Fit for Duty Podcast: Episode 12.

Welcome to Fit for Duty the award-nominated podcast brought to you by Aetna International.

From a consumer perspective we know that the pandemic has brought with it a greater understanding of whole-person health; what affects the mind affects the body and vice versa. As well as greater engagement in self-care, health protection and digital means of accessing that care. Circumstances have also given rise to the prevalence of mental health conditions across people of all ages, and that will continue for the foreseeable future. These range from clinical anxiety and depression-related disorders to stress, mood and sleep disturbances that may indicate low-lying mental illness.

From a corporate perspective the last 12-18 months have seen new digital business models evolving with the adoption of hybrid workforces and, in some cases, a move towards fully distributed teams. Definitions around duty of care and employee productivity have shifted and employee health and well-being needs are continuing to change and evolve.

So, what can employers do to build new, effective, benefit strategies that are robust enough to maintain healthy, productive workforces in the short and long term?

I’m Lorien Norden Global Thought Leadership Strategist and to help me answer that question, I’m joined by Cara McNulty, Head of Behavioural Health at Aetna CVS and Smriti Joshi, the lead psychologist at lauded mental health support app, Wysa. Now, Wysa forms part of Aetna Mind, the Aetna International benefit that promotes a holistic approach to supporting the emotional well-being and mental health needs of members. Hope you enjoy the episode.

Today, I’m really honoured to be joined by Cara McNulty who is the head of Behavioural Health at Aetna CVS as well as Smriti Joshi, the Lead Psychologist at Mental Health Support App, Wysa. Welcome ladies, it’s such a pleasure to have you.

Great to be here, thank you for having us.

Cara, could you please give us a bit of background to yourself, your role as an Executive Leader and also your work as a population health scientist.

Cara McNulty: Absolutely. So, it’s just an honour to be here to talk about such an important topic. So, I’m a population health scientist, think of a population health scientist as a person who looks at a community, or population, and studies what either improves their health outcome or what gets in the way of their health outcomes. And then the goal is to remove those barriers so that we improve population health outcome and reduce disparity. I’ve spent my career in health care and in human resources and my goal has been to advance the health well-being and needs of populations, employees and employers and communities where we live, work and play. At CVS I lead our mental health services and our best-in-class offering for Aetna members and beyond so this includes programmes, such as services delivered through employees assistance programmes, through mental health and behavioural health care delivery and offering support to communities in need. So, it’s an honour to be here, thank you for having me.

Wonderful, thank you. Smriti, if I could ask you as well about your experience and expertise that has led you to where you are today with Wysa.

Smriti Joshi: Sure, so I’m a mental health professional. I am a licensed clinical psychologist in my country of residence, which is India, and I have been practising for the past 20 years. I’ve worked in that period, If I can share about, where I had to stay in the US for six years on a H4 visa which kept me away from active employment and work and that is where I found my footing in digital mental health. I trained with Dr Marlene Maheu in telebehavioural health delivery and ever since, it’s been almost 10 years now I’ve been working in this field, and that’s how I got connected with Jo and the founders of Wysa and I’ve been with them from the very start, I would say the birth of this app. And it’s been great experience learning to design conversations and exercises for Wysa, our AI-based chatbot and I also lead a team of 25 coaches and the experience has been full of learning experiences for us as a team and for me and our goal is to make mental health accessible and make it reach as many people as possible.

And, it’s exactly on that point around making sure that mental health support is accessible that I really want to start diving in to workplace well-being. So, Cara, if I could ask you first and foremost, when it comes to workplace well-being how do you think mindsets have changed in the last 12-18 months and how are organisations changing their approach to employee health and well-being? Given that places of work and daily routines, the fact that some of us are sharing workspaces, some of us are working from home -- It’s so diverse -- So, how are organisations really responding to that?

Cara McNulty: Yes, that’s a great question. So, even before the last 12-18 months, the topic and need and support and demand for total well-being has been increasing. And so when we talk about the idea of well-being, we’re looking at not just someone’s physical health but their physical, emotional, social, their career or spiritual; we’re looking at well-being holistically. And, if you think about it, as we evolve in communities and as humans, our employee population and the relationship with our employees is changing and so the value proposition between an employee and an employer is changing, thus employees expect more from their employer as we’re evolving. And so well-being is no longer looked at as something fluffy or ‘nice to have’; well-being is actually an imperative and it’s an imperative not only for the employee but also for the employer. I mean, we clearly know that employers that have strong cultures of well-being where their employees feel that they can come to work, be themselves, are included, where the environment addresses their mental, physical, emotional, social well-being — those businesses do better. So, we’ve had that evolution. But then take the last 12-18 months and the importance of well-being has even elevated, so we know that well-being is imperative for not only how businesses do but also how their employees perform. And employees, as I talked about, they expect a culture that is alive and vibrant with well-being and that means that we’re not just looking at sick and healthy, we’re looking at: is a culture accepting, is it vibrant, is it ok to talk about your mental health, your physical health. Are there programmes, initiatives, resources available for not only that employee but also their family. And then as you think about the last 12-18 months and many, many people needing to work remotely, the need for well-being and well-being support has only increased. So, we have seen that as people move home or are working from home or whether they’re working in critical, let’s say, health care issues or they’re essential workers we’ve seen stress and anxiety and physical ailments increase and so employees are depending on employers even more to help them with this time and this time of transition. And that means helping people figure out, you know, ‘how do i have a work/life balance when I am no longer going to an office and I’m at home all the time and maybe managing kids who are at school remotely?’. Or ‘I’m worried because maybe my job is being affected and so my stress is rising, cause maybe I’m going to lose my job’. So we see employers being called upon to really lean into providing support, resources, services and, as I know we’ll talk about, digital solutions that meet their employees where they’re at and with what they need.

Yeah, absolutely. And you’ve touched on there about the ability for employees to, well not the ability, but the fact that they are demanding more from employers as well, all around those social determinants of care that you referenced there: in terms of social, environmental and that’s something I’d like to touch on in a little while. And, in terms of the preventative health care, particularly around mental health, Smriti this is a question for you really — what do you find that Wysa is able to provide and is being asked to provide by group business, by corporate customers with regards to helping their employees, their teams, their people overcome the challenges of today?

Smriti Joshi: Right, from our conversations that we’ve had over the past couple of years from our B2C clients as well as with our B2B clients, what we’ve seen is that there’s strong evidence of a missing middle. As, you know, on one end of the spectrum we have users who are looking at mindfulness and well-being resources, looking for support with what we call sunny-day scenarios on an everyday basis and, on the other hand there are people bringing in an intense need for clinical support or maybe looking for diagnosis and both of these account for less than 30% of our usage scenarios. What we are seeing is an increased need made specially relevant especially during COVID for solutions that cater to that middle, that I think even Cara referred to that is, that falls somewhere in the middle where people are struggling but still surviving and still have that need to talk every day, to have that safe space to talk about what’s bothering them much before a formal diagnosis. And what we’re really doing is helping bridge that gap between meditation and medication to help the missing middle, to help bridge that gap. And organisations that are coming up with requests — and the requests definitely have increased in the last couple of months — are looking at support with exactly this missing middle. That we have people, there are EAP services, there are other services where they can reach out to medical professionals, to psychiatrists, to general physicians but we do not know if they are really doing that, and we do not know what they could actually be struggling with, so they would want a safe space where people could come and speak, and talk and be then signposted to any of these resources if the need be. Or their needs get addressed with the app or the exercises that we have plus the coach support and that forms the preventative aspect. So we have a lot of people who bring in sleep issues; 80% of our users use the sleep tool the most and a lot of sleep exercises are used by them. And this pattern we’ve observed with our other users as well and so we have health care providers like Aster or Ascension like clinical staff as we’ve seen during COVID that they form the first line of defence and are especially vulnerable. So, the employers, the organisations are feeling the heat, I would say, of the current times that we are all in and they are wanting to not just look at ROI (return on investment) but also VOE, you know there’s an increased importance on value of employee and it is a much more holistic view why workplace wellness is important. Another thing I would want to say is that employers are seeking the need to take these solutions to where the employee is, like Cara said, rather than the employee coming to them and this means a surge in virtual and remote care telehealth and more sophistication in engaging with them early. So, again those are preventative aspects that people are looking at before they reach that other end of the spectrum, we are somehow able to gauge their needs, assist them with what they are struggling with and then signpost them to more in-person or more specialised support if needed.

