Stressed out

With anxiety and other mental health issues on the rise, experts offer advice on keeping things balanced in the workplace.
0522 Editorialcontent Final Mentalhealth Feature

Feeling bluer than normal? You’re not alone. With one in five people across the U.S. experiencing mental health issues at some point in their lives, and the other four likely knowing someone who has, one can only surmise how the effects of a pandemic, rising inflation, political divides, the Great Resignation, Russia’s war in Ukraine, and a population trying to emerge to some sort of normalcy is impacting our sense of stability.

Mental health is having its day.

From Washington, D.C. to main streets everywhere, humanity’s mental wellness has been challenged. On March 23, Sen. Richard Burr (R-NC) together with Sen. Patty Murray (D-WA), members of the Senate’s Committee on Health Education, Labor, and Pensions, urged support of the committee’s work on meaningful, bipartisan proposals to reauthorize, improve, and expand federal mental health and substance use disorder programs.

The feds also recently announced that effective July 16, the 10-digit National Suicide Prevention Lifeline (1-800-273-8255) will relaunch as 988 to connect people experiencing a mental health crisis to Lifeline network counselors trained to listen, provide support, and connect people to local resources.

Genetic or otherwise, psychological health has long been stigmatized and perhaps not gotten the attention it needs as compared to physical wellness. In the workplace, preventative mental health care is often little more than the mention of an employee assistance plan (EAP) in a company’s employee handbook.

Yet, mental health is a measure of our cognitive state. Everyone has mental health, but not all have mental illness, so whether our ups and downs last a moment, a day, or longer is based on individual circumstances that usually subside.

In this exploration of mental health in the workplace, IB spoke with providers and employers working to improve the outcomes, because the expression, “we’re all in this together,” a rally cry during the pandemic, has never rung truer for our psychological well-being.

As mental health emerges from the darkness, lifelines are becoming more numerous for those who may feel like they’re drowning under the weight of their existence.

Workplace stress

In a recent Gallagher survey of company executives, four out of 10 employers cited employee wellness as one of the top three concerns for their organization’s leadership. As a part of that, the mental health crisis will continue long after COVID subsides, according to Emily Brainerd, physical and emotional well-being consulting leader at Gallagher.

“Stress is very delayed from a crisis,” Brainerd states. “COVID has been a crisis, but we’ve all been in a heightened state of fight or flight. When we start to come down, that’s when the true effects of stress can really hit us — exhaustion, a feeling of burn out, mourning what or who we lost, and longing for what was. There’s still a lot of stressful components that come with coming down, and you can’t forget that the world is in turmoil.”

Managers are feeling the heat as well, with 66% feeling unequipped to be able to help their employees get the help or the emotional support they need.

“That’s a staggering number,” Brainerd notes. Meanwhile, 32% of managers report they’re not prepared at all to support their employee’s well-being, and 68% of C-suite leaders are worried about stress and burnout in the workplace.

“I don’t think this statistic has ever been this high,” she says. “That’s troubling, but at the same time, they’re thinking about it.”

That’s why returning to the workplace should be handled with care. “I think the hybrid or virtual work environment can be very stressful if we’re not intentional about making it work. Employers need to be very conscious and aware of what kinds of workplace practices they need to ensure the hybrid model works for all.”

Brainerd offers some suggestions:

  1. Look at your company’s messaging around health and well-being. What language is being used in messages sent to employees to make them feel safe and welcome? “So much of that messaging can be really powerful.”
  2. Identify and take an inventory of available resources: Reexamine and share the company’s health plan, explain EAP, offer hotline numbers, other third-party resources, and share apps that can help people breathe or meditate.
  3. Hold a “make it OK” campaign to help combat stigmas. “It’s not good enough to include these things in an employee handbook,” Brainerd states. “Put them in front of employees again and again.”
  4. Employers and employees need to take their paid time off (PTO), and executives should lead by example. “We’re seeing that often people aren’t taking PTO or they’re not taking enough. Everyone needs a break.”

Access to health care, whether a shortage of community resources or in rural areas, is another problem. The use of virtual therapists has skyrocketed, Brainerd explains, with people of all ages taking advantage. She emphasizes the importance of self-care to help reduce stress, such as diet, exercise, and meditation.

“We need to practice empathetic behaviors and become more caring for others, and we need to make preventative mental health care as important as physical well-being. Otherwise, we’ll find ourselves in this pickle again.”

