Mental Health and Wellbeing at the Workplace: Creating “Shared Value” in the Age of COVID-19
Patricio V Marquez and Betty Hanan
The “Great Resignation”, a trend in which a large number of people voluntarily resign from their jobs, beginning in early 2021, primarily in the United States and other rich countries, has been one of the ripple effects of the disruption from the COVID-19 pandemic. This trend has been acutely felt in the service industries, such as retail, hospitality, food service, and healthcare, where providers and receivers of a product or service are at the same place at the same time. The experience of white-collar workers has been different. They have been able to “get away from the 9 to 5 office-centric work arrangement” to work from home, with greater flexibility.
In low- and middle-income countries (LMICs), while people in the formal sector of the economy have had flexible work arrangements or remained put to save their jobs, large numbers of informal workers (in Latin America, for example, 55% of total workers) have not had the same choice. They have continued to work on their regular settings to earn a living since they are unlikely to have much savings or to receive support from social protection programs at a level that would allow them to feed their families while adhering to social distancing measures.
Although the country experiences are different, there is a growing consensus that how work is organized and how we work together will not return to the way it was before the pandemic. This should not surprise us. Even before COVID-19, there was much discussion about how technological innovations were fueling momentous change in our daily lives and in the workplace. Indeed, as Professor Klaus Schwab, the chairman of the World Economic Forum described, a range of new technologies are fusing the physical, digital, and biological worlds, impacting all disciplines, economies, and industries, and unleashing changes “unlike anything humankind has experienced before”. They underpin what he calls 'the fourth industrial revolution'.
In workplace arrangements, the “ripple effects” from the pandemic have compounded, deepened, and expanded the impact of rapid and disruptive economic and social changes that were already underway fostered by scientific and technological developments and their applications. What can be done to build social resilience and protect and keep people front and center of the development process?
Working arrangements post-pandemic
As we visualize a post-pandemic future, remote work is becoming part of a highly valued new normal, adding to employer attractiveness, particularly for the younger cohort of knowledge workers who are technologically savvy, value the independence of working remotely from anywhere, and flourish amid flexible arrangements.
Indeed, as observed by Professor Dr. Isabell Welpe at the Technical University of Munich, in an interview summarized in a World Economic Forum post, virtual and remote work are mostly here to stay. She notes that many companies have already announced that their employees will never have to return to the office fulltime. It signals the advent of new post-pandemic working arrangements that move away from a one-size-fits-all approach to one that allows individual and asynchronous (not synchronized or coordinated with time) organization of work and work settings. For example, some companies are expected to allow a part of their workforce to work fully remotely most of the time and to allow another part of their workforce to come to the office only on 1-2 days a week. In Professor Welpe’s view, office buildings will become cultural touchstones, serving as places for meetings, recruiting, meeting customers, and bootcamps to facilitate interpersonal exchange.
However, as Professor Welpe has also advised, the degrees of remote work will also depend upon how well firms manage the challenges that come with remote work: overcoming communication silos, particularly between workers and across departments, already pervasive pre-pandemic, as well as sharing non-codified information and knowledge. She argues that this new way of organizing work requires a different leadership style and new skills from workers. Management through leaders and control will be gradually replaced by self-leadership. Workers who are healthy, able and motivated to take on responsibility will thrive and foster greater agility in their organizations.
How to support the establishment of new work arrangements post-pandemic?
As assessed in a Rand Corporation report, technological changes and new forms of workplace organization over recent decades have led to workers assuming increased responsibilities and more autonomy than ever before. Although this has increased overall productivity, flexible modern working practices have also increased daily job demands, requiring employees to multi-task and leading to increased levels of workplace stress and unrealistic time pressures that have contributed not only to growing levels of absences due to sickness, but also to the emergence of ‘presenteeism’, when employees attend work while in suboptimal health.
