Fit for Duty Memo Episode

Welcome to this Fit for Duty Memo episode, brought to you by Aetna International.

I’m Lorien Norden, global thought leadership strategist. I’m part of a team that works to bring you industry insights. The aim is to help you make informed decisions about your corporate health and well-being strategies as well as other workplace policies that affect the health and productivity of your people.

In this Memo episode, we’re using our proverbial highlighter pen to bring you a round-up of some of the most insightful expert opinions from our recent podcast episodes. Our experts come from the fields of medicine, economics, well-being benefits, executive leadership coaching and workforce communications. These excerpts shed light on some of the most notable trends and influences that will continue to shape employee health and well-being and corporate culture in the coming months and years. This includes shifts in attitudes towards health care tech, self-care – mental, emotional, and physical. It’s also about the influence of social connectedness on our health, as well as changes to duty of care, corporate culture and business leadership.

We hope you enjoy this special Fit for Duty Memo episode.

[01.10]

So, to kick off …at the start of the year, I had a conversation with Dr Hemal Desai, Global Medical Director and Simon Miller, Senior Director of Customer Proposition, here at Aetna. We were discussing the health and wellness trends impacting 2021 and beyond.

Dr Desai had just noted that because of restricted access to health care facilities and treatment during the 2020, we would experience negative health outcomes and excess deaths from conditions such as strokes, heart disease and cancer for years to come. In light of this, I asked Simon to share his thoughts on what employers could be doing to help support their employees’ health and well-being, from a prevention as well as a treatment perspective.

[01.49]

I think the first thing, and this was starting to happen already, will be the need to take a step back and look at the whole person — so a view that's looking at both the physical and the psychological. But also the social needs as well, of their workforce. So, the interconnectivity between all three of those for example — between physical condition, the mental health impacts that might have and then the isolation that somebody might be going through amidst all of that, all of those will contribute to how somebody manages a condition, how somebody recovers from a condition, and also to their productivity within the workforces as well. So, I think what we'll see is an increased focus on more of a strategic approach considering all those pillars of well-being, which of course health care provision, as Hemal alludes to, is a very important part of that – that those softer, more holistic needs are being met around that as well.

[02.49]

Employees have embraced and, in fact, are calling for more employer-provided digital health and well-being services. They’re Googling their symptoms, they are using Fitbits and mindfulness apps and tracking their health data online. So I asked Simon for his views on how employers can respond to this momentum.

[03.06]

I think this is a fantastic tipping point and it's a tipping point for an expectation not just around “can I speak to a GP remotely, but can I access health care in general remotely? So, therapists, nutritionists. Can I get my prescriptions delivered to my home but also maybe get treatment at home? Can I get tests at home?” And that, technologically, is deliverable today — that exists. But I think what we're now going to see is an acceptance and an expectation maybe of that and I think that'll be a big shift to enable providers like us to deliver those services, but I think for also for employers to make sure that it is part of that offering that they're seeking from their providers as well and making sure that the workforce are aware that that's there. So, I think that's a great outcome for the industry, but I think it will lead to an ongoing trend beyond this year.

[04.01]

Duty of care is changing. The pandemic has brought into sharper focus the responsibilities that are facing organisations when it comes to looking after their people. That means, organisations are still evolving their workplace wellbeing, health and safety strategies to keep people well, and to support them when they’re unwell or in crisis. Simon explains where organisations can help focus their efforts:

[04.21]

I think the first area has got to be around, what is the duty of care as an employer, in terms of my responsibilities with the workplace? And the workplace, obviously, moving forward, not necessarily being the office. So, I think the first thing that's already starting to happen, that employers thinking about their physical environments for the people coming back into work, what does it look like in terms of the new workplace? That feels safe, both in terms of physical and psychological safety, that supports the community aspects that an employee expects of a workplace but in a safe way. But then for those not working in the office, working from home as well, what does a forward thinking, occupational health strategy look like that does support that proactive, health care provision, and prevention as you allude to. And this is where things like self-help and self-care, so for example access to digital physiotherapy, which might aid that initial prevention, but also aid with early intervention with early diagnosis cues that can be then referred on to a GP for further investigation. So, thinking a lot earlier within an employer's health care journey, not just being a reactive service, being proactive and preventative, I think will be more important than ever.

