Employers routinely cope with the challenges of their employees’ physical illnesses and accidents, which affect their employees’ well-being, workplace morale and productivity. Mental health issues may be less obvious, but are potentially just as serious. Workers don’t always acknowledge their depression or anxiety to themselves or others, and their supervisors may not recognize the symptoms of mental health problems. Sometimes employees avoid speaking up about mental health problems out of concern that they may be viewed as less significant than a physical illness or as a personal weakness.
Experts agree, however, that concern about mental health in the workplace is increasing. Shawn Premer, chief human resources officer of Consumers Credit Union in West Michigan and president-elect of the national Society for Human Resources Management (SHRM), points to the increasing volume of medications being prescribed for mental health problems.
When the University of Michigan Depression Center began receiving more inquiries about workplace mental health from businesses, patients and members of its national advisory board, they realized that this was a significant problem and developed a special Workplace Depression Program. Psychiatrists and other mental health professionals provide lectures and clinical talks for employers, base line surveys, and workshops to help supervisors and managers understand mental health issues.
Mental Health Problems Are More Public
Clinicians and human resource professionals agree that attitudes have changed and the stigma about mental illness is less than in the past. Discussion of mental health problems by television celebrities such as Oprah and Dr. Phil have made “it okay to have problems and okay to seek help,” says Gregory DeLapp, CEO of the Employee Assistance Professionals Association, citing frequent television ads for anti-depression medications that have also raised awareness of mental health problems and treatment.
Psychiatrist Michelle Riba, medical director of the University of Michigan Workplace Depression Center, says public discussions about mental illness are helping to reduce its stigma.
“Stars are talking about bipolar disease, anxiety and substance abuse,” she notes.
Violent incidents in factories and offices, sometimes involving shootings by current or former employers, have also increased concern about mentally ill workers. However, these situations are rare.
“While it makes the news, it is statistically uncommon,” says DeLapp, an assessment with which Riba agrees.
“Most people with mental health problems are not violent, but rage can occur,” said Riba. “There needs to be training for supervisors to recognize and deal with problems.”
To reduce the likelihood of such problems, Premer stresses the importance of background and reference checks for potential new employees in order to make good hiring decisions.
DeLapp says some employees began to express anxiety over terrorism after 9/11 and others said they were affected by the economic downturn in 2008. Both resulted in greater use of Employee Assistance Programs (EAPs) as workers sought help with stress and financial issues.
Other companies that have experienced tragic suicides by an employee or a worker’s family member met with employees individually and in groups to help them cope.
“Employers have to continually reassure employees and have safety procedures that neutralize the risk and address workers’ concerns,” adds DeLapp.
In the workplace, the first signs of a mental health issue may be increased absenteeism.
“Employees may be worried about making a mistake, so they don’t come in. They may not get a good night’s sleep, so they are late and not able to really engage and optimally function. They may be anxious about getting things done,” says Riba.
Sometimes employees will talk to their primary care physician about mental health concerns, but often a supervisor notices problems and suggests that the employee seek help. Most large companies, an estimated 80 to 88 percent, offer an EAP at no charge to their workers. These programs offer some in-house counseling and referral to a range of community resources.
Mental Illness Is a Legally Protected Disability
When a mental health issue becomes evident, employers need to be mindful of whether it is serious enough to qualify as a disability under the federal Americans with Disabilities Act (ADA). A disability, whether physical or mental, is a condition that affects an individual’s ability to accomplish one or more major activities of daily life and care for oneself, said Patrice Arend, a labor relations attorney with Jaffe Raitt Heurer & Weiss, a Southfield-based law firm.
The ADA requires that employers make reasonable accommodations for workers with disabilities.
“That can mean some time off or a change in work hours that enable the employee to do the essential functions of the job,” said Arend. However, such accommodations cannot place “undue hardship” on the employer. The employee may also be helped by the Family and Medical Leave Act, which allows employees 12 weeks off in certain circumstances, as well as workers’ compensation if stress and anxiety faced by an employee are job-related.
Identifying mental health issues early is very important for successful treatment and sometimes serious problems can be avoided.
At Consumers Credit Union, which has 300 employees and is headquartered in Kalamazoo, the human resources department, headed by Shawn Premer, offers wellness and prevention programs that go beyond diet and physical activity.
Since 2012, the company has offered two-week mental health classes and workshops—Stress Busters, Daily Choices, Soothe the Savage Beast, Meditation, Self-Love, and Negative to Positive. Employee participation for these is 70 to 100 percent, the same as for more traditional health-related subjects, said Premer. She adds that short, single-topic programs have been found to work best. The company also offers wellness coaching through a life coach.
“It’s important to have a health plan that focuses on keeping employees healthy. We take a holistic approach to health so that employees can be self-aware,” added Premer.
While mental health coverage is mandated under the Affordable Care Act, she says that plans vary greatly in the extent of services provided.
Encouraging Employees to Seek Help
“Employers have to make their resources known to, and available to, their employees,” notes DeLapp of the Employee Assistance Professionals Association. He says that 40 percent of employee contacts with Employee Assistance Programs are for stress, anxiety, depression and family problems. Companies offer different levels of counseling services, but typically 1 to 8 sessions are provided at no charge. Those who need more help are referred to outside resources.
While there may be a concern about seeking help from a company program, “The incidence of confidentiality breach is almost negligible,” he says. HIPAA and the ADA protect workers’ health information.
Marina London, EAPA’s communications director, points out that EAPs are usually located off-site but are accessible via video services like Zoom and Skype, and through text messaging and email.
According to Tonya Teal Slawinski, training and education director at EAPA, the nature of a company’s workforce affects the use of EAPs. Men are less likely to use such services and the educational level of the workforce is also a factor. “You must understand the corporate culture and need buy-in from the company,” she says.
Riba says that most employees don’t seek treatment on their own and it is their manager who calls them on it. She says that depression is the most studied form of mental health problem and its incidence depends on the type of work.
“Certain jobs are very difficult, such as reporters in war-torn areas who can’t intervene, and police officers,” Riba explains.
The success of treatment depends on the specific condition and its severity. Usually, medicine and psychotherapy are required. “Medicine isn’t enough. Many prescriptions get filled, but aren’t used,” she says.
DeLapp agrees that drugs aren’t sufficient for treatment and that the fine print on their bottles indicate that they are effective when combined with counseling.
Today most mental health care is outpatient and includes psychotherapy with a clinician or group therapy, explains Riba. There are also partial hospital programs for four to five days a week and psychiatric emergency care. It can be difficult to obtain care for employees working certain shifts.
“More people (with mental health issues) are working. If people lose their jobs, they could lose their insurance,” she adds.
Riba favors collaborative mental health care with a primary care physician and possibly a social worker. “You have to make sure they have the right dose.”
Genetic testing and a family history are important, as well as a profile of side effects of medication.
Early identification of a problem is important for effective care. Health care and human resource professionals agree that training of supervisors and managers is critical, as they are the ones most likely to notice signs of a problem.
“A change in everyday behavior and performance indicate a need to engage more with the employee,” says DeLapp.