3 rules to break for better mental health at work
Despite their negative effect on workplace productivity, conversations about mental health and addiction are often considered taboo.
Mental health and substance use disorder (SUD) are both complex, chronic, progressive diseases that frequently occur together. They affect people holistically, meaning biologically psychologically, sociologically, and spiritually. The number of lives touched by these diseases is skyrocketing. In fact, 70% of those who struggle are employed. The good news is they are both treatable.
Despite their negative effect on workplace productivity, conversations about mental health and addiction are often considered taboo. Someone may mention their New Year’s resolution to stop smoking or lose weight. Another may confide in co-workers they have a cancer diagnosis and need help to complete assignments while undergoing treatment.
Related: As physical effects of pandemic ease, employers must address ongoing mental health impact
Yet when was the last time you heard someone say they are concerned about their panic attacks, alcohol use or inability to sleep without prescription sleep medication?
Those who work in the behavioral health industry, or have “lived experience” with mental health or addiction, can identify attitudes and beliefs of those struggling that also govern the behaviors of individuals in the workplace.
These are the “Three Rules” that influence the thinking, choices and behaviors of those who live with mental health issues, substance misuse and addiction. The rules are: “Don’t talk,” “Don’t trust,” and Don’t feel.”
We are living in a highly disrupted, hyper-political, economically insecure, “me-too”, social-justice-oriented, almost-but-not-quite-post-COVID-19, “woke” era. Warning bells are ringing.
Alarming stats:
According to a 2019 National Alliance on Mental Illness report:
- 1 in 5, or 20.6%, of adults in the U.S. (51.5 million) have experienced mental illness.
- 5.2% experienced serious mental illness (such as schizophrenia or bipolar disorder) in 2019 (13.1 million OR 1 in 20 adults).
- 19.1% of all mental illness is associated with anxiety disorders (48 million).
Of those with mental illness, a significant percentage will also misuse substances or struggle with addiction, aka a “co-occurring” disorder. In 2019, 3.8% of U.S. adults (9.5 million) experienced a co-occurring mental illness and SUD.
With the onset of the 2020 Coronavirus Pandemic, the crisis of mental health and substance misuse became regular headlines and was declared a “pandemic within a pandemic.”
The impact of COVID-19 on mental health
According to the 2020 Behavioral Health Impact Update report, almost half (46%) of American workers struggle with mental health issues related to COVID-19. The rate of increase and severity is alarming when compared to pre-pandemic numbers. Before the pandemic, one in ten U.S. adults experienced symptoms of anxiety, with the number increasing to more than 41% of adults reporting an increase in anxiety and/or depression after the pandemic began.
Problems are not limited to mental health issues. 13% of adults surveyed reported Coronavirus-related stress has caused them to begin or increase consuming alcohol, a greatly concerning statistic given the National Institute of Health ranks alcohol as the third-leading preventable cause of death in the US.
Sadly, countless other deaths of despair can be attributed to drug overdoses and suicide. Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA) recently reported deaths from drug overdoses rose 30%, to more than 91,000 during a one-year period of time ending in October 2020.
Considering the alarming increase in reported instances of mental illness, substance misuse, and deaths from suicide or drug overdose, the workplace can no longer remain silent about these issues. Employers must understand the potential harm to those who follow these rules, and intentionally transform workplace cultures to safely break them.
Existing workplace rules
Treatment for mental health and addiction should be conducted only by trained professionals. Unfortunately, millions who would benefit from mental health services, have not sought, accessed, or received help. These individuals may work for you.
HR must establish and adhere to “best practices”, which consist of clearly defined rules regarding how mental health and substance abuse issues should be handled.
Except for those working in behavioral health services, managers typically are not trained clinical professionals. They must become educated about “signs and symptoms” of mental illness and SUD and take appropriate actions.
HR is trained to think about risk management, liability, and the importance of complying with federal and state laws that govern the workplace in terms of mental health and substance misuse. (HIPAA, ADA, Mental Health Parity, Drug Free Workplace).
Clearly defined policies are established to guide decisions regarding pre- and post-employment drug screening. Some have learned to delicately engage in conversations with employees to assess an employee’s need for EAP services, or in the case of substance misuse, possible disciplinary action.
Seasoned HR people witness “troubled” employees or family and acquaintances dealing with serious issues. If the matter impacts the employee’s ability to perform the job, an intervention is required. During such critical times, while engaging directly with the employee about very uncomfortable and topics, managers and HR professionals must be able to identify the three rules and safely break them.
Rule 1: Don’t talk: The sickness of silence
People with mental illness, alcohol or SUDS don’t talk openly about their struggles. The ‘sickness of silence’ is based on stigma and reflects a learned behavior that began in childhood.
Stigma is defined as something marked by shame, discredited, or disgraced. It is a hallmark of individuals with mental illness, alcohol abuse, or SUD and generally caused by fear and lack of understanding regarding the disease. Because of stigma, people sometimes experience discrimination or unfair treatment, which prevents them from seeking help. This results in a cycle of shame, fear, withdrawal, isolation, disease progression, loss, and suffering.
A 2019 poll by the American Psychiatric Association reports while 51% of employees indicate they can openly discuss mental health issues with supervisors and co-workers, 35% fear retaliation or being fired if they seek help. The poll also reported millennials are two times more comfortable discussing mental health issues than Baby Boomers (62% versus 32%).
