Mental Health Awareness Month is observed in May in the United States and was started in 1949 by Mental Health America (MHA) (then known as the National Association for Mental Health). Mental Health Awareness Month serves as a national observance to bring attention to the importance of mental well-being, raise awareness about mental health conditions and works to address the challenges faced by people living with these conditions who may need mental health support. Our workplaces play a significant role in our lives affecting employees physical and mental well-being — in good ways and bad — and the COVID-19 pandemic brought the relationship between work and well-being into clearer focus.
Economic Cost of Poor Employee Mental Health
The National Alliance on Mental Illness’ Take the Moment social medical campaign is designed to raise awareness of mental health, break the stigma, empower individuals with resources, and normalizing the practice of taking moments to prioritize mental health care without guilt or shame. NAMI research found that, “1 in 5 U.S. adults experience mental illness each year and only half receive treatment, 50% of all lifetime mental illness begins by age 14, and the average delay between onset of mental illness symptoms and treatments is 11 years.”
In October 2022, the U.S. Surgeon General released the office’s first-ever Surgeon General’s Framework for Workplace Mental Health and Well-Being and noted these statistics:
- 76% of U.S. workers reported at least one symptom of a mental health condition.
- 84% of respondents said their workplace conditions had contributed to at least one mental health challenge.
- 81% of workers reported that they will be looking for workplaces that support mental health in the future.
A November 2022 Gallup poll found:
- Employees with inadequate mental health miss four times more work.
- Workers say their job is more likely to hurt mental health than to help it.
- Over half of workers do not have easily accessible support services.
- 19% of U.S. workers rate their mental health as fair or poor.
- These workers report up to 12 days of unplanned absences annually estimated to cost $47.6 billion annually in lost productivity.
- Globally, nearly four in 10 adults aged 15 or over either endure significant depression and anxiety which leads to anger, stress, worry, sadness, and physical pain.
A Safe and Healthy Environment at Work
Abraham Maslow, an American psychologist, developed a five-tiered hierarchy of needs that drives a person’s motivations: physiological needs, safety needs, love/belonging needs, esteem needs, and self-actualization needs. Needs lower down in the hierarchy must be satisfied before higher needs can be attended to. A safe and healthy work environment work supports good mental health and satisfies several lower needs by providing a livelihood, a sense of confidence, purpose and achievement, an opportunity for positive relationships and inclusion in a community. A safe and healthy working environment is more likely to minimize tension and conflicts at work and improve staff retention, work performance, and productivity. By contrast a lack of effective structures and support at work can affect an employee’s ability to enjoy their work, and have a negative impact on attendance and productivity. The U.S. Surgeon General Framework for Workplace Mental Health and Well-Being lists workplace support elements to support employee well-being.
- Protection from Harm – creating the conditions for physical and psychological safety protecting all workers from physical and non-physical harm, including injury, illness, discrimination, bullying, and harassment.
- Security – ensuring all workers feel secure financially and in their job future.
- Connection & Community – fostering positive social interactions and relationships in the workplace through social support (having the networks and relationships that can offer physical and psychological help to mitigate feelings of loneliness and isolation) and belonging (feeling of being an accepted member of a group).
- Work-Life Harmony – ability of employees to integrate work and non-work demands through autonomy (how much control a worker has over when, where, and how they do their work) and flexibility (ability of workers to work when and where is best for them)
- Mattering at Work – employees want to know that they matter to those around them and that their work matters based on the human needs of dignity (the sense of being respected and valued) and meaning (the sense of broader purpose and significance of one’s work).
- Opportunity for Growth – creating more opportunities for workers to accomplish goals based on their skills and growth which in turn aids employees in becoming more optimistic about their abilities through learning (the process of acquiring new skills and knowledge) and accomplishment (the outcome of meeting goals and having an impact).
Work Risks to Mental Health
People with mental health conditions have a greater chance of being excluded from employment and when employed are more likely to experience inequality at work. Also called psychosocial risks, conflicts in the workplace that can pose risks to mental health can include:
- being under-skilled for work
- excessive workloads
- inflexible hours
- lack of control over job design or workload
- unsafe or poor physical working conditions
- limited support from colleagues
- violence, harassment, or bullying
- discrimination or exclusion
Action To Support Mental Health at Work
To protect mental health, the World Health Organization recommends manager training for mental health, which helps managers recognize and respond to their direct reports experiencing emotional distress. Skills to develop include open communication, active listening, and understanding how job stressors affect mental health and can be managed.
