Bringing employee mental health into focus — Part 1

This is the first in a three-part series focused on mental health literacy: what it is, why employees need it, and how to achieve it.

The last year has brought up a lot of feelings. Some — like sadness, anxiety, and exhaustion — are easy to identify. Other feelings are harder to name, making them tricky to recognize, understand, or manage.

That’s why mental health literacy is so important. It may sound complicated, but “mental health literacy” refers to a basic understanding of mental health information that empowers people to make appropriate health decisions. It helps a company’s employees bring health-related issues into focus and creates a foundation for their mental well-being now and in the future.

Without literacy, mental health can look like alphabet soup

Unfortunately, excellent mental health literacy is rare. And that’s an issue for companies and their employees. Without it, for example, employees may find it difficult to relay symptoms to providers, are reluctant to seek care in the first place, and are less likely to follow through on treatments if and when they are prescribed. Not to mention that the mental health field uses countless acronyms and initialisms: between GAD, CBT, APA, and RCT, it’s like peering into a jumbled bowl of alphabet soup.

In an effort to make the language of mental health a bit more approachable, Big Health’s Clinical Lead for Sleep Dr. Jennifer Kanady and Clinical Lead for Anxiety Dr. Michelle Davis discuss the three key skills needed for employees to have good mental health literacy:

1. Recognizing the signs of mental health difficulties and when to seek help
2. Cultivating the knowledge to seek and obtain quality mental health care
3. Rejecting stigma, or unhelpful beliefs that get in the way of achieving a positive mental health outcome

Key skill: Recognizing the signs of mental health difficulties

Being able to recognize symptoms of poor mental health is the first step towards mental health literacy. Here are a few common symptoms:

• Feeling stressed or overwhelmed
• Feeling down or depressed
• Reduced energy or motivation
• Loss of pleasure in enjoyable activities
• Worry, anxiety, fear, or tension
• Irritability or angry outbursts
• Difficulty sleeping (or sleeping too much)
• Changes in appetite
• Social isolation or withdrawal
• Difficulty concentrating or making decisions

Mental health symptoms are highly overlapping

While being able to recognize these indicators is a good first step, it can be difficult for employees to identify a mental health diagnosis on their own because mental health symptoms are highly overlapping. Dr. Davis says, “Recognizing symptoms is important and foundational for mental health literacy, but there is significant overlap across mental health conditions, and that can confuse people.”

For example, when people feel irritable or have energy or motivation loss, they may assume these are symptoms of depression — but those symptoms are also related to anxiety and insomnia. It’s important that employees are aware that identifying a diagnosis can be complicated and require the help of a trained mental health professional.

That’s why it’s important for employees to not only understand what the common symptoms are, but know when and how to seek appropriate care (more to come in part 2 of this series). The good news is that quality mental health care often helps symptoms improve across conditions — our transdiagnostic blog explains this in greater detail. Dr. Kanady explains, “When you engage with insomnia treatment, it’s common to see improved sleep as well as decreased anxiety and depression.”

When does a mental health difficulty become a diagnosed mental health condition?

Another important caveat is that, even when a person has mental health symptoms, they may not have a diagnosable mental health condition. For example, a person can experience several nights of sleeplessness without having insomnia, and feel anxious without being diagnosed with an anxiety disorder. Mental health professionals also take into consideration three key factors:

1. Duration and frequency: How long have symptoms been present and how frequent are they?
2. Severity: How much distress are symptoms causing?
3. Daily impairment: Are symptoms getting in the way of daily life?

That’s why it’s critical for companies to offer an array of care options that meet the needs of a diverse population — from in-person care, to medication, to digital therapeutics.

For example, an employee that is struggling with anxiety but is not diagnosed with an anxiety condition due to short duration — and thus not able to see a therapist — could still benefit from mental health support. In that case, offering the employee a digital therapeutic rooted in cognitive behavioral techniques could teach them the skills necessary to lessen their symptoms in the present and prevent them from developing a disorder in the future.

Risk factors: genetic and environmental

When employees begin to recognize potential mental health symptoms, it often leads them to wonder about what leads to the development of a mental health disorder in the first place.

In general, there are two types of risk: genetic and environmental. Genetic risk includes biological vulnerabilities that can come with family history of mental health conditions. Environmental risk involves adverse events and stressors such as financial trouble, trauma, health issues, grief, or work challenges.

Dr. Davis says it’s important to understand that “Having a risk factor doesn’t mean an employee will definitely develop a mental health condition. At the same time, however, it’s also possible to develop a mental health condition without clear risk factors.”

Conversely, protective factors like social support, personal resources, and coping skills can dampen the impact of risk factors. Dr. Kanady explains, “What leads more immediately to the development of a mental health condition is the balance between the stressors and protective factors in a person’s life.”

We’re one-third of the way there

Understanding symptoms of mental health conditions and how they manifest are important areas of mental health literacy. Equipped with this knowledge employees can better recognize when they, or a colleague, may be experiencing a mental health problem and ways in which they may be able to bolster their protective resources. This in turn creates a healthier workplace for everyone.

Two more critical skills to enhance employee mental health literacy — identifying quality care and fighting stigma — will be discussed in the coming weeks!