[05.41]

Certainly, in the US and also in other parts of the world, we have seen the start of the ‘Great Resignation’, where people have been re-evaluating their life choices, values, purpose, work-life balance - and resigning in their droves. So, when it comes to corporate culture, and talent attraction and retention, Simon comments on what employers, both large and small, can do to consider employee well-being and satisfaction holistically:

[06.04]

So, how do you provide and build recovery into your work pattern and into your workload, just like an athlete would after a heavy training block, how do you build that recovery into your work environment? Not as an exception, but just as part of organisational design. If that's the type of workforce that we have, if we are a small workforce, if everybody is a pinch point – how do we build that flexibility into how we preserve the wellness of our employees. So, I think that becomes as much around policy and working flexibility and approach, as it does around, necessarily, the wellness solutions per se. And I think if you're an organisation, a small organisation, and you think “well I simply can't do that”, then you have to ask yourself well is that viable then? Is this a viable and sustainable business model, both as a business and for the individuals? If we can work in no other way than this, at 150% capacity for everybody. And I think there'll be a lot of individuals that come out of this questioning – what are things all about? What's important to me? You know, what's my purpose? Do we have a shared purpose in our organisation? Am I willing to commit 150%, 200% in a long-term way? If I don't feel that sense of community, if I don’t I feel and share that same purpose and those values to be driven in that way. So, I think organisations that do that, and don't have that connection, I would question how sustainable they're going to be in their long term and how well they retain that talent in their organisation.

[07.35]

I recently spoke with Smriti Joshi, lead psychologist at Wysa, and Cara McNulty, the Head of Behavioural Health at CVS. We talked about the ways in which employers can support employees across the spectrum of mental health needs – from those who are thriving and keen to maximise their mental health, to those who are surviving but struggling, and in need of direction and assistance, to those who are unwell or in crisis and in need of treatment and professional support.

Today, we are more aware than ever of the fact that the mind and body are intrinsically linked. Those managing conditions of the body appreciate the impact on their mood and mental well-being and our frame of mind shapes our recovery, whether we stick to prescribed healthier behaviours, a treatment schedule and medication - it’s all inextricably interlinked. Given that, I asked Smriti for guidance on the ways in which employers can normalise conversations about mental health, encouraging people to embrace whole-person health. 

[08.30]

So, providing safe spaces, normalising conversations around mental health within the culture of the organisation is probably the first step, you know, that organisations are now willing to take. If I can quote some data that was done by Oracle in workplace wellness, it says that 76% of people believe that their company should be doing more to protect the mental health of the workforce and 51% noted that their companies had added more support after COVID-19. So, I think COVID-19, with all the distress and uncertainties it has brought up, it’s also kind of created this noise about the relevance of mental health and resilience. The importance of wellness as compared to letting people reach the other end of the spectrum. So, catching it early and nipping it in the bud is what is currently happening with a lot of organisations. And, you know, like Cara said I think Aetna is very sensitive to the needs of its members, employees and we’ve recently added more modules on COVID-19 plus we’ve also added more support for adolescents, so we’re considering that it’s not just the employee who would benefit from these services but also how we could extend it to their family members, how we could, you know, say the 12-week coaching programme that’s now been introduced could be taken not just for the member or the employee, but also for their family member.

So we are contributing to this cutting-edge approach of expanded access to mental health. We are building a continuum of services across the entire spectrum of that need, starting with wellbeing and then again engaging with that missing middle and handing off to specialised clinical support if needed. So I think that is something that many other providers are also doing. Recently we were a part of a very big research carried out by the Cambridge University under the leadership of Dr Becky Inkster and they were almost like about 50+ digital providers that came together and they shared their experiences about how the demand for digital mental health support has gone up and they also shared that 83% of the global workforce would like their company to provide technology to support their mental health, including self-service access to health resources, on-demand counselling, proactive health monitoring tools, access to wellness or mediation apps, or maybe speaking to chatbots to either seek answers to health-related queries — a lot of people experience health anxiety because of COVID for either themselves or their loved ones. Also in dealing with then their daily life stressors or maybe, you know, it is chronic anxiety but they do not yet know it and they go and speak to a chatbot or a coach like on Wysa and that they get signposted to the right direction.

[11.54]

Consumers are now looking for technologies and pathways that make access to healthcare easier — be that telemedicine or digital health apps or using in-house voice assistants like Alexa to answer their questions and provide the latest evidence or research or health concierge signposting. I asked Cara McNulty how organisations can take the positives from the pandemic to meet employees’ call for better access to health care.

