SHRM All Things Work

Dr. Casey Chosewood on Keeping Employee Mental Health a Priority Post-Pandemic

Episode Summary

Vaccines have proven highly effective at halting the occurrence and transmission of COVID-19. Unfortunately, resolving mental health issues in the workplace hasn’t been as successful at reversing the symptoms of depression, stress and anxiety that have reached all-time highs following 14 months of living and working during a public health crisis.  In this episode of All Things Work, host Tony Lee speaks with Dr. Casey Chosewood, the director of the Office for Total Worker Health at NIOSH (National Institute for Occupational Safety and Health) on how to approach employee mental health and steps employers can take to improve the mental health of their employees in a post-pandemic world.

Episode Notes

Vaccines have proven highly effective at halting the occurrence and transmission of COVID-19. Unfortunately, resolving mental health issues in the workplace hasn’t been as successful at reversing the symptoms of depression, stress and anxiety that have reached all-time highs following 14 months of living and working during a public health crisis.  In this episode of All Things Work, host Tony Lee speaks with Dr. Casey Chosewood, the director of the Office for Total Worker Health at NIOSH (National Institute for Occupational Safety and Health) on how to approach employee mental health and steps employers can take to improve the mental health of their employees in a post-pandemic world.

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This episode of All Things Work is sponsored by UKG.

Episode transcript

Episode Transcription

Speaker 1:

This episode of All Things Work is sponsored by UKG. UKG offers HR and workforce management solutions that support your employees and transform your workplace into a work of art.

Tony Lee:

Welcome to All Things Work, a podcast from the Society for Human Resource Management. I'm your host, Tony Lee head of content here at SHRM, thank you for joining us. All Things Work as an audio adventure, where we talk with thought leaders and taste makers to bring you an insider's perspective on all things work.

Vaccines have proven highly effective at halting the transmission of COVID-19. Unfortunately, resolving mental health issues in the workplace that have developed through the pandemic hasn't been as successful, and there isn't a one or two dose shot that can reverse the symptoms of depression, stress, and anxiety that have reached all time highs. Throughout the entirety of the pandemic, SHRM has partnered with the Centers for Disease Control and Prevention to deliver a series of webcast featuring leading experts and officials from the CDC who provided the most up to date evidence-based information related to COVID-19 and its impact on the world of work.

In today's episode we speak with CDC expert Dr. Casey Chosewood on how to improve employee mental health as we emerge from the pandemic. Dr. Chosewood is the Director of the Office for Total Worker Health at NIOSH, the National Institute for Occupational Safety and Health, which is part of the CDC. In his role, Dr. Chosewood promotes the protection and improvement of the safety, health, and wellbeing of workers around the world through research, intervention development, and partnerships. From 2004 to 2009 he was the Director of the CDC Office of Health and Safety, and also previously served as Medical Director at tech manufacturer Lucent Technologies. I think you'll enjoy our conversation, Dr. Chosewood has some really great insights on improving employee mental health.

Casey, we're so pleased to have you join us, thank you. So it's been a tough 14 months, obviously, a lot of organizations and employers and employees alike have all really struggled. What have been the biggest challenges you're seeing now after that long period?

Dr. Casey Chosewood:

Thanks so much for having me today. Yeah, it's an excellent question because we know that it's been a tough year, or 14 months, as you said. Really an unprecedented time in our lives with so much disruption, really increasing demands, both as workers and as family members, or community members, and all these changes came about so quickly, and impacted so much of our lives, that obviously this has been a major blow, especially to some higher risk groups than others. We've also had this experience of isolation, of being separated from the things we like to do, or the people that we like to hang out with, so that combination really has led to an increase in the stressors that people feel day in and day out. We know that more than 80% of Americans say the pandemic is a significant source of stress in their lives. SAMHSA, the Substance Abuse and Mental Health Services Administration, reported a 900% increase in distress calls into their helpline. More than 40 states around the country have reported increases in substance use disorders and overdose deaths even.

So this is a real critical issue, and as employers I think we have an opportunity to shed important light on the challenges that our workers have faced, and really give them more assistance and resources to make it through these difficult times. First of all, we can just talk more about what these challenges mean to us as individuals. We can share our own personal stories as supervisors, as managers, as HR directors. If I had one wish for companies right now, it would be to do all you can to maximize the amount of flexibility that you're giving your workers. Supervisors need to let workers have more control, a more day to day role, if you will, in the decision making in their own workplace environments. Giving them a greater say in how they do their work is really critical right now. It's not a magic bullet, but it's the closest thing that we have to one.

Tony Lee:

So for a lot of people, the primary source of stress in their life is their work. So I guess the question is, what's the connection then between stress and mental health, and what steps can employers take to help lower the stress that their teams are facing day in and day out, especially over this last 14 months where productivity went way up, and then expectations get reset and bosses say, "Well, if you do it the last year, you can do it the next year," so the stress just keeps getting greater. What should employers be doing about that?

Dr. Casey Chosewood:

You're exactly right. The expectations of people who've blended work and home like never before are really out the roof, and it's going to be really interesting to see how the work demands unfold over this coming year, and what those expectations are around really being accessible night, day, around the clock, being fully on, if you will, all the time. We know that work demand, that long hours of work can be challenging, and in fact, as you mentioned, it's a significant source of stress for workers. Job stress, for many people, is a common pathway for so many poor outcomes, whether it be our physical health, our psychological health, the way we interact with those we care about, the caregiving that we're able to provide, all of those things are impacted by the stress that we perceive and experience at work.

And work stress, doesn't just stay on the job, it doesn't just impact our coworkers and our productivity, we carry it home with us. And likewise, the stressors that we feel at home, whether they be financial, or relationships, or struggles with substance or chronic disease, those things we carry with us to the workplace. There's this really close link, if you will, between stressors at work and stressors at home. We know also that our supervisors play an important role in creating environments where stress can be reduced, prevented altogether, or managed if it does occur.

We also know that there's a link between stressors and poor chronic disease outcomes, like depression and anxiety. We're also seeing new evidence of a link between work stress and cardiovascular disease, and this is quite alarming because cardiovascular disease is the leading cause of death in this country, and there's some estimates that up to one in five cases of cardiovascular disease are related to our working conditions. A new World Health Organization report also implicated long work hours and cardiovascular disease, and we know there's a link between long work hours, shift work, really unrelenting work demands, and the stress that can arise from those challenges.

So what are we going to do about this? The good news is that there are ways to intervene to help reduce workplace stress. Implementing both organizational and management interventions is critical, and I would prioritize those over individual efforts, like resiliency building, or lunch and learns on how to endure the stress a bit better. We're much better off if we think about how we can lower the stress meter in our workplace environment, and that largely is an organizational and a supervisor responsibility. We need to increase awareness of the impacts of stress, give our managers more training on how to recognize and reduce stressful working conditions, providing skill building interventions for stress reduction for all workers, access to employee assistance programs, those are critical, but I would invest my first dollar in the prevention effort at the organizational level, and we do that by better policies, better awareness, better attention to supportive supervision, and other ways that we can enhance the environment for all workers, whether they perceive stress or not.

Tony Lee:

Casey, you've brought up some great points, and I want to follow up on several, but first I have to ask, as a physician, you bring up obesity, you bring up cardiovascular illness, do you think employers should be doing more to help with the physical wellbeing of employees as a step toward better mental health of employees?

Dr. Casey Chosewood:

It's an excellent question. We know that our physical health and our mental health are extremely closely linked. In fact, I don't see much value in differentiating the two. Depression and anxiety are as real as cancer and diabetes, both sets are chronic conditions that have real costs associated with them, really can tax us and change our lives for the worst, can really impact our ability to achieve what we want to achieve in life. So I think there's a strong relationship between work, how we spend so many of our waking hours, oftentimes what makes so many decisions about every aspect of our lives, and our physical health.