Costly conditions

At the center of the mental health conversation is the National Alliance on Mental Illness, or NAMI, an organization that was founded in Madison in 1979 by two mothers of schizophrenic boys. NAMI.org now has 1,000 affiliate groups nationwide and has moved its headquarters to Arlington, Virginia, while NAMI Wisconsin, which has 28 local affiliates throughout the state, was incorporated in 1981. Mary Kay Battaglia is the executive director.

“Now is the time to consider employee mental health,” Battaglia urges, “because COVID only exacerbated the problem. We’ve seen an increase in anxiety and depression but not in serious illness [such as schizophrenia or bipolar disorder]. Mental health does not discriminate. It doesn’t choose one race or income level.”

Battaglia is pleased to see mental health being discussed more broadly, saying it’s NAMI’s intent to normalize it. “The earlier people reach out and get support,” she notes, “the shorter the duration of the illness and the quicker the recovery.”

Mental illnesses are medical conditions and should be treated the same as a physical illness, she insists. In Wisconsin, there are six respite centers operated by different organizations where people in crisis can stay for free for up to seven days. NAMI Fox Valley operates one. Each site has certified peer specialists who have worked their way through their own mental health issues and now counsel others.

Interestingly enough, anxiety disorders are the most common mental health concern in the United States, according to NAMI’s website. Over 40 million adults (19.1%) have an anxiety disorder, while about 7% of children ages 3–17 experience issues with anxiety every year.

There is an absolute economic benefit to taking care of employees, Battaglia asserts. To illustrate, mental illness costs the U.S. economy about $200 billion a year in lost earnings. Employees suffering from mental illness are 62% more likely to take more time off work and are 30% more likely to quit a job.

“This is not a conversation we can continue to avoid,” Battaglia states.

If an employee noticeably disengages, seems unable to focus, concentrate, or keep still, they could be struggling, especially if those symptoms last over an extended period and disrupt the employee’s ability to perform their job duties. When the mental health industry has struggled with a lack of workforce providers, NAMI’s free online support groups and telehealth appointments have made things easier, with clinicians reporting fewer no-shows than in-person appointments.

Battaglia, who makes presentations to businesses about mental health awareness and creating a wellness-friendly environment, suggests the following:

  1. Ask, “How are you feeling?” rather than just, “How are you?”
  2. Don’t expect employees to work more than 40 hours a week.
  3. Set up evaluations or weekly check-ins with employees.
  4. Acknowledge that some workers may need to walk or get outside during the day, or someone struggling with seasonal affective disorder may need to sit near a window in the winter months. You won’t know until you ask.
  5. If an employee reaches out for help, be an active listener. Turn away from your computer, and don’t interrupt.

Unfortunately, due to the lingering effects of COVID, Battaglia expects more people to seek mental health support even as the pandemic wanes. “The fact is, we don’t know all of the long-term effects of COVID, and we’ve seen some neurological issues beyond not being able to taste or smell that need to be studied.

“I do feel that people are starting to believe that [living with a pandemic] is going to be part of our lives moving forward,” she adds. “I am hopeful that instead of stopping, halting, and isolating ourselves, we will move forward in a smarter way. So, reach out, vaccinate, and be safe.”

EAPs to the [short-term] rescue

“It has certainly been an interesting time in the EAP industry,” comments Tresa Martinez, manager of the city of Madison Employee Assistance Program, as programs everywhere try to help employees struggling with stress, anxiety, or overall mental health.

For the first time since she joined the department 17 years ago, Martinez is noticing supervisors experiencing the same level of stress as employees. “Not only are they trying to manage their departments, but they’re dealing with their own families and fears at a time when staff is at a lower capacity,” she explains. “It’s been very challenging.”

The city’s EAP program is a free, 24/7 benefit for employees and their family members to receive short-term counseling. Employees can usually connect with someone on the EAP staff within 48 hours. “We act as the bridge until they can get to extended support,” Martinez explains.

The benefit includes several counseling sessions, which may be enough for people to get through a temporary crisis. If more help is required, the EAP team will help the person navigate to an outside therapist.

Two years after the coronavirus first took hold, effects linger. “When the pandemic first started in 2020, people with school-age children were consumed with their home responsibilities, so it wasn’t just about isolating at home,” Martinez states. “I think many were in shock, trying to figure out their next steps.” As time went on, some people lost loved ones and may not have gotten the closure they needed to say their final goodbye, which also is important to mental health.

