Addressing Stigma of Behavioral Healthcare in the Workplace

Kristin Gernon, LCSW LMSW, Behavioral Health Training and Development Specialist, Blue Cross and Blue Shield of Kansas City

Despite significant progress in treatment and public awareness of behavioral health conditions, stigma, defined as “the negative social attitude attached to a characteristic of an individual that may be regarded as mental, physical or social deficiency,” (stigma – APA Dictionary of Psychology) remains widespread. This can be particularly true in the workplace where employees fear being marginalized, retaliated against, and overlooked for promotion if perceived as impaired or compromised due to a behavioral health condition. The truth is that behavioral health conditions are incredibly treatable—especially if identified early. Too often, however, individuals do not seek help for their behavioral health symptoms because of social stigma and internalized shame. The results can be devastating. Between 1999 and 2016, suicide rates in this country increased by more than 30% in much of the country (Suicide rising across the US | VitalSigns | CDC). In the same period, suicide rates increased by 36.4% in Missouri and 45% in Kansas (Suicide rising across the US | VitalSigns | CDC). 

One of the unexpected gifts of the Covid-19 pandemic is that companies are looking more closely at the benefit packages they offer—and particularly those that support employees’ behavioral health needs.  The pandemic has brought into focus the challenges faced by working adults who are balancing careers with caring for children and often for elderly family members, managing households, and relying upon readily available services and supports to make this balance work. Talking more openly about the added stress this has caused all of us is a starting point for reducing the stigma around seeking behavioral health support, but there is much more organizations and individuals can do to eliminate stigma and promote whole person employee well-being.   

Organizations and their leaders can take an active role in creating a work environment that is psychologically safe for its employees, easy to ask for help, free of stigma and stereotyping of mental illness, and conducive to wellness and recovery. Below are six steps leaders can take to foster a culture of wellness that is free of stigma. 

1. Set the tone. Because our workplace culture is created and represented by the leaders within the organization, leaders have great influence. When leaders speak about difficult topics with sensitivity and compassion, speak respectfully of all others inside and outside of the organization, and strive to connect with employees as individuals beyond their work product, this sets the tone for a positive workplace culture free of stigma and stereotyping of individuals.
2. Be proactive. Some organizations wait for a crisis or significant trauma or loss to bring in crisis support for employees. We know that 1 in 5 Americans will experience a mental illness in any given year (Learn About Mental Health – Mental Health – CDC). This crosses all industries, demographics, and socioeconomic lines. Having employees means having employees with mental health needs or employees who are impacted by the mental health needs of families and friends.  Being proactive by providing resources, education, and support for employees means being proactive about preventing absenteeism, burnout, and turnover which can be costly.  Additionally, this can improve engagement and employee retention. Further, educating employees specifically about the signs and symptoms of common mental health conditions and how to support a colleague who may be experiencing a behavioral health crisis may prevent a traumatic event or employee death by suicide.
3. Walk the walk. Modeling self-care and wellness activities may have the greatest impact on an organization’s culture and employee wellness.  When employees see leaders being intentional about taking their paid time off, engaging in wellness activities, and talking openly about the importance of self-care and well-being, employees will feel empowered to do the same.  Workplaces that praise and promote employees for working excessively long hours foster an environment ripe for burnout, disengagement, and turnover. 
4. Talking the talk. Words matter. When leaders use common descriptive terms such as “crazy”, “nuts”, “bipolar”, or “OCD” to describe individuals or situations, know that these terms have all been used to shame and marginalize those who have a behavioral health diagnosis or have experienced a behavioral health crisis. These terms (and many others) used casually serve to make light of very real challenges people in your workplace face. It is unlikely that a person who is experiencing symptoms of a mental disorder would feel comfortable disclosing that to a manager who casually calls colleagues or customers, “psycho”.
5. Foster connection. Many of the best leaders demonstrate genuine interest in their employees as people, their lives outside of work, and any unique circumstances the employee may be experiencing. This occurs through building a bi-directional trusting relationship, listening to understand, and maintaining confidentiality in the context of that individual relationship as needed. When leaders honestly admit when they do not have the answers, own their mistakes, and disclose personal experiences of failure or hardship, this further solidifies a leader’s genuine connection to employees. Finally, a leader who is approachable, interacts respectfully with all individuals regardless of hierarchy, and seizes opportunities to build others up both publicly and privately, builds a culture of connection and caring. 
6. Rethink and reframe wellness. As organizations are looking ahead to a post-pandemic “new normal”, there is an opportunity to hit the reset button on business as usual. There is an opportunity to rethink policies and procedures that are not conducive to wellness and self-care or to offer greater flexibility in the workplace to accommodate individual needs. While most workplaces have explicit policies prohibiting retaliation, it may be an opportunity to more clearly articulate that this applies directly to employees who have disclosed mental health needs to a manager. Leaders should encourage employees to use their paid time off to take an occasional day to simply rest, relax, and recharge. And managers should accept a request for time off at face value without expecting the employee to disclose the reason for the request or justify the need for a day off work. A rested, recharged employee is a more productive and engaged employee. 

For Blue KC members, behavioral health support is available 24/7 and one call away. Right now, it is easy to feel overwhelmed. Mindful by Blue KC includes behavioral health support as part of your plan and Mindful Advocates are available 24/7 to listen, navigate care, and provide guidance for your behavioral health needs. Call 800-302-MIND (6463) or visit MindfulBlueKC.com to learn more.