Please contact John Sarno (john@eanj.org) if you are interested in scheduling an in-house presentation.

1. Mental Health and Wellbeing at Work
An HR Toolkit - 2019

2. Opening remarks
Ingrid Astudillo
Director, Human Resources, Miele, Inc.
Presenters
• John Sarno, President, Employers Association of New
Jersey
• Tracy Kaplan, Director of EAP, Preferred Behavorial Health
Group
• Clarice Holmes, Chief Clinical Officer, Members Health Plan
• Tom Daniels, Senior Vice President, Members Health Plan
• Christopher D'Marco, Principal, Change & Response
Strategies, LLC

3. An American State of Mind
• One in five Americans are diagnosed annually with a mental
health condition
• Nearly 60% of Americans reported experiencing symptoms of a
mental health condition in 2018 – anxiety, depression, eating
disorders, worry, fear, general manic behavior
• Half reported that symptoms lasted for more than one month
• About 25% received a formal diagnosis
• 38% stated that they would not be open to treatment

4. Mental Health and the Workplace
• About 40% stated that work contributed to their symptoms
• 60% said that productivity was affected
• 60% said they never talked to anyone at work
• Of those that discussed issue at work, most felt uncomfortable
speaking with HR and senior managers
• Over a third had left previous jobs due to mental health
conditions
• Perceptions are mixed – about half willing and unwilling to hire
or work with a person with a mental health condition

5. For Most Employers – Don’t Ask, Don’t Tell
• Most employees do not believe that management supports
mental health
• About a third believe that their manager is unapproachable or ill
equipped
• Most common approach is time off from work
• Many employers are more likely to incur the costs of turnover,
lost productivity and disability insurance payments than helping
employees get support.

6. Worker Attitudes Depend on Age
• Younger generations -Millennials and Gen Z – are more likely to
experience symptoms than Baby Boomers
• More likely to be formally diagnosed
• More likely open to discuss it at work (Baby Boomers are highly
resistant to discussing at work)
• Only 40% of Baby Boomers say that an employee with a mental
health condition can be just as competent – 60% of Millennials
and Gen Z
• Younger workers generally want a more open/supportive work
culture

7. Worker Attitudes Depend on Gender
• Women are more likely to seek treatment for anxiety and eating
disorders
• Men are more likely to seek treatment for aggression and
violence
• LGBTQ+ are more likely to experience symptoms
• More likely to receive a formal diagnosis and treatment
• Almost 80% of transgender respondents received treatment and
90% quit jobs

8. Stress and the Workplace

9. Workplace stress is the harmful physical and
emotional responses that can happen when there
is a conflict between job demands on the
employee and the amount of control an employee
has over meeting these demands.
Excessive workplace stress causes a staggering 120,000 deaths
and results in nearly $190 billion in health care costs each year

10. What Can an Employer Do?
• Raise Awareness
• Treat workplace stress and burnout as a bottom line issue – a
problem to be solved rather than avoided
• Open up the culture with dialogue and procedures
• Employee Assistance Program
• Know what is in the healthcare plan and use it as a tool
• Organizational training – supervision and referral
• HR as part of the solution and not the problem

11. Stress Interventions
• Stress screenings and information on stress reduction and the
early warning signs of mental health conditions;
• Effective intervention programs like cognitive-behavioral therapy
for stress management;
• Programs that effectively address stress like mindfulness,
relaxation, yoga and tai chi and encourage exercise,
emphasizing the value to mental and physical health; and
• Programs that improve resiliency.

12. BURNOUT
UNDERSTANDING THE PROBLEM AND
THE ROLE OF THE HR PROFESSIONAL

13. Burnout
Previously was defined as “General Exhaustion”
Where the term came from:
Herbert Freudenberger – 1974
Researched by:
Christina Maslach - 1981

14. Burnout
New standards from World Health Organization
• Not a medical condition
• “occupational phenomenon” affecting health
• Symptoms of burnout result “from chronic workplace
stress that has not been successfully managed”

15. THREE CENTRAL ISSUES
EXHAUSTION
ENGAGEMENT
EFFICACY

16. WAYS TO PREVENT BURNOUT
IN THE WORKPLACE:
Communicate with your employees:
1. Hold regular productive staff meeting
2. Emphasize positives and downplay
negatives
3. Recognize and acknowledge their work
4. Clarify expectations and job
requirements

17. WAYS TO PREVENT BURNOUT
IN THE WORKPLACE:
Motivate your employees:
1. Find out what Motivates your employees
2. Encourage stress relievers
3. Show appreciation
4. Encourage fresh air
5. Encourage Vacation Days
6. Increase compensation

18. WAYS TO PREVENT BURNOUT
IN THE WORKPLACE:
Lead your employees:
1. Improve your leadership skills
2. Send your employees to training
3. Assign tasks accordingly
4. Limit overtime
5. Encourage participation in EAP

19. What to look for in a distressed Employee:
Unexplained absences from work
Showing up to work late/leaving early
Decrease in productivity
Apparent frustration
Decline in health
Lack of enthusiasm
Isolation

20. Keep work performance based:
What do they feel is contributing to the workplace burnout?
What do they feel would be helpful?
What do they think would need to change?
How can you be helpful?
EAP referral - informal
If it is now become a Disciplinary Issue based on performance?
EAP involvement – Supervisory Referral
How to have a conversation a with a Distressed Employee

21. Prevention
Support
Interventions
Case Management if symptoms escalate
If you have an EAP – What is the Role of EAP

22. If EAP is not an Option
Develop Workplace Wellness plans
Yoga Classes onsite
Weight watchers Onsite
Group mentoring
Read at work – Book Clubs
Massage Day
Walking Lunch Clubs
Ensure time off is being used/Mental health days
Celebrate Family Days – Trick or treating, tailgating party, bring your
dog/pet to work day,

23. If EAP is not an Option
Resources:
Post hotlines and self-help meetings in bathroom stalls (not just for adults include children)
https://www.samhsa.gov/
https://www.state.nj.us/humanservices/dmhas/home/hotlines/
Meditations Apps
Headspace
Happify
Mental Health First Aid Program
Joe Gratzel, Training and Outreach Coordinator
Mental Health Awareness Training, Preferred Behavioral Health Group
732-492-1481 (mobile)

24. 24
Title I – Americans with
Disabilities Act
“No [employer] shall discriminate against a
qualified person with a disability because of the
disability of such individual in regard to job
application procedures, the hiring, advancement,
or discharge of employees, employee
compensation, job training, and other terms,
conditions, and privileges of employment.”

25. 25
“Disability” also means “a record of such
impairment” or “being regarded as having such an
impairment”
Examples:
-a person with a record of treatment for a disability
-a person has some physical limitations that may
not be disabling but is perceived by others as
disabled
i.e.: person who returns from a leave following
a workplace injury and is told he is too
impaired to work

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Peters v. Baldwin School
(Second Circuit, 2003)
Peters, a guidance counselor, suffered from a serious
medical problem, of which the school was aware.
Peters’ job performance was good and was
recommended for tenure by her supervisor. In a
conversation with a co-worker, Peters jokingly said
that she could not take her medical condition any
more and was going to commit suicide with her
husband’s gun, a member of the NYPD. The school
psychologist got wind of the conversation, became
alarmed, and told school officials.

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School officials called NYPD in an effort to secure Peters’
husband’s gun. She was then reassigned to
administrative duties because of her “mental breakdown.”
The school also required a fitness for duty report from a
psychiatrist. Peters was cleared to return to work but
school officials already had notified parents that Peters
was no longer a guidance counselor “due to medical
reasons.” Thereafter, the school disciplined Peters for
“serious performance errors and falsifying records to
cover-up her mistakes.” She was denied tenure and
ultimately discharged.

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The court finds that the school perceived
Peters as suffering from a mental illness
that made her suicidal, i.e. a condition
that substantially limited her ability to
carry on life’s affairs. “A mental illness
that impels one to suicide can be
viewed as an instance of inability to
care for oneself.”

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Holodak v. Rullo
(Third Circuit Court of Appeals 2007)
Referral to an EAP does not violate the ADA when the referring
manager has no knowledge that employee was trying to give up
drinking.
Employee was experiencing personality conflict with co-workers and
had a harassment charge filed against her. When interviewed by HR,
the employee’s supervisor noted that employee was more
temperamental than usual because she “was trying to quit drinking”.
Employee was referred to EAP for drinking problems.
Months later employee was counseled and was passed over for an
assignment that she was supposedly promised.
The manager that made the decision on the assignment had no
knowledge as to why employee was referred to EAP.

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Whether employer “regards a person” as having a substantially
limiting impairment depends on facts and circumstances.
Referrals to EAP
Gazaway v. Makita USA – After employee is involved in fatal traffic
accident, he begins to act erratically and sullenly at work.
Supervisor’s suggestion that employee seek EAP counseling is
not “regarding” him as having disability
Holihan v. Lucky Stores – Hostile and abusive employee is
repeatedly counseled, placed on medical leave with organic
Mental Syndrome and treated through EAP. While on leave,
employee receives real estate license and pursues real estate
career. Leave is extended twice, supported by medical
certifications. Third request to extend leave is denied and
employee is let go. By counseling employee, referral to EAP and
obtaining medical certification, employer may have “regarded” him
as disabled.

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ADA job protection does not apply when person
with disability poses a “direct threat”
“Significant risk of substantial harm to the health
or safety of the individual or other that can be
eliminated or reduced by reasonable
accommodation.”

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Ward v. Merck & Co.
(Third Circuit Court of Appeals 2007)
An employee who acted in a bizarre fashion and who was in
a “zombie-like” state could be subject to a fitness for duty
examination as a condition of employment.
Researcher with anxiety disorder acts out in lunch room. He
takes a leave of absence and returns to a temporary part-
time job that has less stress. His performance deteriorates.
He is terminated for his refusal to take medical examination.
Termination is upheld. Strange and bizarre behavior, with
the implicit concern for employee safety, justified
examination.

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Selected Types of Accommodations for
Psychological Disabilities
• Short-term leave of absence
• Temporary modified work schedule
• Physical changes to environment, i.e.: room
dividers, partitions, lowering the volume or pitch
of telephones, use of “white noise”
• Adjusting supervisory methods, i.e.
communicating in effective ways, more feedback,
additional “face time” or more e-mail
• Job coach or mentor
• Reassignment to a vacant position

34. The Health Care Plan: A Vital Tool
• What are the relevant coverages
- Mental Health Parity & Addiction Equity Act of 2008
- ACA Mandated Coverage for Mental Illness.
- Essential Health Benefit. No Limits.
- Telemedicine. Confidential sessions available for:
- Anxiety, Stress, PTSD, Depression, Substance Usage
• Communicating with employees
- Educate your employees on their benefits. (Not all health plans are created equal!)
- Conduct enrollment meetings.
- Provide links to benefit plan documents
- SBC (Summary of Benefit Coverage)
- SPD ( Summary Plan Description)
- Benefit Summaries

35. The Health Care Plan: Benefits and Parity
Mental Health Condition Treatment
Covered Charges include the treatment of Mental Health Conditions provided by a Hospital, Psychiatric Hospital,
Residential Treatment Facility, Physician or Behavioral Health Provider as follows: • Inpatient room and board at
the semi-private room rate, and other services and supplies related to Your Condition that are provided during
Your stay in a Hospital, Psychiatric Hospital, or Residential Treatment Facility.
• Outpatient treatment received while not confined as an Inpatient in a Hospital, Psychiatric Hospital or Residential
Treatment Facility, including:
• Office visits to a Physician or Behavioral Health Provider such as a psychiatrist, psychologist, social worker, or
licensed professional counselor (includes telemedicine consultation)
• Individual, group and family therapies for the treatment of Mental Health Conditions
• Partial Hospitalization treatment provided in a Facility or program for Mental Health Conditions treatment
provided under the direction of a Physician
• Intensive outpatient program provided in a Facility or program for Mental Health Conditions treatment provided
under the direction of a Physician
* Full description of covered services can be found on plan SPD at www.membershealthplannj.com

36. “Members Health Plan NJ is the brand name used for products and services provided by
Affiliated Physicians and Employers Master Trust.”
Teladoc – Peace of Mind

37. The Health Care Plan: Helping Employees
Connect the Dots
•Free or Minimal Cost On Line Tools
- Happify (Web based videos and activities) Conquer Negative Thoughts,
Confidence and Optimism, Transformation of the Mind and Enhancing Relationships)
- Web MD (Diet, Happiness, Use of Sound Therapy, Aromatherapy)
- Simple Truths Website (Web - based tools and library)
On - line music or screensavers (Tranquility music, beach scenes with sound)
•Use Your Benefits
- Aetna A1A Concierge Services – Extra hand holding with advocacy for
members and family
- Acupuncture
- Hypnotherapy
- Web- Based support groups for health / wellness and anonymous disease specific
chat rooms

38. Short Free Video Examples
• The video is available for your viewing pleasure at
https://vimeo.com/95310708
https://vimeo.com/94658985

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Thank You