by David Epstein, SHRM-SCP, CWP, CDP
It is important to point out that prior to the pandemic, there were already existing gaps in wellness, mental health, and support systems for employees in all organizations, and disparate access and outcomes for marginalized communities in society at large. So, it is not surprising that organizations had gaps prior to and during the pandemic as organizations reflect society. The pandemic simply illuminated existing gaps and created new ones. One group of professionals who were severely impacted was healthcare professionals.
Prior to the pandemic, burnout had already reached alarmingly high levels among United States healthcare workers, with over one-half of physicians and one-third of nurses experiencing symptoms, according to a National Center for Biotechnology in an NIH study in 2018.
By 2019, the World Health Organization classified burnout as a “syndrome” that is caused by “chronic workplace stress.” While burnout is specifically described as an “occupational phenomenon,” it can lead to serious physical and mental health concerns.
Prior to COVID-19, there were indications of an epidemic of mental health issues before the pandemic:
- About one-fifth of Americans aged 18 to 54 suffered from some form of anxiety. Suicide loomed as the second leading cause of death in the US and the tenth leading cause of death around the world.
- Women are twice as likely to be diagnosed with major depression.
- One-third of adults aged 18 to 25 had a diagnosable mental illness. 10% had been classified with a serious mental illness such as clinical depression or severe anxiety disorder.
- Almost one-half of the LGBTQIA+ community suffered from some form of mental illness.
- Transgender adults were 12x more likely to experience suicidal thoughts.
As a result of the pandemic, according to studies by Johns Hopkins and Keiser Health, to name a few found:
- Anxiety and depression increased 25% during the first year of the pandemic.
- Over 40% of all American adults reported having symptoms of anxiety and/or depression during this time.
- In 2020, 26.3 million people received mental health services virtually or online.
- 23% of people aged 18 to 25 said that the pandemic had a significant negative impact on their mental wellbeing.
- 35% of people making $40k or less reported a significant negative impact on their mental health compared to only 17% of people who make over $90k a year. This was reflective of a gap for essential workers who were not able to work remotely.
- During the pandemic, there was a 13% increase in substance abuse problems.
According to a 2021 report by HHS “persistent systemic social inequities and discrimination” worsen stress and associated mental health concerns for people of color during the COVID-19 pandemic.”
The COVID-19 pandemic has disproportionately impacted communities of color in America. Racial and ethnic disparities in health care are known factors contributing to the higher morbidity and mortality among people of color, as compared to white Americans. Housing insecurity, job loss, and essential work vs. being able to work remotely were among many disparities for BIPOC communities.
SHRM surveyed more than 500 working Americans in 2021 as the pandemic entered its second year. These employees shared insights about their mental health and the workplace. Overall, they felt worn down. Six out of 10 respondents said they were exhausted when leaving work. Four out of 10 said they were burned out from work. And 3 out of 10 said their workplace’s culture was making them irritable at home.
Indeed, the job site conducted a survey of 1,500 U.S. workers to determine the level of burnout exhibited by different groups of people. The subjects were picked from various age groups, experience levels, and industry sectors. The study compared current findings against a prior pre-pandemic study in January 2020.
Some of the highlights of this survey indicated:
- Burnout is on the rise. Over half (52%) of survey respondents are experiencing burnout in 2021—up from the 43% who said the same in Indeed’s pre-Covid-19 survey.
- Fifty-three percent of Millennials were already burned-out pre- pandemic, and they remain the most affected population, with 59% experiencing it today. However, Gen-Z is now right on their heels, as 58% report burnout—up from 47% who said the same in 2020.
- Baby Boomers show a 7% increase in burnout from pre-pandemic levels (24%) to today (31%). And at 54%, more than half of Gen-Xers are currently burned out—a 14% jump from the 40% who felt this way last year.
- 80% of respondents said COVID has impacted workplace burnout—though, how and to what extent varied. A significant majority say burnout has worsened.
All of these factors and statistics make it critical for organizations to try to fill gaps in mental and emotional care for their employees. They also must reassess what mental health and wellness programs they had in the workplace pre-pandemic, during the pandemic, and post-pandemic – and identify and address the gaps in order to prevent burnout.
Traditional benefit programs and Employee Assistance Programs (EAP) were not sufficient to meet the needs of employees. Also, many employers’ benefit plans lacked sufficient mental health coverage, especially since most therapists do not take insurance so out-of-network coverage is essential. According to the World Health Organization (WHO), there was a 25% increase in anxiety and depression, impacting productivity, employee engagement, and well-being. In the wake of the pandemic and social unrest due to the tragic murder of George Floyd, along with anti-Asian, anti-BIPOC, and anti-Semitic violence, employee expectations for their employer should support them changed.
