Businesses Materials for
a Mental Health Friendly Workplace: Executives Booklet
A Mental Health-Friendly Workplace: It’s in Every Company’s Best Interest
An introduction for business executives
This booklet introduces a new program developed through a partnership between your State’s mental health department and the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services.
The program offers a free-of-charge startup package—Workplaces That Thrive: A Resource for Creating Mental Health-Friendly Work Environments—that your human resources personnel or managers can use to become familiar with practices that promote good mental health and with ways to institute them in your workplace. The resource also provides ready-to-use materials for supervisor training and for communicating with employees about their role in creating a Mental Health-Friendly Workplace.
The resource is provided to businesses in California, Florida, Pennsylvania, Texas, and Wisconsin, all of whom are participating in a pilot program to promote mental health and reduce stigma and discrimination associated with mental illnesses. To obtain a free-of-charge resource for your business, of-charge resource for your business, contact the individual or organization in your State that provided you with this booklet, go to www.allmentalhealth.samhsa.gov, or call 1-800-789-2647 (English/Spanish) or 1-866-889-2647 (TDD) to learn who to contact within your own State.
This booklet is an invitation to you—one of America's business leaders—to take
a serious look at the role of your employees' mental health in relation
to their well-being and productivity, and your bottom line. As you undoubtedly
know, costs related to health issues and employee productivity are highly
salient in today's increasingly competitive marketplace.
Mental Health in the Workplace
The phrase "mental health" brings
- on-the-job stress and/or "burnout;"
- the need for conflict resolution between employees;
- the emotional "fallout" from
a traumatic event; or
- dealing with employee anxiety when there are major changes.
Often proactive "mental health-friendly" practices can prevent or help resolve problematic work situations such as those above.
Mental health and mental illness can be pictured as two points on a continuum
with a range of conditions in between. Mental health issues that employers
face range from stress to serious mental illnesses such as depression,
anxiety disorders, or adult attention deficit/hyperactivity disorder.
Mental illnesses are surprisingly common. They affect almost every family
and workplace in America.1
It has been said that many
employers simply do not know how to work productively with employees who
have mental illnesses.2 In fact, many people don't
realize that effective treatments are available for mental illnesses
and that people recover from mental illnesses and continue to live productive
Unfortunately, many people with serious mental illnesses do not seek or
receive treatment. Common reasons people do not seek treatment include:
cost, fear, not knowing where to go for services, and concern about confidentiality
and the opinions of coworkers and others in the community. This fear
of what people may think—the stigma that surrounds mental illness—is
a serious barrier to treatment and recovery. The Mental Health-Friendly
Workplace can help overcome these barriers by providing access to appropriate
mental health services for employees.
No community is unaffected by mental illnesses; no school or
workplace is untouched.
Most of the estimated $79 billion in annual costs associated with mental illnesses is due to lost productivity—approximately $63 billion.3
—President's New Freedom Commission on Mental Health
Benefits to Business
A Mental Health-Friendly Workplace makes good business sense. It benefits owners, managers, and employees in ways that affect the bottom line. Consider the following outcomes:
- Higher productivity and motivation. Employees feel valued and secure and work more effectively when employers demonstrate a commitment to their well-being.
- Reduced absenteeism. Workplace stress is a major cause of absenteeism. Helping employees manage their stress and overall mental health can boost productivity.
- Health insurance cost containment. Instituting health and wellness programs can help hold down health insurance rate hikes.
- Preparedness for disasters. Assisting employees in times of sudden unexpected trauma with counseling, peer support groups, and links to needed community services can help businesses become productive again sooner.
- Loyalty and retention. Businesses with mental health-friendly practices have documented remarkably low turnover rates, along with cost savings in recruitment, new employee orientation, and training.
- Hiring and promoting the most qualified people. By openly supporting mental health-friendly policies, employers can increase the pool of qualified applicants.
- More efficient workplace practices and policies. The process of thinking about mental health can generate helpful internal policy and benefit reviews, and more effective workplace systems and procedures for employees as a whole.
- Better workplace relations. Awareness of and openness to mental health issues help create a positive climate for understanding, conflict resolution, and support.
