Mental Health & COVID-19: Supporting your Employees
Nearly half of Americans report that COVID-19 is harming their mental health. Many are struggling to connect with each other in an increasingly virtual world. As this pandemic continues, it’s essential for organizations to make mental health a priority and engage employees in accessing care and resources.
In this episode, you’ll discover why supporting employee mental health is critical to sustaining trust and engagement throughout the COVID-19 pandemic. You’ll also find out how you can manage your own distress as you lead your team during these challenging and unprecedented times. Finally, we’ll explore how the proactive steps you take today will pay off in both the near and distant future.
Jennifer is a national recognized behavior health expert and founder & CEO at Emvitals, a SentryHealth Partner. Jennifer is trained as a Cognitive Behavioral Therapist and Substance Abuse Professional. She is a published research author and has worked as an individual therapist for over 20 years with a focus on stress reduction, anxiety and depression.
Hey everyone, thanks for joining this episode of For Your Benefits. My name is Julia Peebles, Marketing Events Manager for Sentry Health, creators of WellOnMyWay, one of the industry’s leading employee health and wellness solutions.
We recently hosted a webinar with Jennifer Hunter from Emvitals. She discussed mental health and COVD-19 and how to take a proactive approach to supporting employees. It was such great information and we wanted to share it on our podcast as well.
Jennifer is the founder and CEO of Emvitals and is a nationally recognized behavioral health expert and Emvitals, a SentryHealth partner, is transforming the way behavioral health care is delivered. Shifting from reactive behavioral health to a proactive, emotional health model, they empower employees to understand their emotional health while educating and motivating them toward care. So without further ado, here it is.
About Jennifer Hunter
Thanks, everyone, for being here today. The goal of the conversation for me is really to offer you what I hope is helpful and actionable information as all of you lead your teams, continue to support your populations in this just remarkable time.
As Meghan mentioned, I’m a behavioral health specialist. I’m a cognitive behavioral therapist by training. And just to share with you a little bit about my background, I haven’t done kind of that important therapy work in many years or so. I’ve really been focused on how to promote employee wellbeing and achieve prevention in mental health across a large employee populations for about the last 15 years. And so I look forward to sharing with you what is really my life’s work around,”How is it that we can improve the standard of care of mental health and how can we work together to really combat this issue know and vitals?”
Mental Health and COVID-19 Statistics
We were certainly focused on employee emotional health before the COVID pandemic showed up. And I think what’s really important to understand about where we were as a society when the pandemic hit is that we were really grappling in waking up to the mental health crisis that we were experiencing. Mental health conditions are the most costly medical conditions in the world. They’re more than cancer and diabetes combined. And people often ask me, why is that? Why are they so expensive? One of the reasons is the high rates of prevalence. The reality is, is that one in five people will experience a mental health condition every year and 50 percent of people will experience severe symptoms of mental health, perhaps not a condition over the course of their lifetime.
Improving Mental Health Access
One of the things that we’re really focused on emVitals is a couple of statistics. And one is the fact that people who are actively symptomatic wait 11 years before receiving care. And I have to say, I certainly experienced this as a therapist. People would show up in my office and the reason they were there is because they had tried everything they could think of and they just couldn’t take it anymore. It was really their last attempt at trying to manage what had for them had become completely unmanageable in their lives.
Cost of Poor Mental Health
And so how is it that together we can really shorten that journey to care? What I think is also remarkable about mental health is that 57% of people who need care simply never receive care. And so this was kind of the state of affairs when COVID hit. The other thing that I think’s an important bit of information to think about is that employers are the largest purchasers of behavioral health care in the world. And mental health care expenditures increased 58% over the ten years previous to this year. And yet a small fraction of those were spent on mental health care. And so we really have kind of this system in place that is fragmented, difficult to access. There’s there’s barriers to care, which I’ll talk about in detail today.
Mental Health and COVID-19
And in the midst of that, the pandemic showed up in our lives. And I’ve been doing I was looking back at my calendar and I think the first mental health and covid-19 presentation that I did was around April 14th. And at that time, we had no idea certainly where we would be today with this pandemic. And as the secondary consequences of COVID-19 emerge, mental health is front and center in that crisis.
CDC has really been tracking mental health symptoms across the country since COVID-19 hit and COVID-19 has really served to accelerate and intensify mental health risk in our country. And the reality is, we had a lot of people who were at risk coming into the crisis and so many of them have really experienced an intensification of the of their symptoms and of the need for care. Meanwhile, we have new workforces sitting at home really working, engaging in medical care in ways they’ve never had, perhaps remotely.
