In the Know

Caring for Your Employees' Mental Health

09.04.2017 Clayton Chau, MD, PhD, Regional Executive Medical Director Mental Health Network

Mental Health in the Workplace

We spend most of our lives either at work, getting to and from work, or worrying about work at home. So, the workplace is probably the first and most important place we should be talking about mental health. Unfortunately, it is typically the last place we actually talk about it. This has to change.

Healthy employees are more productive and more focused on the job. They also take fewer sick days and consume fewer health care dollars. This is an important consideration since it’s estimated that mental health and substance abuse problems cost American businesses over $200 billion a year. Even more alarming, only 20% of that staggering sum is due to absenteeism. The rest is due to what labor experts call “presenteeism” or working while sick. In other words, being present at work, but being unproductive due to illness, lack of motivation, or burnout.

Over the last five years, I’ve witnessed growing awareness of the importance of mental health in the workplace. In Orange County, many mental health risk factors compare favorably to state and national averages. That said, we still have ample opportunity for improvement.

While mental health problems can be harder to detect, diagnose and treat than physical ailments, there are plenty of resources available to help employers tackle the challenge.

We can start by looking at the “triggers” that cause mental stress in the workplace:

  • Working excessively long hours without breaks
  • Unrealistic deadlines and un-manageable workloads
  • Unreasonable or hostile supervisors and co-workers
  • Environmental stressors, such as poor lighting, uncomfortable temperatures, and loud noises

Of course, there are laws and regulations designed to prevent workplace duress. But many employees are unaware—or they simply don’t want to appear incompetent or weak, so they just get on with it. On the employer side, these triggers are often not well understood—or not proactively managed.

What Can Employers Do Better?

Communication is vitally important and surprisingly powerful. I recently came across a story that perfectly illustrates my point. A young, female software developer had emailed her team, notifying them that she was taking a couple of days off for mental health reasons. The company’s CEO found out about it and emailed her a ‘thank you’ for speaking candidly about her reason for taking sick time. The young woman was so surprised and impressed that she posted the entire exchange on Facebook, where it quickly went viral. Imagine if every employer in America treated mental health the same way. Imagine the loyalty and motivation that would engender in your workforce—by simply creating a safe space to talk openly and honestly about mental health.

HR policies, programs, and procedures should explicitly support mental health care. There’s an easy litmus test for this; it should be just as easy for an employee to request and be paid for time off for a visit to their therapist as for a visit to their primary care doctor. Especially since very few therapists have evening or weekend hours—leaving employees no option but to go during the normal work day.

There is a systemic flaw in the way most employers fund their mental health benefits. For example, most companies contract with an entity to provide mental health services for employees. But those entities—those networks—are usually different than the providers in the Employee Assistance Program (EAP). Most EAP programs only cover short duration events—sudden but brief crises in the employee’s personal life. But if the employee needs ongoing help—beyond the immediate crisis—they will usually be transitioned to the regular mental health benefit—with a different set of therapists. So, there is absolutely no continuity of care.

Plus, there’s another problem. When employees attempt to use their mental health benefit, they are often just given a list of therapists’ phone numbers and very little else. It’s up to them to conduct research and try to determine which provider would be the best fit. If it’s the first time someone has sought counseling, this can be a confusing and even harrowing experience. Fortunately, there’s an easy fix. When companies contract for mental health services, all they need to do is ensuring that there are navigators readily available to walk the employees through the process because it’s not as simple as finding a primary care doctor or a local urgent care.

Lastly, and most importantly, if you get through all the hurdles, most of the time the initial appointment could be weeks out. By the way, there’s no urgent care in the phone book for mental health.

An ounce of prevention is worth a pound of cure. There is a growing body of evidence-based practices that are very successful when applied as early intervention strategies. The California Mental Health Services Agency (CalMHSA) has developed curriculum to help employers raise awareness of mental health in the workplace. In Orange County, the local chapter of the National Alliance on Mental Illness (NAMI) is a wonderful resource.

I talk to many employer groups about improving mental health care for their employees—and my message is really quite simple. To maximize employee productivity, retention, and happiness, pay attention to your employees’ total well-being—including physical, mental, emotional, and spiritual health. Proactively create a workplace environment that is supportive, healthy, and non-prejudiced towards individuals that have mental illness, or might be at risk of having mental health problems. The reward will far outweigh the effort.

For more information on St. Joseph Hoag Health’s mental health network and how employees can schedule a mental health benefit check-up, call 949-381-4777 or email

Categories: Mental Health