The Mental Health Link

Perspective

The persistent stigma around mental health has contributed to employee suffering by hindering progress and extending the struggle. But when organizations remove this obstacle from the workplace, they can become catalysts for healing. In the absence of negative and unfair beliefs, positive solutions such as open dialogue, psychological resources, and modeled conversations promoting mental wellness can significantly improve the prognosis. Add recognition, so people feel appreciated and valued for their contributions, and both the individual and employer become stronger together. It’s time to replace silence with support and cultivate workplaces where caring is the protocol and mental health is nurtured, not neglected.

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Introduction

Mental health issues are common, costly, and rising to the top of employers’ minds. According to a study by Mind Share Partners, 76% of U.S. workers have at least one symptom of a mental health condition—burnout, depression, or anxiety.¹ These ailments also prove widespread in our global research this year. Employees who could qualify for a probable diagnosis of depression: 44%. Those who could qualify for a probable diagnosis of anxiety: 39%. And employees who reported levels of burnout: 77%.

While many organizations may be unaware of how they contribute to the problem, they do keep track of the expense. The economic burden of American adults with depression is estimated at $325 billion, with 61% of that attributable to lost productivity at work.²

Despite the ubiquity and financial toll of mental health issues, employees and employers are reluctant to talk about them. Only 42% of employees claim to feel comfortable discussing mental health at work,³ and even fewer (32%) believe it’s a priority for their organization.⁴ However, 81% say they will be looking for workplaces that support mental health in the future.⁵

When asked to define mental health, employees in our focus groups described experiences in terms similar to the criteria used to diagnose depression and anxiety (e.g., tiredness, fatigue, irritability, worry, restlessness):

“Excessive work demands”
“No work-life balance”
“Stress from financial insecurity”
“Lack of fulfilling work”
“No advancement or opportunity”
“Underappreciation”

Employees and organizations often use words like “burnout,” “quiet quitting,” and “absenteeism” that can disguise or avoid the real problems. Ideally, both sides would benefit if they could address mental health issues in an open, caring, and non-stigmatized environment.

So how can organizations best support employees’ mental wellbeing?

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“Creating a mentally healthy workplace should no longer be considered a peripheral concern for leaders. It is something that needs to be at the core of successful, thriving organizations.”
—Professor Samuel Harvey, Executive Director and Chief Scientist, Black Dog Institute Australia

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Poor Workplace Cultures Contribute to Mental Health Struggles

Most of us spend a large part of our lives at work, and work can affect our mental health positively or negatively. Unfortunately, poor mental health (and a lack of organizational care for it) is prevalent in many workplaces. On the social media platforms we visited, 32% of posters mention employment difficulties. Other studies show that 84% of employees say workplace conditions—such as emotionally draining work, challenges with life balance, and lack of recognition—negatively impact their mental health.⁶

To help identify mental health concerns and the role employers play in their development, we asked the employees in our samples nearly two dozen yes-or-no questions about ways their work could contribute to several mental health conditions. Organizations with employees likely to answer yes to the questions are also likely to have a higher risk of these conditions. The following tables show the five greatest predictors that increase the chance for burnout, anxiety, and depression.

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“There are a lot of things that can impact employees’ mental health. The job itself can be a factor. If the job is not manageable or reasonable, that can definitely lead to an employee feeling trapped and overwhelmed.”
—Colleen Marshall, Chief Clinical Officer, Two Chairs

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Given that organizations with poor workplace cultures and practices may unintentionally harm mental health, those that make improvements and foster an environment where employees are likely to answer no to these questions can potentially reduce the likelihood of these concerns.

However, such changes must happen at the organizational level. For example, when faced with work pressures, unrealistic deadlines, toxic work environments, insensitive managers, or conflict among teams, employees are often expected to “just get through it” or “grin and bear it” to demonstrate resiliency and grit. But our research last year finds this doesn’t address the root cause of employees’ mental health struggles.⁷ On the contrary, it adds to them. Creating a healthy workplace culture that encourages connection, community, care, and appreciation can reduce stress and lower levels of burnout, anxiety, and depression.