Consequences of COVID-19
What we know is that about 59% of employees simply don’t know how to access mental health resources from home. And I know that many of you on the phone today have been doing, I’m sure, really important work around awareness and communication. So hopefully we’ll be able to help offer you some some additional strategies there. And my conversations around the consequences of the pandemic have certainly grown more serious, was critically important to understand, is that as this pandemic goes on, as it has become, this protracted circumstance and global impact in our lives is that is that stress and trauma is additive and cumulative.
And what the what the World Health Organization is projecting at this point is that there will be eight thousand additional suicides this year due just to the economic effects of the pandemic. And so I think that when we talk about a proactive approach to employ emotional health, it’s critically important to understand that early detection connection to high quality care saves lives.
And so how is it we can work together to make sure that that that that occurs for so many people who are who have perhaps kept their head above water the first several months of the pandemic, but are continuing to work to meet the challenges of this pandemic and care for their families and continue their work, that the cost of the pandemic around on mental health certainly grows more serious every day?
Barriers to Mental Health Care
How is it we can really move the needle on employee mental health? How is it that we can find people sooner? We can connect them to the right care and resources. We begin to talk about the barriers of care. We talk about issues like awareness. We talk about access. What is the time to first appointment in you’re in your outpatient mental health mental health panel. Are there cost barriers?
But what’s critically important to understand is that stigma has really driven where we are as a society and the lack of attention that we’ve spent with men around mental health, the fragmented, reactive mental health care system that we have in place, the don’t ask, don’t tell approach to mental health that we used for so many years. All of that is driven by stigma. And so we really do have to address this issue of stigma in the workplace.
Mental Health Stigma
Oftentimes when we talk about stigma, we’re really talking about people who have a diagnosed mental health condition. And how is it that we can help them get the care that they need and not experience stigma around having a mental health condition? I think what’s important to understand is that, yes, there’s that societal stigma, but the stigma that we really have to overcome is self stigma. It’s what people say to themselves when they begin experiencing these symptoms and these challenges.
How is it we can help people feel empowered and and activate them toward care and resources sooner and not ashamed of what it is they’re going through? And that’s really where culture comes in and we see the consequences of that of reactive mental health benefits, of the frustration that employers often have around the fact that their benefits are underutilized, even if they feel like they have best in class mental health benefits. Why is it they say to me that I have so many employees who are struggling and yet they’re not connecting to the resources that we have in place and we see this in real-time across our book of business?
Proactive Mental Health
Fifty-two percent of Emvitals members are at moderate/high or severe risk for a highly treatable mental health condition. And 75% of our members who are at risk have simply never engaged in care. People wait too long or they simply opt to never engage in care. And that’s why we believe that the answer to reactive based sometimes I refer to it as symptoms based mental health is a proactive whole population model and that you as employers are in a unique position to educate and motivate your workforce, the family members of your workforce, toward pro at what we call proactive, emotional health. And we believe that there’s really a simple pathway to personalized care.
One of those is consistent proactive outreach in building a culture that values early intervention. I’m going to break each of these elements down and hopefully offer you some great strategies in a moment. But I was speaking to a leader of a large health care organization earlier this week, and he said, you know Jenn, apps are great, meditation apps are great, having technology and having the EAP is great, but nothing replaces someone going up to one of our nurses and asking, “How are you doing today?” And leaders and managers really owning and supporting the emotional health of their employees.
Building a Culture of Better Mental Health
And so how do we build that culture where emotional health is valued and that mental health is a safe topic to discuss at work? And next is really helping people to understand their emotional health.
Early detection, emotional health literacy in our country is incredibly low. People really don’t understand why they’re having these symptoms of depression and or anxiety, for example. They’re not sure where to go and get help and they’re not sure how to strengthen their own emotional health. So what are those early warning signals of mental health? How do we help people understand that they really need to strengthen their emotional health because they’re on a path toward a mental health condition. How do we help people really activate toward care who need care?
Personalized Mental Health Care
One thing that we talk very little about when we’re discussing mental health, and that’s the idea of precision mental health care. It’s great to have a meditation app and to offer that to your employee population, for example, but how is it that you help employees understand the right level of care for them and not just the right level of care, but the right mode of care? And so how do we achieve precision mental health when someone breaks a bone? They don’t go to a surgeon, they go to an ICU specialist.
