Abstract
Introduction
Supporting employee mental health has been of growing focus of employers, even before the pandemic. For decades, research and media reports have highlighted the prevalence of untreated mental illness in the workforce and the link between mental health and productivity1,2 In response, employers have expanded behavioral health coverage and invested in worksite health promotion programs. 3
When COVID surfaced in the U.S. in early 2020, employers initially focused on the health and safety of their employees. This included preparing workspaces or temporarily closing workspaces to stop the spread and supporting employees and families infected by the virus with additional sick time. At that point, pandemic-related increased risk for depression, anxiety, and stress was a secondary focus for most employers. However, as the months passed and the pandemic lingered even after the introduction of effective vaccines, employers increasingly focused on employee mental health and burnout as a primary health concern.
Findings from across independent surveys of employees 4 report varying approaches to specifically addressing mental health concerns related to the pandemic. 5 Understanding what shifts took place at U.S. businesses and organizations, large and small, allows us to identify best practices for future implementation and evaluation. Describing what has been helpful in different workplace contexts is helpful as employers continue to find solutions that are practical for their business to best meet the needs of employees. This article highlights a diverse set of companies that identified mental health as a concern after the onset of the pandemic and implemented solutions specific to their workforce needs.
Methods
Summary of Case Study Sites.
We note that, due to space limitations, these descriptions do not always reflect the full breadth of support that these businesses undertook. Many businesses, for example, shifted their response with different phases of stay-at-home orders and in response to evolving needs of their employees over time.
Goodway Group: Blending Supportive Policies With Digital Solutions
Since 2006, the digital marketing agency Goodway Group has operated with a remote workforce, now with over 450 employees located in 40 states and 3 countries. Prior to COVID, Goodway Group had already introduced an open PTO policy, known as “My Time”, and had also created a program to support growth and development called Dedicated Development Day, where non-essential meetings were avoided. Also prior to the pandemic, Goodway Group offered a 2 week-long working and bonding summit for all employees twice each year.
In contrast to many businesses that had to shift to remote work setting, Goodway Group employees were already accustomed to this configuration. Yet feedback from the teams suggested that employees were nonetheless adjusting to an entirely new routine at home as they balanced pressures related to childcare, virtual learning, elder care, and finances. Goodway Group’s solution was to combine individualized policies with digital approaches. Goodway Group encouraged teams to create schedules that worked for their individual groups. For example, a team developed a work schedule that accommodated members overseeing remote learning with young children. Teams shared feedback that being provided this sense of autonomy strengthened bonds and trust within the teams, and team members continued to support each other when in need. Goodway Group also recognized that some employees were experiencing significant financial impacts of COVID, though others were not. Goodway Group established a confidential employee emergency fund for team members to work one-on-one with those in need to determine the level of financial support needed, and then provide those funds on the same day. Donations from employees were matched by owners, demonstrating support from leadership while also reinforcing the bonds among employees. Goodway Group implemented additional initiatives, such as Family Friday Fun days via Zoom to highlight family talents and surprise all-company holidays, to make sure employees were taking time off.
As a digital marketing agency, Goodway Group took a unique approach to facilitate their biannual summits in a post-pandemic world. Goodway Group introduced Virbela, a 2D virtual reality (VR) program that allowed employees to use avatars to explore the company’s online campus, giving them the feeling of walking around an event, while providing a break from Zoom. Goodway Group instituted a full VR option for all teams to use both at the summit and throughout the year for team building. As the pandemic has waned, Goodway Group provided all employees with an Oculus headset, a dedicated trainer and a full array of social and educational programs to continue virtual connections. Goodway Group is continuing conversations with team members to determine which initiatives will continue in 2022 and beyond, and notes that it is critical for businesses to approach conversations around mental health with compassion and empathy: “[C]onsistent conversations that are focused on well-being, progress and development are key to having happy, engaged employees who power successful business outcomes.”
Focus on Finances: The Morris
The Morris is a well-regarded restaurant in San Francisco, in operation since 2016. In line with The Morris’s goal of being a true neighborhood restaurant, the owners embraced their diners while also focusing on their staff right from its inception. Both the founder, Paul Einbund, and his chef and partner had been in the restaurant industry long enough to have exposure to restaurants where the climate was stressful, demoralizing and rife with harassment. Even prior to COVID, the restaurant leadership made an effort to make The Morris a happier place to work. With COVID, The Morris was thrown into the same turmoil as restaurants across the U.S. with questions about whether allowing guests to dine and staff to work could literally be killing people. Morris founder Einbund recalls that everyone was stressed: “We all needed to pay bills, but we all needed to stay safe.”
The primary mechanism to support the restaurant’s staff was financial. When the restaurant stopped on-site dining at the beginning of the pandemic, the owners asked their investors to donate whatever money they could and wrote checks to every employee to try to offset their loss of income. The management then operated a GoFundMe and wrote another 2 checks to employees. During the entire pandemic, anyone who wanted shifts was given them, and no one on salary received any less pay than they did before the pandemic. In addition, the management emphasized balance, breathing, meditation and safety above all. The Morris received attention from the San Francisco Chronicle after closing for a week for a “mental health break,” at which time they wrote another check to every employee to offset the loss of income.