Martinez noted a few instances of animosity bubbling up between some of the city’s field employees who were unable to work from home because of the nature of their jobs, and others who had the flexibility to do so. Meanwhile, the EAP department remained proactive, sending out countless briefs and flyers on mental health concerns, tools, and techniques emphasizing self-care, resiliency, and managing the emotional trauma of a pandemic without self-medicating.

“[Self-medicating] has definitely increased,” Martinez observes, “either new substance-use concerns or relapses.” Alcohol and drug use rose as some people admitted to drinking at home during the workday because alcohol was easily accessible. Meanwhile, EAP requests for teens and young adults also are increasing.

“I thought we had moved beyond this, but people are still trying to navigate their new way of looking at the world and priorities have shifted. Those in management-level positions don’t want the stress, and workers who were unhappy decided to leave. We’re seeing that everywhere certainly, not just in Madison.”

Martinez credits the city’s quick response when the pandemic first hit. “The mayor frontloaded sick leave balances so employees could use sick leave without worrying about it. We increased our services with access to EAP counseling and trauma counseling. There was more demand for workshops to discuss resiliency and health care, navigating change, and how to treat each other.”

But switching to virtual versus in-person workshops presented new challenges. “Normally you’d attend a three-hour workshop,” Martinez says. “Now workshops can’t be any longer than 90 minutes due to computer screen fatigue.”

Meanwhile, nerves remain on edge. “We’ve seen more negativity directed toward government employees and officials,” Martinez states. “We’ve pushed out more training materials on EAP services and how to interact with customers who may be experiencing mental health challenges of their own.” Sadly, there have been overdoses in libraries that some library staff has had to deal with, and bus drivers have been assaulted.

It all makes Martinez wonder if and when the pendulum will swing back, and what that world will it look like. Meantime, the city continues to encourage its workers to hold on to their routines — drink water, exercise and eat well, get enough sleep, and spend time with people they love who are healthy and whom they can trust and talk to.

But there are positives, she insists. “Technology has made the city much more efficient in terms of communicating, and we’ve learned that our people really do good work at home, and we can trust them.”

Reconnecting in the hybrid office

Crisis calls to Madison’s Journey Mental Health Center rose 25% in 2020, and another 16% in 2021, notes Nichole Wright, chief clinical officer for the center. At the same time, clinicians have left, and schedules are fully booked.

Journey listed a record 40 open positions in March because some people changed careers, left for better paying jobs, or just took a pause. “If we don’t have staff, we can’t work,” Wright says.

Like the city, the center’s counselors are seeking help too. Wright, a therapist for 10 years, has heard more from the therapists themselves about their own mental health. “There’s been vicarious burnout over the past two years,” she states.

Wright offers her thoughts on bringing people back or going to a hybrid model.

  1. “Be flexible. Hybrid offices can cause gaps between the virtual and on-site worlds [and introverts and extroverts]. Two years of isolation has really impacted people. Humans need connection, but often colluding with avoidance is easier.” She recommends thinking about how to create the human connections that have been lacking.
  2. Consider devoting 10 or 15 minutes of virtual staff meetings to reconnect with random or fun discussions that used to happen in the breakroom.
  3. In virtual meetings, employees should be engaged and their faces visible to the rest of the team. “If someone regularly keeps the camera turned off during virtual staff meetings, that would be a red flag to me.”
  4. Create staff engagement surveys to ask what the company can do to support their wellness or their transition back to the office, she suggests. “How will you honor everyone? People need to thrive in their work environments, and employers need to meet everyone where they’re at.”

Struggling workers can seek help on their own, contact their primary care physician, or talk with a family member or a close, trusted friend. “Sometimes that person may have a resource for them. Often, by opening up the stigma around mental health is reduced as well,” Wright adds.

Journey Mental Health Center works with various continuums of care for crisis events, including suicidal thoughts. The nonprofit also offers telehealth counseling and has a kiosk available in its office should someone care to speak to a clinician virtually, from behind a closed door.

Virtual counseling programs, including betterhelp.com or talkspace.com, have become more popular and work with businesses as well. “If someone doesn’t want to go to a local provider, this is an easy option,” Wright suggests. “Just make sure the counselor you’re talking to has the necessary credentials,” she cautions.

For employers, the Wellness Council of America, or WELCOA (welcoa.org), is a nationwide group with a Wisconsin chapter. It focuses on employer and employee wellness certifications. Companies can become a member for a nominal fee.

