The Persistence of the Pandemic and a Mental Health Awakening (Part 2)

Podcast: Line on LeaveIn today’s episode of The Line on Leave, we continue our conversation about mental health with Dr. Christine Crawford, associate medical director with NAMI, and Adele Spallone, head of clinical operations for The Hartford Worker’s Compensation and Group Benefits. Listen as we discuss the impact of burnout on employees and tips for employers to consider in order to support their employees’ overall well-being during these times of intense change.
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Laura Marzi: Hi everyone, I’m Laura Marzi and thanks for tuning in to The Hartford’s Line on Leave podcast. Today, we’re continuing our discussion on mental health and burnout. Americans have endured a lot in our workplace, and in our homes and communities for almost now two years. So as many begin returning to the office and to the classroom – we’re asking, “What’s Next?”
Here to help answer that and share strategies on how employers can best support their workforce are two experts:
Adele Spallone, who oversees clinical operations for The Hartford’s Group Benefits and Workers’ Compensation businesses – and that also includes disability behavioral health.
Also joining us is Dr. Christine Crawford; and Dr. Crawford is a psychiatrist with NAMI. That stands for the National Alliance on Mental Illness. She’s also an assistant professor of psychiatry at Boston University School of Medicine. The Hartford is partnering with NAMI to help break down stigma and encourage support and treatment.
And it goes without saying that the pandemic has been challenging on so many fronts, and we've also had a racial reckoning in America at the same time. Diversity, equity, and inclusion are more and more becoming top of mind for employers. So, Dr. Crawford I was wondering if you could share your perspective on this and the impact it's had, particularly in communities of color.
Dr. Christine Crawford: You're right, Laura, it's been a really challenging time and not only with this pandemic, but all the conversations around racism, all of the media coverage, seeing all of the videos of black and brown people being harmed in a systematic way in this country, really has been a form of trauma for a lot of communities of color that they've been experiencing day in and day out. And to be reminded of these images while you're just trying to watch TV and to take a break from all the stressful things going on, working from home, dealing with childcare, and you are seeing people who look like you, who look like your family members, who look like your children experiencing significant trauma from racism. It's just so disheartening. And what we have been able to see is that, unfortunately, there's been a little bit of a silver lining in that, finally, folks have a better appreciation for how racism can have a direct impact on one's mental health and one's physical health. And that it's not okay for this to continue to go on.
And my hope given all of the conversations that we've been having over the past year and a half about racism and its impact, that it has led to more conversations outside of just communities of color. But for other people who may not have had a full appreciation of the ongoing impact that racism has, and it has been quite encouraging to see that even employers are willing to have some of these difficult conversations around diversity, equity, and inclusion. And it's clear that it's coming from a place of empathy that people actually care and want to make sure that their employees feel well supported by all of this, because there is now, appreciation that if people do not feel safe in their communities, in their workspaces, and they're bringing in all of this trauma from what they watch on the TV or what they experienced in the community, and they're bringing this to work, that's going to have an impact, not just on that individual, from the community of color, but to everyone.
And I think that people now can understand what has been taking place for many years when it comes to racism. People know the impact that this trauma has on mental health, and they're talking about it openly in mixed communities. And so I do think that this conversation, this movement is here to stay when it comes to talking about racism and calling it out because it's been too painful, and we do need to see some change for sure.
Laura Marzi: So, thinking about all that, what can an employer do? And maybe I'll direct this question to Adele, what can an employer do to best support their employee's mental health and well-being, since again, we're looking at statistics that say workers are facing burnout again on multiple levels, just thinking about what Dr. Crawford said. So Adele, what are your thoughts on that?
Adele Spallone: Yeah, so, having been a behavior or actually being a Behavioral Health Clinician in this field, but also in my career, I had a psychotherapy practice at one point. And I can tell you that work is therapeutic. People identify with their jobs, and we know individuals can be successfully treated for many mental health conditions while continuing to be productive employed. They don't necessarily have to file a disability claim. So I think what's important is that we ask employers to become more informed, educate their employees, help minimize stigma, and encourage their workforce to seek help, and especially educating supervisors so that they can see signs of burnout.
