Put the “Health” Back in Employee Mental Health

Employee mental health is a critical—and human—concern for any workplace. After all, healthy, productive employees are key to a thriving and successful organization.

Unfortunately, 76% of U.S. workers reported at least one symptom of a mental health condition in 2021, which underscores the need for a greater focus on this aspect of employment.

The mental health of employees is also a long-term human resources concern. A 2022 survey by the American Psychological Association notes that 81% of workers agree that how employers support mental health will be an important consideration when they look for work.

If you run an employee health & wellness department or program, the information in this guide provides useful guidance on improving your efforts to provide employee mental health support across your health system.

This is also relevant if you’re a provider or clinical manager running a small facility, especially since the impact of a single disengaged or burnt-out employee is more noticeable. You may have a smaller budget, but you can focus on implementing what you can to support your staff’s mental health.

Employee Mental Health in Healthcare Professions

1. Healthcare Faces a Health Scare

Did you know that healthcare workers experience burnout at higher rates than other workers, even ones who are considered essential?

Data from the U.S. Centers for Disease Control and Prevention (CDC) indicates that nearly half of health workers (46%) reported often feeling burned out in 2022, up from 32% in 2018. By comparison, 40% of other essential workers and 37% all other workers reported often feeling burned out.

As the graphic below shows, multiple areas impacting the mental health of healthcare workers have outpaced the two comparison groups since 2018. These troubling trends highlight why healthcare organizations need to shift or continue to focus on supporting employee mental health.

2. Common Employee Mental Health Challenges

While employees at any organization may face similar mental health challenges, healthcare employees face a unique set of stress sources we call out below.

• Burnout: This is a pervasive issue characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Factors like long hours, heavy workloads, and administrative burdens contribute significantly to this feeling.
• Anxiety: Healthcare workers often experience anxiety related to patient outcomes, potential medical errors, and exposure to infectious diseases. The pressure to perform under high-stress conditions can exacerbate this feeling.
• Depression: The emotional toll of witnessing patient suffering and death, coupled with the stress of the job, can lead to depression. Shift work and sleep deprivation also play a role.
• Post-Traumatic Stress Disorder (PTSD): Exposure to traumatic events, such as critical patient situations or violence in the workplace, can result in PTSD. This is particularly relevant for those working in emergency departments or trauma centers.
• Moral injury: This occurs when healthcare professionals are forced to make decisions that violate their ethical or moral beliefs. This can lead to feelings of guilt, shame, and distress.
• Substance use disorders: As a coping mechanism, some healthcare workers may turn to substance use, which can lead to abuse and addiction.

3. Impact on Patient Care and Operations

The impact of poor employee mental health on both patient care and organizational efficiency is substantial and multifaceted.

Patient Care

• Increased risk of medical errors: Burnout and stress can impair cognitive function, leading to decreased concentration, poor decision-making, medication errors, diagnostic errors, and other adverse events.
• Reduced quality of care: Emotionally exhausted healthcare workers may exhibit decreased empathy and compassion, leading to a less positive patient experience. Poor mental health can also affect communication and interpersonal skills, hindering effective patient-provider interactions.
• Compromised patient safety: When healthcare workers are not mentally well, their ability to be alert and attentive is diminished. This can lead to oversights that compromise patient safety.
• Decreased patient satisfaction: A stressed and overwhelmed staff can create a tense and unwelcoming environment. Patients can perceive this negative atmosphere, leading to dissatisfaction with their care.

Operations

• Increased absenteeism: Mental health conditions are a leading cause of absenteeism, resulting in lost productivity and increased costs. Frequent absences disrupt workflow and place additional strain on the remaining staff.
• Higher employee turnover: Burnout and stress are major sources of turnover, which disrupts team dynamics and reduces institutional knowledge.
• Decreased productivity: Mental health conditions can impair cognitive function, leading to decreased concentration and reduced productivity.
• Negative impact on organizational culture: When mental health is not addressed, it can create a toxic work environment. This can lead to reduced job satisfaction and engagement, increased conflicts, and a decline in overall employee well-being.
• Increased costs: The financial burden of poor employee mental health includes increased costs for delivering healthcare and recruiting and training new workers.

