All of Us

The Next Big Leap in Managing Health and Wellbeing

by Mike Critelli

At the MakeUsWell Network, we have focused on the need to increase public health attention to stress, anxiety and burnout. These are the triggers and precursors to serious mental health crises. Employers must always focus on what their leaders do to increase or decrease stress, anxiety and burnout for individual employees. 

Recently, we reflected on the death of Dee Edington, a trailblazer for all of us who wanted to get out ahead of population health issues, as opposed to addressing them in the healthcare system. The progress from crisis-driven mental health treatment, such as responses to attempted suicides, domestic violence, extended homelessness, substance dependence, or acts of public violence, to an effective preventive strategy that addresses population-level mental health issues preventively is at its earliest stages.

Historically, the first challenge for employers and other health plan providers was parity in health plan coverage for mental health treatments of all kinds. We are making good progress, but are far from the finish line, if for no other reason than the range of therapies available does not match the needs of our populations.

We also recognize that a stigma attaches to a patient’s acknowledgment that he or she needs mental health treatment. As someone who started his business life as a private practice attorney 48 years ago, I am struck by the challenge that someone aspiring to a career in law must face in addressing the Character and Fitness qualification process in many states. This process often deters aspiring attorneys from getting help early in their careers.

Members of the military also are reluctant to acknowledge a mental health issue, as are many others who are either currently employed or seeking employment. While many states provide an additional layer of privacy protection for mental health and substance abuse health information, the concerns about what would happen if employers knew about someone’s condition are real and legitimate.

Some leading-edge vendors use a wide range of data points, including non-health data, to discern potential mental health and substance abuse in individual cases, and do a highly effective job getting individuals to seek help.

As Pitney Bowes’ CEO, I recognized the importance of mental health. Individuals needed the services of our employee assistance program to enable them to get help on mental health and substance abuse issues before they reached crisis proportions. We particularly wanted to de-stigmatize decisions by employees to get help coping with life’s problems. We also recognized that mental health and substance abuse treatment choices present complex trade-offs for which a patient needs guidance.

We also wanted to create a work environment that, to the degree possible, would reduce, rather than add to, the stresses employees experienced in their daily lives. Employees lost loved ones, went through divorces, grappled with difficult and stressful elder care issues, had dependents with acute health issues, and sometimes were victims of domestic abuse or other crimes. We offered a package of services and programs that were well ahead of the game in providing professional support for employees going through these crises. 

I also learned that the transparency with which we communicated, the building of trust with employees, the calmness with which we addressed external crises, and our consistent application of ethically based business practices significantly reduced workplace stress. We strived to make the workplace an oasis of sanity and enjoyment, regardless of what was going on in the outside world.

Unfortunately, the world outside of work now is both more challenging and stressful, and far more difficult to fence off from what happens at work. Political and cultural issues dominate the 24x7 news cycle, plus social media channels, on a non-stop basis. The portion of employed populations induced to worry has grown significantly. 

The elections of 2016, 2018, and 2020 have divided workforces. The establishment of rules and processes that try to balance voter access and voter fraud prevention have been particularly divisive. How leaders and peers feel about how Covid is also divisive. Mask-wearing, quarantining, and vaccination requirements divide teams and organizations that never knew that there were different points of views on these topics. In fact, these divisions strain family and close-knit social group relationships, too.

Politics intrudes into online forums in ways that resemble bullying in the physical world. One unfortunate consequence of online dialogues is that we often really do not know who the bullies are. The ability to meet in person to resolve conflict does not exist in the uncontrolled, anonymous, angry online world.

The cumulative effect of multiple acts of police violence against black citizens angered many employees. But the out-of-control violence in many cities because of political decisions to pull back on police enforcement angers and terrifies others.

The Supreme Court has recently torn open wounds on issues like how to reconcile gun ownership rights with the need to protect ourselves against gun violence, how to find a workable consensus on abortion, and how to accommodate divergent religious beliefs and practices, all in one week of published decisions. 

In his 1996 book Only the Paranoid Survive, Andy Grove, Intel’s CEO at the time, defined what he called “strategic inflection points,” changes on the horizon that, if not addressed as quickly and intelligently as possible, become the source of serious threats to an organization. His book was a call to action to identify these inflection points earlier and more decisively. In the second edition of his book, he provided a cautionary tale about his failure to understand as quickly as possible that a problem with a floating point decimal calculation that appeared once in 9 billion calculations was perceived by major customers as a crisis.

Fortunately, we have tools Grove did not have available to guide decision making on major population-level wellbeing issues. 

Social media postings are the metaphorical “canaries in the coal mines” that can signal issues months before members of the media, organizational leaders, or even highly attentive front-line supervisors can spot and report on them. UPenn’s Center for Worldwide Wellbeing and other research institutions are analyzing Twitter postings to derive much better insights much earlier on employee health and wellbeing, as well to identify myriad opportunities to build high performance in workforces.

Employers who want to achieve high performance workforces must use every available tool, including an in-depth look at what is often called the “digital chatter” on online social media sites that operates as an early warning of future health and wellbeing issues, as well as opportunities to get out ahead on major issues and build greater trust, resilience, and energy in employee populations. 

Contrary to popular belief, it is not necessary to learn what individual employees are posting on social media. The tone of social media postings in a geographic community is remarkably reflective and predictive of the future health and wellbeing of even those individuals who never do social media postings. These postings are the tip of the iceberg in terms of daily social interactions in a community, and, depending on whether they are negative or positive, the stresses or bonds that ultimately affect every employee living in that community.

Being able to spot strategic inflection points and to distinguish them from false alarms earlier and more completely is a major competitive advantage for employers to become an employer of choice and take the best actions to build customer loyalty. 

But one of the potentially highest and best uses of these predictive tools is to anticipate and reverse progressions toward stress, anxiety and burnout in employee populations. For many members of our Network who broke new ground in preventive health initiatives, thanks to Dee Edington’s mentorship and inspiration, this is the next big leap in maximizing the health, wellbeing and performance of our employees.