Positive work culture

1. Creating a Positive
Workplace for Employee
Mental Health

2. 1. Strategies
a. Range of Problems
b. Range of Programs (Worksite Wellness/Health Promotion,
Organizational Factors, Clinical Services)
2. Practicalities
Worksite Mental Health for
Owners and Managers

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STRATEGIES

4. Types of problems
• Diagnoses
– e.g., Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD)
– As per Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5)
• Broad range of problems – hassles, feeling anxious or sad, family stressors, etc.
• Problems of the workplace – stress, morale, cohesion, absenteeism
Objectives
• Reduce absenteeism
• Increase presenteeism
• Increase morale, productivity, customer satisfaction
• Raise reputation of company as a good place to work and progressive, reliable source of products
• Reduce health care costs (mental health major driver itself and contributor to physical health
problems)
Problems and Objectives

5. Clinical Services and Resources
For diagnosed problems, those needing professional care
• EAP
• Adequate behavioral health coverage
• Family coverage (adolescent and spouse mental
health often major driver of employer health costs)
Layers of Programs
Objectives
• Reduce absenteeism
• Increase presenteeism
• Increase morale, productivity,
customer satisfaction
• Raise reputation of company as
a good place to work and
progressive, reliable source of
products
• Reduce health care costs
(mental health major driver itself
and contributor to physical health
problems)
Worksite Based Resources & Activities
For Problems “We all Have”
• Workshops, Classes
• Group Programs
• Promotional Campaigns
Policies and Practices
• HR
• Supervision and reporting relationships
• Organizational climate

6. Range of Activities
• Wellness and peer support group and individual activities
• Incorporate mental health into general management practices, e.g., Quality Circles
• Company investment in resources: e.g., work-out room and equipment; nursing mothers
facility; attractive, private room for group meetings; healthy vending machines and
facilities for healthy diet – refrigerators, stoves, microwaves
Organization and Governance
• Employee engagement in program direction and implementation
• Employee steering committee – workplace wide in small company, within units in larger
• When possible, choices by employees (e.g., purchases of break room equipment, topics
for monthly wellness meetings)
Advantage of Community – Smoking Cessation in St. Louis
• Higher quit rates among those exposed to the broad campaign than among those who
joined classes to help them quit (Fisher et al. Am J Health Promotion 1994 9: 39-47, 75.)
Worksite as Community

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PRACTICALITIES

8. Contracted Services
• Professional, services provided by organization focused on health/mental health
• Fixed costs
• Reduced management burden
• Confidentiality
Company Based Services
• Direct management of nature, quality of services
• Reflect corporate culture
• Connect with worksite, employee-based activities and services
• Opportunity for leadership to set tone, example
• Link with broader organization initiatives re: morale, quality control, etc.
Questions:
• To what extent is mental health, morale, etc. a core concern for business? (e.g., customer service vs.
low tech manufacturing)
• Contract out for core business?
• Blending of types of services?
Contracted vs Company Services

9. Perspectives of Employees vs Management
• For management: stress management to teach employees skills that will increase
productivity/decrease absenteeism
• For employees: stress management = fix my boss!
Framing and Promotion
• Organize around common concerns, e.g., weight, exercise, feeling down, rather
than clinical concerns, e.g., diabetes, depression.
• Provide company time for activities (assume gains in productivity will balance out
lost time).
• Develop with employee input and employee exemplars in promotion.
• Critical roles of supervisors: endorsing vs “grudging” permission.
• Roles of managers: As participants? Setting tone. Clarifying commitment.
Wellness and Related Services

10. Individual Support
• Great capacity – e.g., successful cognitive behavior therapy for post-partum depression
implemented by nonprofessional health workers in Pakistan
• Range of services: promote, navigate (e.g., insurance or available services), support
health behavior change, implement health education
• Training: depending on services, 8 to 40 hours
• Need for coordination and back-up by HR or employee health staff
Mutual Support
• Encourage all to support all, e.g., training on “How to be a friend at work”
• Train individuals to promote mutual support activities, “pods”
• Groups of coworkers focused on wide range of topics: exercise, shared interests, “Moms’
Group” or “Cat Lovers”
• Objective: everybody has someone at worksite with whom they can confide or call on for
a favor – What would achieving this do to corporate culture?
Peer Support

11. • Key Theme: Stress is what we do in dealing with stressors,
not something that happens to us
Example of Worksite Program: Stress Management
In Charge Session Topics Homework
1. Orientation: Stress is normal thing that we do Complete Daily Stress Inventory
2. Examine our stressors and how we react; Changing how we think Monitor how we think and alternative reactions
3. Changing global beliefs that drive how we think Monitor role of global beliefs in how we think
4. Combatting stress: Muscle relaxation intro and practice Practice muscle relaxation
5. Recurrent stressors: Assertiveness and problem solving Monitor recurrent stressors and antecedents and responses to them
6. Brainstorm application of assertion and problem solving Monitor assertion and problem solving and results
7. Making it mine: integrating how we talk, relaxation, assertion, problem
solving
Monitor personal plan for integrating how we talk, relaxation, assertion,
problem solving
8. Summary and integration: What to watch for to keep it going Identify key challenges to watch for, how to address them
Key to Behavior Change: Develop skills over time with homework leading to next
session leading to homework…….

