Supporting Individuals with Serious Mental Illness in the Workplace

Crystal Brandow: Hi everyone. Thanks for joining
us today. This is Crystal Brandow, the Assistant Director of SAMHSAs Program to Achieve Wellness
and we appreciate you logging on today to join our webinar on Supporting Individuals
with Serious Mental Illness in the Workplace. Before we get started on this very important
topic, a quick disclaimer that the views expressed in this training do not necessarily represent
the views, policies, and positions of the Center for Mental Health Services, the Substance
Abuse and Mental Health Services Administration or the U.S. Department of Health and Human
Services. Once again, I’d like to thank you all for
joining. I’m going to hand it off to our moderator for today’s discussion, Caroline Snyder, who
is a Research Analyst at Westat, and she’ll give a more thorough introduction of herself
and our guest speakers today. Caroline. Caroline Snyder: Hi, thank you Crystal. As
Crystal mentioned, my name is Caroline Snyder and I work for Westat and I’m joined today
by Darcy Gruttadaro and Ewuria Darley, with the American Psychiatric Association Foundation. We look forward to speaking with all of you
today a little bit more about how you can support individuals with serious mental illness
in the workplace. With this, we’re going to go over the importance
of employment to recovery, talking more about techniques that you can employ to create a
more supportive workplace, including related to culture, programs you can use, accommodations,
processes, and then pointing out some relevant resources. To start, serious mental illness is defined
as the mental, behavioral, or emotional disorder resulting in serious functional impairment,
which substantially interferes with or limits one or more major life activities. SMI includes
conditions such as bipolar disorder, schizophrenia, and major depression. The 2016 national survey on drug use and health
found that approximately one in 25 adults had a serious mental illness in the previous
year. Unfortunately, approximately two thirds of these individuals with serious mental illness
do not currently have full-time employment. Why are employment rates for individuals with
serious mental illness so low? Many report encountering stigma or discrimination because
of their mental health condition from employers, and that in turn discourages them from disclosing
their mental illness and getting the support they need to be successful at their job. At
times their illnesses can create challenges for them to maintain steady employment, sometimes
they need to take extra time off to attend behavioral health appointments, or perhaps
have difficulties concentrating of maintaining focus. But there are many misconceptions about individuals
with serious mental illness and their ability to or desire to work. Approximately 2/3 of
people with SMI are interested in working, and this number increases further if they
felt there was adequate support in the workplace. Also, some studies have found that employment
is actually associated with a lower risk of psychiatric hospitalization for individuals
with SMI and this finding persists even after controlling for an individuals’ physical
health and their history of psychiatric hospitalization. Some employers or other employees may worry
that individuals with SMI are prone to violence, however, in reality, most individuals with
SMI are not dangerous and they’re actually more likely to be victims of violence than
to commit any violent acts themselves. Why should we try to increase the number of
individuals with SMI who are employed? For many people employment can be a critical step
to recovery and researchers indicated that employment is associated with a reduction
in mental health symptoms and their need for services. One study even found that individuals
with schizophrenia who had paid employment were five times more likely to achieve functional
remission. Employment is also critical to an individuals’
holistic wellness. Having a job can improve someone’s’ financial wellness, for example,
because it provides them income and it can allow them to have some degree of financial
stability or independence. Also, participating in the workplace can help people build relationships
and social connections, and it can provide them a way to feel more integrated into the
community. Then finally, being able to work can be highly valuable to help someone’s
self-esteem and self-worth. It can give them purpose and meaning, both of which are very
important elements to recovery. And I’m going to pass it over to my colleagues. Darcy Gruttadaro: Thanks for that introduction
and really now that we’ve heard about the importance of employment to recovery, we’re
going to talk a little about how, at the Center for Workplace Mental Health, we are helping
employers understand how to create a mentally healthy workplace and the importance of doing
so, so that people with mental illnesses are comfortable in the workplace and can help
them succeed. We approach this with four principals in mind
for driving change in the workplace, and I’m going to talk about the first two and then
my colleague, Ewuria Darley, will talk about the second two. The first really is about knowing the impacts.
