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Three CAHRS Partners Talk About Unseen Struggles of Mental Health

Three Center for Advanced Human Resource Studies company partners (Prudential Financial, DuPont and Aon Hewitt) discuss their proactive approaches to mental health in the June 2, 2017 Human Resource Executive issue's "The Unseen Struggle."

Back in 2007, Prudential Financial, which supports 45,000 employees globally and 19,000 in the U.S., conducted its first annual health assessment. After analyzing the data, it discovered that roughly 25 percent of its workforce was at risk for depression, says Andrew Crighton, the company's chief medical officer.

"In the mid-2000s, we really started understanding that the work environment was a big driver in a lot of things we were trying to focus on from a health perspective," he says, adding that the plan was to train supervisors on helping people with such conditions. "A lot of times, they wanted to back away and give an individual more space when they really needed more structure."

Crighton's strategy included expanding the company's mental-health offerings, bringing mental-health issues out in the open through various methods such as weekly news videos and educating employees about such illnesses. This, in turn, has helped decrease the stigma that has been tied to mental illness for so many years, he adds.

Formalized in 2010, the mental-health strategy at Newark, N.J.-based Prudential gave managers a road map for addressing mental illness in the workplace. For example, when employees take a leave of absence due to mental illness, Prudential's return-to-work team of nurses manage the process early in the absence and will offer a behavioral health professional to assist them through the transition.

At the very least, Crighton says, hundreds of managers have been coached and received training in workshops on subjects such as ethics or diversity that also include a component on mental illness. Managers learn how to spot warning signs, approach staff and become familiar with the multiple pathways for help, such as the company's onsite clinic and HR leaders.

Employees suffering from depression have also spoken about their illness on Prutube, the company's weekly news video. The daily email newsletter featured a series of articles on depression. Employees addressed their post-traumatic stress disorder, substance abuse and domestic violence experiences on Prudential TV. Over the past several years, the company has also held workday seminars such as "Navigating Our Troubled Times," which are videotaped and replayed on demand.

Collectively, Crighton says, all of these efforts have helped drive down the number of employees at risk for depression by 8 percentage points over the past decade, to 15 percent. For its efforts, the company won the 2017 Organizational Excellence Award from the American Psychological Association.

Meanwhile, in-house data revealed that psychotropics -- anti-depressant or anti-anxiety drugs -- were being prescribed to more than half of the company's workforce without a mental-health diagnosis. Crighton believes they were possibly being mistreated or misdiagnosed. Either way, he says, these individuals tend to experience high numbers of medical visits and are the company's next area of focus.

HR can play a big role in this process, he says, explaining that this is not something that can be outsourced. HR must own it by training and collaborating with managers who serve as the linchpin to identify and guide employees with potential mental health concerns.

Roughly five years ago, DuPont developed an employee program called ICU, which compares mental-health services to those products in an intensive-care unit. Miller says the initiative was so successful that the global science and engineering organization made it available to the Partnership for Workplace Mental Health to share with other employers.

At the heart of the free program is a short video that addresses emotional distress, which can be embedded within any company's EAP. She says it teaches employees some of the common symptoms or behavioral changes that co-workers with mental-health conditions may demonstrate, such as distancing themselves from others, and gives them "permission" to offer direction or guidance to co-workers.

"It's designed to avoid potentially problematic interactions between a manager and an employee," Miller says. "If you don't have a robust program that's training managers on how to intervene and reach out to employees, this circumvents that by being peer-to-peer."

Employers also receive a poster they can customize or brand, a PowerPoint presentation that can be used to solicit senior-level support for programs aimed at helping employees with mental illness, and pre- and post-survey tools to measure the program's impact.

So far, she says, at least a dozen employers have implemented the program, while several large employers are in the midst of piloting it.

Another free program being offered is Mental Health First Aid, an eight-hour course that teaches a five-step strategy that helps people identify, understand and respond to signs of addictions and mental illnesses. Up to now, more than 1 million people have been trained.

But awareness and education is just half the battle. The other half is access to care.

Based on Aon Hewitt's 2016 Consumer Health Mindset Study, 74 percent of the 2,503 responses from employees or dependents with employer-sponsored coverage faced one or more barriers to access to support, says Rod Hart, vice president of the national health transformation team at the global consulting firm.

"Oftentimes, people get a referral list, but the individual has to call the referral," he says. "If you're already struggling with depression, you don't have a lot of self-motivation to do that. That becomes a challenge for a lot of people, because they don't have the energy."

Hart, who works out of Aon Hewitt's Portland, Ore., office, says effective workplace strategies focus on ABLE: Advocate to break down the barriers to support; build awareness and create a sense of belonging in the workplace; lift the curtain on the stigma of emotional health disorders; and establish a total well-being and an emotional-fitness approach to your health and well-being program.

Likewise, he advises, HR should rename its EAP to eliminate associated stigmas. Focus more on the work/life components of what the EAP offers and reframe emotional struggles as being part of the normal human condition, he says.

In the past, Hart says, many employers compared addressing mental-health issues in the workplace to opening a Pandora's box. But more employers are straying from that perception and implementing anti-stigma campaigns, such as Stamp Out Stigma. Some are even pressing their EAP vendors for more access channels such as digitized, cognitive behavior therapy delivered via mobile devices and tablets, which removes one more barrier to counseling.

"The most important piece is seeing emotional health as something that's just a normal part of life," says Hart. "Focus on restorative practices -- anything from talking about emotional health and relationships to how people are overwhelmed in today's society . . . . By talking about it and bringing it to the surface, you allow that dialogue to be much more real, start to establish trust and build competence within your culture."

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