And there's increasing evidence that more and more of the physical outcomes, what we've traditionally regarded as physical outcomes, like cardiovascular disease, and risk for stroke, or obesity, as you mentioned, have a strong connection to the demands of our work. A great example is the long haul truck driver. Our research with this working group shows that their rates of obesity are not the national average of 30, 40%, their rates of obesity are 70 to 80%, and this is largely reflecting the challenges that they face on the job, the sedentary nature of truck driving, the very long hours of work, the fact that they have to remain constantly vigilant, which increases stress, the poor access to physical activity and nutritious meals, all of these things are part and parcel of the job design and the job requirements, and they're leading to this terrible take home benefit of significant obesity. It's a great example of how work conditions drive both stress and poor physical health outcomes.

Tony Lee:

You know, what we're talking about here is really so personal for many employees. How involved should employers get? I can hear some employees saying, hey, I like my beer and my Doritos on the weekend, leave me alone. But employers know better, they can see the damage that's taking place. At what point should employers get involved, and is privacy a concern here?

Dr. Casey Chosewood:

Privacy is a concern, and whenever you're mixing work and non-work issues, which is oftentimes the domain of the human resources professional, it is important to give workers privacy, to treat medical information confidentially, to not let those personal and private issues interfere with workplace opportunities, I think the critical piece of managing this very difficult line between personal and professional. But the truth is, most workers are ready and willing to take information and guidance from their employers on these critical issues. For the most part, workers trust their employers as a source of quality information, oftentimes work and our healthcare benefits are closely linked. Some people get their healthcare directly through an onsite provider of healthcare. So while privacy is important, I think employers do have a role to play in improving the work and non-work life of their employees.

We also talk, especially when the issues around mental health, or very personal issues like how much I drink on the weekend, or what I snack on, those can be really personal issues. So we really push a voluntary approach to participation in any of the Total Worker Health programs, that folks should have a say whether they participate or not, they should have a say in how much information they share with their employer, and they should be assured confidentiality when it's appropriate, like when they do talk to an employee assistance professional, or when they do bring up a medical issue. We know that the ADA certainly protects the medical information of employees, for example, but I think it's important for our supervisors, managers, our owner operators and leaders to talk about these issues, to say, hey, this is something that I've dealt with, and I think these programs could help you or your family members as well.

Ideally we can address, as I mentioned, mental health issues and some of these personal private issues like we would any other chronic disease, that we can lower the barriers for people getting information, seeking care when they need it, we can decrease stigma, which is a really big issue, especially when we talk about mental health issues in the workplace. All of these approaches, being open-minded, feeling free to talk about these issues, they go a long way to increasing awareness, lowering stigma, and decreasing the barriers to seeking care. I think it's important for us to reiterate that mental health conditions, concerns, it doesn't represent a moral failing, neither does obesity or diabetes may be related to our lifestyle habits, these are not moral failings. These are challenges that many, many Americans face, and they can be managed, people do get better, they can remain productive at work. There are solutions here, and I think we need to all be more open to talking about them in our workplaces.

We also need to be comfortable discussing these issues if they arise from our employees. So managers need a skill set to not only be good listeners, but to have a game plan in place if a worker comes to you and says, "Hey, I'm really struggling with this. I'm feeling depressed, I'm not able to meet the demands of my work today because I just can't get out of bed," our managers need to be able to recognize when the red flags go up, to be a supportive listening ear, and then to have a place to refer, a plan in place to actually help. We can respond with empathy, which can be taught, we can offer peer support, that's an important intervention in a lot of workplaces, and we can be encouraging, open the door for those who want to seek help. As I mentioned, all of these can go a long way to increasing awareness, decreasing stigma, and really lowering those barriers to seeking care.

Tony Lee:

That's asking a lot of employers to make sure that people managers are trained, is that realistic?

Dr. Casey Chosewood:

You're right, it's not easy, and it's not off the shelf plug and play product. What we're talking about here is really building a better workplace culture over time, and that's not a quick fix. Hopefully the pandemic has given us an incentive to look at these issues more realistically. I also think it's important to know that not every manager's going to have the same skill set, the same ability to do these more than others, so it's okay to identify a champion in your organization who takes on the mantle of some of these challenges. But every supervisor can do a better job than they're doing today, we all can take steps to make sure the work demands that we put on our workers match the skill sets they have. We can all do a better job of increasing the recognition and rewarding employees, paying attention to wages is another natural way to decrease stress. If I have more resources at the end of the week, automatically my home stress, my work stress, goes down.

