Mental Health Stigma at Work

According to the National Institute of Mental Health (NIMH), 1 in 5 adults in the U.S. has a diagnosable mental health condition. That’s nearly 40 million Americans. Interestingly, 70% of individuals with a mental health condition do not seek treatment (Kessler et al., 2005).

This poses an important question: if mental health conditions are so common, why aren’t more people seeking help?

According to analyses done by Big Health researchers, there are four major barriers to care.

1. Access (I can’t fit this into my schedule, I can’t afford it)
2. Low perceived need (I don’t have anxiety, I’m just a worrier)
3. Desire to handle the condition independently (I don’t want to be a burden)
4. Stigma of condition and treatment (What will others think?)

The stigma around mental health is one of the primary barriers to care, and it’s arguably the most difficult to address. This is especially true in the workplace, where individuals’ concern for their professional reputation can amplify the impact stigma has on their choice to seek help.  

By addressing mental health stigma at work, a positive, supportive environment for those dealing with mental health conditions is created. This can also benefit organizations in many ways:

• Reduced turnover
• Reduced sick leave
• Improved performance and productivity
• Attraction of high-quality talent

What is stigma?

A stigma is an attribute or trait that sets someone apart from the rest of a group, and it brings with it feelings of shame and isolation. As a result, a person may experience prejudice, rejection, or discrimination. It can be a barrier to employment, insurance, medical care, housing or financing (CDC).

Stigma originates from multiple sources, which work together to create serious impacts on an individual’s life. These may originate from personal, social, and family sources, and from the nature of the illness itself. Stigma arises from one or a combination of factors, including:

• Lack of awareness
• Lack of education
• Lack of perception

How to Identify Mental Health Stigma in the Workplace

Another important element of reducing mental health stigma in the workplace is being able to accurately identify signs that the stigma is being perpetuated. However, it can be challenging to quantify the impact stigma is having on your workplace culture.

Here are some key signs that indicate stigma could be improved at the organizational level:

1. The use of judgmental language — Overt examples of stigma in the workplace may include negative comments about mental health conditions or people who have them. Even if the comments are not directed toward a specific person, using and accepting harmful language implies that such views are tolerated at an organizational level.
2. Increased absenteeism —  In many developed countries, 35-45% of absenteeism from work is due to mental health problems (WHO, 2003). Therefore, mental health conditions could be increasing in prevalence or severity if absenteeism is on the rise at the team or organizational level.
3. Not hearing anything about mental health stigma — Mental health conditions are incredibly common, with 1 in 5 US adults living with a diagnosable condition. If you’re not hearing anything about mental health from your employees, it’s likely because individuals aren’t comfortable talking about it.

How to Reduce Mental Health Stigma in the Workplace

There are many ways to address mental health stigma in the workplace. The most important thing to keep in mind is that each organization is different. The most effective approach will be one that is customized to your unique population.  

Mental Health Awareness

One strategy for addressing stigma is to work toward normalizing mental health as an important and universal health component slowly over time. Typically this approach centers on broad awareness campaigns designed to educate and engage people on mental health.  Internal “wellness champions” can also be recruited to distribute information and serve as a resource for other employees. Several Big Health clients have tried this strategy, often using social media and hashtags to help spread the word. While this approach can be done successfully, the sheer volume of work it requires may be a barrier for some organizations.

Physical and Mental Health Parity

The Affordable Care Act was a major milestone in achieving physical and mental health parity, but there remains work to be done. Let’s use diabetes as an example. If you had diabetes, you would measure your blood sugar daily with a glucometer, take insulin as necessary, make regular visits to an endocrinologist, and take several other steps to remain healthy. Living with a mental health condition is similar, in that it requires work every day. Sometimes, in either scenario, things don’t go as planned and time away from work or professional treatment is needed. One way employers can promote physical and mental health parity is to encourage employees to utilize sick days for either physical or mental health reasons.

Language (person-first)

Language can unintentionally propagate stigma.  “Language frames what the public thinks about mental health, and it can also affect how individuals think about themselves and their ability to change” (Broyles et al., 2014). The American Psychological Association published guidelines on the use of people-first language, which is characterized by acknowledging the person before the condition. This approach enables us to describe a condition without implying negative judgment. Person-first language should be adopted as standard practice in benefit communications and other internal resources for employees.

Additional Reading:

Healthy Workplaces: a model for action (World Health Organization, 2010)

Workplace prevention of mental health problems (University of Melbourne, 2013)