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The Future of Work Podcast

Episode 49
Mental health in the workplace

Workplace mental health: It’s ok not to be ok

10 October 2023

With one in five employees experiencing mental illness in their lifetime and an estimated 12 billion workdays lost annually due to depression and anxiety, tackling mental health issues in the workplace may seem insurmountable. Yet according to management expert, Emily Rosado-Solomon, there are pre-emptive quick fixes that employers could take that would make all the difference to employees suffering from chronic mental health conditions - including simply letting employees know that it’s ok not to be ok.

Discover the four steps that employers can take to ease mental stress at work before it starts, and why common sense actions to achieve well-being at work, are not common at all.



Hello, and welcome back to the ILO's Future of Work podcast.

I'm Rosalind Yarde.

Today we're focusing on a workplace issue

that has mushroomed in the last few years, mental health.

Now, work can be a positive factor in our mental health.

It can provide a stable income, structured routines,

positive relationships, and a sense of purpose, achievement, and self-esteem.

However, work can also pose a risk

to mental health from precarious employment,

discrimination, and poor working environments for instance.

According to a 2022 report by the ILO and the World Health Organization,

an estimated 12 billion workdays are lost annually due

to depression and anxiety costing the global economy US$1 trillion,

mainly from lost productivity.

The problems seem immense.

However, our guest today, Emily Rosado-Solomon,

believes that they can be tackled.

As assistant professor of management at Babson College,

a business school in Massachusetts, United States,

she was one of a team of academics that researched workplace

wellbeing and how to reduce mental health risks for staff.

Emily, welcome.

Thank you so much.

Firstly, can you give us a feel of the scale and impact of the problem?

Sure. Mental illness by which I'm talking about chronic conditions

such as major depressive disorder, general anxiety disorder,

bipolar disorder, those sorts of things, the common statistic that we talk

about is about one in five employees will have those in their lifetime.

What that means is that any company with more than five people,

statistically, is likely to have someone with a chronic mental health condition.

The impact of poor mental health at work

is actually much bigger than that.

According to a 2021 survey of American workers,

84% of those surveyed experienced at least one symptom

of mental health challenges such as burnout or stress.

That means that really this is ubiquitous and at some point,

almost all workers are feeling some sort of a mental health challenge.

The impact is felt even more strongly in middle and low-income countries

where there is still a very high prevalence

of mental health challenges,

but significantly less access to treatment and medical support for those.

Those are huge numbers, 84% of those surveyed.

I think that people are probably not even aware

of the scale of this problem.

I imagine that's why you decided to conduct this research.

That's part of it, and those numbers have certainly increased

during the COVID-19 pandemic, but my interest in this topic

actually goes back even before COVID-19.

Both of my parents work in the mental health field.

I know that mental health challenges

are ubiquitous from growing up with them.

I was really struck when I started studying organizations

that management scholars

weren't necessarily conducting research that I felt corresponded

to the ubiquity of mental health challenges.

Now, that's strange that this research hasn't been done so far.

Why do you think that is?

Well, what we see in our review--

My colleagues and I reviewed 556 studies

on mental health and mental illness and work.

There is quite a bit of research out there,

but it's really not integrated very well.

There's some done by psychologists.

There's some done by people who study occupational health,

there's a bit done by management scholars,

but nobody had really looked at the totality of that research.

When we did, we found quite a bit,

but it's hidden in those disciplinary silos.

Were there any findings that really surprised you and your team?

Yes. When I started thinking

about mental health and particularly mental illness,

or those chronic conditions and how that impacts work,

and how work can support people with mental illness,

I took the same perspective that I think we see most researchers taking,

which is I was interested or thinking about the individual who struggled.

What we see in our findings when we look

at the totality of these hundreds of studies is I was really surprised

by the disproportionate role that the organization can play

in either causing or exacerbating

people's mental health challenges and really what we think

of as mundane organizational practices

that actually have a really big impact on employees' mental health.

Does that mean that this is almost a compartmentalization in terms

of we know that many people suffer from mental health issues,

and you've told us the figures, but people don't necessarily associate

it with the environment in which they're working.

Is this the reason why perhaps employers haven't really seen

it in a way that ends up meaning that they are looking for solutions?


What we see a lot is when organizations

want to support employees with mental health challenges,

we see them taking these individualized approaches.

Perhaps the individual needs counseling

through an employee assistance program or the individual needs to engage

with a mental health support app on their smartphone.

All of these are on the employee to take care of their own

mental health as though it is somehow an individual problem only.

We don't really see as much of an organizational focus

on what the organization might be doing to perpetuate or to exacerbate

these mental health challenges.

Also, the flip side of that is the power

that the organization has through potentially systematic

or proactive change to really improve

people's mental health in a large-scale and meaningful way.

So is this what you mean by organizational culture,

I know for example there's the phenomenon of presenteeism.

I think that's the correct way of pronouncing it.

Just this pressure on people just to be present and sometimes

pressure on them to actually work over their hours.

Is that what we mean by culture?

That's definitely part of it.

Culture is really just the norms

and the taken-for-granted values in an organization.