Knowing the impacts is important because mental health conditions are common. One in five
Americans live with a mental illness and these are conditions that often impact people during
their prime working years, so it’s really important that employers, especially at a
time of very low unemployment and with many positions open, really need to be thinking
about, how do we support all of our employees, including those that live with a diagnosable
and diagnosed mental illness. We also know treatment is effective. In the
overwhelming majority of cases, when people get help and get the care they need, they
can get better and perform at their peak in the workplace. We also know that mental illness costs employers
in two ways. There’s both the direct healthcare costs, the cost of medication and therapy
and treatment, but also there are indirect costs and this slide actually identifies some
of the indirect costs that employers are increasingly beginning to pay attention to and try to figure
out ways to address these so they can make the workplace work much better for people
that live with these conditions. These are things that people may or may not think about
but, things like disability and lost productivity, absenteeism, not coming to work because the
workplace is not supportive and the condition is getting in the way of that. The stress that can exist on team members
when people are not given the support they need to succeed. The staffing issues, temporary
workers. I think retention is a very big issue. Employers don’t want to lose good people when
they know that if someone gets the help and care they need they can get better, just like
any condition, whether it’s diabetes or cancer. Often, when people get treatment they get
better and they stay in the workplace, which is very important to employers at a time like
this when we’re at this low unemployment status. But the good news is that employers are increasingly
tackling how to do a better job in the workplace for their employees when it comes to mental
health issues. There were two major surveys done by Willis Towers Watson in 2017 that
really showed that over the next three years large numbers of employers are focusing on
developing more resources to make the workplace more accommodating and more supportive for
those who are living with mental illness in the workplace. Employers are tackling this
by addressing things like educating people more about mental illnesses and raising awareness.
What we have seen employers do is start by understanding their organizations culture.
This is not a one size fits all, how we make our organization more … how do we effectively
address mental health in the workplace for our organization. They need to understand
their culture. What will work well here? Is it bringing in a speaker? Is it bringing in
a turnkey program? Do we need to form a committee and have the committee decide what’s best
in terms of addressing mental health in the workplace? It starts with the culture of the
organization and looking at the demographics and looking at what will work well. Also, it’s very important that employers share
their commitment to mental health, whenever possible. Any time they’re discussing health
issues or the importance of health and wellness to the organization, they should always add
mental health in there, it can’t be said enough. Mental health has remained a taboo topic for
many, so the more we discuss it in the workplace the more we can normalize it and bring it
out of the shadows and into the light. Also, employers are increasingly looking at
opportunities to train leaders, managers, and employees to recognize the early warning
signs and feel comfortable to know what to do. How do you start that conversation? How
do you show kindness and compassion to a co-worker? How do you ask, are you okay, without making
the other co-worker, other person, feel uncomfortable? What is it that employers can do to get that
conversation starting and normalize the topic of mental health in the workplace? I really
think to that we’re at this turning point in a moment, given the recent high profile
suicides and a recent CDC report that came out showing a rise in suicides. There’s a
lot more conversation right now about mental health in communities, in faith communities,
in the workplace, so this is an ideal time for employers to take advantage and capitalize
on that otherwise robust conversation that’s happening in communities. In terms of breaking the silence and tackling
stigma and improving workplace mental health, what’s really great is when the CEO or someone
in the C suite talks about the importance of mental health. We know mental illnesses
impact people at all levels of organizations. We know there are those in the C suites in
this country that are living with mental illness, right on down to line staff. It’s all along
the continuum that people experience these conditions so it’s important when leadership,
who many look to, to understand the culture of the organization, when they speak about
mental health, it makes it a much more … makes it much more likely that those in the organization
that may not otherwise want to speak up because they’re afraid of negative consequences for
their career, will come forward and get help and feel more comfortable in the workplace
overall. Also, as employers engage in workplace mental
health, it’s always helpful to notify the health plan and EAP. EAP’s are increasingly
looking at innovative approaches to how to encourage people to seek help when it comes
to emerging or existing mental illness. There’s real concerns on the part of employees around
confidentiality, around privacy, around coming forward out of concern that doing so may cause
negative repercussions in their careers, so the more the EAP can be onboard and understand
this is a priority for the organization and the employer, the better. Again, as I mentioned earlier, training managers
on how to effectively respond to behavioral performance issues is very important. Again,
kindness and compassion, but certainly managers need to hold employees accountable. This is
not about not having accountability in the workplace. This is about asking someone, again,
in a supportive and kind way, are you okay, I’ve noticed things changing in your performance
and mentioning that specifically and then reminding the employee about options that
exist should they need help and support in the workplace. Because, after all, a manager’s
job is to help all of us perform at our best, so the more they can do that, even when it
relates to mental health condition or emerging mental illness the better. I want to mention two turnkey programs we
have at the Center for Workplace Mental Health that many organizations have found helpful
as a starting point because they’re easy to pick up and easy to run with. The first is
Right Direction, which I’m going to talk a little bit more about in a moment, and the
second is ICU, which my colleague Ewuria Darley will talk more about as well. We developed these programs, I’m going to
start with Right Direction. We developed these programs in conjunction with Employers Health,
which is an employee … it represents large employers in the mid-West of the country … actually
in other places across the country. It is focused on depression, so it is about raising
awareness and it has lots of turnkey resources that employers can use. We have everything
from internet site postings that organizations can use on their intranet, to Power Point
templates, to posters. These are all customizable so that if employers want to put their logo
