COVID-19 vs. mental health: How businesses can help employees win

Mental health is coming out of the shadows. What was once taboo is becoming mainstream. What was once stigmatized is becoming accepted and understood. And this trend is in evidence around the world. The result has been a growth in governmental, charitable and professional initiatives to support good mental health with products, programs and education.

In 2020 the global pandemic impacted the lives of millions of employees as people were furloughed or began working from home.

Our 2020 survey, Polarised perceptions of corporate health and wellness, explores the direct and indirect impact of COVID-19 on the international community. This article discusses how the pandemic impacted our mental health and what can employers do to help support their employees build and maintain good mental health — now and after the pandemic.

As many employers have less face-to-face contact with their staff, how can they reprioritise mental health, and what strategies can be put in place to tackle stress, anxiety and depression? How will this be affected by people returning to the office?

Mental health: The status quo

• One in four people will experience a mental illness at least once in their life
• Every 40 seconds someone commits suicide.

Dr Sneh Khemka, Vice President of Population Health Solutions and vHealth, explains that there are unique challenges when tackling mental health as opposed to physical health: “Mental health is very personal. Unlike physical health, where a broken bone is a broken bone and you've got a fixed treatment pattern for that, mental health is so individual. It depends on a person’s character, on their individual preferences, on their expressions, on where they live, how they live, who they live with.

“And so, tackling mental health is much more complex than many aspects of physical health and there isn’t a panacea solution that works across the board.”

But, as Dr Khemka explains, progress is being made to tackle mental health: “The revolution that we’ve had in the last 12 to 18 months, has really been short of nothing but amazing.” Today the UK royal family are engaged in the topic, there are global summits of world leaders and businesses of all sizes are implementing initiatives to tackle mental health.

COVID-19: Multiple mental health stressors

As the pandemic spread, governments began issuing guidance including self-isolation, closing of public spaces and working from home. People became distressed because of the impact of physical isolation and many people were afraid of infection and losing family members. In May 2020 the United Nations said that the pandemic has led to widespread psychological distress in populations. Sadly, mental health services in 93% of countries have been disrupted or affected by the COVID-19 crisis.

With the speed of the virus’ spread, there is little data on its impact on mental health. Our survey of 1,000 expat workers sought to shed light on this. Our data supports the United Nations’ statement, with 74% of our respondents saying their mental health has been impacted by COVID-19.

Our findings also show that those who continued to go into the office had different concerns and levels of concern to those who were working from home. The former group were far more concerned about stress and less about general mental health. Their main concern was contracting coronavirus (48%, compared to 16% of home workers).

Dr Khemka comments: “We don’t know the long-term effects of COVID-19 on mental health yet because we’re still in the thick of it. But, UK mental health charity, Mind, surveyed around 16,000 people and found that 22% of people who had no previous experience of poor mental health said that during lockdown they were having poor or very poor mental health. That’s startling. It suggests that lockdown has caused significant mental health issues.”

He also cites a statistic from Aetna International’s parent company, CVS Health Care, who saw virtual consultations go up by 200-400%, but notably, an increase of 3,000% for mental health conditions across the U.S.

COVID-19 and depression/anxiety at home

Mental health was one of the main concerns of employees, especially those who were working from home.

• 33% said mental health problems such as depression or anxiety was the health issue they were most concerned about when working from home (second only to gaining weight at 43%)
• 23% for those going into the office.

Dr Khemka explains that community is very important to mental well-being, and many people get much of their human contact from their workplace. For single parents with young children, coming into the office may be the only adult interaction they get on a regular basis.

27% of employers from our survey said that they have made efforts to improve social activities during the pandemic, for example with virtual hangouts. However, only 16% of employees said that work-based virtual social activities had improved — showing that, for many workers, the efforts made by their HR directors aren’t apparent.

“People in neighbourhoods with a higher level of social cohesion and social bonding, experience lower rates of mental health problems,” he says. “If you are lonely and if you are socially isolated, that is significantly worse for stress and mental health issues.”

COVID-19 and stress in the office

While those working from home were concerned about conditions such as depression, those heading into the office were more worried about stress.

