Building a Workplace Culture of Health—During COVID-19 and Beyond
Vincent Nelson, M.D., Vice President, Medical Affairs, Blue Cross Blue Shield Association
Building a culture of health is a strategic priority for many large companies. It begins with employers broadening their view of health to embrace the interconnectedness of physical and mental health and take a full health approach. While the coronavirus pandemic has complicated the challenge of building a healthy workplace culture, it has also created new opportunities for employers to initiate open and candid dialogue with employees about how they are feeling, and what they need to maintain and improve their overall health and well-being.
KEY CHALLENGES FACING EMPLOYERS TODAY
Easing the stigma surrounding mental health.
Despite glimmers of progress, 68 percent of employees believe that reaching out for help with a mental health condition could negatively impact their job security.1 The National Alliance on Mental Illness (NAMI) finds that eight out of 10 people suffering from mental health conditions report that shame and stigma prevent them from seeking treatment.2 The downsides to avoiding treatment are dire. As a result, both the employee’s health and company production stand to get worse. A trends survey by Willis Towers Watson projects the potential for global economic losses related to mental health challenges between 2011 and 2030 are estimated to total $16.3 trillion.3
To mitigate workplace mental health stigma, leaders within their organization need to openly discuss mental health and show support for employees seeking care. Leading integrated creative agency Berlin Cameron and global data insight and consulting company Kantar conducted a survey of 1,000 employees in which 62 percent of respondents said having someone in a leadership role speak openly about mental health would make them feel more comfortable talking about it themselves.4 Fifty-seven percent responded that to help reduce mental health stigma, it should be openly discussed in the workplace.5
Millennials’ call for whole-person care.
Millennials, who now represent 50 percent of the US workforce, and will soon become the largest segment, have different expectations than previous generations when it comes to the workplace and their benefits. Three-quarters of Millennials (73 percent) say mental healthcare counseling needs to change and 84 percent of Millennials say their health insurance has impacted their decision to stay with their current employer.6
Millennials want to feel that their employers are invested in helping them achieve a healthy work-life balance. That investment includes flexible schedules and cultural permission—the sense that it’s OK—to take breaks when needed and to disconnect at night and on weekends. They also want more whole-person care, not only integrating physical and mental health, but also including holistic, natural and alternative wellness perks, such as acupuncture, homeopathy and financial coaching.
The new stress of a new normal.
The pandemic is also taking a toll on the American worker. Disruptions to daily routines and new professional and personal challenges have exacerbated stress and anxiety for millions of Americans. New data from mental healthcare app Ginger (www.ginger.io) showed that 69 percent of workers claimed this was the most stressful time of their entire professional career, even more stressful than major events like the September 11 terror attacks, the 2008 Great Recession and others.7
Healthcare experts predict that heightened stress and anxiety levels may decrease over time but will most likely never return to pre-pandemic levels. This further underscores the idea that traditional approaches to employee health and well-being, which typically center around wellness programs, are no longer viable.
SOLUTIONS FOR A HEALTHY WORKPLACE CULTURE
Culture must be top-down and constant.
Cultivating a healthy culture starts at the top, but needs to be supported by all managers. “The companies that seem most successful and have higher utilization of Employee Assistance Programs (EAPs) and higher employee satisfaction have strong leadership support. C-suite leadership will talk about it publicly and speak about their personal challenges. But a caveat is that it can’t just be C-suite leadership, it has to trickle down and have leaders across the organization bought into it as well,” says Dylan Landers-Nelson, a director at the Business Group on Health.
Employers do well to focus on creating work environments that value and regularly talk about mental, physical and emotional health, and the importance of caring for them together. “Rather than concentrating on certain times or a special month, make it ongoing,” says Susan Foosness, senior program manager at Blue Cross and Blue Shield of North Carolina. And, this message should be echoed everywhere—from onboarding to company communications that promote health and wellness. This is not just better for their workforce—it creates the opportunity for their workforce to be more invested, involved and productive, which, in return, is better for the business.
Health-culture building is really where the rubber meets the road. It’s not enough to just put benefits, resources and even policies for managing whole-person care in place. Your workforce needs to feel that health is fundamental to the workplace and work life. This is done through integrating wellness into everything from on-site gyms and spaces for disconnecting, to ongoing lunch-and-learns and guest speakers, to supported peer-to-peer programs. It can be demonstrated even further by actively decreasing behaviors that contribute to burnout, such as expecting responses to late night or weekend emails, and instead promoting behaviors that reduce stress, like encouraging employees to take their PTO and to unplug from work when doing so.