So there are a number of interventions that our research shows, from benefits, to wages, to supportive supervision, to increased flexibility in my work hours, to having more say in how we solve problems, we call it the participatory approach, workers need a stronger role and voice in the way work gets done. Just asking, "Hey, is there a problem I can fix for you today?" That can open the door to an important conversation that we need to be having, frankly, more often.

Tony Lee:

Yeah, it's that subtle skill of being able to talk to people without being, I think, probably too intrusive. I want to ask you just briefly about some recent SHRM research that I think you might have some interesting insights on, that focused on the demographics of mental health, and it found that lower income workers are facing much greater mental health challenges, especially those earning 30,000 a year or less, and they report symptoms like just constantly feeling tired, having little energy, having little interest in finding pleasure just in the daily life. Is there anything employers can do for lower income workers who are coping with these types of feelings?

Dr. Casey Chosewood:

First I want to say how much I appreciate SHRM really taking the survey and stepping into this issue so that we as a country, as a community of employers and organizations, can have better insights into these issues. For me, the study that was done in March, that you guys did that compared how things are from a year or so ago, was really eyeopening, and I think it uncovers this very essential truth. There are pockets that are much higher risk than others. So it really is incumbent upon us to design our interventions not as a one size fits all, but really seeing where the challenge and the struggle is greatest, and putting the most intensive, and the most number of resources, and the most intense interventions in those populations where risks are greater. In general, with any workplace health, safety, and wellbeing intervention, lower paid workers are going to be at higher risk, and I think your study showed that beautifully.

The other area that your study highlighted some significant challenges for burnout were in that second rung of employees as well. So they weren't the very lowest paid, but they were the mid-level employees where expectations were probably high, but my guess is those workers in that 30 to 60,000k range had lots of expectations, but did not have a lot of control, so they were not able to make their own decisions, they oftentimes were under probably deadlines and other restrictions from management layers above them, lots of expectations, but not a lot of agency and control and decision making. That is a recipe for high stress and burnout.

Tony Lee:

It's interesting, the one area that really surprised us was that millennials were more likely to say that they were feeling burned out than any other age group. Any thoughts on why that group feels more put upon than any other?

Dr. Casey Chosewood:

I think there is a more likelihood that this generation of workers feels more comfortable talking about some of these sensitive issues, and to be honest, I think that's a very positive thing. I think that this is a group that is especially challenged with a combination of both home and workplace challenges. This is a time in a worker's life when they are making shifts, oftentimes, in their responsibilities and their roles at work, they're having increased family responsibilities, perhaps some big decision making about new home purchases, where are we going to live? Are we preparing adequately for our own kids' future, getting ready for college expenses? All of those things I think are at play here.

Tony Lee:

Casey, this has been a terrific conversation, thank you so much for your insights. I have to put in a plug that, all goes as planned, Dr. Casey Chosewood will be speaking at the SHRM annual conference in September in Las Vegas, that's our hope, and I just want to thank you so much for joining us today.

Dr. Casey Chosewood:

Thank you, I look forward to being with you guys all in person.

Tony Lee:

Indeed, I think we all look forward to being together again all in person.

That's going to do it for today's episode of All Things Work. A tremendous thank you to Dr. Casey Chosewood for his insights and thought leadership on how to improve employee mental health. Before we get out of here, I want to encourage everyone to follow and subscribe to All Things Work wherever you listen to your podcasts. Also, listener reviews have a real impact on a podcast visibility, so if you enjoyed today's episode, we'd love it for you to take a moment to leave a positive review and help others find the show. Finally, you can learn more about All Things Work, and find all of our episodes on our website at SHRM.org/atwpodcast. Thanks for listening, and we'll catch you next time on All Things Work.

Speaker 1:

All Things Work is sponsored by UKG. Your business is important to you, and the best way to improve your business is to improve the lives of your people. UKG develops HR and workforce management solutions designed to take care of your employees, because when they feel supported, connected, and appreciated, your business will transform from a workplace into a work of art. UKG, our purpose is people.