Harvard Business review

It’s a New Era for Mental Health at Work

When we published our research on workplace mental health in October 2019, we never could have predicted how much our lives would soon be upended by the Covid-19 pandemic. Then the murders of George Floyd and other Black Americans by the police; the rise in violence against Asian Americans and Pacific Islanders (AAPIs); wildfires; political unrest; and other major stressors unfolded in quick succession, compounding the damage to our collective mental health.

One silver lining amid all the disruption and trauma is the normalization of mental health challenges at work. In 2019, employers were just starting to grasp the prevalence of these challenges, the need to address stigma, and the emerging link to diversity, equity, and inclusion (DEI). In 2020, mental health support went from a nice-to-have to a true business imperative. Fast forward to 2021, and the stakes have been raised even higher thanks to a greater awareness of the workplace factors that can contribute to poor mental health, as well as heightened urgency around its intersections with DEI.

Although employers have responded with initiatives like mental health days or weeks, four-day workweeks, and enhanced counseling benefits or apps, they’re not enough. Employees need and expect sustainable and mentally healthy workplaces, which requires taking on the real work of culture change. It’s not enough to simply offer the latest apps or employ euphemisms like “well-being” or “mental fitness.” Employers must connect what they say to what they actually do.

Mind Share Partners’ 2021 Mental Health at Work Report in partnership with Qualtrics and ServiceNow offers a rare comparison of the state of mental health, stigma, and work culture in U.S. workplaces before and during the pandemic. This follow-up study to our 2019 Mental Health at Work Report uses the same metrics and includes additional questions and segmentations on the effects of the pandemic, racial trauma, and the return to office; it also fleshes out our less comprehensive study from April 2020. As in 2019, we collected responses from 1,500 U.S. adults in full-time jobs, with statistically significant representation across racial and ethnic backgrounds, gender identities, membership in the LGBTQ+ community, generational divides, primary caregiver statuses, levels of seniority, and other factors. Here’s a summary of what we learned and our recommendations for what employers need to do to support their employees’ mental health.

The Employee Mental Health Experience

When we examined the data on how employees experience mental health challenges, we found that prevalence increased from 2019 to 2021 and that younger and historically underrepresented workers still struggle the most.

Increased attrition.

More employees are leaving their jobs for mental health reasons, including those caused by workplace factors like overwhelming and unsustainable work. While the 2019 rates of attrition were already surprisingly high, they’ve gone up even more since then. Sixty-eight percent of Millennials (50% in 2019) and 81% of Gen Zers (75% in 2019) have left roles for mental health reasons, both voluntarily and involuntarily, compared with 50% of respondents overall (34% in 2019). Ninety-one percent of respondents believed that a company’s culture should support mental health, up from 86% in 2019.

High prevalence.

Mental health challenges are now the norm among employees across all organizational levels. Seventy-six percent of respondents reported at least one symptom of a mental health condition in the past year, up from 59% in 2019. While that’s not surprising due to the many macro stressors, it supports the notion that mental health challenges affect nearly all of us on a regular basis.

Our 2019 study showed the same prevalence of mental health symptoms across all levels of seniority, debunking the myth that successful leaders are immune. Perhaps as a result of having to lead through this unprecedented era, our 2021 study showed that C-level and executive respondents were now actually more likely than others to report at least one mental health symptom. Let’s finally put the stigma to rest and admit that mental health challenges affect us all.

Widespread disclosure.

More employees are talking about mental health at work than in 2019. Nearly two-thirds of respondents talked about their mental health to someone at work in the past year. This is an important step in the right direction, especially in terms of reducing stigma, which affects willingness to seek treatment. That said, only 49% of respondents described their experience of talking about mental health at work as positive or reported that they received a positive or supportive response, which is comparable to 2019 rates.

DEI implications.

Demographics continue to play a strong role in workplace mental health, with younger workers and historically underrepresented groups still struggling the most. Millennials and Gen Zers, as well as LGBTQ+, Black, and Latinx respondents were all significantly more likely to experience mental health symptoms. Like Millennials and Gen Zers, caregiver respondents and members of historically underrepresented groups — including LGBTQ+, Black, and Latinx respondents — all were more likely to leave roles for their mental health and to believe that a company’s culture should support mental health. In fact, 54% of all respondents said that mental health is a DEI issue, an increase from 41% in 2019.

The Company’s Role in Employee Mental Health

Employees don’t experience mental health challenges in isolation. Employers play a role, too — both good and bad.

Certain workplace factors negatively affected mental health.

The way we’re working isn’t sustainable, and it’s hurting our mental health. Until recently, the conversation has primarily centered on preexisting mental health conditions and the related stigma. Increasingly, the focus is on work’s effect on everyone’s mental health.

An overwhelming 84% of respondents reported at least one workplace factor that negatively impacted their mental health. Younger workers and members of underrepresented groups were affected even more severely. When looking across all respondents, the most common factor was emotionally draining (e.g., stressful, overwhelming, boring, or monotonous) work, which also worsened since the pandemic. This was closely followed by work-life balance.

The other workplace factors that most notably worsened since the pandemic were poor communication practices and a low sense of connection to or support from one’s colleagues or manager, perhaps unsurprising in a predominantly remote workforce. The workaholism that characterizes much of U.S. culture has only been exacerbated by the challenges of the pandemic, leading to increased employee burnout.

Companies increased investment in employee mental health — sort of.

