Could Well-Intentioned Efforts to Protect Employees with Mental Health Issues Hurt More Than Help?

Employers can create mentally healthy workplaces. One key component is talking with employees about potential solutions to help reduce workload or stress instead of acting independently to protect them; actions that could be misconstrued and cause more harm than good. In this episode Paula Allen, global leader and senior vice president of Research and Client Insights for TELUS Health, offers insights and tips to help identify and mitigate mental health risks in the workplace, equip managers with the information and skills they need, and access the right resources when employees need them most. Listen in for details, and read the Q&A with Allen “How to Create Mentally Healthier Work Environments” in @Work magazine for additional context.

Resources cited in the podcast:


DMEC: You welcome to Absence Management Perspectives: A DMEC Podcast. The Disability Management Employer Coalition, or DMEC as we're known by most people, provides focused education, knowledge, and networking opportunities for absence and disability management professionals. DMEC has become a leading voice in the industry and represents more than 18,000 professionals from organizations of all sizes across the United States and Canada. This podcast series will focus on industry perspectives and provide the opportunity to delve more deeply into issues that affect DMEC members and the community as a whole. We're thrilled to have you with us and hope you'll visit us at to get a full picture of what we have to offer, from webinars and publications to conferences, certifications, and much more. Let's get started and meet the people behind the processes.

Heather Grimshaw: Hi, we're glad you're listening. I'm Heather Grimshaw, communications manager for DMEC, and we're talking about stress sensitivity among employees, which can, if left unaddressed, lead to substance use disorders and other behavioral health issues. We've asked Paula Allen, global leader and senior vice president of research and client insights for TELUS Health, to join us and elaborate on some of the comments she made during the 2023 DMEC annual conference. Paula participated in a panel discussion titled a Mental Health Culture Shift, addressing it from the top down, which was of great interest to hundreds of absence and disability management professionals in attendance. So we're going to kick off here. And Paula, we're so glad you're with us. My first question for you is, while employers have invested more in employee mental health, panelists talked about a different type of investment that is needed today. Would you elaborate on how employers can approach employee mental health from a preventative vantage point?

Paula Allen: Yeah, absolutely, Heather, and it's great to have this conversation. I think when people started to think about mental health before, it was generally about people with ill health. It was about people who were at risk of going on disability leave. It was about return-to-work from disability leave. And all of those things are still important things for us to attend to and to invest in and to optimize. That hasn't gone away. But there's more than that. There's a greater recognition right now that when you are talking about mental health, we're talking about an issue for the entire population. And one of the reasons why we're recognizing this more is that, number one, our collective mental health has changed and has been over quite some time over the past couple of decades. So just like changes in our society and the ability to have cars and machines and things of that sort have really kind of impacted our physical health because we're doing things differently. We're experiencing life a little bit differently, and we have to be more conscious of taking care of our aerobic capacity and our physical stamina. Similarly, things have changed in our society that have impacted our mental health. The pace of change is extraordinary right now and is accelerating. And the human mind doesn't like change. It gives us a sense of things not being in control. It gives us a sense of anxiety. The other thing that has changed, and even the surgeon general from the United States has a couple of times actually come out with statements on this, we're becoming more isolated, and that's a very big deal, because when you have social support, when you have deep connections with others, that's actually a buffer to day-to-day stresses and big stresses. So when we are feeling more isolated, that actually puts such a strain on us because we're not built like that as human beings. We can't be isolated. If you look at our history as human beings, if you were isolated before, if you were alone before you died, you didn't have anybody around you to help you fight the elements, to help build housing or anything of that sort. So there's a natural anxiety. So we're not necessarily going to die now, but that anxiety is still there. So we've really seen an evolution in how employers are looking at mental health more along the continuum, and for very good reasons, our mental health has changed.

Heather Grimshaw: One of the things that we hear and we know really is that mental health is a sensitive topic. A lot of people are wary about talking about this and asking about it, especially in the workplace. During the panel, you shared some thoughts about how employers can identify employees who are at, and I'm using air quotes here, high risk for substance use disorder and other behavioral health issues due to their sensitivity of stress. Would you share some details about how employers can do this, how you can identify employees who might need help?