Cara: That was so well said, so well said. You know I would reinforce to say when we think about the needs of a population, you know, really at Aetna CVS Health we look at mental health well-being on a spectrum and just like what was stated, that spectrum is everything from resiliency and stress management and helping people deal with in-time or in-the-moment stresses to anxiety, depression and serious mental illness, opiate addiction, alcohol addiction etc. So it’s that broad spectrum and it’s really important as Smriti said that we not only address the ends of the spectrum but we address that missing middle because if we’re going to meet people where they’re at that means providing prevention, intervention and acute care. And so when I think about what we can do and what we do is that means meeting people wherever they’re at on that continuum — how they need to be met. And, so sometimes that’s through a face-to-face brick and mortar session, whether that’s a therapy session with a licensed social worker or it’s a meeting with a psychologist or psychiatrist but it might be first an assessment and maybe that’s a digital assessment, it might be a televideo or telechat offering and it might be a tool like we’re just talking about with Wysa, a technology tool, that helps people who maybe want that remote experience or quick time when it works for their schedule to be able to receive care. So we see the importance of having that continuum, having the opportunities so we’re not just addressing people at one or other end of the spectrum.

The other thing that she said that I thought was really important is that if we’re really going to improve mental health outcomes, we need to look at it not only from return on investment but value on investment and we need to come at it from a way that meets the people, again, where they’re at. So, we know that often people would rather talk about their financial issues, their relationship distress, rather than talking about ‘you know i’m just not feeling great, or I’m feeling very anxious, or I’m drinking more than I have been’ … we’ll tell people almost anything, but we have concerns talking about our mental health well-being and so some of the ways we can do that is by talking about your sleep, ‘how are you sleeping?’. Talking about ‘how are you managing your stress?’ You know, making it very easy for people to seek services.

And then the last thing I’ll share is this is so important as we think about addressing this whole spectrum and making sure that people are getting the care and support they need. You know from an employer perspective, what we hear and see (and I have been a former employer who ran benefit offerings), you know what’s really important is to create the culture where people feel they can talk, and get the care they need but ask for what they need; also provide the opportunity for people to have assessments and tools that help them identify ‘gosh, maybe I do need to talk to someone’. Also, training our managers and supervisors. We expect that if we’re building cultures of collaboration and inclusivity and without stigma to talk about mental health, we think that managers and supervisors just know this information intuitively and it’s really important we give them the training and resources that they need, so that they don’t feel isolated and alone because they might be feeling the same type of anxiety or stress. So, really important that we’re helping those employers build cultures and provide support to managers and supervisors that build the mental health resiliency of a population. And, if we do that, then we can work from a prevention standpoint, an intervention standpoint and also an acute care standpoint.

Hm, there’s so many things there that you’ve both mentioned that I’d really like to unpack a little bit more. But, one of the things you touched on right there, Cara, is inclusivity and of course that can mean a great deal, but specifically in this instance how do you feel that organisations have had to pivot recently to ensure that they do remain inclusive when you consider that the diverse needs of a population are potentially even more acute today — even more pronounced across age groups, different age groups, across different locales, as we mentioned earlier across gender, seniority and looking at the extended commitment of the family as well. So, again, just to reiterate, how have organisations had to pivot recently to ensure that their well-being strategies are inclusive?

Cara: I’m happy to start. You know, the pandemic has really required employers — and I believe employers have done a really nice job — to pivot and to pivot quickly. And, it’s also required our health care providers to pivot and to pivot quickly. If you think prior to the pandemic, you know the mental health field utilised virtual technology, so video chat therapy, applications, but the utilisation was very low. Then you have a pandemic happen, where anxiety, depression, substance use is on the rise, there is a lot happening not only with the pandemic but racial and community upheaval across many countries and you have the perfect storm. So, employers have had to look at what are the solutions that meet my population, knowing that not one size fits all. And, then how do I deploy these solutions in a way that makes it easy for my employee and their family, as appropriate, to get the care and support they need, how do I remove any barriers for them to seek that help and care and how do we make it easy? Unfortunately in mental health and mental health care it’s not common when we have people say ‘gosh, I had a mental health issue and it was super easy, I knew exactly what the issue was, I knew exactly where to go, I knew exactly how to get care and then I knew how my benefits were going to be covered’. That’s not the norm so we at Aetna CVS Health are working really hard to improve that member experience, to engage the member and their family or ecosystem so we can support them across this journey. And, it’s applications like Wysa that are helping do this when you think about meeting people where they’re at, and how they need to be met. And, to close this out, I think about how employers and providers have stepped up to the challenge. Prior to Covid probably national average of mental health providers using digital or tech therapy was under 10%, right now I will tell you that we serve almost 80-90% of the population and we serve 25 million members a year through digital technology right now, because of need. And that digital technology might be an app, it might be a telephonic or televideo session but because of the pandemic. So you’ve seen this increase which also allows us not to have a one-size-fits-all mentality.