4. Lasting Effects of COVID-19

The federal COVID-19 public health emergency (PHE) lasted over three years and negatively contributed to employee mental health due to:

• Increased exposure to trauma
• Fear of infection
• Staffing shortages and overwork
• Emotional isolation
• Moral distress

The COVID-19 PHE declaration ended on May 11, 2023. However, while the acute phase of the pandemic has passed, the psychological and physical impact on healthcare workers persists.

• Lingering mental trauma: Many healthcare workers continue to experience symptoms of PTSD, anxiety, sleep disturbances, and depression.
• Ongoing staffing challenges: The pandemic caused a significant exodus of healthcare workers, further contributing to existing staffing shortages. This places continued strain on remaining staff, perpetuating burnout.
• Long COVID effects: Like their patients, healthcare workers also contracted COVID-19 at high rates. The long-term effects of long COVID are still being studied, but it’s clear that many healthcare workers are still experiencing the physical and mental impact of this illness.

What Measures Can Organizations Take to Improve Employee Mental Health?

Providing employee mental health support requires a multifaceted approach that addresses both organizational culture and individual needs. Below are some effective strategies to this end that you can implement at your healthcare institution.

1. Show Leadership Commitment

Leadership commitment is foundational to creating a workplace culture that genuinely supports employee mental health. It’s not just about implementing programs—it’s about embedding mental well-being into the organization’s core values and practices.

What does this commitment look like?

• Visible prioritization: Leaders must demonstrate that mental health is a top priority through their actions and words. This includes openly discussing mental health, sharing personal experiences (when appropriate), and consistently reinforcing the importance of well-being.
• Resource allocation: Commitment translates into tangible resources. This means allocating sufficient budget and staff to mental health initiatives, such as employee assistance programs, wellness programs, and training.
• Training and education: Leaders should ensure that managers and supervisors receive adequate training on how to recognize and respond to mental health concerns. This includes training on active listening, empathy, and providing appropriate support.

2. Reduce the Stigma of Mental Health

Stigma reduction is a critical component of fostering a mentally healthy workplace, especially in healthcare, where the pressures are immense. Stigma, in this context, refers to the negative attitudes, beliefs, and discriminatory behaviors directed towards individuals with mental health conditions.

Such stigma has tangible effects. For example, a McKinsey survey of employees with a behavioral health condition noted that respondents would avoid treatment because they didn’t want people finding out about their mental illness (37%) or substance use disorder (52%). In addition, “close to seven in ten respondents with high self-stigma levels reported missing at least a day of work because of burnout or stress.”

So how can you reduce stigma in your organization?

• Spread education and awareness: Provide accurate information about mental health conditions to dispel myths and misconceptions. Conduct training sessions for employees and managers to increase their understanding of mental health issues.
• Promote open dialogue: Create a safe and supportive environment where employees feel comfortable discussing mental health. Encourage open conversations about mental health in team meetings and other forums.
• Implement inclusive policies: Review and revise organizational policies to ensure they are inclusive and non-discriminatory. Provide reasonable accommodations for employees with mental health conditions. Ensure that mental health is treated with the same level of importance as physical health.
• Focus on recovery and resilience: Shift the focus from illness to recovery and resilience. Highlight the fact that individuals with mental health conditions can lead fulfilling and productive lives.

3. Offer Employee Assistance Programs

Employee Assistance Programs (EAPs) are a valuable resource for healthcare organizations aiming to support the mental and emotional well-being of their staff. They provide a range of confidential services designed to help employees address personal and work-related challenges.

What may your EAP include?