In the local community, Journey’s CARES team recently announced expanded services throughout the city of Madison. CARES, or Community Alternative Response for Emergency Services, pairs a licensed mental health therapist with a community paramedic to provide mental health assistance before law enforcement gets called. The pilot program has been a popular resource and allows police to focus on other matters. A second CARES team will be created soon.

Journey is also partnering with Madison College to create more career pathways, increase diversity of staff, and explore new ways to support people needing mental health care.

Call 211 for help

United Way of Dane County’s 211 Center was launched 20 years ago to provide access to resources for food, housing, and countless other concerns. Ed Wall has been the director of the 211 Center at United Way of Dane County since October.

Dialing 211 connects people 24/7 with the resources they need to hopefully get over the hump on a variety of challenges, from housing and food to disaster relief, financial assistance, health care, job searches and everything in between. 211 does not take names, only the caller’s zip code, and the 211 network is available to over 90% of the U.S. population.

In south-central Wisconsin, the 211 Center covers seven Wisconsin counties (Dane, Columbia, Green, Iowa, Lafayette, Sauk, and Rock) representing about 875,000 people, including more than 93,000 living in poverty. Dane County alone has over 1,000 resources available to help, and 211 can also connect people to the Wisconsin Addiction Recovery Helpline for substance use treatment and recovery services.

Of more than 47,000 total referrals made by the 211 Center last year, there were 12,484 requests for health care; 11,207 referrals made for housing needs; 3,850 requests for food; and 3,441 referrals for behavioral health and drug addiction.

“Let’s face it, everything is connected to mental health,” Wall explains.

“When you get to the point where you’re calling 211, you need help, and we’re here to provide it. In the height of COVID, we heard from parents who didn’t know if they should keep working or quit to stay home to take care of their children because schools or day cares were closed.

“Once someone loses their income for the basics like food and housing, things can deteriorate into mental health issues.

“We deal with a lot of heartbreak here,” Wall admits, “but we’re happy to listen and to help.”

Taking the load off

Area employers respond to their employees’ mental health needs in creative ways. Below are just a few examples from American Family Insurance, Epic, and Quartz Health Solutions.

American Family Insurance
Melissa Vaughan, Manager, Enterprise Benefits
“We feel confident that our managers are equipped with the tools and re-sources we have around talking to people about their mental health,” states Melissa Vaughan. American Family Insurance also:

  • Surveys employees regularly and offers an EAP program for employees and their household members;
  • Evaluates and reviews services that can provide virtual, next day, or same-day counseling support;
  • Offers multiple virtual programs and as well as monthly and biweekly webinars where employees can learn tips, techniques, and practices to reduce stress, calm anxiety, and overcome conflict; AmFam also offers programs for on-demand mindfulness, nutrition, and fitness classes;
  • Makes daily tasks easier by allowing employees to shop for groceries on Instacart and, where available, have items delivered.

Epic Systems
Erin McWilliams, Director-Benefits
McWilliams says Epic prides itself on education and focuses on individual connections and having a safe space. With nearly 10,000 employees, the company also:

  • Has a team of Staff Success Owners considered trustworthy, welcoming people other employees can confide in; this group receives QPR training (question, persuade, and refer) to reduce suicidal behaviors and save lives through practical, proven prevention training; QPR helps bridge the gap when long wait lines cause delays in seeing a therapist;
  • Offers a two-hour interactive class, “Let’s Talk About Mental Health,” twice a month. Thus far, nearly 700 people have been trained to de-crease the stigma around mental health;
  • Has Mental Health First Aiders, a small group of employees with extensive training in providing immediate crisis support and that connects people to resources and promotes awareness.

Quartz Health Solutions
Tom Ward, Senior Director-Human Resources
Quartz is committed to creating a work-life synergy by being flexible and meeting employees where they are, notes Tom Ward. With a focus on the well-being of its employees, Quartz also:

  • Enhanced its PTO policies, allowing employees additional banks;
  • Improved an existing PTO donation policy initiative specifically for parents with children to help fund extra PTO requests;
  • Instituted a new parental leave policy for 2022, recognizing that parental care often goes above and beyond PTO; and
  • Shifted organizationally from a traditional performance-management structure to a “boss-to-coach” leadership design that supports the whole employee and focuses on employee strengths. The idea is to better set employees up for success, which leads to employee well-being.

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