Expand options for employees, and drive awareness.
Companies can do many things, from plan redesign to expanding telehealth options to creating ways for employees to share concerns, ask questions and support one another. Many employers are doing more to expand their EAPs. But adoption takes awareness. The good thing is, by creating a culture of regular communication both at the top and grassroots levels in your organization, you also create new areas to explore having real dialogue about what is available, the importance of taking advantage of help when it’s needed, and how to access resources easily and discreetly.
“We have seen large employers that are exceptional at this,” Dylan Landers-Nelson of the Business Group on Health points out. “One in particular onboards people really well. They make a point of talking about their EAP, and have managers and leaders talk about how they’ve used it themselves, rather than just handing out a brochure. We’ve seen them have higher EAP utilization than others.”
Even longstanding employees may be surprised to learn or appreciate reminders that they have access to mental health offerings, financial benefits and other nontraditional programs, including financial education, tuition reimbursement and flexible work hours. These benefits play an instrumental role in helping employees reduce stress and anxiety and enhance well-being in today’s deeply challenging environment. So, explore new avenues to educate your workforce on their healthcare plan and benefits through lunch-and-learns, town halls, coffee talks or one-on-one sessions with HR.
Adapt culturally as employees’ needs change.
There are examples of companies flexing to meet coronavirus-related needs as well. The issue of employee burnout is especially relevant now, with more employees working remotely most of the time—and in many cases, handling increased workloads resulting from mass layoffs. Health benefits provider Anthem has expanded its own employee benefits in order to provide support to its workers in response to the COVID-19 pandemic. Anthem is offering employees up to 80 hours of paid emergency leave for qualifying needs—including if associates are experiencing symptoms of COVID-19 or are caring for young children whose schools have been closed. Anthem is also expanding the use of sick time to include caregiving related to COVID-19.9
Employers should never overlook the importance of periodically checking in with employees to see how they are feeling and encouraging them to openly talk about mental health. Signs of stress, anxiety and burnout are often more visible when employees are working side-by-side as opposed to when they are working from home. Make time to connect with your employees around their health—even those who are coping well will appreciate the gesture of concern.
Now, more than ever, consider behavioral health conditions specific to remote work environments. For example, to make sure your employees working from home don’t feel isolated, consider offering virtual coffee breaks, lunches and group chats. To help prevent your employees working from home from slipping into inactivity, promote virtual exercise classes and fitness contests.
IMPROVING ACCESS: THIS IS HOW
Start, but don’t stop, at the top.
It’s important for business leaders to openly talk about behavioral health and share personal stories. But also give managers the training to educate employees about resources and provide encouragement and support. Develop ongoing opportunities for your workforce to discuss mental health conditions through lunch-and-learns, webinars, speaker series, videos, newsletters and peer-to-peer programs.
Make behavioral healthcare business as usual.
Start during employee onboarding and send out regular reminders about your EAP and the benefits it has for both behavioral and physical health. Normalize full health by referencing both behavioral benefits and challenges in conversations about benefits. Reexamine company policies to eliminate improper labeling, stereotyping or bullying of employees with behavioral health challenges.
Expand non-medical benefits.
Find ways to connect behavioral and physical health offerings, as well as non-medical benefits (e.g., financial programs, tuition reimbursement, work from home options, transportation). Together, these benefits contribute to positive well-being and a healthier workforce.
Think about organizational factors.
Consider your company’s physical work environment as well as policies and processes and the impact they may have on employees’ health and well-being. Aim to build a balanced and healthy workplace culture that is inclusive—reducing stigma and unnecessary stress inducers wherever possible.
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1 Agovino, “Mental Illness and the Workplace,” SHRM, 2019.
2 National Alliance on Mental Illness (NAMI), “StigmaFree Company Partnership Initiative,” 2020.
3 Gavidia, “Mental Health Conditions Projected to Be a Significant Factor of Employer-Sponsored Healthcare Benefit Costs, Survey Finds,” AJMC, 2019. 4,5 Brodey, “62% of Employees Want Leadership to Speak Openly About Mental Health,” Forbes, 2019.
6 Blue Cross Blue Shield Health of America National Generation Survey, 2019.
7 Ginger, “COVID-19: Four Radical Changes in U.S. Worker Mental Health Needs,” 2020.
8 Willis Towers Watson, “2019 Best Practices in Health Care Employer Survey Highlights,” 2019.
9 Schiavo, “Anthem Expands PTO in Wake of Coronavirus Pandemic,” Employee Benefit News (EBN), 2020.