In North America, about 1 in 5 people suffer from mental health challenges. That means if you have five managers in your organization, chances are, at least one of them is suffering from some sort of mental illness. This is a problem for your organization, because if they are suffering, and aren’t getting treatment, this will impact their ability to stay positively engaged at work. And, that will cascade down into their employees creating a drag on productivity.

Gallup’s studies of workplace engagement have shown that a manager’s attitude has a significant impact on the attitudes of their employees:

A manager’s engagement — or lack thereof — affects his or her employees’ engagement, creating what Gallup calls the “cascade effect.”[i]

The issue of mental illness in management is further compounded by the fact that mid-level managers are significantly more likely to be suffering from mental illness. In 2015, The Columbia University Mailman School of Business released a study that demonstrated that managers are twice as likely to be suffering from depression and anxiety compared to workers or senior leaders[ii].

What this looks like in the office.

When I first started my career as an engineer, I had a manager who was friendly and engaging. We worked together as a team, building mutual trust and respect. I was inspired to try hard and do my best. Then, there were some significant challenges for the organization due to greater economic issues, that lead to changes in our organization. My manager began to withdraw from me, talking with me less, and leaving me feel unsupported. At the time, I just assumed it was that he had too many responsibilities and didn’t have time to engage with his team. We talked less, and the trust and respect we had for each other began to erode. It made it harder for me to do my job, because I started to feel I couldn’t be open and honest with him. It impacted his other relationships as well, making it harder for him to be proactive in addressing strategic initiatives that he wanted to pursue.

At the time I didn’t think much about it, but looking back, I can now understand something deeper was likely going on with his own mental health. The stress of the business was weighing heavily on him, which he tried to internalize. This behavior, which is common among many managers, creates a vicious circle. Managers internalize the stress, which causes them to change how they interact with their employees. A Norwegian study from 2014 found that Managers experience stress far more positively when they have good relationships with their employees[iii].

The stress my manager was suffering under lead him to internalize his feelings and withdraw from his work colleagues. As he withdrew, he negatively impacted those relationships, making the pain of the stress even worse, which further kept him from restoring his relationships. This type of situation is perfectly described as “chronic stress”. There are many studies that have shown the links between chronic stress and mental illness.

What if the mental health of managers was considered a critical element of performance management at your company?

This very question has been explored by the UK National Institute for Health and Clinical Excellence. They estimate that by creating practices to support the mental health of employees in the workplace, including prevention, early action to combat stress and early identification of problems could decrease losses to productivity by as much as 30%[iv].

One part of the challenge of addressing mental health at work, is the continued stigma of it. A Canadian study in 2015 found that 64% of Ontario workers would be concerned about how work would be affected if a colleague had mental illness[v]. And, fear of disclosure is legitimate: a 2008 survey found that 42% of Canadians were unsure whether they would socialize with people who have mental illness.

A critical part of addressing mental health issues at work is better education about what it looks like, and that it is treatable.

Another challenge for addressing mental illness at work, is creating meaningful support programs. Many large companies invest in an Employee Assistance Program that offers counselling to employees and family members. Yet, these programs aren’t performance based—they are cost driven. This cost metric means that a sub-standard quality of care may be given to your employees, so while it may feel like your organization is trying to actively address the mental health of their employees, they may be making the problem worse.

Additionally, the EAP programs are all designed for the individual to be proactive and contact them. For this type of action to take place, the worker needs to recognize they have a mental health challenge, and believe that the support offered will help.

A few years ago, my wife was suffering from acute depression. She contacted my EAP and arranged to visit with a counsellor provided by the program. This counsellor, to put it mildly, wasn’t effectively trained to support someone suffering from acute depression. The interactions made my wife’s mental health worse. It was only when we sought out a private Cogitative Behavioural Therapist that she got the treatment she needed. And this problem wasn’t just limited to my wife: I know of one other work colleague who visited with another counsellor from that same EAP, and did not get any meaningful support.

I had another colleague who was suffering from acute depression at work, and it was only through my regular encouragement that he reached out to the EAP program. Had he not been open to me about what he was feeling, he would not have reached out on his own. Even still, I am not sure whether the counsellor he saw was overly helpful.

What to look for to determine if Mental Health is a problem?

If you have a large organization, mental illness will be present in some form in your employees. Traditionally, it’s not been something that’s looked for by HR or management. Given that effective treatment of mental illness creates a demonstrable performance benefit, it seems like it should be something that’s looked for as part of a company’s regular performance review process. The following are a few tools to use in screening for mental health issues at work.