on and want to make some changes to make them work better in their culture, that’s something
they can certainly do. The materials have been used by school districts, by large commercial
employers, by smaller employers. There’s guides and everything that employers need to succeed. I also wanted to mention that we are currently
undergoing a research study with Kent State University on Right Direction, where we’ve
taken 50 months of data and we’re actually looking at the impact of the program on things
like EAP use, accessing mental health care, productivity, performance, retention and other
issues. We’re really … the early results are showing very positive upward trajectory
with EAP use on the part of employees, so we’re really excited about that, but we will
be publishing it. As we know, employers are really interested in what’s effective, what
works, what will lead to the best results. At this point I am going to turn it over to
my colleague Ewuria Darley. With one other thing I mention and that is, we also have
on our website, if you’re interested in what are other employers doing, we have 70 case
studies that go into detail on different approaches, diverse approaches different organizations
have taken to addressing workplace mental health. I’d really encourage you to look at
those to learn more. At this point I’ll turn it over to Ewuria. Ewuria Darley: Thank you so much Darcy. Darcy
mentioned Right Direction and now I’m going to talk a little bit about ICU. The letters
I C U can be interpreted to mean I s-e-e y-o-u. I see you, and it really encourages employers
to create an environment where it’s safe for employees to connect with one and other, to
really care about one and other, and also to support one and other whenever that is
needed. And the core of this campaign is a five minute video that teaches employees how
to I, identify the signs. Maybe you’ve noticed that an employee does not like themselves,
or maybe they’re a little withdrawn. Then C, you want to connect with that person. This
is in no way means is a way to be intrusive or a way to pry into other people’s business,
but you truly, authentically care and you just want to connect with that person. You
may just ask, are you okay, I noticed that you haven’t been yourself lately. Then finally,
the last letter, U, just means to understand the way forward together. Ultimately, employers are really equipping
employees to recognize the signs of distress and refer each other to resources that already
exist in your organization. It could be HR, it could be the Employee Assistance Program,
it could be mental health and substance use benefits. Whatever it is that you’re promoting
within your workplace. ICU was developed by DuPont and delivered
to over 70,000 of their employees worldwide. It was given to the Center because they saw
so much success and they wanted to generously donate it to the Center to make it available
to all employers and employees. With that, we have two versions of ICU on our website
currently and we are going to be offering two additional versions in Spanish language
and Portuguese very soon. This is made possible through another global organization that adapted
the ICU initiative. Just like Right Direction, this initiative
fits within the branded structure of any organization and it has a full implementation guide, and
a Power Point deck for those who may be implementing it to present it to the C suite or to leadership
to really make that business case. It also has downloadable and customizable flyers,
email templates, and, what’s really important, pre and post evaluation forms so you can determine
the effectiveness of the actual initiative. As we move to creating a supportive workplace,
there are four core elements to do that and that we’re going to share today. These core
components are essential in helping individuals with serious mental illness maintain employment,
and to maintain employment in a successful manner for them to be productive and be able
to stay and keep employment. One of them would be deliver affordable access to mental healthcare
and building a culture of well-being. The others would be having a defined accommodations
process and then finally, developing a plan with the employee. I’m going to talk in depth about the first
two and Caroline with discuss the later. Delivering affordable access to care is more
than just saying that, “Okay, we offer benefits, it’s available,” it’s more about making sure
employees know that those benefits are actually available to them, and making sure that they
know that they can use it and it’s accessible, easily accessible. I want to say, just look
at your organizations data and then also look at ways to engage your employees so that,
again, they know that these benefits are available to them. Employee satisfactions surveys, that’s
one way that you can do that. See what’s working, see what’s not working. Engage employees on
what’s working in terms of accessing mental healthcare. See if they’re having difficulties
or if they just stop with the process because it’s too difficult. Look at your claims data
and EAP data, and I’m going to go into a little bit more depth about the EAP data as well. Finally, you want to provide Health Risk Appraisals,
but make sure you include mental health questions. When you do that, you can also connect with
your EAP vendor and have them find out ways that they can support you and being able to
communicate with those who may screen positive for any kind of mental health condition. Delivering affordable access. Part of the
steps would be promoting EAP, as I mentioned earlier. Understanding the current use of
EAP, and I’d say, unfortunately, EAP utilization rates tend to be very low, and this is in
spite of the fact that we know it can be very effective, a very useful tool if those who
it’s available to, if they actually use it. You want to encourage and promote the use
of EAP and be careful about how utilization rates are defined. Instead of a phone call
for information in how you determine utilization rates, you want to make sure that you’re measuring
utilization in terms of getting those who need certain services, that they’re connected
to those correct services, not just a phone call. You want to examine your organizations mental
health benefits. Think about it, what’s covered in these mental health benefits? Is collaborative
care being offered? Are the CPT billing codes being turned on to even allow collaborative
care to be accessible? How’s you network adequacy? Are there enough mental health professionals
participating in your health plan? Do employees have access to navigating, or do they even
know how to navigate through the mental health care system that is available? Does your health
plan comply with mental health parity? Those are all questions that you want to ask as
you think about delivering affordable access to care. Sometimes it’s helpful for leaders
and HR managers to go through the process themselves, really understand what it’s like
if you were an employee or a patient going through the system, see what it’s like to
… if it’s actually easy for you to access the information. Also, it’d be helpful for
you to know how it goes so that you could explain that to those who are also wanting
to access the information. Once you do those, we talked about breaking
the silence and delivering affordable access to care, and all those different mechanisms
that we want to have in place, now you want to move into building a culture of well-being.
