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Learning Corner with Jeff Pfeffer: It's Time We Talk About Mental Health at Work

Jeffrey Pfeffer

Professor of Organizational Behavior, Stanford University

Mental health is finally getting more attention in the working world. In fact in January, the World Economic Forum held meetings in Davos that featured a dedicated mental health track. The goal? Raise awareness of mental health as a global challenge—outside and inside of the workplace.

According to data from the Kaiser Family Foundation, 18% of adults in the U.S. (some 42 million people) have a mental, behavioral or emotional disorder. And a report from Mental Health America found that almost 20 million Americans have a substance abuse problem, while nearly 9 million people (3.8 percent of the population) reported having serious thoughts of suicide.

The workplace isn't immune to the challenges of mental health. And as the working world strives to master new, unfamiliar technologies, mental health issues could even be exacerbated by work. What's more, a systematic review of studies of work-related stress estimates costs to be as high as $187 billion, with 70% of the sum coming from lost productivity. I believe that learning and talking about mental health issues at work is a necessary first step to improving mental health in the workplace, and by extension, curbing the enormous costs they create.

How Employers Can Do More to Mitigate the Costs of Mental Illness

According to The Center for Workplace Mental Health, nearly 7% of full-time workers experienced major depression during the year, with the total economic burden estimated to be about $210 billion per year. Major depression increases absenteeism, presenteeism (reduced productivity) and has direct medical costs.

Employers bear a lot of these costs and, therefore, have a role to play in addressing mental health issues—both through the medical benefits they provide and by building cultures of physical and mental health in their workplaces through management practices that promote well-being.

In order to get to a place where managers and employees understand the implications of mental health at work, companies should stop treating it as something distinct (and less important) than other forms of illness. They should provide comprehensive mental health coverage as part of their medical benefits, all while working to reduce the stigma.

Understanding (and Treating) the Pervasion of Mental Illness at Work

In 2008, the U.S. passed a mental health parity law mandating equal medical coverage for mental and physical illness, but big differences in coverage and access remain. One study found that in 2015, behavioral care was between "four to six times more likely to be out-of-network than medical or surgical care," and insurers paid primary care providers 20% more for the same types of care than they paid addiction or mental health specialists.

Some of this difference is the result of the stigma associated with mental health problems. A Financial Times reporter recently told me that when doing interviews for a story about mental illness in the C-suite, a board member told her that if the CEO admitted to mental illness, the board would fire that individual. An article about depression in the technology industry noted that admitting to depression could harm company perception and would put obtaining funding at risk.

Another contributing factor in the difference in cost and access is the sense that mental illness is not a "real" illness like cancer or heart disease. But that is completely incorrect: As my Stanford colleague Leanne Williams has demonstrated, neuroimaging studies show real changes in the physiology of the brain diagnosed with depression.

Making access to care more costly and difficult for insured employees and stigmatizing mental health issues just drives people to try and hide issues and not get care—perpetuating the problems and their associated costs.

A Path Forward for Employers and Employees

Ultimately, the best way companies can eliminate the stigma around mental health at work is to just start talking about it. EY (formerly Ernst and Young), for example, launched a program called We Care with the goal of educating employees about mental health issues and encouraging them to seek help. The program is also centered around support for colleagues who may be struggling with illness or addiction.

More employers should take a similarly proactive approach to get mental health out of the shadows. And once the lines of communication are open, HR departments can (and should) consider offering benefits that provide more accessible mental health care.

Mental illness is enormously costly, both to society and employers, yet research advances make the effective treatment of disorders such as anxiety and depression much more possible. For reasons both economic and humane, employers should work to destigmatize mental disorders, increase insurance coverage of treatments and ensure that care uses the best, most recent available evidence.

Photo: Creative Commons

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