Companies are finally investing more in mental health support out of necessity, but they still haven’t achieved true culture change. Our respondents noted that the availability of many resources provided by employers grew since the pandemic, including extra paid time off, company-wide mental health days, and mental health training.

In addition, employees used accommodations to a much greater extent — especially those that provided day-to-day support. These included extended or more frequent breaks from work and time during the workday for therapy appointments. Utilization rates for other accommodations included time off and leaves of absence, which saw no growth from 2019. This highlights a contrast in what employees used versus what employers provided, which were often more temporary, Band-Aid solutions. In fact, the “resource” most desired by respondents (31%) was a more open culture around mental health.

Companies took steps toward culture change.

While there is still a great deal to be done, some companies have made progress on the culture front, likely fueled by the pandemic. Fifty-four percent of respondents believed that mental health was prioritized at their company compared to other priorities, up from 41% in 2019. In addition, 47% of respondents believed that their company leaders were advocates for mental health at work (compared to 37% in 2019), and 47% believed that their manager was equipped to support them if they had a mental health condition or symptom (compared to 39% in 2019). These are both potentially results of increased training and discussion.

However, the added awareness surprisingly didn’t translate across all dimensions. There was a 5% decline in respondents who felt comfortable supporting a coworker with their mental health and a comparable percentage in who knew the proper procedure to get support for mental health at work.

Employers benefit from supporting mental health at work.

Employers that have supported their employees with the pandemic, racial injustices, return-to-office planning, and/or mental health overall have better mental health and engagement outcomes. For example, workers who felt supported with their mental health overall were 26% less likely to report at least one symptom of a mental health condition in the past year. Respondents who felt supported by their employer also tended to be less likely to experience mental health symptoms, less likely to underperform and miss work, and more likely to feel comfortable talking about their mental health at work. In addition, they had higher job satisfaction and intentions to stay at their company. Lastly, they had more positive views of their company and its leaders, including trusting their company and being proud to work there. This reinforces the tie between workplace culture and its ability to support mental health at work when done intentionally.

What Employers Need to Provide

Employers must move from seeing mental health as an individual challenge to a collective priority. Given all the workplace factors at play, companies can no longer compartmentalize mental health as an individual’s responsibility to address alone through self-care, mental health days, or employee benefits. Here’s what they need to provide to make real progress.

Culture change.

Culture change requires both a top-down and bottom-up approach to succeed. Workplace mental health is no different — our recommendations from 2019 still hold. Mind Share Partners’ Ecosystem of a Mentally Healthy Workplace Framework illustrates that everyone has a role to play, starting with leaders and managers.

Leaders must treat mental health as an organizational priority with accountability mechanisms such as regular pulse surveys and clear ownership. It should not just be relegated to HR. Leaders should serve as allies by sharing their own personal experiences to foster an environment of transparency and openness. Due to fear and shame, even companies with the best mental health benefits won’t see an uptick in usage unless a stigma-free culture exists.

Organizations have to train leaders, managers, and all employees on how to navigate mental health at work, have difficult conversations, and create supportive workplaces. Managers are often the first line in noticing changes and supporting their direct reports. Building an environment of psychological safety is key. Mental health policies, practices, culturally competent benefits, and other resources must be put in place and (over)communicated.

Investing in DEI to support employee mental health and address its intersectionality is also crucial. Black and AAPI employees have been hit especially hard by the trauma of systemic racism and violence. Workers who are caregivers — often mothers — have faced school closures and the associated burnout. Our study found that allowing employees to discuss challenging social and political topics at work is also part of a mentally healthy culture. At the grassroots level, employees should be empowered to form mental health employee resource groups (ERGs) and other affinity groups, become mental health champions, and start peer listening initiatives.

More sustainable ways of working.

Employers must change their ways of working to be more sustainable — it’s time. A critical component is providing flexibility, which many workers experienced with remote work for the first time during the pandemic. Respondents reported that their company’s return-to-office plans were negatively impacting their mental health. The top two reasons given were the policies around in-person versus remote work (41%) and the lack of work-life balance or flexibility based on the policy (37%).

Promoting autonomy, establishing boundaries, and creating norms around communications, responsiveness, and urgency can go a long way toward building a mentally healthy culture. For example, a professional services firm might require long hours for a client deadline but could make internal deadlines more malleable. Other ideas include no email after hours, focused work time, and no-meeting days. Leaders must model these and other mentally healthy behaviors for employees to truly feel like they can do the same. Having conversations between managers and direct reports to articulate individual working styles and preferences supports inclusion. Employers must also ensure that teams have the resources and bandwidth necessary to do their jobs effectively while remaining mentally healthy.

Deeper connection.

Finally, a culture of connection is key — from regular check-ins that make time for the question, “How are you?” to healthy working relationships to meaningful interactions among teams. Employers should provide organization-wide opportunities for connection and also promote these ongoing, deeper one-on-one conversations between managers and direct reports as well as between colleagues. “How are you?” should always be followed up with “How can I help you?” especially at the manager level. The importance of empathy and authenticity cannot be overstated.

The massive societal shifts underway have changed company cultures and employee perceptions around mental health. Although employers have started to invest more, employees have rightfully increased their expectations. The future of workplace mental health demands culture change — with more vulnerability, compassion, and sustainable ways of working. We’ve already started down the path of culture change thanks to Covid-19. Let’s use this moment to be intentional as we craft new ways of working instead of rushing back to the status quo of 2019. Let’s imagine what could be.

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