- Diversity, acceptance, and respect in the workplace. Embracing diversity includes people who live with mental illnesses. In becoming more inclusive, businesses can both thrive and set a standard for others.
What does a Mental Health-Friendly Workplace Look Like?
Businesses that value the health of their employees, including their mental health and well-being, have specific practices and policies in place. Such companies can be small, medium, or large. Outstanding examples abound among large corporations in the United States; however, businesses with only a few employees also have found meaningful and innovative ways to be mental health-friendly.
Below are specific practices and policies that characterize a Mental Health-Friendly Workplace, many of which are found in organizations large and small.
The Mental Health-Friendly Workplace:
- Welcomes all qualified job applicants; diversity is valued.
- Includes health care that treats mental illnesses with the same urgency as physical illnesses.
- Has programs and practices that promote and support employee health-wellness and/or work-life balance.
- Provides training for managers and front-line supervisors in mental health workplace issues, including identification of performance problems that may indicate worker distress and possible need for referral and evaluation.
- Safeguards confidentiality of employee health information.
- Provides an Employee Assistance Program or other appropriate referral resources to assist managers and employees.
- Supports employees who seek treatment or who require hospitalization and disability leave, including planning for return to work.
- Ensures "exit with dignity" as a corporate priority, should it become essential for an employee to leave employment.
- Provides all-employee communication regarding equal opportunity employment, the reasonable accommodations policy of the Americans with Disabilities Act, health and wellness programs, and similar topics that promote an accepting, anti-stigmatizing, anti-discriminating climate in the workplace.
Three Portraits of Mental Health-Friendly Workplaces
Small Business: Coffee By Design, Portland, Maine
Shortly after opening her first Coffee By Design shop a decade ago (which has
now grown into three shops plus a coffee roasting business), Mary Ann
Lindemann was inspired by a television report that described a European
village that took responsibility for the mental health needs of its residents.
At the same time, she read about Maine's transition to a community-based
mental health system. These two converging experiences led her to a simple,
yet profound epiphany: "One person at a time, we can make a difference."
With this realization, Lindemann renewed her company's commitment to
the mental health of her employees, who number about 30, and patrons.
She has helped staff learn about working with customers who may have
mental health problems, and she has put in place a number of mental
health-friendly practices for her employees. These include:
- Employee trainings about mental health and mental illnesses;
- Flexible shifts for employees recovering from mental health problems;
- Support for an employee returning to work after a mental illness;
- A revised job application form that stresses the company's commitment to "honesty and diversity;"
- Dissemination of brochures and other materials on mental health during May, which is Mental Health Month; and
- A benefits package that includes mental health coverage. Recently,
short-term disability was added.
Lindemann's mental health-friendly policies and practices have produced
positive results: In 2002, Coffee By Design won an award from the Disability
Rights Center for work on behalf of people with mental illnesses, based
on a word-of-mouth nomination. In 2003, Aetna Inc. named Coffee By
Design its Northeast Region winner of the Small Business of the Year
award. Strong customer loyalty has helped them achieve 40 percent annual
earnings growth, in spite of competition from Starbucks and Dunkin'
Donuts. Lindemann says, "A
mental health-friendly workplace is inseparable from our bottom line."
Large Corporation: Quad/Graphics, Pewaukee, Wisconsin
It happens every day, but most people never give it a thought until it
affects them—tragedy in the workplace. Quad/Graphics, America's largest
privately held printing company, experienced a catastrophic fire in
which a 10-story storage facility collapsed and caused the company's
first onsite employee death. Shortly after, Quad/Graphics lost its
president, Harry V. Quadracci, in a drowning accident. To handle these
major events, Quad/Graphics, QuadMed employee assistance program (EAP)
proactively addressed bereavement needs for all employees. Information
packages were provided and QuadMed team members visited all of the
plants and spoke to employees individually, letting them know they
were available to help if needed.
It might not seem like a lot," said
Dan Bird, employee assistance counselor, "but this really went a long way toward keeping our company on track in this very
Beyond its employee assistance program, Quad offers trainings and accommodations
to its 12,000 employees to help them care for their mental health.
