How are Today’s Workplaces Managing the Crisis of Mental Health?

I’m gobsmacked (as my British friends would say) after reading the recent Wall St Journal article, Managing Mental Health at Work.
If you research the issue of mental health in the workplace you’ll turn up some alarming statistics and little in the way of hopeful solutions.  I’m not naïve, but honestly, I thought we’d be further along the evolutionary path on this issue by 2012 – sadly, we’re not.
In her Wall St Journal piece, author Melissa Korn mentions John Binns, a partner in the U.K. based Deloitte LLP, who waited nearly a year, while his depressive symptoms worsened because, “There was no culture of talking about mental health or recognizing some of our best and brightest people, statistically, would have a mental health issue.”  Fortunately for Mr. Binns, his bosses supported his efforts to restore his health which Binns described as “massively instrumental in speeding up my recovery.”
While the statistical realities of mental illness are daunting, our lack of preparation and management in the average workplace is even more disturbing.

 The Facts

While the U.S. leads the world in mental illness, the statistics are on the rise world-wide. Dr Ronald Kessler, a Harvard professor who led a 2005 study to document the prevalence of mental illness in the U.S. reported, “We lead the world in a lot of good things, but we’re also leaders in this one particular domain that we’d rather not be.” 
According to the World Health Organization, mental illness results in more disability in developed countries than any other group of illnesses, including cancer and heart disease. Ileana Arias, a principal deputy director of the CDC (Centers for Disease Control)  commented that it isn’t clear why so many Americans suffer from mental illness, “This is an issue that needs to be addressed, not only because of the illness itself but because mental disorders are associated with other chronic diseases like heart disease and cancer.”
One critical finding of Dr. Kessler’s study was that less than half of the 9,000 randomly selected Americans in the sample got treatment. Thomas Insel, Chief of the National Institute of Mental Health, which funded the $20 million dollar study said the nation needs to recognize that mental illness is a chronic condition that requires expert medical attention just as heart disease, Alzheimer’s and diabetes do. In a report on the study, Washington Post author,  Rick Weiss writes, “ Insel was disappointed to learn from the survey that despite the availability of effective treatments for many mental illnesses, about a third of people rely on nonprofessional sources such as Internet support groups and spiritual advisors.” 
 Since Kessler’s study, the global economic crisis has tightened mental health services budgets in the U.S., U.K. and the Euro Zone and advocates are deeply concerned that more people will be denied treatment while need is growing.
A recent CDC report also found that about 25% of the U.S. population suffers from some type of mental illness and nearly 50% of U.S adults will develop at least one mental illness during their life time.  Mental Health America reports that depression has become one of America’s most costly illnesses. Left untreated, depression is as costly as heart disease or AIDS to the economy, costing over 50 billion in absenteeism from work and lost productivity and $26 billion in direct treatment costs.

Mental Health in the Workplace

There is no excuse for the general lack of preparedness of most workplaces in managing mental health related performance issues.   While it is clear that improvements have been made, especially those forced by the passage of the Americans with Disabilities Act (ADA) in 1990, most organizations are failing to address the urgency and prevalence of the fully anticipated occurrence of mental illnesses among workers.  Unfortunately many organizations have not coordinated their policies and efforts to address the realities of the steady increase of mental illness present in the larger culture.
Nothing in the literature fully examines or addresses the chronic impediments to structuring workplace policies and cultures that are so desperately needed to treat human problems. I believe one of the chief obstacles to changing policies and work environments is the persistence of mindsets locked in old models of business thinking that see human beings as “performers” rather than “creators.”
From the top, executive thinking is still fixed on bottom lines and limited in understanding the human dynamics that drive the engine of profit.  Performance as a behavioral tool is still largely viewed and managed in the obsolete command and control model. The old shibboleth that the personal life is separate from business is still the dominant modus operandi of most business systems.  Emotions are still suspect and most business leaders still believe that rational thought alone  is the main ingredient for success.   These beliefs fly in the face of the findings of neuroscience which has evinced that the brain is a social entity and that decision-making is more a function of the gut rather than the neocortex.
To be sure, the populace in general lacks information about the basics of their own mental health processes.  It’s only been 133 years since Wilheim Wundt founded the first lab to study psychological research in Leipzig, German.  Since that time, we’ve been working through prior centuries of myth, superstition and religious doctrine to understand how the human psyche really works.  The average American child is taught next to nothing in elementary school about human psychology which is left to high school electives and specialization in college.
But it’s not just fossilized thinking that keeps us from advancing in our acceptance and recognition of human dynamics. The engine that drives business is organized almost exclusively around profit and power, often to the exclusion of the resilient yet fragile internal life of the workers on which it relies.
While the  rhetoric and avowed practices of many organizations  has changed over the past few decades to acknowledge the value of worker’s talents and skills,  many employees simply do not experience it – and more important – believe it.
Comments to the Wall St. Journal article written by Melissa Korn were particularly illustrative of the fear, mistrust and cynicism of workers dealing with mental illness in their workplaces.

