The Working Wounded

According to the 2022 Mental Health America’s Survey, four in five employees report that workplace stress affects their relationships with friends, family, and coworkers, and 78 percent of employees agreed that their workplace stress affects their mental health. According to the Centers for Disease Control and Prevention (CDC), depression alone costs 200 million lost workdays per year in the United States at a cost of $17 to $44 billion dollars in lost productivity.

As a clinical manager for an employee assistance program (EAP), I not only agree with these numbers, but I also hear stories daily from workers of all types who are feeling the negative impacts of work-related stress on their well-being. I have trained front-line workers, supervisors, human resources (HR) and occupational health staff, vice presidents, and presidents on the importance of developing strategies to address the growing numbers of workers who are experiencing mental health crises.

The CDC defines mental health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” This seems like a high bar to many wounded workers who are simply trying to maintain both their sanity and their paychecks. Most of the people I meet with would be satisfied with simply being free of the nervous twitch that develops whenever they think of work.

While workplace stress is not a new phenomenon, levels of distress, exacerbated by the COVID-19 pandemic, are at an all-time high. Within the last 10 years of my EAP work, I have noted an alarming increase in the number of employees who are showing up at work and reporting suicidal thoughts. This increase has been so dramatic that I have trained several HR departments on how to identify and respond to suicidal employees. Other common diagnoses showing up at work include anxiety, substance abuse disorders, and posttraumatic stress disorder.

As a result of both the increase in acuity in mental health concerns and a growing emphasis on employee wellness, many worksites are intensifying their efforts to offer support. According to the 2022 American Psychological Association's Work and Well-being Survey, 81 percent of individuals said they will be looking for workplaces that support mental health when they seek future job opportunities. In response, companies are moving beyond slogans and banners and are providing direct access to mental health services. EAP services, wellness apps, and trainings on stress-related topics are just a few of the mechanisms being deployed to assist employees in building both psychological resistance and resilience.

Signs of Mental Health Struggles in the Workplace

A common starting point for addressing mental health issues in the workplace is alerting leaders, at all levels, to the signs of possible mental health struggles within their workforce. A partial list of these indicators includes the following:

• An increase in unexplained absences or sick leave
• Poor performance
• Poor judgment/indecision
• Constant tiredness or low energy
• Unusual displays of emotion (e.g., frequent irritability or tearfulness)
• Missing deadlines
• Difficulty concentrating
• Appearing numb or emotionless
• Withdrawing from work activity
• Forgetting directives, procedures, and requests
• Having difficulty with work transitions or changes in routines

Strategies for engaging employees with mental health conditions are only effective if they move beyond the mantra of “practice work/life balance.” Many of the employees I meet complain of the mixed messages they receive from managers regarding this balance. As one employee shared with me, “I would love to balance my work and home life, but, whenever I ask for time off, I’m encouraged to wait until things slow down.”

Components of Successful Workplace Mental Health Programs

As pressure to keep working mounts, many employees respond by calling out sick to take a mental health day. Burning through one’s sick time for a wellness break is, at best, a Band-Aid for dealing with stress and burnout on the job. A robust mental health program begins with developing a plan to prevent distress, develop screenings, provide information and resources, add incentives to encourage engaging in wellness activities, and actively intervene with those in need. Successful programs may include the following:

• Referrals/self-referral to EAP and behavioral health benefits
• Emphasis on social connectedness
• Strategic hiring to ensure a positive person–job fit
• Job skill and career development, including mentoring for new hires and new supervisors
• Ongoing supervisor training
• Performance-review practices that enhance team communication
• Flexible work practices

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The challenge inherent in the wellness movement is that, when it comes to mental fitness, it’s not true that if you build it, they will come. The utilization rates for most EAP programs, including the one I work for, usually top off around 3 to 4 percent of a workforce—and this is for a free service open to both employees and family members. I’ve had multiple firsthand experiences sitting on-site at a workplace as the designated counselor only to have no one show up. As further evidence of the staying power of the stigma, I have attended numerous health fairs when employees gather around the sites set up for dental and health programs, retirement accounts, credit unions, etc. and watch as they pass me by with a variation of a nervous joke about not needing our services, yet.

While the increased awareness is a sign that the work culture is shifting toward removing the stigma associated with asking for help with mental health concerns, there are still barriers. Not all workplaces feel the need to meet the needs of workers who are struggling with “personal issues” and apply pressure to simply “get over it.” Added to that is the economic reality that mental health services are often seen as add-on benefits that are easily discarded during financial downturns.

The counter-argument to cutting costs by eliminating wellness programs is simply summed up by the phrase “A healthy worker is a productive worker.” In a culture that is shifting from employee satisfaction to employee engagement, this commonsense approach is good business. Additionally, as workplaces continue to reorganize in a post-COVID world, there is little likelihood that mental health issues at work are going to decline. Given that reality, along with the impact on the bottom line, wrapping mental health services into an overall wellness package will almost certainly become a standard operating procedure in most companies.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.