Clare Morin (00:11):

Welcome to HR Trends. I'm your host Clare Morin and today we are talking about an extremely important topic of behavioral health at work. Today's date is August 17, 2021.

Clare Morin (00:27):

The pandemic is continuing to disrupt daily life as we head into a fall where schools are reopening yet many businesses that might have been planning on reopening more fully might be delaying plans due to the Delta variant sweeping through the country.

Clare Morin (00:46):

Meanwhile, many workers, of course, have continued to work on-site throughout this entire time, amid all of this, those heightened levels of anxiety and depression. We have two fantastic experts with us to talk about this and really focus on some practical best practices.

Clare Morin (01:03):

We have with us Dr. Kerry Ressler, the chief scientific officer at McLean Hospital, a world renowned psychiatric hospital in Boston. He's also a professor at Harvard Medical School. His work focuses on translational research, bridging molecular neurobiology and animal models with human genetic and epigenetic research on emotion, particularly fear and anxiety disorders. He's published over 300 manuscripts.

Clare Morin (01:34):

We're so happy to welcome him back. He appeared on the show exactly a year ago today. So welcome, Kerry.

Dr. Kerry Ressler (01:40):

Thanks so much for having me, Clare.

Clare Morin (01:42):

And we also have with us, Swapnil Prabha, who's the vice president of digital offerings at Unum. She has 15 years of experience in the insurance industry. Prior to joining Unum, Swapnil spent seven years at McKinsey & Company, where she was a leader in the insurance practice, focused on digital services across all lines of business and employee benefits. She's also been leading Unum's behavioral health solutions.

Clare Morin (02:09):

So welcome back, Swapnil.

Swapnil Prabha (02:11):

Thanks, Clare, very happy to be here.

Clare Morin (02:14):

So let's begin reflecting on where we are today. So, Kerry, exactly pretty much a year ago you came on the podcast. At that time we had just surveyed over 400 employers and we were finding that nine out of 10 were citing mental health as their number one concern.

Clare Morin (02:33):

Certainly, by this point in 2021 we were expecting to be in more of a new normal and yet the pandemic is continuing. I wonder, from your perspective working at a leading institution like McLean, what are you feeling right now as we head into the fall?

Dr. Kerry Ressler (02:54):

Yes, thanks again for having here today, Clare. It's been a very important discussion. I think, as you have mentioned, there's so much stress in so many ways, both in everybody's general lives as well as in the mental health community, everything from school reopening versus not, mask mandates, vaccine mandates.

Dr. Kerry Ressler (03:14):

We all had hoped that by this spring and summer we would ... and certainly by the fall, everything would have settled down, the majority would be vaccinated and the world would be opened back normal again and with the Delta variant, obviously that's not the case and there is so much uncertainty.

Dr. Kerry Ressler (03:30):

And at the level of mental health and behavioral health we've certainly seen some of the predicted increases, significant increases in depression, anxiety, trauma over the course of the spring through the summer to the point that many states are having quite a bit of difficulty with staffing and having enough beds at the mental health and behavioral health level.

Dr. Kerry Ressler (03:52):

So we are seeing these increases and people were certainly stressed and we hope to continue to do everything we can to help people through this next phase.

Clare Morin (04:00):

Definitely sobering to hear that from you and just so I'm clear, you're essentially saying since the springtime then you're actually seeing these increasing trend lines of rising levels of anxiety.

Dr. Kerry Ressler (04:14):

Yes, in the winter of late 2020, early 21, we were hoping that the predicted wave of mental health needs weren't going to be as high as they were and I think to some extent with the hopefulness of the vaccine it really gave everybody another round of resilience and then with the variant coming on over the summer we are seeing increased numbers again and you do wonder if there's some sense of just being overwhelmed in our communities.

Clare Morin (04:46):

Exactly. Swapnil, I'd love to hear what your thoughts are too, from your perspective, working with a lot of employers.

Swapnil Prabha (04:53):

Yes, happy to share that perspective, Clare, and what Dr. Ressler was talking about certainly resonates and it's we're seeing that come through in our conversations with employers who are certainly recognizing the need in their employee populations for more mental health support.

Swapnil Prabha (05:11):

So that's the good news that employers are recognizing the role that they can really play in helping their employees and ... However, as they're looking for the right level of support there are a few common themes that we are hearing across most employers and then some that are unique to specific types of companies when it comes to the needs that they have, or concerns that they might have.

Swapnil Prabha (05:33):

One is of course, in relation to the desire to provide more mental health support they are recognizing that the employee population is more distributed now than it was in the past and as we are going into September and you alluded to this earlier, it's unclear if ... when and if ever we are going to go back to a normal that existed in, say in 2019.

Swapnil Prabha (06:00):

So how do you actually provide the mental health support for hybrid workforces where things like on-site resources, et cetera become less valuable? It's something that a lot of employers are thinking about.

Swapnil Prabha (06:12):

The second thing that comes up is, quick and reliable access to therapists and coaches, regardless of what type of employee population you're talking about. That is a universal need out there and continues to be so and especially with the demand being as high as it is we are hearing a lot more about that.