So for example, if an employee has a sudden change in their production or quality of work, or maybe they're not as talkative as they used to be in meetings, there could be an underlying issue there. So it's good to have this kind of education and training for supervisors so that then they can have a real meaningful conversation with their employee about what's potentially going on in their lives. And do they need some additional assistance or resources? So openly talking about mental health in the workplace can definitely help address stigma that still exists.
A majority of employers and employees think mental health will become less stigmatized in the workplace as a result of the pandemic. And we applaud their efforts to support employees’ overall well-being during these times of intense change. I think employers have been doing more, have been more focused and really understand the importance of this to their workforce. And no matter what size the company, I think business leaders have an opportunity to work with their benefit providers to evolve their benefit plans and programs, and support services to meet those employees changing needs and overall health and well-being. If possible, providing access to employee assistance programs that can help employees handle stress and emotional pressures and raise the visibility of these programs through education and frequent communications.
Now, there's obviously small employers who might not be able to offer employee assistance programs, but they can lean on resources such as NAMI. We're talking with Dr. Crawford today, the National Alliance on Mental Illness, which is the nation's largest grassroots mental health organization, or even community resources such as 211, which is a program offered by the United Way. And they connect their employees to helpful resources in their local communities. And then I think ultimately employers still have an opportunity to remain flexible and empathic understanding that this is very real and it's impacting a majority of their employees. So again, if possible, allow some remote work options, continue to offer flexibility with work hours, as well as maybe considering job modifications. And most importantly, creating ways of addressing the challenges caused by the increased stress, this uncertainty and anxiety that people are dealing with.
Laura Marzi: I think about that and all the opportunities that employers have to support their employees. And then I also think about this statistic in the encuesta that says, 72% of HR professionals that we talked to, think that stigma can be a barrier to treatment, and I understand this. I think a lot of people understand that the stigmatization of mental health and wellness can prevent people from getting help. So now I'm wondering, and Dr. Crawford, maybe you can answer this question. What do employers, and maybe all of us in society in general, really need to realize about the effects of stigma and the importance of mental health education.
Dr. Christine Crawford: Stigma is huge, and it creates a huge barrier to people feeling comfortable discussing openly and what it is that they're experiencing inside if they are going through a mental health condition. And there is a lot of concern about how other people are going to think about them, or if they will treat them differently, if they find out about their mental health condition. When I think about stigma, I think about having this internal sense of shame perhaps that, "Man, I should be able to pull myself up by my bootstraps and get through this. I shouldn't be feeling like this. Is there something I'm not doing? Is it a failure on my part that I feel this way?" And then also having to deal with this fear of discrimination, like I had touched upon before, where you're worried that people are going to look at you differently and treat you differently.
And so having that concern, having that stigma in place, well, makes it difficult for people to feel comfortable perhaps in a work environment, because they may be concerned about being mistreated or concern that if they speak openly about their mental health, that it might get in the way of their ability to be promoted. Yeah. And I worry about stigma, especially in the workplace setting. If there are people who need to take much needed time off to take care of their mental health, and they don't know how to initiate these conversations with their supervisors in order to get treatment. Because again, there's this fear of being treated differently by people in the workplace. I think one thing that employers can really think critically about is the culture that they promote within their workplace when it comes to mental health. And one of the areas that people can look at first when it comes to culture around mental health is thinking about the language that is being used to describe mental illness and the language that's being used to describe at individuals who are living with a particular mental health condition.
We need to make sure that the language that we're using is not stigmatizing because just because someone has a mental health condition that doesn't define who they are, it doesn't label them as a human being. They are a human being first and they are also living with this condition. And so saying things like, "Oh, they’re schizophrenic, or they're crazy, that person has all these problems, they're crazy, they're not well." That's does not promote a culture of acceptance and make people feel comfortable disclosing if they have a condition and whether or not they need to take time off to get some help. And also, part of the culture is being able to display warmth and empathy for people who are going through a mental health related issue. And to really demonstrate to folks that you are open and willing to have these conversations about what your employer needs to feel well supported during this challenging time.
Empathy is so important. And it's something that a lot of people think they understand what it means, but they don't really have a clear understanding about it. When I think about empathy and I think, again, this is so key to reduce some of the stigma and to make people feel like they're not going to be negatively judged by other folks. I mean, think about empathy. Think about someone who has fallen into the hole, right. You fell into a hole in the ground and you happen to be looking up from the top of the hole and you look down at them and you say, my goodness, I'm so, so sorry that you're down there in that hole. I'm really sorry that happened to you. And, that's someone who is being compassionate and who has compassion for that individuals, some sympathy for that individual who's in the hole.
But when I think about empathy, that is the process of saying, my goodness, you are in that hole. I am so sorry you're down there. And I'm going to go down there with you so I can help you come up so that we can come up together, so that we can work on a way to rise you up. That's what empathy is all about. And we need to ensure that we promote a culture within the workplace that makes people feel like they're being heard, that they're being understood, and that people are there to support them.
Laura Marzi: That's a great analogy. I think a lot of our listeners can understand that and place that and think through how they can really live with a more empathetic mindset towards this. I have an additional question for you, Dr. Crawford, and it's going to move topics a little bit into more of the practicum of supporting people and employees that want to even a compliment to traditional health care. So at our company, The Hartford, we've been using digital health and telehealth for our own employees. And that includes a mobile app that uses behavioral techniques for reducing worry and anxiety. And it's something that is available 24/7. I was wondering, do you see digital health and telehealth as a trend that's here to stay and maybe even put it in the context of support for mental health more broadly?
Dr. Christine Crawford: Absolutely. I think telemedicine, telehealth has been an incredibly powerful tool that has opened up doors for many individuals to access mental health supports who might not have had the means to do so previously. And another thing that came up during this pandemic was how, as we've already described before, how so many people were experiencing anxiety and depression, and it was so comforting to know that a number of mental health providers were able to quickly pivot to providing mental health supports in a virtual format. And it provided such needed support and guidance to people who are really having some difficulty.
And I think now that a lot of mental health providers feel comfortable using that platform to connect with patients and patients are also quite relieved that it's a way to get the help that they need without it being incredibly disruptive to their daily lives. They don't have to worry about the commute, taking time-off of work in order to get mental health treatment. They're no longer in this position in which they have to pick and choose. Should I do this, or should I attend to my mental health? It reduces that dilemma for a lot of people. And knowing that you have access to mental health supports at your fingertips can certainly reduce some symptoms of anxiety because the uncertainty about your treatment, the uncertainty about your health is reduced, if you know that you have access to someone who can certainly support you.
And, there are some people who live in communities in which there were very limited access to therapists and psychiatrists, but now, no matter which part of this country, you're now able to reach out to someone and get help sooner rather than later. And having this ability to receive treatment early on, and the illness progression is so powerful. And it can make it such that people don't have as negative outcomes as those who wait and delay treatment, because they don't have access to it.
Laura Marzi: Well said. And, I have one more question that I'd love to ask you, Dr. Crawford and Adele, if you want to think about it for a minute too and offer some final thoughts. As we think about the continuum of mental health support and we think about burnout and what everyone is experiencing, there will be a day and we're all hopeful for it, right? That employees are going to be brought back onsite, even in maybe bigger numbers than we have now. So, what advice would both of you offer employers to be thinking about when they're bringing their employees back on site? And, Dr. Crawford, I'll start with you and some of your thoughts.
Dr. Christine Crawford: Yeah. So people are nervous, people are scared, people are worried, people don't know what to expect. And having all this anxiety about making the transition back to work can be incredibly overwhelming and distracting for a lot of employees because they have these ongoing worry thoughts, and it may be difficult for them to be able to be productive, to focus on their work. And so I really encourage employers to be very flexible when it comes to this transition of back to the office, of returning back to the office, because employees are going to have a lot on their minds. They're going to be worried about their kids and whether or not their kids are able to stay in school, whether or not their kids are safe from the virus. And, we know that they're coming into work with all of these burdens.