When employers foster a culture of well-being, it moves away from relying on traditional
biometric screenings or wellness programs, which, there’s nothing wrong with that, but
you want to make sure that you include a holistic approach and that holistic approach would
also include emotional and mental health programs. Areas that have the biggest influence are
those that include these cultural shifts that involve leadership. Involve shared values
and effective communication within that environment. It involves showing and creating an environment
where employees can treat one and other in a way that they want to be treated. Trust
and commitment are really important, they’re central to any kind of cultural shift. If
you think about it, just for your own workplace, imagine what a cultural shift would mean for
you. For employers who are implementing effective
mental health workplace strategies, the yield is so much greater than just cost savings.
Darcy mentioned some of the things about what lies beneath, some of those hidden costs.
It’s really more than that. Companies that support well-being of other employees will
find higher engagement, they will find loyalty, and that all correlates to productivity and
effectiveness and good business results. It also will result in higher productivity and
all those things that will add up in cost savings. Every work environment is different.
I would say, look at what is important for your own workplace, what are the valuable
tools and information that’s important to your employees, and really build on those
things. Part of building the culture of well-being
means that you create an open and understanding, and work environment for everyone, including
those with serious mental illness. Creating an open and understanding workplace means
that you show and you reinforce the values that are important to your environment, but
then it also means that you’re including those employees with serious mental illness and
you include those with any kind of mental illness overall just as much as you do physical
health. We talked about some health programs that can help you achieve this, ICU and Right
Direction, but you also want to promote social activities that let colleagues form supportive
relationships. Encourage that and be sensitive of situations that would also make people
feel uncomfortable. You don’t want to force any kind of situations or any kind of well-being
programs on anyone. But make sure you provide manager and employee education, as Darcy mentioned
earlier. There’s no such thing as one person bigger than the other to be included, everyone
should be included in those trainings and that awareness of mental health conditions. Lastly, I want to emphasis that the importance
of useful and respective language is so important. You want to be careful of language that is
not respectful of those with mental illness, and you want to encourage others to do the
same. Make sure that you’re careful about even saying … sometimes people use the language,
crazy or that’s insane. You want to just be careful about those when you hear about that
in the workplace and maybe encourage those people who are using that to use language
that’s outside of those words. I’m going to now turn it over to Caroline
to discuss the accommodations process. Caroline Snyder: Thank you. As Ewuria was just talking about, having affordable
access to mental healthcare and building that supportive culture are very important, but
it’s also best practice to have a defined accommodations process. Just to note, we are
not legal experts, so this is really more about reviewing the general best practices
in the field related to accommodations, and if you have any questions about what is or
is not required, or what’s allowed in terms of accommodations, or confidentiality related
to these issues, we would always recommend that you consult a legal professional in your
state about any federal, state, or local requirements that you might have to abide by. With that being said, we wanted to speak a
little bit more about this because it’s very important and the accommodations process should
be a collaborative effort. The employer and the employee should be working together to
find out how they can best meet the employees needs and help them be successful in the position.
As most of you probably know, the Americans with Disabilities Act is a federal law that
prohibits employers from discriminating against individuals with disabilities. The term disabilities
does include psychiatric disabilities and psychiatric disabilities covers a range of
conditions including serious mental illness. These protections from the ADA would extend
to both current employees and potential employees applying for a job. This law requires employers to provide reasonable
accommodations in order to help the employee perform the essential functions of the job.
Two key phrases there is, reasonable accommodations and essential functions. These accommodations
must be provided unless they would cause undue hardship to the employer. There are several main steps to the accommodations
process, and we wanted to highlight these and discuss them a little bit further. As
I described earlier with the ADA, it refers to these essential functions of the job. First
you need to determine what are considered these essential functions, and to do that
it helps to sit down and look at the job description and identify the relevant lists of skills
or competencies that someone would need in order to be successful. Those are the goals
of what you are trying to get the employee to be able to complete. Then, next, you need to sit down and talk
to the employee and figure out what are his or her needs, or what are the functional limitations
in performing those job responsibilities. What are they having challenges with? Then,
because it’s a collaborative process, it’s very important that you ask the employee for
their input. They should be part of the brainstorming for strategies and accommodations that may
help. They know themselves best. They know their needs best. It is more of a give and
take, back and forth, because some things might cause undue hardship to the employer,
they simply don’t think that it would work within the parameters of the job and so you
could be flexible, but working together to find a solution that’s going to meet all party’s
needs. Then once you’ve put an accommodation in place,
you’ve decided what you’re going to try, you give it a defined interval, say, “Maybe we’ll
check back in in a week, or two weeks.” After that initial check-in we’ll check in on a
monthly basis to see how is the employee feeling and is this accommodation helping. Do we need
to adjust something? Do we need to try something different? Add another accommodation. Really
getting a sense of what do they need to succeed in the workplace? What exactly are reasonable accommodations?
They are modifications or adjustments and they might be to the job application process,
so, as I mentioned, the ADA does cover potential and prospective employees as well. Perhaps
someone needs help with the interview process or the online forms to apply. They could also
be modifications or adjustments to the work environment, or to some of the actual ways
in which the job is performed or perhaps supervised. The main goal of these accommodations is to
ensure that employees with disabilities can enjoy the equal benefits and privileges of
employment. There are a number of accommodations that
can be put in place and if you’re struggling to come up with what would work best for the
employee, there are a number of resources out there that have specific examples. We’ll
talk about a few of them now, but, we’ll list those resources at the end of the presentation
and please do go and visit those websites and those organizations because they have
a lot of examples about things that you could try, if you don’t know where to start, perhaps
they give you an idea for something that you could adapt for your own workplace, and that
can be very helpful because sometimes someone might be struggling and they don’t know exactly
what they need, so it might be a little bit of a give and take, back and forth, until
you figure out what really works. These are some of the types of accommodations
that you could possibly put in place, categorized by topic area. For example, in terms of scheduling,
working remotely has become a lot more common, whether it’s planned remote work on a certain
day of the week or giving more flexibility to unplanned remote work if someone’s having
a difficult day that they are having a hard time getting into the office. You could also
allow them to have a more flexible schedule to accommodate mental health appointments,
sort of shifting their schedule based on those needs and having them work hours on a different
day to make up and not interfere … sort of, use all of their sick leave, things like
that. Sometimes there can be issues with the work
environment itself. Maybe they’re struggling to concentrate and you could move them to
a different part of the office that perhaps has less foot traffic, or you could provide
them with noise canceling headphones to drown out some of that background noise. For example,
if someone has serious depression, maybe they need to be somewhere with different lighting
or more natural light, something that helps with their mood and will, in turn, help with
their work performance. Sometimes serious mental illness and other
mental health conditions can challenge concentration or memory. You could work with them to figure
out strategies to help them know what they need to do and make sure that they have all
the tools available to them to do that. For example, you could provide written instructions
for job tasks or you could allow them to use a recording device during meetings so that
they are able to leave that meeting and have a recording of the things they’ve been asked
to do, and they can go back and refer to that. Feedback and supervision is another area which
can possibly be overlooked but can have a really big impact on how someone feels at
work. Different styles and techniques can make a difference in someone’s work performance
and maybe you can ask for their preferences on communication methods. Do they prefer receiving
feedback in person or do they not necessarily like having that direct contact and would
actually like written feedback in an email. Maybe you have to schedule regular check-ins
to discuss their performance so they feel supported and like someone knows how they’re
doing and that they have the opportunity to improve. For challenges related to organization, you
could create detail timelines for job tasks, or you could create structured to do lists
and help them prioritize those tasks so they know how they should be dividing their time
and make sure they’re meeting all the expectations. Then finally, in terms of stress and emotions.
Work may unintentionally create some emotionally stressful situations and honestly, that can
be true regardless of whether you have serious mental illness or not, but, in this case,
perhaps you could make a plan to use stress management or conflict resolution techniques
should any situation arise. You really have to go with all these accommodations, as I
said before, something that really gets at what the employees needs are and what they
need to feel as though you, as the employer, are being more supportive. Next, we wanted to speak a little bit about
privacy and confidentiality. The truth is, is that this is a … can be a very sensitive
issue, obviously, and one of the key tenets to the accommodations process is the need
to maintain privacy and maintain that employee confidentiality. This is a more complex issue
than can just be captured in one slide but at the very high level it means that any private
health information that is collected or any communications about the accommodations process,
or about the individuals’ mental health condition need to be kept secure. One of the ways that you could this, for example,
is also to make sure that any of the documentation is kept separate from the main personnel file.