[12.19]

And those positives are that we as a society have had to lean into agility and innovation, and so we’ve had to look at how could we advance care differently across that continuum? And I think, I know we will continue to see mental health as a key focus in how we’re advancing care, and that means from a prevention, intervention and acute standpoint. It means reducing stigma, it means normalising, it means meeting people where they’re at, and it also means rethinking how we provide care and care delivery, how we configure networks. It’s not always easy for people to figure out ‘gosh is this person in my network or out of my network?’ I think we’ll see a lot of advancements in network and network partnerships, we’ll see advances in AI and specific technology that again don’t create barriers but remove barriers to tools, resources, support and care and then access to, you know, specialists - say an adolescent psychiatrist. So, we’ll continue to see those advancements. The other thing I would add is the pandemic has also helped to reset what EAP is, or Employee Assistance Programmes, and often we use that term and people don’t know what you’re talking about, and they think about that from a ‘oh, that’s that service that my employer offers but isn’t that for people who are in trouble? Or can’t get along with their co-workers?’.

[14.23]

We all know that there are practical steps we can take to keep our mental well-being, our sleep, nutrition and physical activity on track. Some of us are managing multiple conditions and need a bit more support and hands-on guidance from our employers, via Employee Assistance Programs, for example. EAPs are still relatively misunderstood and are not the easiest to access from an employee perspective. I asked Cara about tackling low EAP utilisation for the benefit of employee health and well-being, productivity and happiness.

[14.54]

We will continue to see health care providers, technology companies, data analytics innovators look at EAP differently and reinvent what it means to the individual and the employee, because as was stated, think of just our adolescent population in the US. Over the pandemic 1 in 4 adolescents has contemplated taking their own life. We need to get care and support to adolescents far earlier than we are and so I’m so excited about the innovation that is coming out of this pandemic, the agility that’s taking place and the rethinking of how we support people so that this does not have to be the quiet conversation, this is a normalised, healthy important conversation talking about our mental health.

[15.58]

Time and again, we hear poor internal communications blamed for employees’ lack of understanding of Employee Assistance Programs – their purpose, breadth, confidentiality and points of access. So, when I spoke with Workforce Communication consultant Jesse Lahey recently, I asked him for his take on the barriers to access, and what organisations can do about it.

[16.19]

Part of it is that it doesn’t feel very human, you know, the way that it’s been communicated in the past is just a phone number and ‘am I going to get stuck in a phone tree?’ and so a lot of companies now are making it more human, especially with the available telehealth resources, it’s a lot easier to make it human. Now you can actually talk to a real therapist and see who you’re talking to. Telling the stories of the types of situations that EAP can help with. We’ve been doing, for example, a two-minute video that makes it more human, talks about it in a caring but light-hearted way ‘you don’t have to be on the window ledge about to jump off before you call and ask for help, go ahead and start reaching out for help when life’s smaller speed bumps come and you’ll get more comfortable with the idea of I don’t have to go through this alone’ and putting some language to those. So, it’s the storytelling and using some visuals to make it seem more human and more approachable and more normal has been very helpful.

[17.41]

There has been a notable shift in attitudes towards self-care and health since the onset of the pandemic. These days people are far more likely to consider their health in day-to-day decision-making, and to care about the health of those close to them. This is also really good news for employers looking to help their employees manage not just one condition, but oftentimes multiple conditions, such as depression and type 2 diabetes. The fall-out of repeated lockdowns, social isolation and working from home have caused weight gain, MSK conditions and stress. Coupled with lack of access to health care, leading health authorities are concerned about a tsunami of heart disease and post pandemic stress disorder, for example. I asked Dr Nairah Rasul-Syed, Global Medical Director for vHealth, at Aetna, what employers can do to help people managing one or more conditions.

[18.31]

This has to come from leadership, they have to be engaged, they have to be listening and understanding what their employees want. But it’s also taking a step back and looking at the demographics of your population: age, gender, all these things and looking at how can we best provide for them? Do they need wellness checks in this age group? Maybe they need better access to medical visits, or they need to ensure they can get their prescriptions refilled without unnecessary visits to expensive secondary care specialists. Mental health as well is a huge problem at the moment; maybe you’ve seen a spike in absence or depression or anxiety so maybe you need to think about what other mental health services your employees can tap into, and this doesn't have to be expensive specialists, it could be something as simple as access to digital health apps and technology. Just giving people a way to access these services in a very confidential way without stigma.