• 32% said stress was the health issue they were most concerned about when working from home
• 43% of those going into the office said stress was their main health concern (second only to contracting COVID-19 at 48%)

Concerns around stress may well be related to workers’ worries about contracting COVID-19. Stress may also have come from concerns about furlough, pay cuts, longer working hours, increased workloads or even redundancy as the news channels started discussing and reporting on economic contraction.

Our survey also shows that only 25% of employees think that their company’s level of support for stress is ‘good’ when they are working from home (32% when in the office).

READ: Mindfulness and meditation: 9 stress-management strategies to consider in the workplace

COVID-19 and other mental health conditions

• 27% said fatigue or not sleeping was the health issue they were most concerned about when working from home.

As Dr Khemka explains: “Less severe impacts include changed sleeping patterns — sleeping less, having nightmares — and facing more stressful situations on a daily basis. There are also psychosomatic physical health issues, such as increased high blood pressure and cardiovascular disease, related to the mental health impact of lockdown.”

In another survey, we found that 78.3% of expats said they had sleep problems during the pandemic. Read the full report here: Expat Family Wellness Survey 2020.

Support for remote workers

Over the last few years, mental health initiatives to support employees at work — and even in their personal lives — with issues such as substance abuse/dependency have expanded. These were often tailored for specific workplaces, spaces and industries, addressing factors such as high-pressure, dangerous jobs and dealing with the different personalities in a workplace.

Could any employers have truly implemented for a change to remote working over night?

In many cases, governments provided businesses with guidelines, but those in power were just as unprepared as the general public. Businesses of all sizes had to arrange social distancing and sanitation measures in the office while also ensuring those being sent home were set up for remote work, as well as making improvements to health and wellness benefits and support, and catering to employees’ needs in a new remote-working scenario.

We asked workers what their employer had done to improve support for their health and well-being in the last six months.

• 43% said introducing flexible work hours to help with childcare
• 37% said mental health support through tech such as apps/telemedicine
• 31% said physical health support through tech as apps

Only 16% said their employer did nothing.

And how was this support viewed by employees?

27% of those surveyed said that the level of support provided by their employer for mental health conditions such as depression and anxiety was poor when working from home (compared to only 16% for general wellness support for those working from home).

It is understandable that many employees think their businesses were ill-equipped to support their mental health when working from home — the practise was as new to managers as it was for employees. This is highlighted by our finding that 84% of employers have improved support for health and well-being, but only a third think support provided for mental health and stress is good. There is more work to be done.

Changing employee demands

As Dr Khemka states, COVID-19 has turbo-charged the interest, awareness, investment in mental health, and our survey data shows how much it is driving demand for employer support:

• Is mental health care provision from your employer now more or less important to you?
  • More – 68%
  • Same – 21%
  • Less – 11%
• Is physical health care provision from your employer now more or less important to you?
  • More – 63%
  • Same – 25%
  • Less – 12%

“Once, professionals were advised to leave their personal lives at home when at work. Today, our homes and all they encompasses — children, spouses, parents, pets, meal times, appliance deliveries and couriers — are now places of work for many people,” says Simon Miller, Senior Director, Customer Proposition, Aetna International.

“It’s more difficult to separate the personal from the professional, in terms of stressors, whether they come in the form of increased time pressures, loss of household income, school closures or sick relatives. As we become increasingly aware of the influence of our emotional well-being on our overall health, our ability to manage multiple stressors from multiple sources and complete our work duties, so too have people realized that the support they receive from employers needs to cater to all those stressors. Only then can they take well-rounded steps to look after their own health and the well-being of their families and be focused and productive at work.”

Advice for employers

There is a difficult period ahead, but organizations have a once-in-a-generation opportunity to harness all the learning and make long-term changes: To engage with their workers and create a stronger and healthier workforce for the benefit of the employees themselves but for the longevity and sustainability of the business.

“As a global community we've never talked about health and well-being as much as we are now.,” says Dr Hemal Desai, Global Medical Director, Aetna International. “This health crisis has provided an opportunity for everyone to embed how we want to live and work in the future, as well as for organizations to grasp this moment to improve people's health and well-being.”

Not only does improved health and well-being of employees support productivity, but 27% of employers we surveyed said that a clear policy on supporting employees with mental health problems is the biggest factor in talent retention versus 12% of employees.