That helps add an extra barrier so that access to this information is limited and that it’s
only available to someone on a need to know basis. But it also is important to note that
when accommodations are visible, you might have questions from people, other people in
the office and things like that asking, “Well, why did they … why do they suddenly do they
have headphones? Why do that have a different schedule?” We would recommend, as I said,
always consult with a legal professional or the Equal Employment Opportunity Commission,
or the Office of Disability Employment for specifically how to handle those situations.
The main principle is, always maintain the privacy and confidentiality of that employee
and find a way to communicate any changes about the workplace environment in such a
way that does not disclose their disability. The next thing, which is an adjunct to the
accommodations process, but something that we thought would be good to spend a little
bit of time on is this idea of developing a written plan. The Accommodations Process
should really be similar regardless of whether someone has a serious mental illness or any
other mental health condition. But, in the case of someone with a serious mental illness,
it might be helpful for also develop a written plan describing how the employer can best
support this person. This plan can include the employees’ goals,
because, ultimately, the goal is for the accommodations and everything to help the employee succeed
so you want to know, what are those goals? What are we trying to accomplish? It should
detail the planned accommodations and what your plan is for accessing their impact and
seeing whether or not they’re working. It’s also possibly helpful to identify potential
stressors in the employees’ life. Are they stressed about family, finances? Obviously,
any conversations like that, you should be sensitive and only ask for things that the
employee is willing to disclose. But if that’s something that they would like to be noted,
it can be helpful to understand what’s going on in their life that might impact their work
performance. Then, it’s also helpful to potentially detail
a planned response if the employee appears to be unwell. What are their preferences?
Make a plan now while the employee is doing well so that if anything seems to change you
know how to handle it and also the employee knows what to expect, and that they’re able
to give their feedback and communicate their preferences. Similarly, as I spoke before,
feedback can sometimes be a difficult and sensitive issue so it’s important to be respectful
of the employee preferences related to management and supervision. That can be something that
is also very helpful to detail in the plan. Then, finally, you want to detail when you
hold scheduled check-ins to make sure that everything is working smoothly and whether
you need to make any adjustments. This is just a few resources that are available
for employers and there, obviously, many, many more out there. First, as noted by both
Darcy and Ewuria, the American Psychiatric Association Foundation and the Center for
Workplace Mental Health have wonderful resources available that you can refer to. The two programs
that they mentioned, Right Direction and ICU, are those turnkey programs that can be adapted
and implemented in a variety of businesses. The Working Well: Leading a Mentally Healthy
Business is a toolkit that also provides recommendations and concrete strategies to improving mental
health in the workplace. Then, some of the other resources listed here, the Job Accommodation
Network has a wealth of information. Resources, tools, toolkits, related to the accommodations
process. It provides more detail about what you should and should not do. NAMI, the National Alliance for Mental Illness,
again, has a lot of information about the importance of employment to recovery and how
employers can be supportive. Then, finally, the Office of Disability Employment Policy,
with is within the US Department of Labor, has some of those technical requirements related
to the ADA and other relevant laws, and it also does a great job of linking to other
organizations that have resources that might be of help. Crystal Brandow: Great. Thank you so- Darcy Gruttadaro: Hi, this is- Crystal Brandow: Oh, sorry, I was just going
to say go ahead. I know Darcy had something to add. Sorry about that. Go ahead. Darcy Gruttadaro: Oh no problem. Thank you
so much. I did want to mention something that I forgot to mention during the presentation
earlier, and that is the role of caregivers. Employers are increasingly recognizing that
employees who have a loved one with, especially with serious mental illness, because some
of the needs can be significant, particularly early on. Employers are increasingly recognizing
the need to support their employees that may be serving in a caregiver role. We actually
did … we recently published a blog on our website about a mom whose son developed schizophrenia
when she was a software developer at IBM. Highly valued employee. Extremely productive.
