The mental health crisis among American workers didn't begin with the COVID-19 pandemic, but it certainly intensified it. The pandemic provoked profound stress and anxiety in people who may not have previously considered themselves anxious or depressed.
As companies, including The Hartford, shifted to work-from-home arrangements to keep employees safe, they found themselves confronting urgent questions about how to support worker wellness during a time of isolation and uncertainty.
More than a year since the pandemic began, those questions are no less significant. Leaders can learn important lessons from this time about what meaningful mental health support looks like, and how they can champion their employees’ well-being.
The New Normal of Stress
The pandemic caused significant stress in workers' lives. In fact, 70% of people surveyed by the American Psychological Association (APA) cited work and worries about the economy as stressors in 2020.1 Fears about the economy were substantially higher than in 2019 and reached levels similar to what people experienced at the onset of the recession in 2008. The APA also found that parents were particularly stressed about meeting their families’ basic needs and accessing health services.
The acute stresses of the early pandemic have now been compounded in the form of chronic stress that is wearing away at workers. According to Rachael Cooper, a senior program manager with the National Safety Council, even those who may not have suffered mental health challenges before may be experiencing adverse effects from the prolonged crisis.
“There's two ways to look at mental health now. There's the group of people who are living with some sort of diagnosable mental illness,” she said, referring to conditions such as generalized anxiety disorder and depression. “The other part is the people who don't meet that diagnostic criteria, but are experiencing a lot of symptoms of anxiety and depression and fear."
Data from the Centers for Disease Control (CDC) indicates that the percentage of Americans experiencing symptoms of anxiety and depression has increased since the start of the pandemic.2 In late April, roughly 36% of Americans reported symptoms. By January 2021, that number was 41.1%, though it spiked above 50% at some points during the past year.
“The high level of disruption, uncertainty and excessive stress are fueling a decline in employee mental health and well-being.”
– Darcy E. Gruttadaro, J.D., Director of the Center for Workplace Mental Health at the American Psychiatric Association Foundation
The increase “results from a trifecta of disruption from the global pandemic, economic downturn and major political and racial injustice concerns," said Darcy E. Gruttadaro, J.D., director of the Center for Workplace Mental Health at the American Psychiatric Association Foundation. “The high level of disruption, uncertainty and excessive stress are fueling a decline in employee mental health and well-being.”
Substance use is also increasing. A recent article from the APA's Monitor on Psychology magazine indicates that alcohol consumption rose during the pandemic.3 If people are drinking more heavily on a regular basis, the risk for addiction increases, according to the article. The CDC also reported an increase in deaths from opioid overdose since the onset of COVID-19.4
Adele Spallone, vice president of clinical operations for Workers’ Compensation and Group Benefits at The Hartford, noted that surgery delays may have also contributed to increased use of opioids to manage pain.
"Because of postponed surgical procedures, many Americans now are taking pain pills, such as opioids, or other medications longer than planned, which increases their chances of forming an addiction," Spallone said. "Many of these are people who never took these powerful medications before."
This consequence of the pandemic could have long-term repercussions as well. Research shows that 64-77% of patients who use opioids to cope with pain prior to surgery continue using those drugs after their operations.5 Patients whose surgeries were pushed back and have become dependent on opioids while waiting for their procedures may face a more difficult time coming off those prescriptions.
“We've not been built in a way to deal with the multiple stressors that have faced us, and we've had to create our own coping skills.”
– Adele Spallone, Vice President of Clinical Operations for Workers’ Compensation and Group Benefits at The Hartford
How stress manifests can vary from person to person, which is why companies need to look at the unique needs of their workforces.
"We've not been built in a way to deal with the multiple stressors that have faced us, and we've had to create our own coping skills,” Spallone said. "While many people are coping with stress and anxiety by watching more TV or exercising, some of the coping skills of workers we surveyed could create new problems. There have been a lot of Americans who have used food to self-soothe and others are drinking more alcohol, for example. They're finding themselves at home more and their levels of anxiety increase because there's been blurred boundaries between home and work.”
