Expanding workplace wellness to mental health

Workplace wellness programs typically target employees’ physical health through weight loss and healthy eating initiatives, measured by clinical benchmarks like Body Mass Index, cholesterol and blood pressure.

But, while those metrics may be easy to track – and could tamp down health care costs – wellness experts say it’s no longer enough to focus workplace wellness efforts on just physical health but to broaden the scope to include mental health and provide access to psychiatric services.

“What we’re seeing is that the definition (of wellness) is widely expanding, from a place where it was a lot more focused on physical health and how to support people to become healthier physically, to now encompassing a wider definition of what wellness can be,” said Marissa Kalkman, executive director of Wellness Council of Wisconsin. “One thing we’re having a lot of conversations with employers about is how do we support more of the whole person? And mental health is very much a part of that.”

Poor mental health affects workplaces in various ways, translating to lost productivity, absenteeism and high turnover. Depression, in particular, interferes with a person’s ability to complete physical job tasks about 20% of the time and reduces cognitive performance about 35% of the time, according to the Center for Disease Control and Prevention.

Still, the stigma of mental illness, combined with fears about employers involving themselves in employees’ “personal business,” can deter employers from having an open discussion about mental health in the workplace, said Maureen Siwula, a human resources business advisor with MRA, a Waukesha-based nonprofit employer association.

Maureen Siwula
Maureen Siwula

“This is an uncomfortable area to talk about,” Siwula said. “I guess we can talk about diabetes and cardiac disease a whole lot better than we can talk about mental health.”

But, she said, it’s an issue employers can’t afford to ignore.

“Employers are forced to think about it because, as we treat the whole person in the workplace, you can’t avoid mental health issues,” she said. “One in five (adults) is plagued with mental illness so that means there are a lot of people at work that suffer from everything from depression to anxiety to drug addiction to trauma to post-traumatic stress disorder. These are things we’re seeing more and more in life in general, so of course in the workplace employers are faced with this.”

Experts recommend employers take proactive steps to prevent burnout and other stress-induced conditions, while also destigmatizing the conversation around mental health at work.

Some ideas include offering on-site stress management exercises, posting information to inform employees of suicide prevention and other resources, bringing in speakers to discuss stress in the workplace, offering adequate time off and flexible scheduling, and designating areas in the office that are designed for employees to decompress, Siwula said.

Kalkman said a focus on mental health should be infused throughout the entire organization, and championed by leaders.

“There are a lot of different components that can influence an employee’s experience: having a positive health-supporting workplace culture, having comprehensive insurance benefits that are covering mental health support, having specific opportunities – whether that’s a supportive employee assistance program or bringing in different training programs – and then a big thing is leadership engagement in this and having top-down support,” Kalkman said.

While trauma-informed care is often promoted as a best practice among educators, employers should also be considerate of how employees’ past experiences might affect their performance in the workplace, Siwula said.

“It’s about understanding the worker has grown up in trauma situations and if we understand those trauma situations, we can better understand our workers,” she said.

If an employer needs to confront a suspected mental health issue that appears to be interfering with an employee’s work, it’s important for them to not “play therapist,” Siwula said. Instead, employers may note and discuss changes in work performance and listen to the employee’s concerns.

As with physical medical conditions, employers are limited in what they can ask employees to disclose regarding their mental health conditions.

“Employers should understand they need to follow the same rules when it comes to mental health issues as they would any other medical condition,” said Erik Eisenmann, partner at Husch Blackwell LLP. “(An employer) can’t require employees to disclose personal medical information, regardless of whether it’s a mental health condition or a physical condition.”

However, if an employee makes use of a resource that’s included in a company wellness or health plan, it may open the door to discussions regarding possible accommodations, such as providing time off for treatment, flexible scheduling and assistance in transitioning back to work.

Under federal law, an employer is generally entitled to ask questions that help determine whether the company needs to make reasonable adjustments because of medical condition.

“But they are not entitled to ask what the specific medical diagnosis is, what specific medications or treatment may be prescribed,” Eisenmann said. “The employer should be focusing on questions that would relate to the way in which the condition could impact or interfere with an employee’s ability to do the job.”

If an employee is seeking a significant accommodation – such as changes to the employee’s core job functions – it becomes more complicated for an employer.

As mental health awareness has grown in recent years, there has been a corresponding increase in complaints filed with the state Department of Workforce Development and federal Equal Employment Opportunity Commission alleging disability discrimination on the basis of mental health, Eisenmann said.

“We see more and more employees who are comfortable disclosing mental health conditions to their employer,” he said. “Not every time that somebody discloses a mental health condition does that mean that somebody is disabled under the law. And not every time that someone makes a disclosure does it mean that an employer has an obligation to modify the job or grant an accommodation. But my advice would be that every time an employer receives information like that, there should be a procedure in place whereby a person within the organization can analyze it and knows what to do with that information on a case-by-case basis.”

He also recommended employers receive outside legal counsel to help navigate those discussions.

Employers can have compassion and refer employees to appropriate resources and available benefits, while also holding them accountable to their work, Siwula said.

“If (an employee’s) attendance is slipping, their attitude is rough around the edges, we begin with a conversation: ‘What’s going on? You’re acting differently. Your attendance is slipping. Is there anything you need help with? How can we better support you as an employee?’” she said. “But if an employee is closed off and doesn’t want to do that, you can tell the employee, ‘We’re here to help but, if not, I’m going to hold you accountable to the policies and procedures we have here.’”

Siwula said employers should also seek the help of an employee assistance program, a voluntary program that offers confidential assessments, short-term counseling, referrals, and follow-up services to employees dealing with work-related or personal problems. EAPs are purchased plans, typically associated with a health insurance plan.

“You can refer an employee to the EAP and say, ‘I see you are struggling; you don’t have to get into the conversation,’” Siwula said. “‘We have this benefit called the EAP. There are people there 24/7 ready to talk to you and offer some free services and low-cost services.’”

Action steps to promote mental health in the workplace

  • Make mental health self-assessment tools available to all employees.
  • Offer free or subsidized clinical screenings for depression from a mental health professional, followed by directed feedback and clinical referral when appropriate.
  • Offer health insurance with no or low out-of-pocket costs for depression medications and mental health counseling.
  • Provide free or subsidized lifestyle coaching, counseling or self-management programs.
  • Distribute materials, such as brochures, fliers and videos, to all employees about the signs and symptoms of poor mental health and opportunities for treatment.
  • Host seminars or workshops that address depression and stress management techniques, like mindfulness, breathing exercises and meditation.
  • Create and maintain dedicated quiet spaces for relaxation activities.
  • Provide managers with training to help them recognize the signs and symptoms of stress and depression in team members and encourage them to seek help from qualified mental health professionals.
  • Give employees opportunities to participate in decisions about issues that affect job stress.

Source: The Center for Disease Control’s Workplace Health Resource Center

For more information about promoting mental health in the workplace:

National Institute of Mental Health, nimh.nih.gov

Center for Workplace Mental Health, workplacementalhealth.org

Center for Disease Control and Prevention, cdc.gov

Equal Employment Opportunity Commission, eeoc.gov

Occupational Safety and Health Administration, osha.gov

Wellness Council of Wisconsin, wellnesscouncilwi.org

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