Kristin Tugman, PhD, CRC, LPC, vice president of health and productivity and holistic wellness, Prudential, answers questions following the presentation “Mental Health at Work: Employee Rights and Employer Responsibilities” at the 2023 DMEC FMLA/ADA Employer Compliance Conference.
Question
During the session you posed the question, “Are you going to continue to have a mental nervous or a mental health limitation?” Would you elaborate on this?
Dr. Tugman
It is time to consider whether or not the disability insurance industry in general is perpetuating mental health stigma by treating mental health conditions differently than physical conditions. The argument has always been that these conditions are subjective, meaning they lack objective evidence, and therefore, have a propensity to go on longer than physical conditions, thus costing the industry more money. My view: It is time for the industry to reconsider. We know how to medically treat mental health conditions; we know how to manage mental health conditions in the disability realm; and it is time to regard them just as we regard physical conditions. Stating that they are subjective and, as a result, will go on longer than we expect is stigmatizing and does not equalize mental and physical health.
Question
What is the employer’s role here versus insurance companies?
Dr. Tugman
The challenge for employers is that they do not control premium increases. Currently, the industry will remove the limitation but then assess a hefty premium increase that may have to be passed on to the employee or absorbed by an employer with an already minimal budget, which makes removing the limit cost prohibitive. Employers should, however, continue to challenge the industry to evolve, which includes requesting the removal of the limitation and pushing back on large increases to premiums.
Question
You mentioned that “there’s a lot we can do to help create a mentally healthy workplace.” Would you give one example of what employers can do now? Ideally a practical, hands-on change?
Dr. Tugman
Employers should start by verbalizing a commitment to the mental well-being of their employees.
From there, they should work to create a culture of mental well-being that includes a steady drumbeat of events and conversations around mental health. Encourage executives to share their mental health stories; encourage managers to check in on employees’ mental health and self-care during one-on-one meetings and staff meetings; and have large events and smaller events to discuss mental health, work-life balance, and self-care. The goal is to normalize the mental health conversation.
Creating peer support or mental health champions is another way to provide mental health support. Sometimes all we need is to vent. So if there are peer resources available to listen and, in the event it’s necessary, make referrals to employer resources, then employees start to feel more supported and mental health becomes more normalized. Mental health champions should be trained in reflective-listening techniques, but to be clear, they are not intended to provide counseling, just a supportive ear. They should also be trained on available resources and be given a support network that includes workplace mental health professionals should they need guidance. In addition, mental health champions should also work with the organization to champion events and talk openly about mental health and well-being.
Question
You talked about “surge capacity depletion” during the session. Would you define and elaborate on this concept?
Dr. Tugman
Surge capacity depletion happens when our resilience runs out. Typically, in a crisis, people are resilient. They tend to adjust, think positively, and even become more productive. But what we know is that as a crisis is prolonged, resilience runs out. This is what we mean when we say “surge capacity depletion.” It may feel like hitting a wall; there is a sudden decrease in motivation and/or significant fatigue. It can come on suddenly, which can put our mental health at risk. Self-awareness is key to recognizing what is happening so that one can put techniques in place to mitigate the impact. It may be just taking a day off, ensuring self-care each day is more deliberate, and allowing yourself the space and grace to remove the pressure of high-volume productivity for a while.
Question
What can employers do now to have a positive effect on employees who are “on the edge of being at risk for anxiety and depression”?
Dr. Tugman
One of the most important things that employers can do is train employees and managers to be more aware of mental health issues. Help them understand what depression and anxiety may look like at work. Help them know how to recognize a change in behavior as a possible emerging mental health condition versus jumping to the conclusion that it is a performance issue. And finally, teach employees and managers how to ask appropriate questions, such as “I have noticed you have missed a couple deadlines in row. That isn’t like you. What can I do to help?” This will help change the culture to one that values and supports mental well-being.