Swapnil Prabha (06:28):

And then, finally, I think employers have known this for a while but again, given the world that we're living in right now with COVID and the social justice issues and other things that have happened over the last year and some change, they are recognizing that there has been a lack of transparency around reporting and metrics. So it's unclear to employers when they are investing in different solutions, what is actually delivering value and how much.

Swapnil Prabha (06:56):

So I would say those are the key themes that come up across most employers and then certainly some employers who have a lot more portion of their employee population in front line work, et cetera have been feeling the pain more so than others.

Clare Morin (07:11):

That's so helpful and I wonder if we could hear from you both around a few key best practices to share with our audience. In listening to both of you speak previously I know there's a few key areas.

Clare Morin (07:28):

The first one, which I know, Kerry, you talked about in a wonderful [inaudible 00:07:31] webinar earlier this year. Sorry, last year. You were emphasizing clear communication and why that's so important. Could you talk about that?

Dr. Kerry Ressler (07:41):

Sure. So we know from both human studies and pre-clinical studies that one of the largest sources of stress is unpredictability and uncertainty. So I think the simple take home there for employers is being able to be clear in one's ... in communications, expectations and understanding. And there's so to be uncertain about now, everything from mask and vaccine mandates to on-site versus off-site regulations, hybrid regulations.

Dr. Kerry Ressler (08:12):

So the more employers can be clear in their communications about uncertainty and overcommunicate if needed. I think that's an important rule and I think there's a number of other pearls that can be really helpful.

Dr. Kerry Ressler (08:24):

First of all, simply having patience and kindness and realizing that everybody's coming from this, at this from a different place, with different histories, different stressors, different trauma histories. So being able to meet people where they are and be patient.

Dr. Kerry Ressler (08:40):

Helping people remember, as well, that flexibility is critical for folks juggling families and uncertain school situations and maybe having changing needs for remote versus on-site. Being able to be flexible is going to be critical during these times.

Clare Morin (09:00):

I love that, Kerry, and patience and kindness I think we should all probably just write that on and stick it somewhere very close to our workspace. That's wonderful.

Clare Morin (09:11):

Swapnil, do you have any thoughts to add to that idea of clear communication?

Swapnil Prabha (09:16):

I think what I'll say is that clear communication and maybe I'm going to take a slightly different lens to it from an employer perspective. I feel employers can certainly do more and have been already recognizing the need to do more in terms of how clear is it for employees where they need to go to get the right level of support.

Swapnil Prabha (09:37):

So something that we often talk about and I call it usually navigation. So what I would say is that a lot of employers are doing many, many things and providing many resources for their employees to the extent that if not communicated clearly it often will actually add to the confusion and employees would be going through the internet and looking for the support that they need but would be very, frankly, confused around where to go.

Swapnil Prabha (10:03):

And so it's really critical that as employers start to think about providing more resources or replacing what they have right now, are they actually thinking about providing that really one-stop shop sort of experience for ... or a hub experience, if you will, for all things mental health related so employees have one place to go to and they can actually be guided ideally through that experience where maybe they share a little bit about themselves in a digital format and the tool or the hub, if you will, will guide them through to the right level of support for that employee and they can then be on their way to seek that support and get better.

Clare Morin (10:46):

It's such a great point because everyone's talking about pre-COVID and how fundamentally the world's different in so many ways and you alluded to that earlier about previously on-site there'd be a lot of communication perhaps around resources but now yeah, how are we leading people to those resources.

Clare Morin (11:08):

Swapnil, you've also spoken previously about maybe one of the silver linings of the pandemic is how it has accelerated digital access to therapists and counselors. You've talked about rural areas where there's been a huge lack of access. Could you speak a little bit about that too?

Swapnil Prabha (11:25):

Sure, yes. I mean, if we have to look for a silver lining in this, right, that probably is certainly a big one. Given access continues to be a challenge and it was already a challenge even prior, back in 2019 it was still a challenge and now it has just become worse. I do think that we should be thinking about virtual or digital therapeutic programs in a very different light in terms of can they actually add value, even if it is not in an in-person setting.

Swapnil Prabha (11:59):

There are certainly a lot of biases towards what I would call more the "traditional" methods, but we've been really impressed as we've been exploring the market in many virtual therapy programs, cognitive behavioral therapy based programs that are delivering clinically valid improvements while allowing for that larger scale.

Swapnil Prabha (12:21):

And the other thing, you made a point around rural. Clare, I think that's an excellent one. The other thing that I would want to call out what this has enabled is reducing the friction a little bit more. So imagine a world where you might need to drive for an hour, let's say, to get to an appointment. Now you can actually access that care from your living room or home office or wherever.

Swapnil Prabha (12:43):

And the other thing that often it sounds trivial but is worth noting, if an hour worth of commitment is a lot to do for an actual appointment, which a lot of the traditional supports out there provide, what the new or maybe not necessarily new, but the virtual context allows us to do is allow people to engage with their therapists or coaches in smaller increments of time.