• Confidential counseling: EAPs offer short-term, confidential counseling sessions with licensed mental health professionals. These sessions can address a wide range of issues, including stress, anxiety, depression, relationship problems, and substance abuse.
• Referral services: If an employee requires long-term or specialized care, EAPs can provide referrals to appropriate mental health professionals, substance abuse treatment centers, or other community resources.
• Crisis intervention: EAPs are equipped to handle crisis situations, such as workplace violence, traumatic events, or suicidal ideation.
• Work-life balance support: EAPs can provide resources and guidance on managing work-life balance, including time management, stress reduction techniques, and parenting support.
• Substance abuse support: EAPs may provide confidential support and referrals for employees struggling with substance abuse.

4. Optimize Staffing and Workloads

Optimizing workloads and staffing is a critical component of employee mental health support in healthcare. The intense and often unpredictable nature of work in this industry can easily lead to burnout and stress if workloads are unmanageable or there simply aren’t enough staff members.

How can you ensure your staffing is optimal?

• Accurate staffing ratios: Implement evidence-based staffing ratios that reflect patient acuity and workload. Regularly review and adjust staffing levels based on patient volume and seasonal fluctuations.
• Flexible staffing models: Utilize flexible staffing models, such as per diem or float pools, to address short-term staffing needs. Offer flexible scheduling options to accommodate employee needs and preferences.
• Streamline processes: Identify and eliminate unnecessary tasks and processes. Implement technology solutions to automate repetitive or time-consuming tasks. Optimize workflows to improve efficiency and reduce wasted time.
• Reduce administrative burden: Minimize administrative tasks and paperwork, enabling healthcare professionals to focus on patient care. Simplify documentation requirements and improve the usability of electronic health records (EHRs).
• Manage patient flow: Implement strategies to improve patient flow and reduce wait times. This can help prevent bottlenecks and reduce stress for both staff and patients.

5. Improve Communication and Feedback

Improving communication and feedback is essential for fostering a positive and supportive work environment. Effective communication can reduce stress, prevent misunderstandings, and enhance teamwork, while constructive feedback can promote professional growth and improve performance.

How can you communicate more effectively with employees?

• Establish clear communication channels: Ensure that there are clear and accessible channels for communication, both formal and informal. Utilize various communication tools, such as email, instant messaging, and regular meetings, to facilitate information sharing.
• Promote open and transparent communication: Encourage open and honest communication among all staff members. Create a safe space where employees feel comfortable expressing their concerns and ideas. Share important information in a timely and transparent manner.
• Crisis communication plans: Have well established crisis communication plans in place, so that in times of stress, everyone knows how communication will flow.

Improving Employee Mental Health at Mount Sinai The Mount Sinai Healthcare System (MSHS) in New York City was one of the epicenters of the COVID-19 pandemic’s first wave in the U.S. The health system faced an overwhelming surge of COVID-19 patients, leading to severe resource constraints, high patient mortality, and intense emotional strain on staff. Employees experienced: – Psychological trauma – Moral injury – Burnout and exhaustion – Fear and uncertainty In response, MSHS founded the Center for Stress, Resilience and Personal Growth (CSRPG) in April 2020, which offered varied health and human services to address anticipated mental health challenges: – Mental health screenings – Resilience-promoting workshops – Mental heal and wellness mobile app – Crisis support task force – Temporary housing and meals – Virtual support groups The center, while not a cure-all solution, provided much-needed relief for some of the country’s most hardworking healthcare workers during a time of unprecedented stress and turmoil. Its services were undoubtedly a key reason workers were able to press on and provide critical patient care and comfort throughout the pandemic. “The COVID-19 pandemic has transformed our Health System in so many positive ways. We are more resilient and more adaptable than at any time in our history,” says Jeremy Boal, MD, executive vice president and chief clinical officer at MSHS.

Employee Mental Health Benefits from Every Effort

Employee mental health, especially within healthcare, is a critical concern since it significantly impacts employee well-being, patient care, and operations.

To improve mental health in the workplace, prioritize leadership commitment, stigma reduction, and other strategies to ensure employees can thrive healthily at work and the organization continues to operate effectively. By addressing these issues—even if only one or two are within your budget—you can cultivate a healthier, more resilient workforce.