When we talk about organizational culture, what we could be talking

about is an organization that has a cooperative culture

where people are encouraged to support each other and help

each other versus another organization

in the same industry or the same size

might have a competitive culture where people

are really incentivized to only focus on themselves.

Part of what we find, as you mentioned,

is this overwork that leads to presenteeism,

but also we find that toxic cultures,

so cultures in which bullying or disrespect is tolerated,

or people who engage in those behaviors are rewarded

and promoted throughout the organization,

that that is disproportionately harmful to employees' mental health.

Now, one of your main findings and linked to that was that simple fixes

like reducing workloads could take some of the pressure off employees.

It sounds to me that that's kind of common sense.

Why is it that this seems not to be done?

Is it that employers don't even recognize their own culture,

the starting point, I suppose, the self-awareness,

or maybe is it that employers or organizations don't even understand

what kind of culture that they have created

in their organization?

I think that's definitely part of it.

Certainly, when we say it in that way, it does seem like common sense.

I think anybody sitting in their car may be listening

to a podcast or sitting certainly in a business school classroom,

when I sit with my students, it sounds like common sense not to overwork

your employees or they might get burned out.

The reality of organizational life is that it's often

very hard to fix these problems in a straightforward way.

If we say see an employee who maybe is chronically overworked,

certainly we can and perhaps should reassign their tasks

or some of their tasks to a different employee,

but if all we do is pass around the overwork between team members,

then that doesn't really solve the problem.

It just rotates the burden.

In order to solve this problem,

we really need organizations to engage in systematic change,

so fundamentally rethink the way their jobs are designed, perhaps,

potentially hire more employees.

That takes time. That takes resources.

Not all organizations recognize the importance of this.

They think of it as a mundane HR function or something

that human resources is in charge of as a procedural issue,

but they don't necessarily think about the link or realize

the link to mental health and so they might choose

to spend their limited time or their limited

resources on other things like product development,

like expanding to new markets.

Certainly, while it sounds like an easy fix,

I think the complicated pressures of organizational life,

and particularly on managers, this just slips through the cracks.

Can you give us some examples?

You mentioned already workload but can you give

me some examples of the things that cause stresses on employees,

but also maybe explain some examples of job design as well?

Sure, definitely.

Another thing that we find

is particularly important is flexibility in job design.

Job design is just how tasks are grouped

into jobs within organizations and how people

in different jobs interact or don't interact

with one another to perform their work.

In terms of the way jobs are designed, flexibility is key

because one of the things we find is that work-life conflict,

when your work responsibilities interfere with your non-work responsibilities

and you consistently can't balance the two,

that becomes incredibly problematic.

Where possible, flexibility, flexible work arrangements is great.

The other thing that enables is for people who maybe would benefit

from therapy or would benefit from some other medical support,

that if they have a flexible work arrangement,

they can take an hour out in the middle of the workday and go

see a therapist or go seek medical treatment without having

to tell the employers why they're doing that or without having

to balance or lie to employers to keep a secret,

and so flexibility is helpful.

Other things that are helpful are solving what we call role ambiguity,

which is where employers, employees

rather aren't really sure what their job

entails or they're not clear if something is their responsibility.

That uncertainty is really problematic for mental health.

Even just clarifying to employees what their job is,

making sure that when we're evaluating their performance,

we're really evaluating them based on what we've agreed

their tasks and their responsibilities are.

When we talk about fixes around job design,

those are the things that we're looking at.

Isn't it a problem though that often employees

don't even want to admit that they feel

overwhelmed with their work because they think

they're going to be judged by their employer,

that they'll have a poor performance evaluation?

Having that enabling culture is actually quite tricky, isn't it?

It is really tricky

and there are a couple ways to go about addressing that.

One of them is that organizations and managers

can work to normalize people not feeling okay.

Oftentimes in the midst of the COVID pandemic, at least in the States,

we would hear people throw around this phrase,

"It's okay to not be okay."

It might sound a little cliche, but it's really important for managers

and for organizations to share that message.

What that might look like is if a manager feels

comfortable sharing their own mental health struggles,

certainly that can be a powerful way

to de-stigmatize mental health challenges.

It could also be as simple as a manager saying,

"Hey, I'm having a really hard day today."

Modeling for employees that that's okay,

that the manager understands that people have hard days,

and being more broadly supportive can actually trickle

down so that employees do feel more comfortable saying,

"Hey, I'm struggling."

Certainly, there is a societal stigma

about mental health and mental illness.

An employee might not want to come out and disclose, "Hi,

I have a major depressive disorder."

But they might then feel

comfortable saying to their manager, "I'm struggling.

I'm having a really rough time.

Can I work from home today?"

Be able to seek that support without necessarily risking the backlash

from the stigma of naming their mental illness.

Yes, it sounds like when we talk about management styles here,

that it has to be a management style with a more human face,

not seeing workers as just part of a production line so to speak.

I think that part of it also goes back to really who managers are.

In most organizations, people are promoted to managers

because they're good at whatever their job is.