One way to address these health challenges is to heed the advice of Professor Michael Porter of the Harvard Business School that the next transformation of business lies in the application of the principle of shared value: creating economic value in a way that also creates value for society by addressing its needs and challenges. At the workplace, the adoption of the shared value proposition means that organizations and businesses have in their role as employers a great responsibility to nurture employee (and their families) resilience, particularly in these changing times. If we accept this proposition, then, it becomes clear that disease prevention and promotion of good health are vital investments to accompany the new working arrangements post-pandemic.
Indeed, while employers have a responsibility to provide a safe and hazard-free workplace, they also have abundant opportunities to promote individual physical and mental health, fostering a healthy work environment to reduce health risks and improve the quality of life for workers and their families. This can be achieved by supporting the development of an employee-centered wellness culture in the workplace; providing supportive environments where safety, respect, and equal treatment to all are ensured; work-family balance is codified in the institutional culture; and facilitating access and opportunities for employees to engage in a variety of workplace health and wellness programs.
A healthy workforce is not only vital to the workers’ wellbeing and that of their families, but it is key for the continuous development of human and social capital in the workplace. It enhances the productivity, competitiveness, and bottom line of firms. The latter is easily grasped when one considers that poor health and well-being costs the UK economy up to US$75 billion a year in lost productivity due to a combination of presenteeism (being in suboptimal health at work) and absenteeism (missing work due to illness). Both are associated with a range of factors, including job and work environment (e.g., stress); personal (e.g., health risk-factors related to smoking, substance use disorders (alcohol, drugs, opioids), sedentarism and obesity, and health and physical risks (e.g., chronic conditions and mental disorders).
There is also growing evidence of the significant impact of the workplace health and wellness programs. In the United States alone, these programs are now a US$6 billion industry, with more than half of firms with at least 50 employees offering these programs. Results of a national survey conducted by the Rand Corporation showed measurable improvements among program participants in their physical activity, smoking cessation, and weight control programs over a four-year period. The study also found that participation in a wellness program over five years is associated with a trend toward lower health care costs. The return-on-investment is noteworthy when comparing the ratio of reductions in the cost of health care (e.g., keeping people healthy and out of hospital) to the costs of the programs: wellness programs generated a return of $1.50 for every $1 invested and a return of $3.80 for every $1 spent on disease management.
A study done by the World Economic Forum, covering 25 firms with 2 million employees in 125 countries around the world, also found that firms that champion workplace wellness are reaping significant benefits in terms of increased productivity, reduced cost of employee healthcare, and increased employee engagement leading to reduced turnover.
The importance of mental health and well-being in a society
The COVID-19 pandemic has taken a significant toll on people’s mental health. A recent global study has estimated a significant increase in the prevalence of both major depressive and anxiety disorders among all gender types across the lifespan versus before the COVID-19 pandemic—a worrisome finding because these disorders were already leading causes of disability worldwide. Social restrictions, unemployment, financial instability, and school closures are among the COVID-19-related factors that have contributed to worsened mental health outcomes.
Mental disorders are also a major risk factor for developing alcohol and drug dependency. Globally, 107 million people or 1.8 percent of the total population are estimated to have an alcohol use disorder. The results of a study on mental health and alcohol use in developing countries showed that the consumption of alcohol is heavily gendered, characterized by a high proportion of hazardous drinking among men. Hazardous drinkers not only consume large amounts of alcohol, but also do so in high-risk patterns, such as drinking alone and binging, both of which are associated with depressive and anxiety disorders as well as suicide and domestic violence. In terms of drug use, it is estimated that globally in 2017 around 71 million people had a drug use disorder. Most of these people have an addiction to opioids, which accounts for around 55 percent of drug use disorders globally. As documented in a previous post, people are more likely to drink or use drugs as a coping mechanism "during times of uncertainty and duress," such as during the COVID-19 pandemic, particularly in the face of rising unemployment, underemployment, changes in work arrangements, loss of income, and other disruptions in daily routines.