Paula Allen: Well, first of all, I wish it wasn't so sensitive. I think it is sensitive because people really don't have a lot of knowledge. When you think about it, you and I didn't learn about mental health growing up in school. We learned about dental hygiene and things of that sort. We didn't learn about our mental health. So it's scary for a lot of people, and there's a lot of stigma around it. So I do think that there's an opportunity to kind of look at what organizations do from that point of view to sort of normalize conversations around mental health, not just illness, but also well-being. But answering your question very specifically around what managers can do and identifying people. I don't think that we need to go out and kind of hunt for people who are struggling. I think what we have to do is to pay attention to what we actually do. See? So I'll give you a bit of an example. I think we're a lot smarter as human beings than we give ourselves credit for. A number of years ago, we did a study that asked managers when they first sort of had a sense that somebody might be going off on disability leave. They had a sense that somebody is not coping well, that they've seen some changes that concern them. We were shocked to find that the length of time between when the manager first had that initial feeling and when the person actually went off on leave averaged out to be 18 months. 18 months, wow. So people change over time. You see signs of strain. That happens in an evolution. It's really just flipping a switch. But what happened in those 18 months was really important because most often what happened was nothing. People saw something not going right and they didn't know what to do, so they did nothing. Or they did things that were. They intended to be kind, but they actually weren't helpful. So I'll give you a common example. You see somebody who is struggling and you say, okay, well, I feel I need to protect them. I'm not going to give them difficult projects. I'm not going to put the same demands on them as someone else. I'm not going to go to them for advice around things that are challenging. So you might think that you're protecting that person from undue stress, but here's the issue. You've done that unilaterally without having a conversation with them. You have shown them that you have less confidence in them. You have changed their environment in a way that they don't understand. So what does that do that increases their anxiety? Are they not valuable anymore? Are they about to be fired? So it's so important to equip managers with the skills and the words for how to step in, and it's not that hard. So number one is that managers should never be expected to become counselors. That's off the table, right. You stay within your role. You have a role as a support to that person in terms of their general well-being and their work. Right? You're not there to provide therapy. You're not there to come up with questions, to come up with answers, to fix problems that might have been developing for years. So being a counselor is kind of off the table. But what you do need to be is a human being. So just taking back the analogy between physical and mental health, if you see that somebody has fallen, you see somebody is in pain, our natural human reaction is to go to them. To say that you're concerned about them, to bring in help, if they are okay with you. Bringing in help is not to fix them. Somebody falls off the ladder, you're not going to reset their ankle, but you're not going to leave them alone. You're not going to see someone in physical pain and just turn away. You're going to go to them the same. If you see somebody in any kind of anguish, you want to show them that you care about them as a human being. Jabab, I've seen certain changes. I'm concerned. I care about you. Is there anything that I can do to help? Is there any information that I can give you that might help? The main part of that conversation is showing that you care about that person, not leaving them isolated and sitting on the same side of the table as them and saying, let's problem solve around this. Because as a manager, you could maybe have adjustments in know, but it involves the person. You're not doing it unilaterally. But most often if you give that person information around Eap or some other service that's available to them, then you've done a lot. Now, there's one thing I want to just highlight in that. What's really important there is showing that person that you care, but also being specific on why you're having the conversation. And the reason is you want to be specific about what you see. I noticed that you are not attending our socials any longer. You're not going out to lunch with someone, with any of your colleagues. I've noticed that we've always been on time with your work and everything is a bit delayed right now. And there's some more errors. Be specific about what you see, because that helps people understand how the situation is showing up at work, which is important. Like it is a clarity and it's also not judgmental. You are not in a position to say, I think you have an alcohol problem. You are not in a position to say, I think you might be depressed. You're not because many things can cause the same behavior. People, even in physical pain, might show some angst that might show up as emotional pain. It doesn't matter. You say what you see and you show that you care and you help. That person to the next step. And Eap is a wonderful next step because it not only deals with emotional issues, it can be the first platform for childcare, legal, financial issues, health issues. It's not discriminatory in terms of the types of needs that are serviced.

Heather Grimshaw: I really liked what you said about paying more attention to what we do see. And I think for managers who are nervous about maybe overstepping, to give the analogy of the physical issue, if someone has fallen, what you would do is really helpful.

Paula Allen: It is. And I think, again, the more people know about mental health, the less uncomfortable they will be. There's so many reasons why somebody could have a mental health issue. Every single human being in this world has a vulnerability, and it just really depends on a number of factors coming together all at the same time that creates a problem as a result of that vulnerability, and it could happen to anyone. It's not a matter of having excessive trauma in your life, although that is a factor. It's not a matter of just your genetics, because you could have a genetic history, but you have different things that are actually protective around you when you think about it. And even though we want people to have self-care, there are certain things that are out of our control, such as, just like in cancer, you do what you need to do in order to have a healthy lifestyle to lower your risk. But that doesn't eliminate your risk. And even if you have a risk, your risk is not destiny. So all that means is that as human beings, there is not one single person that doesn't have a level of mental health risk. The thing is that we only know that we have that kind of risk. Often we don't know until it shows itself in a problem.

Heather Grimshaw: I'm wondering if there is one employee cohort that is at a higher risk for the stress induced issues that you've been talking a little bit about and how employers can have a positive influence on them.

