In the Know

Make Mental Health a Cornerstone of Your Corporate Culture

01.08.2018 Clayton Chau, MD, PhD, Regional Executive Medical Director, St. Joseph Hoag Health Institute for Mental Health & Wellness

The World Health Organization (WHO) recently commemorated World Mental Health Day by focusing on mental health in the workplace. Under the banner “Good Health is Good Business,” WHO said this:

“Employment is good for our overall wellbeing—and healthy, productive workers are good for business. The health of business depends on the health of workers. Good health includes mental health.”

I and my colleagues at the Institute for Mental Health and Wellness couldn’t agree more.

How Big is the Mental Health Problem?

One in five Americans struggles with mental illness —which undermines their performance at work. Mental illness is the third leading cause of short-term disability and the fourth leading cause of long-term disability in the US.

It’s a worldwide challenge. A landmark study by the World Economic Forum and Harvard School of Public Health suggests that, over the next 20 years, the global economic cost of mental illness will exceed the combined cost of treating cancer, diabetes, and respiratory ailments.

However, only about half of people with mental illness are diagnosed and treated, even though treatment is up to 80% effective.

A major root cause of this is the stigma attached to mental illness.

So, we need a better approach. Healthcare providers need to help employers destigmatize mental illness—in words and in actions.

But I think we can go even further. We can and should help organizations make mental health a cornerstone of their culture, because good health is good business, and you can’t have good health without good mental health.

Creating a Healthy Workplace Culture

Every organization has its own culture—a unique mix of values, customs, knowledge, and beliefs that governs its behaviors—individually and collectively. Many forces determine the evolution of an organization’s culture, but the main determinant of culture is people—what people think, say, and do.

Thus, the key to positive cultural change—specifically regarding mental health—is getting people to think, say, and do the right things about mental health.

Fortunately, there are lots of best practices, guidelines, and toolkits for organizations to follow from thought leaders like the National Council for Behavioral Health, the National Institute of Mental Health (NIMH), the National Alliance on Mental Illness (NAMI), and the American Psychiatric Association (APA).

Here’s a summary of their collective wisdom:

  1. Make Sure You’re Compliant: There are numerous laws designed to make sure employer-provided health plans offer equal coverage for mental health and substance abuse treatment as for medical and surgical treatment—most notably, the 2008 Mental Health Parity and Addiction Equity Act. The details are complex, but the onus is on employers to make sure health plans comply with all applicable legislation.
  1. Bridge the Gap: Many organizations have a significant problem, hardwired into the very foundation of their benefit plan: Providers for an Employee Assistance Program (EAP) are often different than the provider network under the regular group plan. This can make it extremely difficult for employees to find a provider, and for providers to coordinate care. Simply fixing this disconnect can make a vast improvement to the quality and affordability of your organization’s mental health coverage.
  1. Explain the Impact: Educate your entire organization about the magnitude of the mental illness problem—and feel free to ask your health partners for assistance—especially preferred health care providers, insurance plan administrators, and local mental health organizations. Include concrete metrics like impact on productivity, insurance usage patterns, medication adherence, and disability. And constantly reinforce the fact that assistance is available for your workers—and that it’s okay to ask for help.
  1. Train Frontline Staff: Make sure your HR department and line managers understand disability law, the mental health components of your insurance plans, and mental health first aid. Teach them how to spot telltale signs of mental illness, how to talk to employees about behavioral health issues, and how to guide employees toward appropriate counseling and treatment. Consider providing health risk appraisals (HRAs) to employees that include mental health topics like stress, depression, and substance abuse. Include questions about management support for mental health concerns. Enlist your EAP team to reach out to “positive” screens and initiate appropriate interventions.
  1. Break the Taboo: Make sure senior leadership promotes transparency and speaking out—addressing the stigma of mental health head-on. In many organizations, culture is set at the top. If senior managers model appropriate behavior, that’s a powerful example for the rest of the organization to emulate. And if every subordinate level of management is empowered to address mental health issues directly (but respectfully) with their supervisees, the results can be truly transformative. We’ve seen it happen time and time again. And if management partners with unions or other employee advocacy groups, all the better.

There are many proven programs for breaking the stigma surrounding mental illness:

  • The ICU Program was developed by DuPont for its 70,000-strong global workforce. It uses the analogy of a hospital intensive care unit to dramatize how people with behavioral health issues need “intensive care” from each other.
  • Stamp Out Stigma, from the Association of Behavioral Health and Wellness, utilizes visual symbols (like wristbands) and storytelling to highlight obstacles to mental health care.
  • NAMI’s StigmaFree program encourages acceptance and understanding by getting organizations and individuals to sign pledges to learn more about mental illness.

Community outreach is another opportunity for your business to advance mental health. Consider involving your organization, and inviting your employees to become involved, in Each Mind Matters, California’s mental health movement to raise mental health awareness through the power of community and conversation.

  1. Prioritize Access: Help your employees navigate provider networks and insurance company procedures to streamline access to appropriate, affordable mental health care. Studies show a 4:1 return on investment in mental health treatment. That ought to be a powerful motivator for any organization to enable the earliest possible intervention and treatment protocols.
  1. Build a Culture of Well-being: It seems like an obvious recommendation, but if you don’t fully embrace the importance of your employees’ mental health, you might not appreciate the enormous positive potential of well-being as a cultural strategy. If your company has traditional wellness programs like on-site gyms and biometric screenings, the inclusion of mental health components should be a priority. It literally speaks to the organizational and even philosophical foundations of your organization—its leadership, values, communication, and environment.

Consider this compelling statement that sums it up perfectly. It’s from a great resource called the Working Well toolkit, spearheaded by the Center for Workplace Mental Health:

“Companies that support the well-being of their employees will find higher employee engagement and loyalty which correlates with improved productivity, effectiveness and business results. Employee well-being has been shown to be associated with higher sales, more innovation, lower turnover, less sick leave and reduced burnout. A culture of well-being can also help to prevent the onset or seriousness of mental illness that might otherwise arise.”

The bottom line is clear. An organizational commitment to good mental health—as a cultural cornerstone—is a boon for your employees and a powerful performance and profitability boost for your business.

To learn more about how St. Joseph Hoag Health can help grow mental health and wellness in your workplace culture, contact us at