As the world enters into the third year of the COVID-19 pandemic, we need to accept that perhaps the mental health 'tail' of this global crisis will likely prove quite long for a lot of people, compounding and deepening the impacts of social and economic disruptions that were already underway pre-pandemic. As documented in different articles and reports, the pandemic has changed our lives, overwhelming people with feelings of instability. Anxiety about the future is adding to this burden. While the shutdowns in the spring of 2020 extracted a heavy toll, the Delta and Omicron variants onslaught in the second half of 2021, not only spiked the coronavirus case numbers, but the disruptions that followed brought a sense that the pandemic would never end despite the growing availability of vaccines and new therapies.
Looking forward: mental health and wellbeing in the workplace
While physical health-related metrics associated with workplace health and wellness programs are promising, tackling mental illness in the workplace is lagging. It is a major challenge that needs to be addressed head on. The enormous burden of mental ill health at home and the workplace is aggravated by widespread stigma and discrimination of affected people.
Let’s be clear, mental health is an integral and essential component of health demanding the same priority attention as physical health. Mental health is a form of human capital for individuals, families, communities, and society, which can be looked after and invested in. It is a state of wellbeing in which individuals realize their own abilities, can cope with the normal stresses of life, can work productively, and are able to contribute to the community. Good mental health improves opportunities for positive interpersonal relationships and success in studies and work, and it strengthens trust, reciprocity, engagement, and a sense of belonging in a society. It manifests itself as general well-being and reduced levels of strain on families, in communities, at the workplace, and across the entire society.
The costs of mental ill-health are enormous for individuals, employers, and society. Mental disorders such as depression, anxiety, and substance use impose a significant global disease burden, leading to premature mortality. They are the leading causes of disability worldwide, affecting people’s functioning and quality of life. Mental and physical health are interrelated: people who suffer from a mental disorder also have a higher lifetime risk for serious physical health problems. Mental disorders can result in worse treatment adherence and outcomes for commonly co-occurring diseases, such as tuberculosis, diabetes, cardiovascular disease, and cancer.
Poor mental health is a major issue for employers and employees alike. It costs organizations billions of dollars every year and worsens the lives of millions of people, in the workplace and beyond. For example, in the wealthy OECD countries, which spend on average 9 percent of GDP on health care, the high economic cost associated with mental conditions is largely driven by lost productivity in the working-age population rather than by mental health care expenditure. People suffering from mental ill health are not only less productive at work but are more likely to be out sick from work, and when they are out sick are more likely to be absent for a longer period—around 30 to 40 percent of all sickness and disability caseloads in OECD countries are related to mental health problems.
Despite very high costs to individuals and the economy, there is limited awareness about the connection between mental health and work, and of the drivers behind the labor market outcomes and the level of inactivity of people with ill mental health. Understanding these drivers is critical for developing more effective policies to deal with mental health and work issues during the pandemic and its aftermath.
Addressing mental ill health risks in the workplace could generate significant benefits for workers and firms alike. A study prepared for the 2016 World Bank Group-World Health Organization Global Health Conference estimated that the returns on this investment in a country can be substantial as measured by a favorable benefit-to-cost ratio, ranging between 2.3-3.0 to 1 when economic benefits only are considered and 3.3-5.7 to 1 when social returns are also included.
Integrated health and wellness programs in the workplace, that focus on the physical and mental health of workers and their dependents, are a “good buy” for any organization and business. They generate significant returns in terms of health and economic gains. Investing in these programs can contribute to developing and strengthening new work arrangements post-pandemic and contribute to accelerate the progressive realization of universal health coverage by engaging and leveraging resources and know-how from firms and businesses for the benefit of workers and families alike.
Nurturing the development of healthy work environments that promote the physical and mental wellbeing of employees is not only the right thing to do, but it is a smart economic strategy to enhance human and social capital and to improve productivity and competitiveness of firms, and helps national economies combat poverty and achieve sustainable development.
Indeed, business leaders and senior managers should understand that the adoption of this “shared value” course of action, reflected in corporate decisions to support and sustainably fund health and wellness programs, integrating physical and mental health activities, is “not a corporate social responsibility, philanthropy, or even sustainability, but a new way to achieve economic success” in “new normals” in the age of COVID-19.
Source of Image: Picture taken by Patricio V Marquez in the Fall of 2021.