And with mental health, when someone’s identified with depression or anxiety, they’re often told, “go to therapy.” Well, which type of therapy? What would be the best type of therapist for me? And and so how is it that we really help people understand right away the correct level of care in the type of care that would work best for them?
And just to talk a little bit more about proactive outreach, what I found over the course of my career is that if you call it a mental health benefit, people don’t use it until they’re a crisis. And so how do we speak more broadly about mental health? How do we make it a part of the culture and make it a part of professional development, for example, make it a person’s strategy, and how do we educate and normalize support-seeking behaviors?
We believe senior leadership is critical in giving people permission to discuss mental health and access care, certainly. And the way to dismantle self-stigma is through consistent, empowering, empathic communication all year. How do we really bust through that? The stigma barrier? We talk a lot. We talk a lot about communicating to age and wage the way that people perceive their emotional health, what they value, what they see as as a problem or not. A problem is very much connected to their age and their wage. There really is nowhere else in health care where there are such a mass misappropriation of resources. Those people who need mental health care most simply, oftentimes simply don’t access it.
Communicate to Age and Wage
When you when we when we look at data on mental health utilization across employee populations, invariably it is the lowest wage workers who simply don’t connect to mental health care at all. And so how is it we communicate to those individuals and help them get the care that they need? And considering a population level screening to identify and connect at-risk individuals, it’s really difficult for us to manage what it is we don’t measure and how do we help and how do we empower individuals with their own emotional health data? Critically important. And just talking about quality care.
Quality of Care
We talk a lot about barriers to care. We don’t often talk about quality care when we’re talking about mental health care. How do you know that the benefits that you have in place that you’ve invested for your employees? How do you know the quality and the performance of those investments?
And so certainly we work with employers who have best in class employee assistance programs, and oftentimes we facilitate increased utilization. We drive individuals to that benefit. But it’s also important to know what is the time to first appointment? Are people satisfied with the clinicians that they’re getting connected to? And most critical is that are people getting better? Are they receiving good care? And so as you look at your behavioral health strategy, really as as as purchasers insisting on outcomes, data insisting on performance data.
One thing that’s really important to understand is that 88% of psychotropics are prescribed by primary care physician and so are the primary care practices that your employees accessing. Are they practicing what’s called behavioral health integration or are they measuring for risk or are they measuring whether care is actually effective?
Early Warning Signs
And then looking at outpatient behavioral health telehealth, making sure that you’re really close the gaps in the people can access care. Certainly, cost is a barrier and something that we often help employers, employers create benefits so that cost isn’t a barrier as well. One of the things that last things I want to talk about is these early warning signals of mental health. How do we detect risk early and how do we help individuals understand really what it is that might be driving their symptoms and vitals?
We really believe in a higher standard of measurement, a measurement that really takes in the dynamic factors that make up of our make up, our emotional health, psychological, physiological, interpersonal. So helping people to very quickly know, am I at risk for a common mental health condition or am I experiencing low emotional health? And if I am, what are the drivers of those symptoms? Why am I experiencing those? We have a unique profile that we call social determinants of emotional health. Number one reason why people entered counseling prior to 2008 was family and marital conflict. Nothing stresses us out most to be more than to be in conflict with the people that we love and are closest to us in our lives.
In 2008, certainly, financial crisis took the lead there. And so really understanding across the population, what are the social determinants that are driving people into care and how do we support them? And then looking at overall wellbeing, a person’s ability to manage their day to day lives and how well are they sleeping? Those things that we know are really protective factors in emotional health. And then looking as well at health and health behaviors.
Understanding the Connection Between Mental Health and Chronic Disease
Just one quick example. Diabetics have a comorbid rate of depression at 30%. So 30% of diabetics have comorbid depression. Eighty-five percent of them are not identified and not treated. You know, that has a direct impact on their ability to manage their insulin in the likelihood that they’re going to go out on disability for things like macular degeneration. So helping people understand the dynamic interaction between their chronic condition and their emotional health.
Mental Health, COVID-19, and Stress Overload
And then lastly, I just want to talk about really what people are experiencing in the context of this pandemic when we talk about a higher standard of measurement. It’s important that we’re measuring for the right thing. And if all of us had taken a stress measure at the beginning of the year and taken it now, we would likely be more stressed. The pandemic has had a universal impact across the board. The question that we would want to answer in any population is that who is at what we call in a state of pathogenic stress and we call that stress overload.
COVID-19 is really a perfect storm when it comes to risk for mental health conditions and for what we call stress overload. And stress overload is a state in which an individual feels that the demands of the life events that they’re experiencing far exceed their resources, that they don’t have the internal or external resources to cope with what’s occurring. And that really describes what the majority of people have experienced with COVID-19.