While supplemental checks are not a sustainable practice, The Morris continues to support employee mental health by attempting to offer 4 day work weeks for whoever wants them, including the general manager, and by creating more balance overall. One important shift has been to focus on successes, pointing out repeat guests, birthday celebrations, and other important moments customers choose to spend at the restaurant. Maintaining these changes, along with investment in manager training and engaging in explicit conversations with staff about what they need to feel supported are the key ingredients for supporting employee mental health.
A Multifaceted Strategy: Fors Marsh Group
Fors Marsh Group (FMG) is a 400-employee market and consumer research company headquartered in Arlington, VA, and a certified B-Corp company since 2017. As such, Fors Marsh had policies in place to support employee well-being already, including 16 hours of paid time for employees to volunteer for a personal cause they believe in, offering financial advising, and calling the “sick” leave “personal health” leave to encompass mental health. With COVID, FMG began seeing a notable increased in reports of isolation, disconnection, and uncertainty through their quarterly employee survey.
FMG focused on a strategy to reduce the stigma and financial barriers associated with seeking treatment, working with 3 components. First, they provided employees and dependents 6 free virtual therapy sessions per year and reduced copays for additional visits. Second, to address the increase in substance use disorders (SUD) associated with the pandemic, they implemented a Workplace Supported Recovery Program (WSRP). This Program provides employees (and their dependents) with easy access to substance use disorder services and assistance with returning to work. Through the program, the company also supports employees with SUD while they actively seek treatment.
The third component of their approach was to ensure employees have time to take care of their health, enacted through an unlimited leave program. Employees are explicitly not required to disclose their reasons for needing days off. At the same time, FMG now encourages senior leaders to share their own use of mental health days to help destigmatize the use of this leave. In preparing for program implementation, FMG researched ways unlimited leave programs succeed – and fail. One of the big takeaways was that, in addition to communicating to employees that they have as much leave as they need, the message to employees is that there is an expectation that they take at least 2 weeks of leave per year, with the goal that they would take closer to three-four weeks per year. Like the WSRP, the Personalized PTO program is a permanent change that FMG believes will allow employees not just the time they need to not just balance work and life, but to stay healthy and happy.
Reconceptualizing Support for a Remote World: Jackson Healthcare
Founded in 2000, Jackson Healthcare is a healthcare staffing company consisting of a group of 15 specialized healthcare staffing, search and technology companies. Most of the 1600 employees work out of the corporate headquarters in Atlanta, and prior to COVID, Jackson Healthcare’s approach to employee well-being centered on services located on the physical campus. Employees and their families could access primary healthcare, preventative services, and licensed professional counselors; a fitness center and daily fitness classes; walking trails, and other outdoor recreation. Inside, staff could spend time in a game room or “serenity spaces” to contemplate, meditate or connect spiritually in other ways.
In March 2020, the shift to a fully remote work created an abrupt rupture with these supports. The focus became meeting employee needs in a remote work context, especially for employees with children. Jackson Healthcare instituted personalized, flexible work from home hours to accommodate families trying to balance work with care for children. Although the company’s onsite childcare center was closed, teachers from the center led recorded activities and lessons for associates’ children. When the childcare center re-opened, it did so with new part-time and drop-in childcare options. For parents with older children, Jackson Healthcare reserved spots at a nearby onsite distance learning facility that oversees student work during the school day and offered space on our campus for parents who wanted to host learning pods.
To maintain a sense of cohesiveness throughout 2020, Jackson Healthcare reconceptualized campus traditions as virtual events. These included activities such as virtual holiday decoration and costume contests, a “pay it forward” Thanksgiving dinner where associates could choose a modified meal or donate the value forward to a local area nonprofit, and Santa photos that could include a socially distant in-person photo or virtual photos over Zoom. The organization shifted in-person professional development courses to a virtual, on-demand system and launched an online leadership development program portal to provide additional virtual development opportunities. The leadership team launched a communications campaign called #PositivelyJH, to share good news and celebrate people, the business and the company culture, as another way to help employees feel connected and supported. Through its internal communications platform, Jackson Healthcare provided daily content focusing on ways associates could support each other and the community, wellbeing and work-from-home tips, and more.
Though associates are now back on the physical campus and using in-person offerings, Jackson Healthcare continues to embrace changes that were implemented during COVID. Each of the Jackson Healthcare companies has its own hybrid work model that includes a defined work-from-home policy. Increased telehealth offerings that were launched in 2020 are now permanent. Jackson Healthcare continues to provide virtual professional development options, as well as a virtual component to company and holiday celebrations. And by leveraging focus groups, surveys and one-on-one conversations, the organization continues to assess how needs have shifted over the last few years and what employees currently value most.
Personal Connections: Prevention Insights, Indiana University
Not all efforts to support employees require a lot of resources, investments, or a top-down approach. Prevention Insights, a group of 35 employees within the School of Public Health at Indiana University, took a simple yet effective approach to supporting their employees during the pandemic. Prevention Insights already had an active wellness committee that focused on employee health through newsletters, learning opportunities, and social initiatives. When their organization went from primarily having employees in the office full time to working from home, they understood employees were facing a large change in how they worked on top of the stress of COVID and new family obligations. Some team members had very independent roles and did not have natural opportunities to interact with one another.
The wellness committee developed a plan to have monthly check-ins with all employees. Members of the wellness team were assigned up to 5 employees to check in with over each month. These interactions could take the form of a phone call, an outdoor walk, or even just emails. Over time, the group also added more social activities, including online lunches, a cooking class, and pickleball. Importantly, the wellness team also received training that included a better understanding of emotional intelligence to provide better services to their staff. