Employers Seek Ways to Turn the Tide on Employee Mental Health

It wasn’t just the economic costs to poor employee mental health (estimated at $47.6 billion¹) that drew absence and disability managers to the 2024 DMEC Virtual Mental Health Conference. Nor was it the decreases in productivity, the increases in mental health-related accommodations, and the negative effects on morale that result from this neglect. It was a desire to find practical solutions, or as one attendee noted, “inspiration and ideas” to improve employee mental health.

What changes will move the needle on the worldwide mental health crisis cited by Surgeon General Dr. Vivek Murthy as a national priority?² And how can employers gauge success with investments in mental health that have traditionally been focused on treatment?

Real-World Solutions

During DMEC’s two-day conference in January sponsored by the Marsh McLennan Agency, mental health specialists and employers shared different approaches to employee mental health as well as results.

“Employers have found their hearts recently when it comes to mental health,” said Emma Jellen, associate director, Center for Workplace Mental Health, American Psychiatric Association (APA) Foundation. While she acknowledged that executives must consider budgets and answer to their boards, there is a strategic imperative to mental health investments, some of which have a 4-to-1 return on investment (ROI) and influence recruitment and retention. Salaries alone are no longer as powerful a draw for younger employees, who are leaving their jobs for employers of choice that “design cultures that support mental health,” Jellen said. “This will impact your bottom line.”

Prevention?

Assessing workplace and workload psychosocial risks (described by the Centers for Disease Control³ as hazards) upfront can help employers identify and mitigate issues that can lead to or exacerbate mental illness. The need to assess psychosocial risks was also discussed during the 2023 DMEC Annual Conference⁴ and could mark a turning point for addressing whole-person health.

But it is not yet the norm.

“I find employers forget or confuse workforce and workplace psychological health,” noted one Virtual Mental Health Conference attendee. “They might focus on the benefits without paying attention to the environment and culture, and can’t wrap their brains or action around both.”

Taking a holistic approach to employee health and wellness can, however, have myriad benefits for employers vying for talent. The key to success is to recognize that the relationship starts on day one at the job (or possibly during the interview)⁵ and demonstrates an acknowledgment of shared responsibility for health.

That shared responsibility is expected by younger employees, who see work as a determinant of well-being, and by extension, they see mental health resources as part of an organizational infrastructure that supports them, explained Shayla Gerity, program manager, Center for Workplace Mental Health, APA Foundation. To emphasize the connection between work and mental health, the APA team cited a survey,⁶ which shows that 69% of employees believe managers have the same effect on their mental health as their spouses.

Practical Changes

As a result, employers might want to reevaluate benefit frameworks. For example, consider adding mental health days as part of paid time off banks, offering a company paid family and medical leave policy to ensure equity for employees in different states, and developing employee resource groups that meet during work hours to normalize mental health conversations. Going one step further, employers should demonstrate their commitment to making mental health a priority. To do so, speakers suggest communicating resources regularly through various channels and platforms so they reach all types of learners including audio and visual learners. Employers should also continue to seek ways to reduce stigma, which continues to prevent 47% of Gen Z workers from seeking mental healthcare.⁷

Messaging that comes from the top is especially powerful because it models positive behaviors and encourages people to use mental health services and resources, one attendee noted. This point was illustrated in a video shared by Heather Holladay, integrated health manager, PG&E, a conference speaker, that shows PG&E leaders sharing their experiences with mental health resources that helped them.

“It makes such a difference when leaders indicate that they welcome mental health dialogue in the company,” said Meg Delp, LMFT, director, workplace mental health, National Alliance on Mental Illness. Delp shared an example of a 20% bump in employee assistance program (EAP) usage after an organization’s chief executive officer mentioned using bereavement resources. EAP utilization can also be influenced through manager and supervisor training that helps leaders move beyond noticing a problem to connecting employees with the appropriate resources.

It’s Personal

While initiating these conversation can be daunting, speakers talked about how integrated absence managers can become known as a “mental health safe person” at work by monitoring their own language⁸ and holding people (and themselves) accountable for inadvertent missteps in constructive ways. This resonated with attendees, who shared examples in the conference chat. “It can be very scary to confront someone and have those kinds of talks,” Delp said, “but sometimes it can be just what a culture needs.”

She cautioned attendees about language that could be misconstrued as dismissive. If, for example, an employee shares a challenging situation, a knee-jerk reaction might be to say, “You’ve got this!” in an effort to buoy spirits. But that could inadvertently dissuade the employee from sharing more or seeking support. Instead, Delp talked about the importance of listening, and being empathetic and compassionate when talking with employees, and reminding them that they are not alone.

A Different Response

Seeking support is in and of itself challenging due to the ongoing therapist shortage at a time of increasing demand. Data from a study⁹ shared during the conference found that 89% of managers globally report their own issues with mental health concerns as well as with teammates. Other data shows that rates of anxiety and depression have quadrupled among employees ages 18 to 29.¹⁰

“Obviously there is something dramatically different occurring for people in their lives, including work environments,” and it’s definitely something we should be responding to, said Susanne Bruyère, PhD, CRC, director, K. Lisa Yang and Hock E. Tan Institute on Employment and Disability, Cornell University, who spoke at the conference.

The data, while startling, resonated with attendees, who have seen more mental health-related accommodation requests since the pandemic. This increase has prompted some employers to retool EAP partnerships to increase usage and efficacy. In addition to conducting regular employee surveys to identify needs and assess satisfaction with benefit offerings, employers were encouraged to add participation targets to contracts and clearly define scope of work as well as access for employees in all markets. Recommended questions to ask during contract negotiations included:

• What is the average wait time for employees to get appointments?
• What is the range of providers available?

“We all want to know what success looks like” with EAPs and other investments, said Jellen, who suggests three-, six-, and nine-month interval assessments to ensure investments in mental health meet the mark. Employers can also integrate feedback loops into EAP contracts so they can adjust services as they monitor EAP usage and obtain data from anonymous surveys to gauge engagement.

Industrywide, data shows that EAP usage¹¹ remains between 3% and 5%, and that fewer than 50% of people who need care connect with resources. However, 90% of those who do connect with resources can significantly reduce symptoms and improve their quality of life, Bruyère said.

The question employers must ask is why are these EAP usage numbers so low? Recognizing there is no one-size-fits-all approach, especially with diverse employee groups, speakers encouraged employers to engage employees when designing and assessing programs, and emphasize that EAP usage is confidential.

With high incidence rates, now is the time to draw outside the lines with EAP designs. For example, would peer support help employees address addiction issues? Could the Notice. Talk. Act at School program help school districts support children dealing with the aftermath of the pandemic and school shootings? Would it be helpful to include cognitive behavioral therapy in resources?

Recognizing that what’s been done in the past is not a barometer for future success, conference discussions focused on the value of testing different approaches to increase employee engagement with mental health resources. The willingness to explore options and ask employees what they need and want can enhance company culture and prove that mental health is a priority, which can reduce operating costs, boost productivity, and enhance recruitment and retention. And that is a powerful concept — an ROI that extends beyond the dollar sign and enhances employees’ lives.