Taking a Holistic View of Workplace Well-Being
A range of factors impact employee wellness, including social, financial and familial circumstances. In fact, work/life balance and workload are top stressors for U.S. workers, according to The Hartford’s 2021 Future of Benefits study.
Workers may be worried about decreased income, caring for ill family members and trying to work while helping their children navigate the challenges of remote learning. Blue-collar employees whose jobs require them to be on-site means each one of them must deal with the increased risk of COVID-19 infection. This could mean unintentionally bringing the virus home to their families. This year’s stressors are all in addition to the stresses people faced prior to the pandemic, such as illness, loss and financial struggles.
Because so many elements influence people's health, The Hartford views employee support through the lens of holistic well-being, said Jeannie Tomlinson, head of corporate health and wellness at The Hartford.
“For us, that means addressing the physical and emotional needs of our employees, along with social and financial,” Tomlinson said.
In response to the pandemic, The Hartford offered all employees free access to the Care.com database for finding babysitters, adult caregivers and housekeepers. The company also provided free virtual classes to help employees cope with rapidly shifting household dynamics while everyone was home full-time.
Leaders at companies of any size can create cultures and programs that address their employees' core needs, as well as ensure that employees are aware of the resources that already exist.
“This is a great time to reeducate employees and remind them of available resources such as employee assistance programs,” Spallone said. These programs may include virtual therapy, financial counseling or support for other challenges occurring in the home.
“Most employees don't know about benefits until they need a benefit, and EAP programs are often underutilized," she added. According to The Hartford’s 2021 Future of Benefits study, 70% of employers surveyed indicated that they had seen an increase in the use of EAPs in the past year. Raising the visibility of these programs was a noted focus for employers – and a challenge.
If your company does not offer an EAP, Spallone suggested providing lists of community resources that can help with mental health and crisis situations such those offered by National Alliance on Mental Illness (NAMI) or to community health and human services through the United Way’s 211 network.
She also emphasized the importance of flexibility. Allowing for flexible work hours and compressed work weeks may provide relief to workers who are caring for children or other dependent relatives. Structured breaks may help people switch off regularly and avoid burnout.
Flexibility is also practical, since so much can change so quickly during the pandemic. Dr. Christine Crawford, associate medical director at NAMI, spoke to this issue in a February panel discussion with The Hartford's Chairman and CEO Chris Swift that was shared with all employees at The Hartford, along with a reminder of wellness resources.
“We literally don't know what things will look like week to week, and that is incredibly stressful. For folks who are experiencing anxiety, it is a reflection of the difficulty to be able to tolerate uncertainty," Crawford said. "And we're also losing the sense of stability in terms of work, in terms of relationships, finances and our physical health and well-being.”
Being mindful of that context can help leaders make compassionate and empathetic decisions about workplace support. Fortunately, that understanding is taking root at other companies as well.
Salesforce, for instance, expanded its support programs to help employees navigate the pandemic. While not available for an interview, the company shared that it gave employees the option to work from home until July 31, 2021, regardless of whether their offices had reopened. It also extended its family care leave policy to give parents more paid time off to care for their children.
Spallone said that when companies think about wellness, it's also important to address the fact that many employees are grieving the loss of their social connections.
“Employers can be really creative by replacing in-person team-building events with activities like virtual book clubs, virtual costume parties or favorite t-shirt days," Spallone said. “It's about creating a new culture for staying connected.”
Inclusivity Is Intrinsic to True Wellness Culture
The nationwide conversation about racism also intersects with workplace mental health policies and employee well-being. Dr. Angela Neal-Barnett, director of the Program for Research on Anxiety Disorders among African Americans (PRADAA) at Kent State University, said that many employees of color are living in communities that are disproportionately affected by the pandemic. They may also be providing physical caregiving as well as financial support for relatives, including paying for groceries, rent and tragically, their funerals.
“Then, you add to that systemic racism and the effects of the summer that we keep seeing – George Floyd, Breonna Taylor, the list goes on and on – just trying to do all that increases our stress level, and the stress that we are enduring affects us both physically and mentally,” Neal-Barnett said.
