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Scared of the Stigma
New research highlights, yet again, the fear that many employees have about seeking treatment for mental-health issues, including alcohol and drug addictions. Experts offer some suggestions for HR leaders, including one that advises against holding town meetings on the issue, which she says, are counterproductive. HR must instead "craft the culture in such a way that people have avenues through which they can take care of themselves," she says.
Employees with mental- or physical-health issues have always worried about keeping their jobs. But with a recession raging, a recent study from Arlington, Va.-based American Psychiatric Association concludes those concerns may be heightened. Concerns about losing status at work and about confidentiality are among the main reasons many American workers are more hesitant to seek treatment for mental-health issues than for physical-health problems, according to the study. More than 40 percent of the 1,129 respondents say their employer is supportive or extremely supportive of workers seeking care for health concerns. The online survey (conducted by Harris Interactive), however, also finds that barriers persist for workers who say their workplace is unsupportive of employees seeking treatment, especially for mental-health issues. The research reports that 76 percent of those polled believe their work status would be damaged by seeking treatment for drug addiction, 73 percent for alcoholism and 62 percent for depression, compared with 55 percent who believe seeking care for diabetes would affect their work status and 54 percent for heart disease. "It's important to support an environment that encourages employees to take care of their physical and mental health," says Dr. Alan Axelson, chairman of the APA's Partnership for Workplace Mental Health Advisory Council. "Research supports the fact that, when people receive needed care, they are healthier and more productive -- and employers realize the return on their healthcare investment." There are some actions human resource professionals can do to encourage employees to come forward and get help, say experts. The partnership offers these suggestions: * Supervisors and managers should lead by example by taking care of their physical and mental health. * Workplaces should promote prevention, early intervention and wellness programs. This includes holding health fairs, providing healthy meals and snacks at meetings, encouraging exercise and promoting a work/life balance. * Employees should be discouraged from coming to work when they're ill. * Workers should be reminded of health benefits and available programs, and efforts should be taken to make sure they know how to access care. * Employees should be reassured about confidentiality, especially those seeking mental-health treatment. Dave Sharar, managing director at Chestnut Global Partners, a Bloomington, Ill., domestic and international employee assistance and workplace services company, says that, while there has been some progress in getting help to employees with mental-health issues, the stigma is still alive and well. Addiction issues -- alcohol and substance abuse -- offer the toughest challenge, he says. Employer policies and procedures, especially those of large employers, requiring involuntary drug-testing, for example, can lead to terminations -- and that contributes to the sense that, if you come forward, you will lose your job, he says. "It can happen, but it should not," Sharar says, and he notes that "confidentiality laws ... have been more honored than ever historically." Under the new mental-health parity act, which became effective this year, health plans are not required to offer mental-health or substance-abuse benefits, but if they do, they cannot treat them differently from medical and surgical benefits. In the workplace, he adds, signs of mental health, including substance abuse and depression, can be seen as part of the performance-management process. "People have a sense of what is going on, and that contributes to the concern that, if they come forward, they will be labeled, branded and shown the door," Sharar says, He also says that, while the growing use of health-risk appraisals can help employers provide information to employees about healthcare risks, both mental and physical, such appraisals can also cause concern among employees who must answer questions about smoking, drinking and depression, for example. "Health-risk assessments are wonderful [for] determining who is at risk, but then the employees may say, 'Hey, why are you calling me?' The employee may be identified as depressed or someone who drinks 20-plus drinks a week," he says. "Then, if they lose their job, they believe it's due to those factors, even if the dots don't connect in reality." On balance, Sharrar says, wellness programs are not very effective at getting to that at-risk population. "HR is overburdened right now," he says. "How many more things can they do? But the one thing HR can do is promote their EAPs. It doesn't cost them anything -- they are capped, as are wellness programs -- and HR needs to use those vehicles to get people engaged and receiving the help they need." Helping employees is not only good for them, of course, but it's also good for business. "The research is clear," Sharrar says. "If you can find those people and change their behavior, it will save a lot of money. But CFOs don't have a lot of patience, unfortunately." Dr. Rich Bedrosian, director of behavioral health at HealthMedia, a Johnson & Johnson company based in Ann Arbor, Mich., that develops "digital health" coaching programs to help organizations reduce healthcare costs by enhancing the health and wellness of their employees and members, says the stigma associated with mental-health conditions makes employees more likely to self-disclose mental-health symptoms online. "The APA study results don't come as any surprise and are consistent with everything we know about mental health," Bedrosian says. "Mental-health issues are highly prevalent, and large numbers of people are not necessarily coming forward for help. It's a group of people at-risk, and they can develop worse problems in the future." And, Bedrosian says, when they do seek help, they might get antidepressant medication, but not much else, from their primary-care physician -- instead of being referred to a specialist. "Long-term, they end up falling through the cracks," he says. "We believe employers have to offer a spectrum of help, high-touch on one end, for the ones who can break that barrier, and high-tech, scalable solutions can be deployed to find out who needs help." Most of all, he says, HR must understand that untreated mental-health issues can affect productivity. According to the New Freedom Commission on Mental Health, in the U.S., the annual economic, indirect cost of mental illnesses in the United States is estimated to be at least $79 billion. Most of that amount -- approximately $63 billion -- reflects the cost of lost productivity in the workplace. Karissa Thacker, a psychologist and executive coach based in New York, says HR programs should keep talk at a minimum, but options and opportunities for help at a maximum. "Leaders need to avoid talking a lot about the issue," she says. "This may seem counter-intuitive, but too much talk and a single person having negative consequences creates a credibility gap." "HR leaders need to push line managers to notice if there is any hint of an employee being unfairly affected if he/she seeks treatment," Thacker says. "This issue has been exacerbated because everyone in America is afraid of losing their job. Showing weakness is not revered in our culture anyway, and the economic climate has made that factor worse." Encouraging healthy activities in the workplace by offering health fairs onsite can also help, she says. Also, pairing mental-health information with general/physical-heath information is a smart communication strategy, and consistent with the understanding that physical health impacts mental health, and vice versa. "The technology that we have is great on many levels," she adds. "However, it has taken out a lot of informal relationship building that used to happen. Research indicates that people who have one real friend at work, who they really confide in, are happier and less likely to suffer from a stress disorder. "Cultivating an environment that allows and encourages enough relationship building could be extremely helpful," she says. Bottom line, Thacker recommends anything but an "information session" in which management says it is really okay to get treatment. "Everybody does it, but it's a bad idea," she says. "HR leadership's task is to craft the culture in such a way that people have avenues through which they can take care of themselves as they are productive. Seeking treatment from physicians and mental-health professionals is more likely to happen among people who work in a culture that gives them a license to be human." February 16, 2010 Copyright 2010© LRP Publications |
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