Swapnil Prabha (13:09):

So if you have 10 minutes and you just need to speak to someone or interact with someone through text while you are waiting at your dry cleaning line or what have you, you can do that. I think that's worth acknowledging as well in terms of really maximizing what technology has enabled us to do.

Clare Morin (13:28):

That's great and I'd love to, Kerry, bring it back to you again, too, of really talking about culture and the importance of what can employers do on a cultural level. Could you speak a bit about that?

Dr. Kerry Ressler (13:43):

Yes, I think there's two points I'd want to make. First, I think is just for everybody, the importance of creating space, online forums, webinars, conversations where this communication can happen and where people can feel free to be vulnerable and to open up. There's so much research showing that being able to be vulnerable and share what people are going through individually will both help folks to understand each other and to really better understand how everybody's coming at this from a different place and to decrease misunderstandings.

Dr. Kerry Ressler (14:22):

And also, that sense of vulnerability and support can really enhance team building. And I think that's important for everybody. I think also, in terms of some of the components that Swapnil was talking about in terms of for those needing more help and more access to therapies and counselors is particularly for the workplace and employers to be on the lookout for more significant signs and symptoms of really the red flags of when somebody really needs professional help.

Dr. Kerry Ressler (14:51):

A few of those are anxiety and sadness that are really significantly interfering with functioning and sleep disruption that's significantly interfering with disruption, increased alcohol use for coping, thoughts of self-harm or suicide, thoughts of hurting others, disinterest in eating or other enjoyable activities and significant weight loss, or significant irritability that interferes with working relationships.

Dr. Kerry Ressler (15:16):

As people are pushed and more stressed these things will come up and being looking out for these red flags I think will help the employers to really guide those who are most in need to finding the right treatment options.

Clare Morin (15:27):

That's so helpful to hear and just that, like you said, that understanding, even just of hearing that can be so helpful to team building and the patience we can have with each other.

Clare Morin (15:41):

Swapnil, could you speak to culture as well because I know you talk about the importance of executive modeling too, so the leadership and how is that affecting [crosstalk 00:15:53]-

Swapnil Prabha (15:53):

Yes. [crosstalk 00:15:53]

Clare Morin (15:53):

That actually is, yeah.

Swapnil Prabha (15:55):

Sorry, Clare, I got really excited there for a second. Absolutely. So executive education is so key I feel. And everything that Kerry talked about certainly resonates and it's important to remember that it does start at the top.

Swapnil Prabha (16:10):

Oftentimes the leaders at a company are setting the tone, setting the culture for that company and making sure that the resources that the companies are providing, making sure that they are actually being used really depends on that culture where employees feel and have the trust with their employer that they can actually use those resources without any fear or any repercussions that they need to worry about.

Swapnil Prabha (16:32):

So that's one angle to it that how do you create that culture of trust and executives can play a huge role through role modeling, et cetera. And then the other thing to remember is that everyone is, when it comes to mental health, everyone's needs could be very similar. They don't vary by what rank you have at the company.

Swapnil Prabha (16:56):

So it's really thinking or equalizing everyone and thinking about, whether you are a CEO of a company or a line manager or an individual contributor, you all could be facing the exact same thing when it comes to mental health and hence, making that role modeling aspect even more important.

Swapnil Prabha (17:16):

The other aspect I would add and it's a little bit different from executive education necessarily but as Kerry was talking about some of those signs, if you will, that you could see in colleagues and coworkers, there are actually trainings available out there, specifically mental health first aid and there's a mental health first aid at work curriculum that can be delivered and that can be offered.

Swapnil Prabha (17:39):

And companies should seriously think about offering something like that because that will only equip their employee base and it's not something that 100% of your employee base has to have but a portion of your employees, which should be ideally a mix of leaders, managers, individual contributors, could be trained.

Swapnil Prabha (17:58):

And they are not being trained to be therapists or coaches, to be very, very clear. But more to recognize and be able to be resources to their colleagues when they do recognize those symptoms or signs, I should say rather, come up and be able to appropriately guide them. And I would love to hear Kerry's thoughts on that as well.

Dr. Kerry Ressler (18:19):

Yes, I think so and I think in this time of really insufficient staffing for fully licensed professionals, I think we very much need all hands on deck, if you will, in first level helping I think is much that employers can do to be supportive and then really looking for those who have really the red flags of the most serious concerns to help get more professional support.

Clare Morin (18:49):

Well, thank you both so much. I think this is really a valuable conversation and our audience will really appreciate your time with us today. So hope to invite you back soon and let's hope by this time next fall we are having a very different ... well, a different conversation. Thank you both so much.

Dr. Kerry Ressler (19:06):

Thank you.

Swapnil Prabha (19:07):

Thank you.

Dr. Kerry Ressler (19:07):

We hope to be celebrating the new normal again by then.

Clare Morin (19:11):

Yes.

Swapnil Prabha (19:11):

Yes.

Clare Morin (19:21):

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