They're a great engineer, or they're a great salesperson,

and then they're promoted to the manager of engineers.

Leading people and recognizing when they need

support and what type of support they need

is actually a very different skill set

than being an engineer or a salesperson.

I think it's really incumbent on organizations

to provide that sort of managerial training.

When we are talking about the workplace, of course,

employees can't take away all the stresses.

There are jobs where employees witness trauma.

It could be in a hospital, they could be firefighters,

they could be in the police service.

Surely, maybe we're expecting too much on employers

to do that in those kinds of settings.

I think that's a really great point.

Of course, there's traumatic work organizations like those you mentioned

and there's just inherent stress

in less obviously traumatic work organizations.

There is really good research on the police force

and on the military about things that can at least be done

to mitigate some of this challenge.

For instance, in both military settings and police settings,

there's been research to show a benefit of resilience training

before employees encounter what is sort

of inevitable trauma in their jobs.

In the police force, there's quick access to psychologists

or therapists to help them process trauma.

Those types of interventions,

while we still have more research that needs

to be done on the best way to implement them,

that research really does show promise for those types

of preliminary or preventative interventions that workplaces

can do that can really mitigate some of the inevitable damage

and could potentially be brought into less inherently traumatic work.

Also, there's research to show that,

for instance, there's a great study on humanitarian aid workers,

and certainly, they experienced vicarious trauma,

they witnessed unimaginable loss and illness and death,

but also the things that we're talking about more broadly,

like not letting people

who are verbally abusive or incompetent become supervisors,

that also influence their mental health.

I think that there are a lot of ways that organizations can move

the needle even if they can't solve all of employees' challenges.

Great. I know that in the study you outlined four steps that employers

can take to reduce mental stresses on their employees.

In the short time that we have left,

maybe you could just outline those four steps?

Sure. We've talked about the reasoning behind some of them.

The first is clarifying and revising job descriptions.

Make sure employees know what's expected

of them and make sure that what's expected of them is reasonable in the long term

even if there are short-term fluctuations in workload.

The second is to proactively train staff

on the positive behaviors expected of them.

Things like a zero-tolerance policy on bullying

or disrespect and making sure that managers

know not to hire people who might show

these negative interpersonal behaviors,

even if they're really great performers.

Just like hiring managers have a set

of technical requirements for who they hire,

have a set of interpersonal requirements too to make sure

that any new employees are supporting a positive organizational culture.

The third suggestion we have in this article

is helping employees build resilience,

which we just talked about in terms of taking

what we know from extreme occupations

like police and military and bringing

that maybe into more general workplaces.

Then the fourth is don't assume that employees will speak up.

The research shows that about two-thirds

of employees with a mental health challenge,

will say something to somebody at work.

That means one-third of employees at least won't say something,

or more than that won't say something to their manager.

I think that's why it's incumbent on organizations to assume

that there are these pervasive mental health

challenges with their employees and take whatever

proactive steps they can to improve

the workplace to reduce psychological hazards

to help employees who they may not know have mental health challenges.

Are they proactive in trying to preemptively fix problems

or do you find that there's some reluctance here

to follow your four steps?

Yes, I think that employers certainly try to be proactive

but perhaps they miss the mark a little.

As I mentioned, there's a lot of money invested, for instance,

into employee assistance programs to provide short-term therapy

to individual employees who need it but that doesn't address

the overwhelming systematic influences.

With employees in terms of their proactivity,

there is the real risk of stigma,

and so what we see is a lot of employees, especially those with diagnosed

mental illness might not want to come forward

and proactively talk about that with their manager for fear of stigma.

That is a very real risk.

What we do see is employees starting to partially disclose,

so saying, "Hey, I'm struggling."

Instead of saying, "Hi, my major depressive disorder is acting up,

and so being strategic about how they can seek

support without risking exposure to stigma.

Certainly. I think that in recent years we've seen

well-known personalities who are much more willing to talk

about their mental health struggles which is becoming--

It seems to me more normalized if that's the correct word.

Hopefully, there is some hope that mental health is something

that can be out in the open in the workplace and can be addressed.

Are you hopeful that that's the case?

I am really hopeful.

I mentioned before that I was really surprised

in conducting this review about the disproportionate impact

of the organizational practices and culture on employees' mental health.

I think that the flip side of that is once we know what causes it,

employers actually have an ability to fix some of these things.

As you mentioned at the beginning of the segment,

work can really be a force for good in employees' mental health.

It can provide dignity, it can provide meaning,

it can provide a livelihood.

I think that if organizations get this right

and as the research moves toward a broader and more open conversation about this,

as employees are increasingly willing to speak up, as you mentioned,

certainly the stigma reduction from well-known celebrities,

we also see systematically that younger employees are more willing

to speak up about their mental health in really explicit ways.

I do think that this conversation can move

organizations in general from exacerbating

the problems to potentially being an important part of the solution.

Excellent. On that positive note, let's wrap up there.

Thank you so much, Emily, for discussing

this really, really important issue with us.

Thank you listeners for listening to The Future of Work Podcast.

I'll see you next time.