When schizophrenia hit their family she needed to take considerable amount of time to help
him find a treatment facility, as she said, she could sometimes take … she sometimes
had to take time during the work day to contact different facilities because that was the
only time the business office was open as those treatment centers, I shouldn’t say facilities,
treatment centers and hospitals. The challenges can be quite significant, not
just for caregivers of adults living with serious mental illness, but also parents of
children who may be experiencing the early signs and onset of a mental illness, who are
often called away from work to go schools and pick up their child. Their child may have
appointments during the day that they need to attend to. Employers are focusing much
more on caregivers, recognizing the role they must play for their loved ones when they have
a serious mental illness. The National Alliance for Caregiving, NAMI,
and Mental Health America, put out a report in 2016 called, On Pins and Needles: Caregivers
of Adults with Mental Illness that I think is a really nice explanation of the experience
of those that care for a loved one with SMI. But again, this does not only apply to adults,
it applies quite a bit as well to children and youth. Employers are beginning to find
ways to help employees feel comfortable talking about this in the workplace when they need
to take time away or supporting them through the day and giving them extra time to help
secure care for their loved one. I think we’re going to see more and more of this happening
because employers don’t want to lose good employees and they recognize that if they
don’t support them through the process of supporting their loved one they’re really
at risk of losing very good people. The one thing I would say about the blog we
posted, and most of our blogs go out to … we have about 10,000 on our list that are [inaudible
00:45:26]. This is one of our highest hit rates so that was a sign to us, in terms of
click through rates, that was a sign to us that employers really value the information
about what to do, and we have some recommendations in the blog that the mom who wrote it came
up with that were excellent. Healthy recommendations and otherwise on what employers can do to
really support caregivers and those with serious mental illness. I did want to mention that,
I didn’t want to forget it, it’s extremely important. Crystal Brandow: Great, thank you so much
for adding that and a huge thank you to all three of you, Caroline, Ewuria, and Darcy,
for sharing this information. Caroline started this webinar off saying how one in 25 adults,
or 4% of adults have a serious mental illness, and it’s important to remember that, even
on top of that, one in five has any mental illness, according to the National Institutes
of Health, so for an employer, there’s a chance that one in five individuals in that workplace
are dealing with a mental health challenge and so having this information is very important. What we’re going to do now is hop into the
Q&A session of today’s webinar. We have quite a few comments that have come in about how
helpful this information is. So again, Caroline, Darcy, and Ewuria, we can’t thank you enough,
and we have a couple of questions that we’ll put out to you as well. I just wanted to let you know, as we get into
the Q&A, you’ll be seeing a file share document on your screen with an occupational wellness
mp3. What you see on your screen now is a podcast created by SAMHSAs Program to Achieve
Wellness that goes into a little bit more detail on some of the topics that we’ve talked
about today in a bit of a story telling fashion. It gives some examples of what occupational
wellness, excuse me, what accommodations could look like in a workplace. What would that
actually mean for an employee going through their day at work? Again, it’s a bit of a
story telling narrative and a podcast that we developed and we hope you find it to be
a great compliment to this discussion. We’ll have that file share on the screen. You can
go ahead and download that while we get into the Q&A. The first question we have, you already spoke
to this a little bit, Ewuria and Darcy, but there’s a question about ICU and Right Direction
and whether or not they’re free. That’s part one of the question. And part two, would an
employer use just one of them or both of them? Would they go together? Can you talk a little
bit more about any relationship between the two of them? Ewuria Darley: Yes, the ICU and Right Direction
programs are both free. They’re turnkey and they’re available on our website,
In terms of … Right Direction is a depression initiative. It’s encouraging those with depression
or those who may be experiencing some kind of … some signs of depression, for them
to actually seek help. It also allows employers to get that information and make sure that
employees have that. As far as ICU, it’s more of an emotional response
program, peer to peer learning, and again, going to that cultural shift. Encouraging
employers to just talk about mental health and mental health conditions and making sure
that people know that it’s okay to ask if it’s okay and then people know that there’s
help, there’s EAP, there are resources available. Both of them, together, encourages employees
to utilize EAP, if it’s available in your workplace, and help those who may be experiencing
some kind of emotional distress or may be experiencing some kind of issue, they feel
like something is just not right. It just encourages them to seek the help that they
need. Crystal Brandow: Great. Thank you so much.
A question that any one, any one of the three of you could answer. If an employer believes
they don’t have anyone with serious mental illness on their staff, if there wasn’t anyone
that disclosed about having a serious mental illness that would require accommodations,
do you think accommodations would still be valuable for the entire workforce? So, anyone
who wants to answer that one. Caroline Snyder: This is Caroline. Crystal Brandow: Caroline Snyder: Caroline, do you want to
start and then will go to Ewuria? Sure. I’ll just quickly. In general, I think
its best practice for employers to constantly be understanding of their employees needs
and finding out ways that they can best meet them and that can be in a variety of ways,
whether or not it technically qualifies as a psychiatric disability. I think that, in
general, promoting a mental healthy workplace and finding strategies and ways to work with
employees to support their own mental health, whether or not they have a serious mental
health condition is, in general, something that there’s a lot of value in. I think sometimes when you talk about the
accommodations, reasonable accommodations, it might be in the context of what’s legally
required, but I think that if an employer is rightfully interested and values the mental
health of their employees that that’s something that they should always be taking into consideration
and always be looking at ways to support anyone. Also, reasonable accommodations do extend
beyond just serious mental illness, but any … technically it’s considered a psychiatric
disability that interferes with performing any of the functions of having a normal day
to day life. It can be anxiety and things like that, and so, in general, whatever an
employer can do and is willing to do to help their employees will ultimately be beneficial
to them and to the productivity and happiness of their workforce. Darcy Gruttadaro: Yeah, this is Darcy. I just
want to really piggy back on that excellent response. I think that is absolutely the way
to look at this. That whole … the legal requirements under the ADA and accommodations
that really help people succeed, versus the overall culture and well-being of the workforce.