- Mental health screening and stress management classes throughout the
- Workplace wellness training for managers that includes guidance on
identifying issues and referring employees to the EAP;
- Special efforts when work pressure is highest to make employees aware
of the EAP services and benefits;
- Making the EAP and its services more visible to employees during times
of crisis, such as an employee's death on the job; and
- Special supportive arrangements for employees returning to work after
a mental health-related absence.
Quad's leadership in returning disabled employees to work earned them
the CNA Insurance Companies' first-ever CNA Disability Accommodation
Award in 1995. "While
nurturing the mental health of staff is good for the bottom line, more
importantly, it's the right thing to do," Bird said.
Medium-sized Company: Highsmith Inc., Fort Atkinson, Wisconsin
When Highsmith Inc., a distributor of library furniture and supplies
in rural Wisconsin, experienced a staggering 53 percent increase in
health insurance premiums, the company examined its culture and instituted
programs that they credit with holding premium costs at a steady level,
increasing productivity, and maintaining very low turnover. Mental
health-friendly practices are both implicit and explicit in the corporate
culture. Highsmith's 300 employees enjoy the following programs designed
to help them care for their mental health:
- A comprehensive menu of health promotion and disease prevention activities
and programs such as mental and emotional health programming and screenings,
domestic abuse outreach and education, and stress reduction and time
- Learning and development through classes that span job and career development,
personal well-being, self-care, physical well-being, and work/life
- An employee assistance program (EAP) that pays special attention to
mental health issues. The company partners with its EAP to provide
employees with tools to balance work/life;
- An orientation session for new employees that includes "First
Aid Kit for the Mind," a session about signs of mental illnesses, stress, and substance abuse, and
tips for maintaining mental fitness;
- An annual health screening that includes a meeting with an EAP counselor
to talk about personal well-being and learn more about the tools and
resources to balance work and life; and
- An intranet section that links employees to quality health information
on a variety of topics including depression and anxiety, relationships,
and domestic abuse. Another section, Leader's Edge, features resources
for line managers including "Your
Role and the EAP."
Making the choice to integrate mental health into a comprehensive approach
to encourage healthy lifestyle choices has paid off for Highsmith.
At a time when health insurance premiums are increasing at double-digit
rates, Highsmith's premiums have held steady. The rate increase for
2002 was 2.9 percent, and 3.1 percent for 2003.
Employee loyalty was tested in April 2002 when there was a workforce
reduction affecting 31 employees. A month later, the EAP conducted
a resiliency survey finding that faith and trust in the management
remained solid. The average length of service is 13 years with minimal
turnover. From 1999 to 2002, turnover in the Madison/Milwaukee corridor
was averaging 22 percent, but Highsmith's turnover was around 8 percent.
High Performers May Need Support Too
When a Highsmith employee's 20-year marriage ended in divorce, she was
left alone to raise her teenage son. Keeping problems at home became
difficult. She did not know where to turn for help, but she found support
Highsmith assisted her with educational opportunities in personal well-being
and referred her to a counselor from their employee assistance program.
With the consent of the employee, the counselor came up with an approach
to provide her team with information on depression and discussed ways
they could support her during this difficult time. In addition, the
employee's line manager provided her with time off from work to attend
The result: This employee remains one of the company's top performers.
The employee discovered the positive impact of physical activity on
her emotional well-being and overall health. As a result, she started
to use the one-mile path that surrounds the building to walk during
her breaks, joined in the onsite exercise classes, and saw dramatic
changes in her overall health. She said, "If
it wasn't for the people at Highsmith, I would not be here today."
Next Steps: Using the Mental Health-Friendly Workplace Resource
First, assess where your company is now and where you want to
- Have you noticed excessive absenteeism, low morale, low productivity?
- Could these issues have been dealt with more effectively?
- What elements of a mental health-friendly environment are already in place?
- What additional elements could help you with future issues?
- How will the worth or value to your business of this undertaking be assessed (i.e., how will you know that you are achieving the benefits?)?
Second, order the free Mental Health-Friendly Resource from the individual
or group in your State that provided this booklet (or follow the instructions
The Resource contains:
- Descriptions of Mental Health-Friendly Workplace practices;
- Downloadable materials to help in creating Mental Health-Friendly Workplaces;
- Training modules for supervisors, including reproducible materials and PowerPoint slides; and
- Ready-to-use materials for communicating with employees, including a poster, print PSAs, and drop-in articles for in-house communications.