[19.40]

We’ve all become far more aware of the impact of our social circumstances on our mental well-being. With that in mind, I also asked Jesse Lahey what individuals can realistically expect from their employers in terms of help and support in this area.

[19.53]

It’s been said that the opposite of addiction is not sobriety, it’s human connection and I think that’s true in so many aspects of our health and well-being. So I think individuals should be asking themselves and their employer, ‘what’s available to help me move from isolation into human connection or community?’. There’s so many more technologies and opportunities than ever before for people to connect in healthy ways, but it often feels more like hyper connectivity, not meaningful relationships. And so people often feel less connected than ever with their co-workers, family, boss, health care providers and even with themselves. I don’t want to say that isolation is part of the problem, there’s such a thing as healthy solitude, but within that healthy solitude you’re connecting with what’s important to you and getting to know yourself and not being afraid to look inside yourself and so forth. But most employers now, the progressive employers have all sorts of opportunities for employees to connect with each other, with the purpose of the company, for example and with their co-workers and all this telehealth and ways to get this healthy types of connection because it’s the isolation that things like pandemic, illness, challenges and stress tend to… It’s almost like it’s trying to get us to be all by ourselves and feel like we’re alone and like I’m the only person this is happening to.

[21.43]

This next extract is taken from a podcast episode that looks at the confluence of ambition, purpose, career and personal development, work-life balance and well-being. Here, Executive Leadership Coach and author, Nicolai Tillish, outlines five steps that HR teams and business leaders can adopt to help meet the holistic developmental and well-being needs of their people. These are the principles that are also outlined in the book, Return on Ambition.

[22.11]

I think there are five ways to adapt without regret and also to be transparent about it. The first two are not explicit in our book, so if I take them one by one… the first one is remember that you are on the edge of professional life at the border where it bridges into people’s personal lives and you need to be super careful in not intruding in the latter and that is for motivational, ethical and even legal reasons.

The second thing is I think that executives and HR teams are often can do much more than they do to identify things that hurt people’s well-being and their growth. Leadership theory focuses a lot on how to be inspirational and motivate and often you can actually, in a much more productive way, impact a motivation by removing or at least reducing things that are demotivating for people.

If we move onto the third point — and now we enter the territory of the book — I think executives and HR teams can often do much more in terms of trusting that the well-functioning, adult people working for them have a strong personal interest in both being successful and also living a full life. They will do a lot of the work that is needed.

Point four, and that is to a large extent what the book is all about, and that is to offer people simple ideas and tools and do it in a way where you allow people to pick what works best for them so they can enhance their self-reflection, they can make more conscious choices in their daily life and they can expand their awareness.

The fifth and final point is, and that’s the whole style in our approach, is it’s really important to have adult-to-adult conversations. Too much in corporations happens one way — typically from the top and downwards and it’s a little bit like employees are not toothed wheels in machinery, they are human beings and know a lot about being human beings and know better than anybody probably what it is that makes it so difficult for them to find a balance in their life.

[24.28]

And coming back to that notion of achieving whole person health and finding balance, I asked Nicolai what achieving a healthy balance in life means to him personally?

[24.38]

It’s a little bit like spinning plates to be frankly honest. There are three big plates that are really important: well-being, very broadly defined like you did earlier in the conversation. It’s the growth and here I can say personally, this is tremendously important for me and probably stronger for me than so many others because if I don’t explore something or read something, I mean keep my mind going, I notice it very strongly just within a week or two and often even quicker. I like having things I’m kind of wondering about beyond, like, problems I solve at work. And then the third and final one that is also important, and particularly for ambitious people, is that people actually like to achieve. There’s a lot of pride associated with it. It’s this plate spinning that you have. Most people do way too much and I think most corporations are trying to do way too much which makes this much more difficult and there are these three big plates: well-being, growth and achievement. And even when things are going well, you still need to keep working on them.

[25.49]

These conversation extracts have been taken from longer form Fit for Duty podcasts which have been created by Aetna International. I hope you’ve enjoyed this Memo episode. To hear more, you can search for Fit for Duty podcast on your preferred podcast platform, or visit Aetna International.com and search ‘podcast’.