• Our workplaces are poorly organized and are not based on ordinary human requirements (e.g. our biology as well as our social roles as parents, children, siblings, partners, etc)

• Who would have thought that doubling productivity but keeping almost the same wages over the past two decades would cause more stress?

• The companies are winning against the workers. As long as they keep reminding us that unions are bad and if you work hard you MIGHT be promoted in ten years, people won’t question it.

• A major problem with “mental illness” is that society has a tiny box of comportment. If we dare step out of this box, we are punished. We marginalize many who could be productive because we fear “difference” and what we don’t understand.

• Our society with its competitive materialism is the root cause of many physical and psychological maladies. The old ways of management by fear need to be sent to the scrap heap just as the old religious values of fear instead of respect and love have to be sent to the scrap heap.

• If 45% of our workforce is operating with a mental illness you’ve got to think about the overall adverse effect that this is having on all of us…not just the private sector but in the public as well…teachers, doctors, nurses, police officers, transportation, etc. At some point we’ll have to renegotiate the balance we’ve created between work/progress and life/living. As living creatures we have to recognize that although we operate in a linear, structured society, we ourselves are multi-dimensional and organic.

Plucked from the comments section, this handful of responses to the article capture the essence of the moment we’re in.

The Real Deal

In her Wall St Journal article, Melissa Korn discusses the tightrope that many organizations walk in dealing with employee’s mental health issues, “Intentional or not, “corporations encourage a climate of keeping things under wraps,” according to Jeffrey Khan a clinical associate professor psychiatry at Weill Cornell Medical College in New York.  Korn points out that Dr Khan once treated a manager who didn’t submit health claims for this therapy fearing the details would make their way back to his employer. Even in her follow-up article, Ask at Work: When to Talk about Mental Illness,” Korn recommends that employees with a history of mental illness to “Keep quiet, if you can.”  
Prudential Financial, which offers an employee assistance program (EAP) training program for managers to spot distress among employees but still recommends employees stop short of telling managers about a diagnosis because “We don’t want managers to be acting as surrogate counselors.”  It could be argued that the encouragement of secrecy coupled with a patchwork of services and approaches produce fragmented cultures, where those struggling with mental illness must also labor alone, without support from co-workers and bosses and the treatment they urgently need.
The lack of open policies, information, discussions and solutions, also reinforce stereotypes and ignorance about the realities of mental illnesses.  While the rights of employees struggling with mental health problems are protected and their privacy should be respected,  advocates like Carol Kivler, MS, CSP stress that organizations can take steps to create “an atmosphere of overall wellness” to enlighten employees on the facts about mental illness.
Employers must also recognize that the relentless pressure they often place on employees can also trigger latent psychological issues in many people.  Because the concerns about public exposure and fear of losing one’s job keeps so many employees struggling with mental issues in the shadows, a co-worker may never know just how much pain their colleague is in.
Leaders need to start taking far greater responsibility for the “human side” of the business.  When an organization keeps a manager in the dark about an employee’s psychological issues, it reinforces the idea that performance (meaning behavior) is separate from emotional needs and processes.  Beliefs and practices like these thwart progress, perpetuate stereotypes, reinforce misinformation and inhibit empathy.
Sadly, the stigma of mental illness is real. In 2012 the stigma is still pervasive in every corner of our culture – and the workplace is not exempt.
Thanks for reading. I always appreciate your comments, subscriptions, shares, tweets and likes. 
Louise Altman, Partner, Intentional Communication Consultants