What we’re seeing is there seems to be a bigger focus on stress and work/life balance and
how those issues can play out and people developing mental health conditions, like depression
and anxiety and there’s a lot of concern in looking at things like loneliness and isolation
and how those factors play in to people, perhaps, developing, or showing early signs of mental
illness. Employers are paying attention to the fact
that when you create that mentally healthy workplace, as Caroline described it, where
you have reasonable hours, people actually take their vacation, people are talking about
work/life balance and really modeling it at the highest levels of the organization. Employers
start to see the results in their healthcare claims and healthcare costs. The one thing
we know from the research is that, when an individual … many individuals that have
chronic health issues, things like cardiovascular disease, major back issues, have a lot of
serious health conditions, often, mental health will co-travel with it and when that is the
case the overall healthcare costs to the employer are two to three times higher. Really, employers
are looking at, how do we create that healthy balance so that we can keep peoples overall
health and mental health that’s connected to it, at its best? Crystal Brandow: Excellent, thank you both
for your responses to that question. Another question here that’s tailored a little bit
more for Ewuria and Darcy. You mentioned that there are case studies on your website of
different employers. There’s a question of if there are organizations of all sizes that
you showcase so people know if the examples would be applicable to them, something that
they could do in their own workplace. Darcy Gruttadaro: Yeah, great question. We
have, currently, about 70 case studies, they are searchable, so you can search them with
… by size, by industry, and we do have case studies from organizations of all sizes. Everything
from Prudential, American Express, to much, much smaller companies, to public … we have
municipalities, we have manufacturing, we have white collar service industries. A lot
of diversity and really impressive array of ways in which organizations are approaching
it. We’re about to post one, two actually, with
large academic centers, one is the University of Michigan, the other is Kent State University,
that I mentioned earlier. So we have academic centers at the higher education level. A lot
of diversity. They’re, by the way, when we look at our metrics, the case studies are
one of the most frequently visited places on our website. Crystal Brandow: Excellent, thank you for
that detail. We’re going to take one last question in the interest of time and this
is open to all three of you, whoever would like to answer. And the questions about the
different reasonable accommodations that Caroline went through. Do you know of any training
programs for supervisors to learn how to implement these things? So, if an organization wanted
to try flexible scheduling, can they learn how to do that in best practices? Are you
aware of any trainings or additional resources on those topics? Darcy Gruttadaro: So I’ll start. This is Darcy.
That is a great question and actually, we get asked it a lot and Ewuria and I just looked
at each other and said, “We’re getting that question again.” It is … there’s a great
need for this and I’m not aware of any. I wonder if the EEOC may have some suggestions.
We’ll look into this, Crystal, and if we can find something that you could post perhaps
for this, by contacting the EEOC, we’ll share that with you, but we’re not aware of any,
but it is a great question and there’s a great need. Crystal Brandow: Yeah. We’ll have the email
addresses for all of the attendees and we can send that, if you’re able to come up with
anything, we can send it folks via email afterwards. That would be great. Peggy Swarbrick: Any other questions from
anyone or any other thoughts that people in the last couple of minutes? Caroline Snyder: I just wanted to add. I don’t
know of a specific static training, but, I would definitely recommend checking the Job
Accommodation Network because they do do trainings, they do webinars and things like that, so
they might have something in their training library, although I haven’t delved as deep
as I would have liked to into it recently that might fit that bill and cover those topics
specifically. Crystal Brandow: Excellent. Great recommendation,
Caroline. Thank you. Like I said, in the interest of time, that
was our last question. We’re going to wrap up. As a reminder, the session is being recorded
and the recording will be available on SAMHSAs You Tube channel and in the meantime, everyone
joining today’s webinar will get a copy of the slide deck emailed to you, as well as
a Certificate of Participation, and we’ll try to also email this podcast that’s on the
screen. Once again, you have the file transfer box up on the window and it’s a podcast on
occupation wellness, and talks about reasonable accommodations and how to support individuals
with serious mental illness in the workplace. That’s a podcast developed by SAMHSAs Program
to Achieve Wellness. I’m on it, so if you download it you’ll hear my voice again, and
it also features Jasmine Brando, the Co-Founder of Humankind Workshops. Different speakers
from today’s presentation, but a similar topic that we hope you’ll find valuable and a great
supplement to what you heard today. With that, I would like to say thank you once
again to Caroline, Ewuria, and Darcy, for this very meaningful conversation and we thank
everyone for joining us and hope you have a great rest of the day. Darcy Gruttadaro: Thank you.

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