The road to hell is paved with good intentions

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The focus on employee mental health is understandable – but has too much energy been poured into innovation at the expense of identifying what and where the problem is? Where is the data?

Recently, I caught up with a respected clinical psychologist friend who lamented what he referred to as “the monetisation of madness”.  This is evident in the dramatic upsurge in commitment from businesses around the world to new mental health initiatives.

I guess I’m a population health old timer because I’ve worked on improving people’s health in workplaces since the turn of the century. I remember when employee health and wellbeing was a completely new concept and tended to focus on people’s physical health – for a lot of good reasons. The deterioration in the workforce’s health is evidenced by the statistics. The current crop of employees is the sickest, saddest, fattest, most sleep deprived bunch of people since we brought people out of the cotton mills and coal mines. 

Initially, a lot of gains were made by helping employees move more and eat better as well as helping them to improve the amount of sleep they were getting, their financial literacy, BMI and access to active transport. It feels like today, the stampede towards mental health, as the sole focus of company and insurer wellbeing programs, has forgotten that what is going on between an employee’s ears is impacted heavily by their physical health and everything else going on in their lives.

I would argue the obsession with employee mental health is becoming myopic and is resulting in the proverbial baby being shown out with the bath water. 

Yes, the cost of mental illness to the economy is frightening. 

When you roll up absenteeism, staff turnover, lost productivity, disengagement and health care costs and insurance claims you don’t get much change out of $3 trillion a year. So, in response, companies across the world are trying in-house yoga, mindfulness apps, in-chair massages, unlimited holidays, indoor plants, colouring books, puppies and compulsory mindfulness seminars. 

I am not for a minute suggesting these aren’t well intentioned and positive things, but the harsh truth is that they require money, time and resources, and nobody knows if they work properly. There’s a lack of meaningful data on what is delivering an ROI and what is wasting budget that could be better invested on things that do work. We don’t know which employees are benefitting and which employees are not, and most concerning of all, what harm is being caused. 

Businesses are generally pretty efficient places. Those that aren’t efficient go out of business sooner or later. This drive to find efficiency means that businesses look for ways to measure and manage everything. Yet, workplace wellness mental health programs are rarely measured or managed properly. This is not good business. Actually, when you think about it, it’s not good science either.

The opportunity for employers to make a positive impact on this issue is commercially, scientifically and morally really compelling. The same goes for insurers who have so much to gain from better understanding how to signpost people to the kind of care, help and treatment that will put people on the road to recovery and get them back to work faster. 

Let’s learn what really works

Rather than inventing more solutions, it seems to me that what is desperately needed is a concerted effort to gather data on people’s responses to what is on offer. This way we can help stop mental health issues developing and ensure that when they do, people get the right support at the right time, so they recover as quickly as possible. 

I hear the word ‘holistic’ a lot in the context of mental health initiatives, and yet that seems to be one the element that is desperately lacking. Offering free yoga or a ‘resilience seminar’ is going to achieve nothing for an employee suffering from an eating disorder or a night shift worker who desperately needs help with sleep hygiene. A truly ‘holistic’ approach should identify what the issues are and who needs help and deliver the right kind of intervention.

There are also risks with this one-size-fits-all approach. Offering a free mediation app or a mindfulness room may help a percentage of the audience, but for people living with psychosis or PTSD there are serious risks that need to be considered and addressed.

In a previous life I was on the board of an NFP, the Foundation for Chronic Disease Prevention which supported clinical research that showed a clear dose response between how much an individual walked throughout the day and how they scored on the WHO5 index. 

We’ve seen the same trend in the data of people using HeadUp: the more you move, the better your emotional health.

The overwhelming evidence that physical exercise improves mood and reduces the likelihood of anxiety and depression is well established and has been for some time, and yet, if you were to stand up at a conference this year and suggest a ‘walking program’ to address employee mental health, you’d get laughed at. “Walking programs went out with instant coffee and BlackBerrys”, people would say.

But as a way to improve people’s mood and resilience, it’s a low-cost, zero-risk, high-reward bet. There are lots of things that actually shift the needle, but what seems to be missing is the needle. So much time and money is getting thrown at things without any accountability.

This lack of measurement is resulting in a misguided, one-size-fits all approach to mental health. Yet, the technology, the data and the expertise exist to start measuring the outcomes and determining the efficacy of various initiatives. 

Covid19 has made us stop and look at what we’ve been doing in a new way. I hope this year companies and insurers stop throwing money at what’s new and start investing in what works. People are depending on us.

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