This change in thinking goes beyond the expectation of offering traditional medical, dental, and life insurance; rather, employees expect their workplaces to promote wellness, and in particular support for mental and emotional health. Furthermore, employees expected their leaders to ensure that they felt psychologically safe. Critical to achieving this, was to have diversity, equity, and inclusion (DEI) programs and training, reflecting social justice values. Not only did employees expect wellness programs to include DEI, but organizations realized that doing so was critical to establishing a workplace in which all staff were engaged and felt psychologically safe.
Organizations need to create space for safe discussions surrounding DEI issues such as racism, antisemitism, trauma, and violence directed at BIPOC, Asian, Latinx, and LGBTQIA+ communities.
According to the Guardian’s 10th Annual Workplace Benefit Trends Survey, “Employees who are part of a corporate culture that values flexibility and inclusion, supports diversity, responds to social justice causes, and encourages empathy generally report 70% better well-being than those who work in an organization that does not offer DEI support.”
What is needed to create and prioritize a culture of wellness through a DEI lens requires intentionality and investment. It needs to be communicated as a priority to employees, with a structure that allows for feedback and to pivot as needed. Some areas to consider filling gaps include:
- Anti-racism/antisemitism/unconscious bias training: provide anti-racism, antisemitism, and unconscious bias training to staff, managers, and the Board.
- Vicarious trauma program: recognize that staff may experience trauma through the work they do or their experiences such as caring for a loved one or witnessing a violent event on TV. Bring mental health professionals in to provide training and ongoing support.
- Focus groups on specific issues: Proactively provide opportunities for employees to discuss how they feel on a regular basis. It is important to check in often.
- Affinity groups: Support and encourage existing and new affinity groups in the workplace.
- Employee Feedback Surveys: Have a formal, anonymous survey to get feedback from staff.
- Enhanced mental health programs: Ensure that mental health is affordable and that employees are encouraged to seek help, and that this is not stigmatized. Often, therapists do not accept insurance; it is important to offer out-of-network benefits or a health reimbursement or flexible spending program to help cover these costs.
- Evaluate Employee Assistance (EAP) programs: Ensure that the EAP is meeting the needs of your workplace. For example, how many sessions are offered to staff, and how are these short-term therapy sessions linked to the medical program.
- Flexible and remote work options: Examine how work is done and whether jobs can be done remotely or with more flexibility, in order to meet employees where they are.
- Child and elder care: Consider offering support for child and elder care. This may include a program that provides discounts for childcare, as well as, senior daycare programs, for example.
- Empathic Leadership: Leaders and supervisors need to understand how to support staff who are experiencing mental health issues, as well as impacts on their families as caregivers for children and elderly parents.
- HR’s Role: FMLA, intermittent FMLA, state and city leave programs – educate employees
Impact of caregiving in the workplace
Before concluding, it is important to note that mental health issues for caregivers are oftentimes overlooked in their significant impact on employee stress and mental health.
According to the California Caregiver Resource Center, 60% of caregivers experience signs of depression and are 2x more likely to experience depression than the general population.
Three out of four employees face some kind of caregiving responsibility, and the demands of balancing work, life, and care take a toll. Over 90 percent of caregivers report heightened stress, depression, or trouble sleeping. Eighty percent of employees said caregiving affects their productivity. Between 40 and 70 percent experience clinical depression.
A number of mobile apps like Headspace help employees cope with stress and anxiety, build resiliency, or connect with mental health providers. However, traditional mental health benefits do not always address the root of the issue for caregivers. A key piece of a holistic mental health strategy is the support of employees with their caregiving challenges, many of which I mentioned earlier such as flexible work schedules and access to mental health care.
A recent Society for Human Resource Management article focused on Cancer patients and screenings. According to the University of Cincinnati’s Cancer Center, more than 800 lung cancer screenings were postponed. When screening resumed, cases increased 3-fold from 8 percent pre-pandemic to 29 percent as patients returned.
The American Cancer Society reported 224,000 new Cancer cases with 73,000 deaths among the BIPOC community.
Cancer and Careers reported that their study found that 70% of cancer patients preferred to work. And wanted support for flexible schedules, check-ins, mental health support, and a benefit plan that meets their needs.
I use the acronym (self-created) to evaluate mental health support programs on a regular basis:
Re-Set (Epstein, 2022)
Recognize: employees are or will be impacted by mental health issues, be it caregiving, burnout, chronic stress, illness…also children and relatives of employees.
Evaluate: existing programs, are they working? What needs to change to meet employee needs? Do programs support employees and their families?
Set Goals: Clarify what the goals of programs are, such as flexible work, and make it a goal to have those programs achieve what they’re supposed to. Ask your employees.
Educate: Remove stigmas and educate employees on the help that is available.
Timeline: Ensure that mental health support programs are in place when you have made a commitment to have them.
A constant, proactive approach is needed to address the changing and individualized wellness and mental health needs of employees.