Employee training is recommended to educate workers in mental health awareness, to improve knowledge of mental health, and reduce the stigma against mental health conditions at work. The National Institutes of Health has these self-care tips:
- Get regular exercise as just walking can boost your mood and improve your health.
- Eat healthy, regular meals and stay hydrated.
- Make sure you are getting enough sleep.
- Reduce blue light exposure from your phone or computer before bedtime.
- Explore wellness programs or apps including meditation, muscle relaxation, or breathing exercises.
- Seek professional help if you are experiencing severe or distressing symptoms that have lasted 2 weeks or more, such as difficulty sleeping, changes in appetite, or unplanned weight changes.
The American Psychological Association lists several work-related stress factors that are associated with workplace burnout that may be observed in an employee’s behaviors or employees may mention in passing:
- emotional exhaustion
- did not feel motivated to do their very best
- a desire to keep to themselves
- lower productivity
- irritability or anger with coworkers and customers
- feelings of being ineffective
Under the Mental Health Parity and Addiction Equity Act (MHPAEA), health benefit plans that cover mental health or substance use benefits cannot impose more restrictions on those benefits than what generally applies to comparable medical issues. Under the Americans with Disabilities Act (ADA), the ADA limits an employer’s ability to ask workers disability-related questions. Under Family and Medical Leave Act (FMLA), covered employers must provide up to 12 weeks of job-protected leave to eligible employees experiencing mental health conditions.
Workers with mental health conditions may be protected against discrimination and harassment at work related to their condition, have workplace confidentiality rights, and have a legal right to reasonable accommodations that can help them perform and keep their job. Employers must engage in an interactive process and then develop reasonable accommodations to adapt working environments to the capacities of a worker with a mental health condition if the accommodation does not present an undue burden to the employer. The Department of Labor has a dedicated page to mental health at work and has produced facts sheets on these topics:
- Details about the Mental Health Parity and Addiction Equality Act
- Factsheet: Mental health and substance use disorder parity
- Guidance for employers on disability-related questions and medical examinations of employees
- When covered employees can use FMLA leave for a mental health condition
- Anti-discrimination laws and reasonable accommodations for workers with mental health conditions
- Accommodations for workers with mental health conditions
Accommodations may include flexible working hours, extra time to complete tasks, modified assignments to reduce stress, time off for health appointments, or regular supportive meetings with supervisors. Employers may also consider phased return-to-work programs as a reasonable accommodation when an employee is receiving ongoing clinical care due to mental health conditions.
Employers may want to create voluntary employee action/support groups with employees from a variety of levels and backgrounds to aide in highlighting work environment changes, policy changes, under-utilized resources, missing resources, and generally to understand how employees experience mental health conditions.
Employers can promote the availability of mental health support benefits (if available) such as an employee assistance plan and live/virtual appointments for mental health and substance use disorder support services through the group medical plan.
Publicly available and free resources are available through the National Alliance on Mental Illness:
- NAMI Family & Friends: free seminar that informs people who have loved ones with a mental health condition how to best support them.
- NAMI Homefront: free program for families, caregivers and friends of military members and veterans with mental health conditions.
- NAMI In Our Own Voice: free presentations that provide a personal perspective of mental health conditions, as leaders with lived experience talk openly about what it’s like to have a mental health condition.
- NAMI Peer-to-Peer: free educational program for adults with mental health conditions who are looking to better understand themselves and their recovery.
- NAMI Support Groups: NAMI support groups are peer-led and offer participants an opportunity to share their experiences and gain support from other attendees.
988 is the three-digit dialing code that routes callers to the Suicide & Crisis Lifeline (or 988 Lifeline). When those in need of assistance or know someone in need call, text, or chat with the 988 Lifeline. Lifeline operators are connected to trained crisis counselors for free and confidential emotional support 24 hours a day.