Employers need to create safe spaces for Black employees to gather and discuss their mental health challenges with one another, Neal-Barnett added. But leaders must facilitate conversations about mental health and racism among employees of color and their white colleagues as well, though she acknowledged that those may be uncomfortable. It's important to not avoid those discussions, Neal-Barnett said, because the company can't make substantial change until they address difficult topics.
“We just can't say, 'OK, you're having problems, here's the list of EAP services or a list of counselors in the area,’" she said. “What we see is companies saying, 'We're going to do this at an organizational level. We're going to educate, we're going to give our employees tools. And we're also going to provide services for them as part of their benefits and culturally competent services.'"
Gruttadaro also emphasized the need for culturally competent resources and empathy for employees of color. She suggested that leaders “recognize that people from racially diverse communities – including Black, Hispanic and Asian communities – are less likely to receive mental health care when it is needed.”
“Given that fact, organizations should work with their EAP vendor, health plan and digital wellness vendors to find out how they are using effective outreach to connect with all employee groups," she said. “Also, organizations should work to offer employees an EAP and share mobile apps that connect them with culturally aware, diverse and trauma-informed therapists.”
Making Time for Courageous Conversations
Empathetic leadership doesn't just make for a compassionate workplace culture. It's also essential to building strong companies with loyal, healthy employees who will show up and help the organization achieve its goals.
When workers feel unheard and unsupported, their health and productivity suffer. Those conditions can also lead to a loss of organizational talent.
Those challenges could loom especially large for women, who have lost 5.4 million jobs since the pandemic began. The CDC also notes that two out of three caregivers are women, and they are more susceptible to depression and anxiety than the general population.
“Poor physical health and poor mental health are probably among the strongest drivers of having people drop out of the labor force," said Dr. David Rehkopf, an associate professor with the Department of Epidemiology and Population Health at Stanford University. “Because of the mental and physical impacts of the coronavirus pandemic, we'll see more people taking early retirements, more people dropping out of the labor force at earlier ages and potentially having trouble getting back in and reengaging. There's a lot of lost productivity there.”
Those challenges could loom especially large for women, who have lost 5.4 million jobs since the pandemic began.6 The CDC also notes that two out of three caregivers are women, and they are more susceptible to depression and anxiety than the general population, particularly during the COVID crisis.7 Women must cope not only with job losses, but with the needs of their children and extended families as well. Those who are able to find work or stay in the workforce may struggle to deal with the multiple stressors they routinely face.
But leaders at all levels of a company can play powerful roles in uplifting workers, validating their experiences and getting them the help they need before they need to take leave. That can be as simple as leaders sharing their private struggles to start the conversation about wellness for their teams.
“By sharing a personal connection to mental health – and everyone knows someone – leaders open the door to mental health being more accepted in the workplace,” Gruttadaro said. “These conversations can involve talking about how the pandemic and fear and uncertainty are taking a toll on everyone's mental health, whether you work on a construction site, in retail or in the health care sector.”
Cooper recommended that mental health support be woven into the company's policies and management trainings.
“If your leader is out there saying, 'I understand people are having a hard time,' that's great,” Cooper said. “But does HR understand that? Do supervisors and managers know what that means? Do [employees] feel safe reaching out to their supervisors and saying, 'I'm having a really bad mental health day, I need help'?”
Cooper stressed that supervisors can play a particularly powerful role in these efforts. They work closely with their teams every day, and they may be more likely to notice that someone seems to be struggling. But in order for supervisors to be most effective in this capacity, they need training in how to approach employees who may need assistance. They should also be well-versed in the EAPs and other resources to which they can refer workers.
“When leaders show a little vulnerability, it can go a long way in creating a more compassionate and empathetic workplace,” Gruttadaro said.
These shifts in attitude and policies are long-term solutions that ideally will not stop when the pandemic ends. Employee well-being and inclusive mental health programs require ongoing commitments, including a willingness to address and remove stigmas.
“Stigma can stand in the way of individuals seeking help when they need it most. The Hartford is committed to addressing stigma by engaging with empathy and projecting hope to our employees, customers and communities,” Swift said.