The resource is designed for human resource personnel, or in the absence
of HR personnel, for the staff who administer corporate benefits and other
personnel policies; communicate health, wellness, and work-life balance information;
and coordinate training of supervisory staff.
You can obtain Workplaces That Thrive: A Resource for Creating Mental Health-Friendly
Work Enviroments from the individual or organization in your State that provided
you with this booklet or by calling the National Mental Health Information
Center at 1-800-789-2647 (English/Spanish) or 1-866-889-2647 (TDD). Or visit
www.allmentalhealth.samhsa.gov. Ask for the free Mental Health-Friendly Workplace
Myth: People with mental illnesses can't hold jobs.
Fact: On the contrary, many are productive employees, business owners, and contributing members of their communities.
Myth: Employees with mental illnesses, even those who have received effective treatment and have recovered, tend to be second-rate workers.
Fact: Employers who have hired these individuals report they are higher than average in attendance and punctuality, and they are as good or better than other employees in motivation, quality of work, and job tenure. Studies reported by the National Institute of Mental Health (NIMH) and the National Alliance for the Mentally Ill (NAMI) conclude that there are no differences in productivity when compared to other employees.
Myth: There's no hope for people with mental illnesses.
Fact: There are more treatments, strategies, and community supports than ever before, and even more are on the horizon. People with mental illnesses lead active, productive lives.
Myth:People with mental illnesses are violent and unpredictable.
Fact: Chances are you know someone with a mental illness and don't even realize it. In reality, the vast majority of people who have mental illnesses are no more violent than anyone else.
Resources Used in Developing This Publication
New Freedom Commission on Mental Health. (2003). Achieving the Promise: Transforming Mental Health Care in America, final report. Rockville, MD:
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. DHHS Pub. No. SMA-03-3832.
Center for Mental Health Services. (2001). Hand in Hand: It's Worth the Investment, A National Summit on Best Practices for Mental Health in the Workplace, summary report. Washington, DC: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services.
Gabriel, Phyllis. (2000). Mental Health in the Workplace: Situation Analysis, United States. Geneva: International Labour Office.
Harnois, Gaston and Phyllis Gabriel. (2000). Mental Health and Work: Impact, Issues and Good Practices. Geneva: World Health Organization and the International Labour Organization.
Kramer, Laurie Maloff. (2001). Mental Illness in the Workplace: A Resource Guide for Minnesota Employers, revised edition. Minneapolis, MN: Mental Health Association of Minnesota.
Mindout for Mental Health Campaign. Line Manager's Resource: A Practical Guide to Managing and Supporting Mental Health in the Workplace and Working Minds Toolkit: A Practical Resource to Promote Good Workplace Practice on Mental Health. London: Department of Health.
OpenMindsOpenDoors. (2003). Mental Health in the Workplace: An Investment in Human Capital. Harrisburg, PA: OpenMindsOpenDoors, c/o Mental Health Association in Pennsylvania.
1 New Freedom Commission on Mental Health (2003). Achieving the Promise: Transforming Mental Health Care in America: Final Report. Rockville, MD, DHHS Pub. No. SMA-03-3832.
2 Statement by Rita R. Handrich, Ph.D., University of Texas-Austin EAP, at "Can Health Services Research Influence Policy Private Actions?" Conference jointly sponsored by the Association for Health Services Research and the National Alliance for the Mentally Ill, December 8-9, 1999.
3 Rice, D.P. and Miller, L.S. (1996). The Economic Burden of Schizophrenia: Conceptual and Methodological Issues and Cost Estimates. In M. Moscarelli, A. Rupp, & N. Sartorius (Eds.), Schizophrenia (pp. 321-334). Chichester, UK: Wiley.
For additional copies of this booklet, or to obtain a copy of Workplaces That Thrive: A Resource for Creating Mental Health-Friendly Work Environments, please call the National Mental Health Information Center at 1-800-789-2647 (English/Spanish)or 1-866-889-2647 (TDD).