Hm, absolutely, I quite agree. And one of the other things, Smriti, I’d like to talk to you about, Cara mentioned earlier about really just about culture of well-being and stigma and you mentioned as well you’d identified a need and identified high utilisation of the sleep support that is available on Wysa, for example, and the fact that people find it easier to identify as being stressed than suffering from chronic anxiety or potentially the fact that they could be depressed. So, I was just wondering if you could expand on that a little bit and how organisations can overcome that stigma at the preventative or early intervention stage, let alone when they’re looking at supporting people from an in-patient psychiatric care perspective.

Smriti: Yeah, I think it’s a very valuable question and I can carry it forward from what Cara was earlier mentioning about. The training for employers, the managers, the entire stakeholder community that is present, the awareness, for providers for employers, for managers about the mental health concerns that people could be struggling with, specifically after the pandemic has happened to all of us. And, we’ve had demands/requests coming in from employers to help their managers create safe work spaces and when they say safe work spaces it means that they want people to get their leadership and managers to get trained in skills that could help employees talk about their mental health with ease, to make talking about mental health, to normalise talking about mental health in their office and organisations, you know, to have more acceptance for diversity as a whole, so if there is somebody who associates or identifies as a LGBT community member, they can come up and say or talk about their concerns or if somebody is feeling that there are stresses which are not finance, not work, but personal issues impacting their productivity, or if it is a conflict with their colleague at the workspace, can they bring that up as well? So, providing safe work 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 the COVID-19. So, I think COVID-19, with all the stress and uncertainties it’s 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, I think as we’re contributing to this cutting-edge approach to expand access to mental health, we’re building a continuum of services across the entire spectrum of that need starting with well-being, 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, like, recently we were a part of a very big research carried out by the Cambridge University carried out 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.

Yeah, absolutely, there are so many things there that I really want to ask you about. So I’m just going to cast my mind back, circling back to technology. So, given that you said that the pandemic has really accelerated adoption and utilisation of health care technology from a consumer/patient perspective and also that we know that in the next 5-10 years we’re really going to see the maturing, the coming together, the culmination of the last decade’s worth of work and effort in AI development, the IoT, we’ve got 5G coming along and I wanted to ask you, Cara, you know what do you think the next 5-10 years could promise in terms of digital mental health care and then also to you the same question after that Smriti, please.

Cara: Yes, well I mean Smriti did such a nice job in teeing this up, you know there’s so many things and with the negatives that have come with COVID, there has been some unbelievable positives. 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, you know, 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?’. What we have seen and what we have done is we have reinvented what EAP is and we offer a service called Resources for Living and Resources for Living is a programme that provides real-time confidential service support whether that’s phone or chat, counselling sessions, it provides learning tools and resources and support for the employer, the individual and their family around their mental well-being as well as their total well-being — so think social determinants, physical health, mental health. 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.

So, Smriti, thinking about the opportunities there as Cara has highlighted in terms of connecting the dots in the health care system, connecting people to prevention at an earlier stage particularly around teen health, I was wondering what your views are in the ways that mental health support in the digital realm is going to continue to enhance and develop in the coming years.

Smriti: There is no doubt that 2020 was the year of digital health growth; and it grew by leaps and bounds, and across specialities and you know really across … a lot of different ways came up from assessments to tools that could help people with dementia navigate inside their homes, tools for teens, safe apps that could help individuals see if they’re at risk for SOS or self-harm and make that important call or maybe text-based services grew a lot. So, across carers, providers and employers there’s an explosion of interest so even that Aetna is a leader in the space and like Cara was describing all the other services that are being designed and offered across their employees and members and to their families, but more traditional place are also waking up and saying ‘we need a digital health strategy, as of yesterday’ so like the research I was mentioning about, that we were part of with the Cambridge University there is an 80% increase in users reaching out for support, from just the start of the pandemic to date/now so there’s an 80% increase in that user base reaching out for support so the need is very evident, the challenge of course is probably to adopt the right digital solution, there are so many solutions available I think also because the innovations, the technologies is flattening the world we also need more guidelines, more laws around how to make sure that these services could be delivered ethically, you know, the training for the professionals delivering these cares, all of these would be enhanced and worked on to ensure that the digital solutions that come up would be delivered with that ethical confidence. And, I also feel that mental health care evolved into more individualised whole person care so it would not just be interested in the group of symptoms they present themselves with or maybe just with the diagnostics, but it would probably address the various other determinants that Cara also mentioned while she was describing this and changes that take place in this century will probably shift the paradigm from just a medical mode from an emphasis on treatment of illness and symptoms to an emphasis on something that i describe as normality enhancement, on optimising emotional or behavioural or improving the functioning of how we think and how we respond to stress.