I don’t have enough information to keep my family safe. I’ve lost my job. I don’t have enough money that the chronic inescapable stress, the chronic social isolation, that the financial crisis and job loss that so many people have experienced have really created this environment of high risk for this pathogenic stress, which was called stress overload. And just want to share with you as leaders some warning signs of that so that you can be on the lookout for stress overload in your own with your own teams and certainly for yourselves and your families. It’s a warning signs of stress overload. What we see as far as our thoughts are thinking, how our thinking begins to be impacted is that people really you’ll hear people say, you know, I’m just I’m really foggy. I’m not thinking as clearly as I usually do. There’s a lot of decisiveness. People are really challenged with making decisions.
And then as that stress response continues to rage in their bodies, what happens is that they simply begin to shut down emotionally. They feel they say they feel frozen. They’re just not sure what to do next. Often people get on edge, they become impatient, they’re short-tempered. They don’t understand why you don’t understand. They’re so stressed and really a hallmark symptom of this pathogenic stress that puts people at higher risk for mental and physical health condition conditions and suppresses the immune system is nausea. And so we know that people really will complain about stomach aches. They’ll complain about headaches and muscle tension, but that nausea is really a hallmark somatic symptom of stress overload.
And then in the later stages of stress overload, we see withdrawal and negative self talk. And this is really what we want to look out, look out for people who just want to be alone, don’t want to talk to anyone, and who begin to really take on what’s happening as a failure of who they are. And that’s really a late-stage warning sign of stress overload. I just want to say that while the vast majority of us are managing acute stress and stress overload, those health care workers that are on the front lines of this pandemic, those long term care workers who are really in the trenches of a pandemic are at an increased risk for traumatic stress. Certainly, it’s something beyond stress overload. And as I talk to those employers, I talk to those leaders at health care systems, those individuals are really experiencing something wholly different than what I’m discussing here today, certainly.
And so I want to talk about how is it that we practice recovery in the context of this pandemic in a term this radical recovery? Because what’s critically important here is dosage. And what I mean by that is that as we as we’re managing our own stress levels, it really is about recovery and about prioritizing our own moments of restoration and recovery. And that can feel radical in the midst of all that we’re managing. And what’s important is that we do this often and. I think that’s the radical part for so many of us.
When I look at recovery, I like to talk about recovery and micro, daily and micro and macro recovery in micro is is in some ways most critical right now with all that we’re going through. And this is really proactive recovery. This is taking a few moments in the morning doing whatever it is that ground you that that helps you feel focused and empowered for many people that exercise that’s getting outside. It’s meditation. For some people, it’s just organizing their day and then spending five minutes every two hours doing something you enjoy, stepping away and restoring and recovery. There’s a lot of research around this frequency in this amount of time. And what you do is, is really determined by what is it that really fills you up, what restores you and that and that’s really what we’re looking for in daily recovery is really about restful sleep.
How to Protect Mental and Emotional Health During and After COVID-19
It is core to protecting our emotional health during this time. And so getting rid of electronics at night, doing a meditation prior to sleep, if if you are having difficulty sleeping, that is something to pay attention to focus on that and work towards sleep hygiene, work toward reaching out to your primary care physician and work toward restful sleep.
What we know definitively from the research is that positive relationships, connectedness to one another is the most protective factor when it comes to our emotional health. So reaching out and connecting to people and making that a priority throughout your day. What would it be like if all you had to do was work, you really weren’t going anywhere, weren’t going on vacations? So really stepping away from work for a full day.
Macro recovery is really about taking that full week off and and and and really recharging fully, which I think is particularly difficult to do in this time. And I’ll just end by saying that I think that as we all come through this pandemic, it really does bring people together and it allows us to have a conversation about our emotions, our emotional health, the challenges that we face, perhaps in a way that we’ve never had before. So thank you so much, everyone.
Well, that wraps it up for this episode of For Your Benefits. We’d like to thank Jennifer for such great insight into emotional health and how employers can ensure that they’re providing the tools to help their employees during this pandemic. If you’d like to learn more, please visit the SentryHealth website at www.sentryhealth.com. And if you like what you heard today and want to learn more, don’t forget to subscribe to our podcast. We’ll continue to keep you on the cutting edge of what’s happening in the world of corporate wellness until next time. Thanks for joining us.
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Want to learn more about SentryHealth? Simply fill out this form to request a consultation and learn more about our solutions.