Are you taking incidences of harassment or discrimination against this community seriously?

As columnist and employment law blogger Jon Hyman has written in several posts in Workforce’s blog The Practical Employer, there is no good reason for employers to be anti-LGBTQ rights. Hyman wrote:

“When LGBTQ discrimination becomes universally illegal in the United States (and it will), and history looks back on this era during which this brand of discrimination was questionably legal, on what side of history do you want to be as an employer? The side that condoned (or, worse yet, participated in) this discrimination, or the side that took a stand against it?”

Good news from our columnist!: Jennifer Benz, the Benefits Beat columnist for Workforce magazine, had a major announcement recently. Benz Communications has joined forces with consulting firm The Segal Group. Benz is now the SVP communications leader at Segal Benz. Congratulations, Jennifer!

January 15, 2019June 29, 2023

Recognize the Signs: Addressing Behavioral Health in the Workplace

An estimated 23.2 percent of Americans aged 18 and older experienced symptoms of a diagnosable mental health or substance use condition in 2016. At the same time, fewer than half of those diagnosed with a behavioral health condition received treatment. When left unaddressed, these conditions may contribute to various workplace challenges, including loss of productivity, low morale and turnover.

Although behavioral health conditions are prevalent, there remains a lack of understanding in the workplace on how to properly support them. Given that employees spend a great deal of time at work, this presents you with the opportunity to better assist those with a behavioral health condition to foster trust and aid in recovery.

Understanding the typical progression of a mental health or substance use condition and its corresponding symptoms can help you better identify employees in need and connect them to available resources. While these conditions often begin with a relatively mild impairment that has a minimal impact on the employee’s performance, symptoms can progress and ultimately hinder their work.

Be prepared by knowing how to spot the signs and the appropriate ways you can respond. The following five stages explain the cycle of behavioral health conditions that an employee may progress through and tangible ways you can help:

Risks emerge

A challenging aspect of behavioral health conditions is that they often begin without being noticed. In fact, a manager may confuse the symptoms of a health condition with poor performance. While conditions may be hard to identify at this stage, it’s important for employers to create a safe climate and culture for employees to speak out and seek help.

All managers should be trained on how to document performance on a regular basis, noting any observed performance changes. Managers should also be familiar with resources the organization has available to support employees, such as management coaching and employee assistance programs.

Symptoms escalate to impact performance

In the second stage, an employee’s symptoms may increase to a moderate level and are more likely to noticeably impact work performance. An employee may be absent more frequently or request an accommodation under the Americans with Disabilities Act to help them cope with the situation.

Referrals to an EAP are more common at this point, and the employee may be more likely to seek treatment on their own. Absence management approaches may also help employees address issues and stay at work in this stage. That’s why stay-at-work disability management strategies, such as referrals to workplace resources and accommodations, are best initiated at this point.

An increase in severity

In this stage, the employee experiences severe symptoms that could directly impact their work performance and abilities. Performance problems and employee absences may escalate to the point where they require a disability leave. In many cases, the need for accommodations to support recovery becomes more visible to employers.

For those who are able to stay at work, it’s important to work with the employee to develop accommodations tailored to their specific limitations or restrictions. Proactively implementing accommodations may help keep an employee engaged in their work, successful in their role and supported by their peers. For employees who require a leave, being supportive of the employee’s FMLA application also is important.

Also read: 5 Practical Ways to Support Mental Well-being at Work

Chronic impairment

At this point of an employee’s condition, they may continue to experience severe or chronic symptoms and apply for long-term disability benefits. The employee may also start seeing themselves as “disabled,” struggling to find a sense of purpose or meaning in life.

During this stage, goal-directed case management and return-to-work strategies are generally initiated or continued. But the impact is generally lower than during the previous stages. With earlier interventions, there’s a better chance that the employee will return to work.

Recovery occurs

The last stage is where employees begin to see their condition improve — either through treatment or as part of the natural course of the condition. But with the proper employer response and intervention, recovery can occur at any stage in an employee’s journey.

Recovery before severe or chronic symptoms develop often depends on an employee connecting with timely and effective care and support. Effective support can empower the employee and rebuild confidence.

Given that mental health and substance use conditions are common in the Unites States, it’s important to address this issue through effective services and support for your employees. Research shows that only 50 percent of employees return to work after having been out of work for six months. When you’re prepared, you can intervene earlier and increase the chances that the employee will return to work.

Being prepared for a behavioral health condition means supporting employees in their time of need. Without the proper strategies, resources and assistance, an employee’s work performance may suffer. By offering your employees various programs and benefits, you can help ensure a timely and safe recovery and return to work.

November 21, 2016June 29, 2023

Working Unwell: Mental Health by Profession

If my main source of mental health information is the truly excellent 1990s sitcom Frasier, my second main source is a podcast called Psychology in Seattle, hosted by Dr. Kirk Honda.

There are many parallels with Frasier, including A) the practice of psychology in, you guessed it, Seattle; B) the use of some modern audible medium to get the message across (talk radio in the 1990s vs. podcasts in 2016) and C) the celebrity cameos from people like Halle Berry, Macaulay Culkin and Kevin Bacon. NO! That last one’s a joke … .

A recent podcast I listened to was titled “Depression.” Dr. Honda had an expert on depression (not Kevin Bacon) talk about the clinical illness. Some takeaways were:

Even if somebody with depression isn’t showing the symptoms, it doesn’t mean they’re not going through it.
Depression can have serious social implications. For example, if somebody tries opening up to somebody else who has not experienced depression, they may get advice like, “Just try not to think about it,” or something that really doesn’t help. A person might remedy this by finding other people experiencing the same thing. On one hand, this is positive, because it doesn’t allow one to “marinate” in their own depression alone. One the other hand, surrounding yourself with equally sad people may cause a double whammy of depression.

So, how does this translate to the workplace?

The other day I received a new study, “Depression Among Demographics,” which looked at professions and lifestyles that have the highest levels of depression.

“Our study helped us look at the prevalence of depression across industries and lifestyles,” wrote a spokesperson at MentalHealth.net in an email interview. “The signs of depression can be hidden, and the stigma that often comes along with mental illness can make it tough for those suffering from depression to speak up about their struggles.”

Certain findings were of special interest to me: First, the professions with the highest rates of depression are public and private transportation, real estate, social services and manufacturing. One commonality that connects these very different industries is that these are “often thankless jobs in which workers experience the best (and worst) of society on a daily basis,” according to the study.

Second, and not surprisingly, people with private health insurance see a depression rate of 5.3 percent, compared to 7.8 percent with no coverage and 12 percent with Medicaid or CHIP. So, based on these findings, the type of health care an employer can offer may play a big role in depression among employees.

Based on these findings, what are suggestions of improving mental health from both the organizational and the individual perspective?

My point of view, as someone who occasionally researches mental health for this blog, is that organizations should treat mental health issues the same as they would physical health issues. That is, they should acknowledge that mental health has the potential to affect a person’s life and performance just as much as physical health and then offer appropriate resources — even though the symptoms may not necessarily be visible. Offering nothing seems like the institutional equivalent of, “Try not to think about it.”

On the flipside, employees going through this need to acknowledge the mental health problem, even if it doesn’t manifest in visible symptoms, and take advantage of any resources which their employer may offer.

This is all very basic and obvious. However, American Express’ Healthy Minds program is one concrete example of a corporate program which deals with the mental health of its employees. It’s worth revisiting for more specific workplace initiatives.

Andie Burjek is a Workforce associate editor. Comment below, or email at aburjek@humancapitalmedia.com. Follow Workforce on Twitter at @workforcenews.