12. Begin with employees and their perceptions and needs
• Town hall meetings, surveys, web bulletin boards
• Employee steering committee – look for decisions to turn over
• Consider placement outside of HR or health services, e.g., production manager as management
lead
• Introduce company and management needs as part of the mix – “our ability to stay in business is
threatened by health care costs”
Program emphases
• Traffic > content??
• Promotion, events, contests
• Peer support and/or group programs
• Classes guided by steering committee
• Resources: walking path, cafeteria, exercise room, showers???????
Developing Health Promotion as Part of Worksite Community

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ORGANIZATIONAL FACTORS

14. Organizational Risk Factors
• Poor organization of work plays a significant role in development of
mental health problems
Content of work
• Workload
• Participation and control
• Job content
Context of work
• Role in organization
• Reward
• Equity
• Interpersonal relationships
• Working environment
• Workplace culture
• Home-work interface

15. Content of Work
Workload • Excessive workload
• Insufficient work
Lack of participation
and control
• Inability to participate in decision-making
• Inability to choose how to complete work
Job content • Monotonous tasks
• Unpleasant tasks
• Aversive tasks
• Killer combination: High demand with low control
World Health Organization.
“Mental Health Policies and Programmes in the Workplace.”

16. Context of Work
Role in organization • Role conflict
• Role ambiguity
Lack of reward
(recognition)
• Lack of recognition of work (e.g., through salary)
• Low status
• Inadequate social support in the workplace
Inequity (lack of fairness) • Perception that workplace is not just or equitable(e.g., in terms of workload, salary, or promotion)
• Poor management of organizational change (e.g., downsizing)
Poor interpersonal
relationships
• Unsupportive supervision
• Poor relationships with colleagues
• Bullying, harassment or violence
• Isolated or solitary work
Working environment and
conditions
• Inadequate physical environment (e.g., noise, pollution, light, danger)
• Irregular working hours (e.g., shift work or excessive working hours)
Workplace culture • Poor communication
• Poor leadership
• Lack of clarity about workplace objectives and structure
Home–work interface • Conflicting demands at home and at work
• Lack of support for home at work
• Lack of support for work at home

17. Strategies as Part of Overall Mental Health Policy
• Increase awareness of mental health issues
• Support employees at risk
• Provide treatment for employees with a problem
• Changing the organization of work
• Reintegrating employees with a problem into the workplace
World Health Organization.
“Mental Health Policies and Programmes in the Workplace.”

18. Beneficial Policies
• Encourage employees to use their vacation days
• Send employees home when they are sick
• Use lunchtime for social activities or walking with colleagues
– Map out a walking route for employees to help them get started
• Allow employees to take 15-minute “power naps” during the workday
NB: U.S. needs to reverse view of sleep as weakness
Sleep deprivation = inebriation  Implications for bottom line??
• Set the expectation that people don’t respond to emails over night or over
the weekends
• Normalize talking about stress and other mental health problems

19. Beneficial Policies, cont.
• Create quiet spaces for relaxation
• Train managers to recognize signs and symptoms of mental health
problems among team members
• Team-building with physical activities (like walk-a-thons)
• Meaningful retreats (initiate dialogues around workplace values,
culture, and mental health)
• Clear leadership support for EAP and confidentiality around it

20. Involve Employees
• Solicit feedback and ideas from employees on:
– Things that stress them out at the workplace
– Things that they love about the workplace
– What changes would make them feel happier in the workplace?
– Do they have positive experiences from other companies that might be
adopted?
• Create a workplace wellness committee

21. Ways in which employees want their employers to keep them safe
during COVID
1. Provide personal protective equipment
2. Provide assurances that employees will be notified if a colleague gets sick
3. Require customers to follow prescribed safety and personal hygiene practices
4. Provide assurances on cleanliness and disinfecting practices
5. Provide a clear response and shut-down protocols if someone tests positive
6. Promote and enforce social distancing
7. Require mandatory testing for employees returning to work after being out sick with COVID
8. Provide a method for employees to give feedback on COVID-19 policies and practices
PwC Survey

22. Clinical Services & Resources
• Human Relations
• Employee Assistance Programs (EAP)
• Employee health insurance coverage for behavioral health
• Contract for services from behavioral health provider organization
• Identify services from County Health Departments – Many emphasize mental
health and substance use
• Community Mental Health Centers??
• Primary Care Providers
• National Alliance on Mental Illness / North Carolina: https://naminc.org/
Professional or Clinical Services