How to safely break the “don’t talk” rule:
Companies seeking to heal the ‘sickness of silence’ can break the “don’t talk” rule by following the APA’ Foundation’s Center for Workplace Mental Health recommendation regarding workplace culture. The Center encourages employers to “create a culture in which mention of depression, anxiety, post-trauma, and other common illnesses becomes as mentionable as diabetes, hypertension and migraines.”
The APA’s Working Well Toolkit further encourages employers to design and implement company culture-specific programs that encourage the workforce to “break the silence” about these topics. Johnny C. Taylor, Jr., President and CEO of SHRM, said it best, “At the end of the day, that which we can’t talk about can’t be fixed.”
Rule 2: Don’t trust: Rooted in fear and lack of safety
People suffering with mental illness and SUD often distrust individuals and institutions born out of their lived experience.
For an individual to place trust in another person or an institution, they must believe the individual or institution is reliable or dependable. Trust is a foundational and conditional aspect of all healthy relationships. Any perceived inability to trust results in a lack of confidence, insecurity, or fear, which once established will cause an individual to cover, withdraw, isolate, or sometimes lash out at others.
The implications of a lack of trust in the workplace are devastating. Diversity, Equity, and Inclusion (DEI) initiatives exist to create a workplace environment where all employees can engage, contribute, and add value for the mutual benefit of the individual, the company, and other stakeholders.
Covering works against this concept and explains the behavior of some individuals to protect themselves from the stigma others attach to them. As mentioned, there is a great deal of stigma attached to mental illness, substance misuse and addiction, often perpetuated by well-intentioned media who often show images of disheveled, homeless, or deranged individuals.
To protect oneself from being stigmatized at work, individuals do cover, as documented in an Inclusion Survey by Deloitte titled Uncovering talent: A new model of inclusion. Of the more than 3,000 survey respondents, 61% reported covering at work, with numbers ranging as high as 83% for some specific identity groups.
Companies seeking to break the “don’t trust” rule should implement psychological safety practices.
Psychological safety is defined by the Center for Creative Leadership as a shared belief held by team members that others on the team will not embarrass, reject, or punish you for speaking up. Evidence of the critical role of creating psychological safety in the workplace as a building block for trust was published by Google in 2015. An internal research study, labeled Project Aristotle, revealed that of five factors identified as having an impact on team effectiveness, psychological safety was the most important.
By establishing programs and practices designed to create psychological safety in the workplace, employers will see a significant increase in the level of trust that exists between co-workers throughout the organization. This will help safely break the “don’t trust” rule.
Rule 3: Don’t feel: Protection from the pain
Individuals suffering from mental illness and SUD are familiar with pain. The cause (psychological, emotional, or physical), frequency, severity and duration of the pain may differ, but every person affected by pain seeks to find relief.
According to behavioral health professionals, the “don’t feel” rule applies most often to individuals suffering from emotional pain who are unable to adequately express feelings. The resulting sense of helplessness or desperation can lead one to ignore, hide or otherwise repress their feelings to cope. Some individuals reach a point where they feel nothing at all.
In the workplace, where stress and the pressure to perform are pervasive, people who “don’t feel” contribute to a “toxic workplace” culture. According to The High Cost of a Toxic Workplace Culture report issued by the Society for Human Resource Management (SHRM), the cumulative cost to the American workplace from toxic workplace cultures, as evidenced by things such as turnover, neared $223 billion over a five year period.
SHRM’s Johnny C. Taylor, Jr. offers two solutions to break the “don’t feel” rule. First, he challenges managers to “initiate candid, critical conversations with and among employees.” The encouragement of open, honest, and transparent conversations about difficult issues provides the psychological safety needed for employees to express feelings about important issues IF a focus on empathy is also included as part of the conversation.
Empathetic individuals can understand, be aware of, be sensitive to and/or vicariously experience feelings, thoughts, and experiences of others.
In a workplace setting where empathy is encouraged, managers and co-workers have a sincere interest in the wellbeing of others, enough to express concern and show compassion for employees struggling to cope with the stress of work or personal circumstances.
The value of this effort is documented in the 2020 State of Workplace Empathy Study by Businessolver. Among members of Generation Z, 83% stated they would choose an employer with a strong culture of empathy over an employer offering a slightly higher salary. That same number indicated they would consider leaving their current organization for a similar role at a more empathetic organization.
A little empathy goes a long way to break the “don’t feel” rule.
Workplace mental health trends: Creative but simple solutions
To find creative solutions to workplace mental illness, substance misuse and addiction, forward-thinking employers must “break the rules.” They might consider expanding their Business / Employee Resource (ERG /BRG) or Affinity Groups to include employees desiring to connect with others and learn about, and support initiatives relating to these issues.
In addition to helping the enterprise fulfill its strategic mission, these company-sanctioned, employee-led groups exist to support the needs and interests of individual Black, Hispanic, Asian, Indigenous, LGBTQ+, and other multicultural or identity-specific employees.
The International Center for Addiction and Recovery Education (ICARE) is a Center of Excellence that provides training and certification for employers committed to raising awareness about mental health, substance misuse and addiction in the workplace.
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