That’s really fascinating. And actually from an employer’s perspective as well you touched on earlier about the role of managers and we’ve also spoken about duty of care and the way that that’s changing and the way that employees are expecting more support from their workplaces in terms of that work/life balance and that whole-person health as well, do you think, how do you both think that organisations will need to adapt in the future from a human-centric approach. Is there opportunities for new roles to open up in teams, for example, to coach individuals from a behavioural perspective, from a career perspective or will they continue to rely on EAP partners and providers? What do you think the future of organisations might look like? Cara, if I could ask you for your response first please?

Cara: Well, I think that’s where this field is so invigorating. I mean I look at an employer and if you look at what is their greatest asset, it’s their human capital, so investing in the humans and the employees that are in working for that company is going to give you the best outcome. And, so that investment starts by creating that culture and as we’ve talked about the pandemic has required us all to think differently and to develop different skills and tools and resources, so you know it’s really important that we develop those cultures and we support our leaders in those companies to understand how they can be an asset to building that culture, so when I think about managers, first and foremost we need to help managers understand that they don’t have to do this work alone, that there is support and resources and help them understand, you know, what are the warning signs to watch for, what might you look at, what might be the stressors, are your senior employees burned out or reacting or maybe more confrontational or withdrawn than normal, so knowing those signs. Then helping those managers understand how to create open, easy conversations and then giving those managers the tools and guidance to offer the support that is available through the employee benefit programme to their employees so that it doesn’t have, nobody has to be alone. And, with that, it’s going to take employers, payers, providers innovators, it’s going to take us all working together, all advancing our ecosystem of care delivery, of removing barriers and of working from a prevention, intervention and acute care standpoint in order to drive better outcomes so that people holistically, their total well-being improves.

Absolutely. And the same question to you Smriti please.

Smriti: So, we’ve all faced these new challenges and transitions during the pandemic, I’m an employee myself with Wysa, and given that we spend so much of time, we are so committed to our organisations that the organisations, our employers, become a big part of our lives as well and it is natural that we look at them for help as well and this probably explains the shift in attitudes and need where people are, you know, like I shared in earlier data, where 76% of people believed their company should be doing more to protect the mental health of the workforce, you know, those needs are pretty valid and it’s a call to action for the employer I think and I can give an example of how we are trying to manage it within our organisation, we’ve started running these small group meetings because our team is entirely remote and most teams are now remote but Wysa from the very start had a lot of its employees working remotely, so we used to run these small group calls and we call them Circle of Strength and for each group there is the lead but that lead is also supported by the other group members and these groups are, you know, and then the leads have their own group where they connect every 15 days to discuss what kind of conversations are happening in these groups. And these are open forums where people can bring any form of conversation, sharing happy moments, sharing difficult moments or you know the group leads could probably have an exercise like drawing your happy, safe space that was one of the exercises recently. So, you know, it synchs with what Cara also mentioned about, training the people within the organisations, building that culture, normalise talking about our daily life and not just work or intellectual conversations always, but also having that warm culture within an organisation where people are able to share and talk about their concerns. We also did a compassion fatigue assessment for our therapists, our coaches and team and we realised that they were probably struggling, specifically because we were ourselves in the midst of the pandemic addressing the needs of the pandemic that people were bringing in as well. And we did notice signs of burnout and we realised that, you know, we need to give our coaches something more and we decided to reimburse the therapy that they would probably be taking outside of Wysa for their own selves, so small things that you know organisations could think of to assist their employees deal with these difficult situations better. And because they themselves, the employers, were also experiencing the impact of COVID in various ways, you know they could have a system in place where they had more support, more backing up and they didn’t have to deal with all of it alone. So their, you know, adoption and rollout of digital health approaches at times when access to face-to-face support is limited by social distancing guidelines or reduced hours with each other, then seeking external support would also be very helpful.

