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    Many people feel uncomfortable talking about mental health. Thanks to a long history of movies, books, and news stories, the term “mental illness” may conjure up disturbing images of hallucinating schizophrenics, mass shootings, and psychotic serial killers.

    The reality of mental health disorders is very different. In fact, these issues touch many of us:

    • One in five Americans is diagnosed with a mental health issue each year.
    • More than 40 million Americans live with depression.
    • Suicide is the second leading cause of death for people between the ages of 15 and 24.
    • Drug overdoses are the number one killer of Americans under the age of 50.

    Despite these startling and far-reaching statistics, mental health issues continue to be seen as a source of shame and something to be kept quiet and out of public view. Hundreds of celebrities have opened up and shared their personal battles with depression and other serious mental health issues – from singer Demi Lovato to swimmer Michael Phelps to actor Leonardo DiCaprio – and this has shined a much-needed light on the subject. Still, the stigma around mental health remains

    For employers, mental health issues are a major drag on productivity and driver of healthcare expense. Depression is the leading cause of disability in the United States, and the CDC estimates it’s also the cause of 200 million lost work days per year, costing employers $44 billion in lost productivity. Compounding the problem is the common co-existence of medical and behavioral health disorders:

    • 68% of adults with a mental disorder have at least one medical disorder
    • 29% of adults with a medical disorder have at least one mental health disorder

    Why don’t employees seek help? According to Suzanne Delbanco in How Employers Can View Mental Health Stigma, employees may be afraid to admit, even to themselves, that they need support with mental health. Or they may not be aware that their suffering may be due to anxiety or depression. Those who do recognize the need for treatment may be afraid to leave the office for therapy appointments lest co-workers or employers notice. Many fear, if their employer finds out they have a mental health condition, there may be negative repercussions. A 2017 survey shows that 31% of employees say they would be afraid of being labeled as weak, and 22% fear it would impact their opportunities for promotion.

    Employers can play a major role in removing the stigma of mental health issues and it’s in their best interest to do so. Here’s what we’ve seen work:

    1. 97% of large companies (over 5,000 employees), as well as an estimated 75-80% of mid sized and smaller companies, have an Employee Assistance Program. Your EAP is the most powerful weapon in your arsenal to combat mental health stigma and increase employee access to help. This is certainly the case if you have a comprehensive EAP, but is unlikely to be true with a “free” EAP. So-called “free” EAPs embedded in disability insurance products generally provide an EAP in name only; their business model only works if employee engagement is minimized, so they will be unlikely to serve any meaningful role in creating employee engagement.
    1. Awareness and education are critically important. Your EAP should be very willing and adept in helping to build awareness and educate your employees. Initiatives we’ve seen work include:
    • Hosting lunch and learns and guest speakers on behavioral health topics in the workplace
    • Offering a monthly topical webinar for employers to use to educate their employees and normalize behavioral health issues
    • Providing educational newsletters.
    • Providing special presentations to educate managers and supervisors about key mental health issues: mental health first aid, suicide prevention, PTSD awareness and substance abuse (including the opioid epidemic)
    1. Promote awareness of the EAP and easy access to behavioral health treatment services at company benefit fairs.
    1. Create a culture of acceptance. For example, when speaking to employees about medical benefits, include behavioral benefits and issues in the conversation, thereby normalizing behavioral health. Also, incorporate language in company policies to prevent stereotyping and eliminate improper language/ labeling or bullying of employees with behavioral health challenges.
    1. Provide access to an Interactive Screening Program allowing employees to anonymously take a screening test for stress, depression and anxiety. Then, if they wish, they can dialogue with a behavioral health professional to understand their screening results and, if needed, connect them to the appropriate form of assistance – a therapist, psychiatrist, treatment program or self-help or support group.
    1. Develop a Peer Support Program to train employees to assist distressed employees and encourage them to access professional behavioral health services.
    1. Larger companies should consider placing behavioral health clinicians on-site at workplaces to assess, refer and provide short-term counseling. A 2015 survey by the The National Association of Worksite Health Centers claims that 45% of all employers offer some sort of on-site health clinic. Adding a behavioral health clinician to an on-site clinic is a natural wellness extension and further helps normalize the concept of mental health. If you’ve ever watched the popular Showtime series Billions, you’ve seen one of the main characters serving as the on-site therapist for fictional company, Axe Capital.
    1. As behavioral health professionals, let your EAP help you draft policies that permit employees to leave work to keep behavioral health or EAP appointments. Structure benefits and policies with the awareness that many areas are underserved in terms of psychiatrists, and alternatives to psychiatry may be needed.

    Employers can make a big difference in encouraging and enabling employees with mental health issues to seek help.  We suggest this is the perfect time to start.

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