Paula Allen: Yeah, I'll answer that in two parts. If you recall what I mentioned before about society just changing. We're more isolated. The pace of changes is quicker. There's a lot of things that are happening that are more intense with younger cohorts than older cohorts, because they've come into this fast pace, they've come into this environment that is more isolated, and we've seen that in our numbers. So at TELUS Health, we produce a mental health index, and that looks at the mental health and well-being of the working population. So what we're able to do is to say the population is in a good place and not a good place. Things are getting better, things are getting worse. But we're also able to look at the factors that do make a difference, and we're also able to slice and dice by age cohorts and different other cohorts. What's absolutely and positively clear in our data is that younger groups have that greater sensitivity to stress, and it's absolutely explainable by changes in our society. We're not talking about people who are weak in that kind of horrible language that some people use or over privileged. And that's why they feel that it's not that at all. It's not even about stigma. A lot of people say, well, we're seeing more things in the younger populations because they have less stigma in talking about it. Well, I can tell you that stigma doesn't prevent people from having breakdowns that bring them to the hospital. Stigma doesn't prevent people from having eating disorders and things of that sort. It's not that we are seeing more because things are different right now. If you ask anybody who is in a university or a high school or even an elementary school and has been working there for a number of years, they will tell you that there has been a change in the mental health of the younger population. So that's sort of one thing. But the other thing is that the entire population has been infected as well, so much more intensely if you're younger. But if you're older, you're not immune either. We had a major shift in our environment during the pandemic, and I know people don't necessarily want to talk about that anymore, but you have to play the ball where it is. It's still impacting us. Our mental health index has shown that there is an increase in sensitivity to stress. There's an increase in the proportion of the working population that's high risk, and that peaked during the pandemic, but has not gone anywhere back to where it was before. This is an ongoing issue. So with all the change, all the risk, all the vigilance that we had during that time, it really put us in a prolonged state of fight or flight. That prolonged state where you have that part of your brain that is responsible for self-protection and anxiety, that leads to self-protection really being over engaged. And the consequence of that is that the part of our brain that is responsible for rational thought, emotional control and empathy really doesn't have as much energy going to it. So we've had this long period of time where we were vigilant and on edge, and we're continuing to be on edge. Over 40% of us are more sensitive to stress than we were in 2019. And that shows up in how we relate to each other. More anger, more conflict, more cynicism, but it also creates some vulnerability for us as individuals. So not just our behavior, but vulnerability in terms of greater anxiety and more likely to sort of get involved in behaviors that are not healthy. So high risk drinking, et cetera.

Heather Grimshaw: One of the comments you made during the conference was, and I'm quoting you here, “the only thing that predicts defeat of an evolution is denial of it,” and in relationship to the rapid pace of change in our lives and how that upheaval has affected mental health. I'm wondering, how can employers ensure they are on the right side of that evolution?

Paula Allen: Yeah, this is a really great point. So, number one, we have to play the ball where it lay. We have to listen to this information. I mean, there's sometimes a tendency to say, well, I've heard enough about mental health, I'm going to go on to something else. It's not like that. This isn't a topic that you think about once a quarter or once a year. This is the core of everything. Your work productivity, your quality of life, your physical health, your brain functioning, all of it is important and related to mental health. So you cannot just put it to one side and say, I just don't want to think about it. And you can't deny the fact that there have been changes that increase the urgency from an employer's point of view to deal with it. There's two parts of what's important for employers to understand, because there's two parts of this equation. Just to simplify it. One is the individual and how you can support individuals. You can support people by providing them with training and information and knowledge to address stigma. You can provide them with resources and encouragement for self-care, continuum of services, for when people really do get into trouble, that they have that high quality support. So that individual support is super important, but it's not enough. The other part of mental health is your environment. So you have a personal environment. Yes, but our work environment is a huge part of our life. So if you have a situation where you're feeling unsafe, you feel that people are talking behind your back, you're feeling that if you say anything, the hammer is going to drop down on you. That psychological safety is hugely important, because if you don't have that, then you're in a constant state of anxiety. You can't be productive, you can't move forward. And that anxiety can harm you if you don't have a sense of belonging, feeling that you are included, feeling that you are valued. Think about it. If you were a child, right, you learn a lot from knowing what's good and what's not good for children. A child in a school where they have no sense of belonging, no matter what else is going right, is not going to do well. And that context is so important that we even have legislation in places like Australia that says an employer has a responsibility to do no harm. And if there is anything in the organization that can create a sense of harm, if there is risk. People are isolated in terms of their work structure, isolated in terms of behavior. They have work overload, so they can't possibly be successful. They don't have anything that gives them a sense of recognition, because we need that as human beings as well, that if the organization is moving counter to that and they're ignoring that, then they're going to be fined. Like there's legislation for that. So that's one end of the extreme, but it's actually being discussed in many other geographies as well, and I think it'll eventually be the norm. The good news is that we do have users manuals. We do have things like there's several standards out there. There's an ISO standard. The International Labor Organization has come out with papers, and even our organization has thought this is so important for employers. We've developed something called the Workplace Strategy Index for mental Health, which is a free tool. You can go online, really sort of do a self-assessment of your organization. So this is for organizational leaders, not individuals. Do an assessment and see where you stand relative to the practices that will support a mentally healthy workplace and get a score and get a recommendations. So again, the individual support is important, but the organizational actions are important as well. And we can't just take them for granted because we have an organization with nice people. We have to make sure that we invest so we at least do no harm.

Heather Grimshaw: That's a wonderful point, and I really appreciate you citing that tool. We will include the link for that as well as the mental health index that you mentioned in the notes section of the podcast. And I can't thank you enough for your time today and your willingness to share some great insights and guidance here about this incredibly important topic. Thank you.

Paula Allen: And thank you, Heather. It was a pleasure speaking with you, and thanks for bringing the topic forward.