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Healthy Workplace Cultures Have a Positive Impact

According to our research, organizations can help mitigate factors that lead to mental health struggles. Creating a culture filled with purpose, opportunity, appreciation, and strong leadership—and its impact on employee wellbeing and success—lowers the odds of burnout and probable anxiety and depression, as demonstrated in the following table:

While mental health challenges are everywhere, employers have a clear role to play in solving them. Simply put, organizations can protect against mental health struggles through a positive and supportive culture and Total Rewards offerings that help their employees thrive.

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“On average, we spend 90,000 hours of our lifetimes at work. Businesses and employers have a responsibility to ensure that those hours are spent in environments that support the mental health of employees and their families. Doing so is not only better for people’s wellbeing, but better for the businesses themselves. We cannot underestimate the positive impact we can have when we align our workplace policies and practices with people’s psychological health.”
—Arthur C. Evans Jr., PhD, CEO, American Psychological Association

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Giving and Receiving Recognition Can Improve Employee Mental Health

Clinical research establishes that gratitude can improve mental health, and medical practitioners often prescribe expressing thankfulness as part of treatment.⁸ Showing appreciation is also linked to reduced symptoms of depression and anxiety.⁹ Our research supports these findings. Employees who gave recognition in the past 30 days report significant decreases in the odds of burnout (57%), probable diagnosis of anxiety (24%), and probable diagnosis of depression (28%).

A robust employee recognition program lets employees express and receive gratitude more easily, which leads to positive business outcomes. For example, organizations in the U.S. with such programs can see absenteeism cost savings of over $8,000 annually for employees with probable depression. Furthermore, the World Health Organization states 5% of the global population struggles with depression¹⁰ (an estimate much more conservative than the probable rates of depression and anxiety reported at the beginning of this chapter). So, using those figures, a company of 5,000 employees could save at least $2 million annually.

Let’s take a closer look at the landscape of mental health-related costs and potential savings.

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Absenteeism

The following table estimates the time and money lost to absenteeism (per employee, per month), and the realistic difference a recognition program can make. Predictably, employees with mental health issues report more absenteeism than those without.

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Presenteeism

Employees who show up to work but underperform can also be costly for organizations. The following table estimates the monthly impact when a worker is 50% and 80% productive (because people may experience presenteeism to a greater or lesser extent), as well as the savings a recognition program could provide.

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Workplace accidents

Employees experiencing burnout, probable anxiety, or probable depression are more likely to report having a workplace accident in the past month than employees who don’t have any mental health conditions. However, as the following table shows, recognition programs can decrease the likelihood of workplace injuries by up to 50%.

While single-digit improvements in workplace accidents may seem small, it’s worth noting that even one less accident can be lifesaving.

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Formal complaints

Finally, we assessed the impact that employee recognition might have on documented grievances. For those likely to be diagnosed with anxiety, we see a 33% reduction in a formal complaint being filed over the past month when the organization has a recognition program. For those with probable depression, we see a 20% decrease.

Because mental health issues are so widespread—and no organization is immune—every employer should provide resources to identify, discuss, and address them. Doing so demonstrates the kind of genuine care that improves the lives of employees and enables them to improve the lives of others.

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“The same amount of work can feel like it’s overworking. But with recognition and the accolades that you get from recognition—the validation and the confidence—it turns into something positive.”
—Focus Group Participant, Manufacturing Worker

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Recommendations

Improving workplace culture and leveraging recognition can help protect and support employee mental health.

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1. Focus on the elements of a healthy culture and destigmatize mental health issues

The six areas of culture most important to employee decisions to join, stay, and engage with an organization (see Talent Magnets in the Introduction) can reduce workplace stress, lessen team conflict, and improve connection and community—all of which help reduce stressors that can cause mental health struggles for employees.