One of the simplest tools is a free online quiz called “Check Up From The Neck Up.[vi]” The free quiz offers a very simple screen to look for issues of depression, anxiety, bi-polar disorders. It’s designed as a system where you can bring in your results to your doctor to discuss what’s going on. Obviously, it would not be appropriate to require your employees to bring the results into the office as a requirement, but regularly inviting your employees to use this resource could offer a free and simple early stage detection tool that can encourage your employees to see treatment.

Another effective way to start to screen for mental health issues is through measuring Engagement at work. Gallup, using their Q12 Engagement analysis found that people who are disengaged at work were 78% more likely to be suffering from depression[vii]. Depending on how the results cascade in the office, if you see on department to have higher levels of disengagement, especially if it was an engaged team in the past, there’s a good probability that mental illness may be contributing to the problem. Alternatively, it might be a sign that the manager might be dealing with mental illness, and their attitudes are cascading down to their employees.

Another major indicator that mental health may be at risk is whether specific managers are taking their vacation. Vacation has been shown to be a significant help to employees and employers. Vacations have been shown to increase productivity, as well as offer improved health and stress reduction to employees[viii]. Yet, many people still feel like they can’t take time off. Often, this belief is caused by a fear that work either won’t be accomplished in their absence, or that work will pile up and not be able to be resolved when the employee is back. These fears are either an indicator of a greater organizational problem, or someone who’s likely suffering from anxiety.

Finally, there are three common outcomes of mental-health issues on employees: Absenteeism, Presenteeism (being present, but not contributing, also referred to as “actively disengaged”), and Turn-over. Absenteeism is a simple thing to measure, but this often doesn’t affect managers who usually feel additional responsibility on themselves keeping them at the office. If there is a department that has a high turn-over rate, it may be a sign that the manager might be struggling with mental illness (or needs additional training). Sometimes it’s the employee who’s suffering that quits, but that’s a situation that’s out of your hands. Of the three, the most important symptom to look for, which is also the hardest to observe, is Presenteeism.

There are many symptoms of Presenteeism. For example, someone who is considered friendly is now withdrawn. Or, an individual who has been a regular contributor in meetings is suddenly quiet. You may find that someone who’s worked hard to further their career is actively avoiding growth opportunities. Changes in computer use habits may also be observed, as they are likely spending more time doing non-work related activities.

What can your organization do to improve the mental health of its employees?

Here are some best practices that have been shown to help your organization make positive changes to your employee’s mental health:

• Training:
  1. Make sure everyone in your organization, from entry level employees to the CEO, understand what mental illness is and how it shows up. This will help individuals learn to identify when they are suffering. This will also enable coworkers to learn the signs to watch for in colleagues and managers, to raise their concerns in a respectful manner.
  2. Teach stress management and relaxation skills (or have access to resources to offer this training). Having a regular program that teaches people skills like Mindfulness Based Stress Reduction, or other evidence based programs can help everyone learn to manage stress and anxiety before it becomes a problem.
• Improved Support for Mental Health
  1. Support your employees to get a proper diagnosis and treatment to their mental health issues. This might mean offering money to cover the cost of assessments with psychologists, which can potentially reach a few thousand dollars. Additional “sick time” may also be valuable while they are in early stage treatment—speaking from experience, it can be hard to go straight into the office after a difficult therapy session. Often, people suffering from mental illness are only suffering until they get treatment. Once they have an effective diagnosis and proper treatment, they might be “living with” mental illness, and their performance will be as good as any other employee.
  2. Don’t limit counselling session as part of the EAP program. Many EAP programs only offer limited numbers of sessions for employees, as if someone’s depression or anxiety is a short-term illness. Ensuring that people have access to the support they need, for as long is helpful will pay back its costs in productivity and commitment to the organization.
  3. Ensure a good fit between counselors and participants. Often, EAP programs assign a counselor to a patient, without considering whether there is a good fit between personalities and styles. As I mentioned, my wife’s experience with the EAP counselor made her mental health worse, because of the poor fit.
  4. Have EAP counselors perform evidence based counseling practices. Cogitative Behavioral Therapy is well documented to be a successful treatment program for mental illness. Ensuring that counselors who are employed by EAP programs use evidence based therapy practices will further increase the efficacy of your company’s investment in their services.
  5. Offer alternatives to counselling. Coaching is an effective tool for helping employees develop in their careers, as well as improve their mental health when they aren’t in a clinical state of disorder. This is a way to address issues before they even arise. Many employees are willing to engage with career and leadership coaches, with the understanding that the experience will further their careers. As an organization, you get the double benefit of developing early talent into leaders, as well as benefiting the mental health of the individuals participating. Shopify has made this a key benefit for their organization with the roll-out of their “Magnify 101” program, focused on 1^st and 2^nd level managers[ix]. The best time to engage coaches to employees is at times of job transition: either significant transfers or promotions.
• Supporting the physical health of your employees
  1. Encourage physical activity. Regular physical activity has been demonstrated to reduce the symptoms of mental illness. Helping your employees find and make time for physical activity will improve your bottom line through improved productivity both through the increased energy that results from regular exercise, as well as reduced losses from mental illness. Large organizations often offer on-site fitness facilities. Smaller organizations may offer to offset the costs of gym memberships or fitness equipment. A small investment in the physical health of your employees will go a long way to helping the productivity and mental health of your employees.
  2. Enforce “black-out” times for e-mail/work. Some companies, especially international organizations, send e-mails and expect a response at all hours of the day. Receiving e-mails from a boss at 2am is well documented. I have one colleague who was often expected to attend a 4am conference call, in addition to fulfilling his “8 hours” in the office (which often extended far beyond that). This expectation was not only impacting his physical health, it was also impacting his family relationships negatively. Expecting employees to be “on, all time” leads to reductions in sleep, which leads to a decrease in productivity of your employees, as well as creates many long-term negative impacts on their physical health. By having a “black-out”, where people are required to be off of their work cell phone and computer, will enable your employees to have the time they need to rest and recover so that they can give their best when they are in the office.
  3. Ensure that employees feel that they can take vacation, without it massively “costing” them. Many people have the rest of their vacation negative impacted due to stress before and after their vacation. Many managers often feel that they have to be ahead of their work before they leave, and still have to catch up afterward. How often have your felt rested, and then within one day of being back at the office feeling like you need another vacation? Many managers continue responding to work e-mail instead of resting and recovering, which further reduces their ability to recover from chronic stress. It needs to be an organizational policy to ensure that people have the ability to take a break from work on vacation, and the policy needs to be supported by everyone in the organization.
• Creating the opportunity for meaningful work.
  1. Create conditions for people to feel a sense of motivation for their work. A psychology study from 2000 showed that the elements that are most important to derive a sense of motivation from work are competence, autonomy and relatedness[x]. Creating the conditions for all employees to work towards competence and autonomy, while supporting each other will benefit the organization through improved performance, creativity, and reduce the costs of over-sight management.
  2. Develop the skill of Job Crafting[xi]. Gallup has found that one of the most important factors in helping employees feel engaged and motivated at work is when they are able to “do what they do best, every day,” as well as feel connected to the organizations mission and values[xii]. Through greater opportunities for employees to participate in “job crafting”, they are more likely to create the conditions where they are able to do what they do best every day, while ensuring the corporate work is achieved. This will lead to a greater sense of connection to the company’s mission and values.

Individuals who have mental illness need many of these supports. People who are mentally healthy will also benefit through improved physical health and vitality. Supporting mental health in the work place won’t cure mental illness, but it will improve your company’s productivity, and offer significant benefits to all employees.

[i] http://www.gallup.com/businessjournal/182228/managers-engaged-jobs.aspx

[ii] https://www.mailman.columbia.edu/public-health-now/news/anxious-depressed-blame-it-your-middle-management-position

[iii] https://www.bi.edu/research/business-review/articles/2014/08/less-stress-when-work-relationships-are-good/

[iv] https://www.nice.org.uk/guidance/ph22/resources/business-case-67240333

[v] http://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/addictionmentalhealthstatistics.aspx

[vi] http://checkupfromtheneckup.ca/

[vii] http://www.gallup.com/poll/187865/engaged-employees-less-likely-health-problems.aspx?g_source=EMPLOYEE_ENGAGEMENT&g_medium=topic&g_campaign=tiles

[viii] https://www.inc.com/lolly-daskal/4-scientific-reasons-why-vacation-is-awesome-for-you.html

[ix] http://versionone.vc/shopifys-big-people-investment-how-a-startup-scaled-coaching-beyond-its-executives/

[x] https://selfdeterminationtheory.org/SDT/documents/2000_RyanDeci_SDT.pdf

[xi] https://hbr.org/2010/06/managing-yourself-turn-the-job-you-have-into-the-job-you-want

[xii] http://www.gallup.com/businessjournal/188675/engaging-employees-big-companies-need-improvement.aspx?utm_source=alert&utm_medium=email&utm_content=heading&utm_campaign=syndicationDepressed managers are impacting your business: what to look for, and how to help them.