Combatting isolation

In our Expat Experiences Survey 2020, expats listed their top three challenges relates to COVID-19 lockdowns as ‘missing friends and family’, ‘boredom’ and ‘the feeling of being trapped’ (31%). For respondents with mental health issues, 30.7% said ‘loneliness’ was a major issue.

“In the world of COVID where we have to be physically distanced for non-transmission reasons, online interactions can foster a sense of connection,” says Dr Khemka. “But those interactions must be mentally stimulating. Passive interaction with social media — hours of endlessly scrolling through Instagram and Facebook — does not foster a sense of online community — in fact, it alienates.

“In contrast, if you get online interactions that involve talking, information sharing, learning, with an agenda or an outcome, that can really foster a sense of community.”

And organizations can implement these.

During the pandemic, Aetna International initiated a regular ‘Let’s get talking’ session every two weeks for their staff. “We all go to an online platform and we don't talk about work,” says Dr Khemka. “Employees from all across the organization talk about social and other factors. It’s a positive online community which keeps us sewn together. I would encourage other employers to emulate what we’ve done for our own staff. It’s very, very powerful.”

Virtual health

Virtual health — and telemedicine — is the process and technology that supports remote access to health care (usually primary care) through video or phone calls. While adoption has risen in recent years - especially among expats who may not have easy access to quality health care — the pandemic has driven adoption even more. Virtual health allows those working from home or in lockdowns to access aspects of care remotely — from prescriptions to appointments. The World Health Organisation reports that 58% of the countries they spoke to are now using telemedicine to replace in-person consultations.

Dr Khemka describes Aetna International’s own virtual health service, vHealth:

“It offers everything from having consultations with a doctor or psychologist or a dietitian over the phone or over video, to organising blood tests to be taken at your home or your office. It facilitates drugs being delivered to you where you are, as well as online support and counselling services for dealing with chronic diseases mental health.”

Virtual health is an invaluable tool to support the mental health of workers as we work from home or return to the office — all within a context of financial, familial and emotional turmoil which is having an evident impact of workers around the globe.

“vHealth also offers the patient a level of anonymity which they often enjoy,” adds Dr Khemka. “For many people, anonymity, avoiding stigma, is very important. I believe this is part of the reason we saw a 3,000% increase in virtual health conversations and consultations in America for mental health conditions.”

Returning to work

Listen

“There are several approaches that employers can take to help their employees return to work,” says Caroline Pain, Vice President, Customer Proposition. “The first is to listen to what they’re saying and bear in mind that just because they’re not saying anything, that doesn’t mean there aren’t issues.”

Listening will allow you to tailor the support you offer, as Caroline explains: “Although our frame of reference might be as primarily office workers, there are lots of people who've never been able to work from home and have not been furloughed during this time, and their challenges will be different. As such, the solutions that their organizations need to put in place will be different.”

Provide support

“Make sure that you — as an employer — are working with a benefits provider that has that range of services,” says Caroline. “From smoking cessation to drug and alcohol addiction and even domestic abuse.” This can take the form of in-person or digital tools such as the Wysa mental health and sleep apps. “It's really important that we give people the tools to manage their own mental health resilience.”

Dr Desai suggests employers: “have conversations with their health benefits providers, to ensure that people’s quick return to work doesn’t exacerbate issues which become problems later down the line. For example, we know that presenteeism is already a problem now, particularly with mental illness and this will continue to grow — especially if unaddressed.”

Communicate

It is essential to let your employees know what is available to them and how they can access it. This may include your employee assistance program (EAP) and health care benefits as well as who to talk to if they have concerns. We have found a disconnect between the perceptions employees have of the benefits available to them and what employers say they provide. Communication is paramount.

Step back

“It’s also important to take a step back to allow your employees to access those services confidentially, adds Caroline. “People don't necessarily want their employer to know every intimate detail about their own life.”

Be vigilant

Dr Desai adds: “It’s really important that employers, employees and others remain vigilant around deteriorating mental well-being.” Employers should select the right types of interventions to help support employees at the different phases of their journey, for example the Wysa app can be a good daily touchpoint to help with people’s mental well-being and virtual health/telemedicine — such as our vHealth service — can provide access to medical professionals who are able to provide further support, identify and treat, if needed.

Listen to our podcast: Mental health in the time of COVID-19.

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