As part of the Wellbeing Talent Magnet, remove the stigma around mental health in the workplace. Implement policies that prioritize mental health and encourage employees and leaders to discuss it openly. Have a process and resources available when employees come to leaders with mental health concerns. Interestingly, the most desired resource for mental health, according to one study, was having a workplace culture open to discussing mental health issues.¹³ Also, be flexible and support employees when they take time off. Leaders should model time off and talk about their own mental health struggles when appropriate.

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2. Enable employees to give and receive recognition

Having a recognition program that allows employees to express gratitude at work can reduce the likelihood of burnout, anxiety, and depression, as well as the incidents and costs of absenteeism, presenteeism, workplace accidents, and formal grievances. But just having a recognition program is not enough.

Recognition must be an integrated part of employees’ daily experience. Solutions and tools should enable frequent, timely, and meaningful recognition and provide a variety of ways and reasons to show appreciation and gratitude.

Encourage employees and leaders, as they recognize, to strengthen gratitude and connection in their recognition. Specifically, align employees’ work to a greater purpose, be specific in how they contributed and why it was unique, and focus on genuine, positive sentiment.

Giving and receiving recognition can increase belonging, connection, and gratitude, which counteract many factors that lead to poor mental health. Of course, recognition is not a substitute for comprehensive mental health care (e.g., psychotherapy, medication, etc.). Employees struggling with severe mental health challenges should seek help from qualified professionals, and organizations should provide resources and support for such care.

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3. Include mental health offerings in Total Rewards packages

Medical benefits that cover mental health are critical to helping employees survive and ultimately thrive at work. In fact, employees who believe their compensation is inadequate are more likely to need such benefits because they’re also more likely to feel their work negatively impacts their mental health.¹⁵

Consider adding specific resources, such as:

• Subsidized access to mental health care (either onsite or easy-to-access professionals)
• Dedicated mental health days
• Time or days off to attend therapy appointments
• Mental health training (with time for it during the workday)
• Stress management and mindfulness resources
• Flexible work schedules with more frequent breaks
• Programs that promote positive mental health practices
• Clear, equitable career advancement and training pathways
• A formal, integrated recognition program
  

As we’ve seen in the previous two chapters, organizations must do more than make offerings available; they must also support and provide resources for employees to use them. Train leaders to support mental health (within appropriate boundaries¹⁶), create formal flexible-work policies, and give people autonomy in their work to improve their emotional wellbeing.

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“The most important thing is to be honest about where mental health sits on the hierarchy. If it’s up among the top key priorities for business, as I think it should be, then put structure and responsibility around it—as you would with other priorities for your business.”
—Sam Harvey, Professor of Psychiatry, University of New South Wales

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Notes on the methodology and important limitations for consideration

The Bureau of Labor Statistics in the U.S. reports that the average hourly compensation for an employee is $43.11. This includes both wages and salaries ($30.34) and benefits ($12.77). To calculate the value contributed by full-time employees, we multiply the average hourly rate by the number of hours worked per day (eight) and by the number of days a healthy employee would save the company.

It’s important to note two limitations to the findings in this chapter to avoid confusion. First, the analyses may not generalize well to other conditions not explored in this chapter (i.e., mental health concerns other than burnout, probable anxiety, or probable depression). While we do provide evidence that giving recognition might reduce anxiety and depression, which is in line with other research in this area,^17,18 estimates of recognition’s effectiveness may depend on several factors (e.g., the company, the company’s average salary, the severity of mental health concerns, relevant risk factors, etc.).

Second, while recognition appears to have tangible benefits for both employees and employers and clearly indicates a culture of caring, recognition alone is an inadequate substitute for comprehensive mental health care (e.g., psychotherapy and/or medication). Those struggling with such concerns should seek the help of qualified professionals.

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The Mental Health Link—Key Takeaways

Poor organizational culture can cause or contribute to employee mental health struggles.

Now is the time for employers to address the causes and effects of mental health issues.

Mental health conditions are unavoidable, but organizations can improve them with resources and offerings that support employees.

Giving and receiving recognition increase feelings of gratitude, improve emotional wellbeing, and decrease the impact of mental health concerns.