So being able to have some flexibility for your employees who are rolling back into the workspace and to do it gradually, do not feel the need to be, make it all in done sort of situation where, right away they're in the office five days a week, for some people that may not work, you may have to go really slow. And hopefully that can offset some of the anxiety and worries that people may have. In addition, people really do well when they feel prepared. When there's a set plan, that's in place for them, when it comes to being back in the workplace. So if managers or supervisors can be very clear about what the expectations are, for their employees when it comes to working in the office, when it comes to being remote, when it comes to deadlines and when it comes to the need to be able to communicate that you have to take time off. So just being very clear about those expectations, right at the beginning of the return to work transition can be really helpful and make people prepare in advance for some anticipated concerns that may come up.
And, it's also important to know about people are going to look different when they're back in the workplace settings. There are going to be people who are incredibly happy to be there, who are excited about connecting with others, who are looking forward to those conversations by the copy machine or the water bubbler. And then they're going to be some other people who may not feel that same way, who may have some ongoing difficulty leaving their children behind, their family members behind because of all of these worries. And, as we already talked about the statistics earlier on, we are seeing higher rates of depression and some people who might have experienced some depressive symptoms may continue to experience that as well when they're back at work. And so it's really important for employers to have these conversations about the importance of mental health, maintaining your emotional wellness and taking the time that you need in order to ensure that you are emotionally well and able to focus on your work in a meaningful way.
Laura Marzi: Terrific. Adele, any last thoughts from you around the whole idea of returning to an office experience or an on-site experience?
Adele Spallone: Yeah, I think Dr. Crawford hit on all the points that I think about when it relates to this. And I wonder sometimes, can we really go back to the way it was? I fear that, with the vaccine issues we're having, the fact that we have to get boosters. The variants are still out there. I think it's going to be a long time before we get to a place where things are truly maybe black and white, like maybe we experienced in the past. I do think there is an absolute opportunity for employees to think through hybrid models, to continue with flexibility. And the piece that Dr. Crawford stressed about communication, there has to be open dialogue. I think we really understand now more than ever that people don't leave their personal lives at home, even if they're going back to work site and it's present there, especially if they're working remotely.
So, it's important to check in, we're all experiencing some sort of stress. It will continue to be there. The pandemic has been a unifying experience. So, it's truly an opportunity for employers to really focus on the future culture that they want. And, how do they embrace these opportunities, staying well connected with an employee and what's going on in their home lives, making sure that safety is number one priority, but also having again that flexibility to address individual concerns that people might have, because we know women have specific concerns. Men have specific concerns. We have seen specific issues arise with the millennial population. So, it's not a one-size-fits-all approach. It really is about flexibility and communication.
Laura Marzi: Well, I could say that for me, this has been a very, very informative discussion. I hope our listeners feel the same. Thank you so much, Adele. Thank you so much, Dr. Crawford for your time and all of your thoughtful insights. This has been a really good discussion. I think that has a lot of pragmatic, thoughtful advice that we can offer employers.
Thank you to all of our listeners. And if you like what you hear, please subscribe to our podcast. Please share it with your colleagues. And as always, you'll find it at If you'd like more mental health resources, I also invite you to visit our partner NAMI and that's spelled N-A-M-I .org. Until next time, please be well and stay safe everyone. Thank you for listening.
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This informational material is subject to change as The Hartford continues to receive guidance from states and municipalities. It shall not be considered legal advice. The Hartford assumes no responsibility for legal compliance with respect to an employer’s business practices, and the views and recommendations contained herein shall not constitute The Hartford’s undertaking on a company’s behalf, or for the benefit of others, to determine or warrant that an employer’s business operations are in compliance with any law, rule, or regulation. Employers seeking resolution of specific legal or business issues, questions, or concerns regarding this topic should consult their own attorney or business advisors; and employees should continue to consult their employers’ Human Resources or other employment benefits department for guidance on the application of any law, rule, or regulation.
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