As you said, you know leading with compassion and taking such a human approach, it’s just incredible to hear all these insights from both perspectives from an Aetna CVS perspective and from a Wysa perspective and I realise that we’ve just got a couple of minutes left. So, could I please ask you both as a closing remark really just to reflect a little bit on how you are behaving more compassionately towards yourself and those around you and how the last sort of 12-18 months have really changed your views on self-care and compassion. Cara, may I start with you?

Cara: Sure, you know I think being in this field and being in health care, often it attracts people who give of themselves, and yet put their own health well-being on the back burner. And I have seen that with my own team, with my colleagues and with our health care providers across the country. Noting that, I think it’s really important that I start with myself and my own health well-being and so I’ve worked really hard to try to find the space between, I’m working at home, between and creating space between work and home and making sure there is space so I can lean into my family, my husband and I have two teenage daughters that are going through this pandemic as well and they’re experiencing loss and sadness and it’s important that I can be there to show up, but if I don’t take care of my own mental health well-being I’m not really any good to my family, so really focusing on my own mental health well-being through meditation and exercise and conversation. The other piece I would say is you know in this very stressful time that people are experiencing, I am leaning in with gratitude and positive intent. I think especially now, it’s really easy for us to make assumptions that, you know, if somebody was terse or if somebody sent an email that was short or somebody did something or didn’t do something to, because resiliency is low, to assume negative intent and I would ask everyone to think about the stress that has been caused, we don’t know what people are experiencing and to assume positive intent and with that comes leading with kindness and it’s one of the things I work on every day is how do I show up as a mom, a leader, a community member with positive intent and kindness and if we can all do that I am a believer that this will be a better world.

Oh absolutely, and gosh, you’re going to make me cry! And Smriti, can I ask you the same, for your reflections please on the importance of compassion and self-care.

Smriti: Yeah, when Cara started talking about putting her own health care needs on the back burner being in this particular profession, I just wanted to say ‘I second you there’, it’s so true because truly a lot of us in helping professions, usually, probably are empaths or have the empathy, that need to be there for others is so strong that we can often ignore our own needs. But something that I keep myself reminding of is what we hear when we board an aeroplane when they are demonstrating the use of the oxygen masks, they say that you first use your own oxygen mask before you help another, so you really cannot pour from an empty cup. And that is something I have written on sticky notes and pasted them everywhere because, be it my professional life or personal life, I do have a lot of stresses — I lost my dad recently on the 4th of Jan and we lost our pet earlier and I have two daughters, one is 8 and one is 12, and both these losses were very difficult for us as adults and, for them to comprehend what was happening was even more difficult. And, to be able to be present for my clients and for my family, specifically my daughters and my mom I’ve really had to ensure that I’m getting my space, like Cara also mentioned, I think that the few moments of pause where you can just notice yourself, be with yourself, ask yourself ‘what is it that I need right now, what is it that will help me feel calm right now?’ are some things that I’m practising to keep sane in these times of uncertainty and loss and grief that we’re all experiencing in our way. And I also share my sentiments with Cara when she says that gratitude and understanding that frustration tolerance is low right now, resilience could be low right now, so just be more accepting and forgiving is what I’m also practising with people around me, where you know there would be difference of opinion or there could be disagreements which could draw up into bigger conflicts or arguments but trying to take a step back and trying to address it in a more mature way with a pause, reflecting later when things are cooling down, are some of the things that I’m trying to do with people around me.

Well, thank you both so much for being so open and I think that there is a testament to you both in terms of how you’ve demonstrated how vulnerability and compassion and expressing gratitude is a real strength. So, I’d like to thank you again both for your time and your insights on this conversation today and I really hope to get the opportunity to speak with you both again soon. So, thank you.

Both: Thank you.

I hope you’ve enjoyed today’s discussion and don’t forget you can follow Fit for Duty on your preferred podcast platform. And next month I’ll be speaking to an international expert in cultivating leaders about the changing role of HR and leadership in supporting the career development, health and well-being and personal and professional growth of individuals and teams.

Aetna International is a global health and wellness benefits provider but we’re more than just an insurance safety net, our skill lies in delivering tools and services and resources that drive health care costs down and people’s health and well-being up. And that’s something that’s important to our clients and self-funded members alike and that’s why we currently serve almost 900,000 people around the world — from Shanghai to Seattle. Ultimately, we believe that when people thrive, their work and their personal endeavours thrive too. For more information about us you can visit aetnainternational.com.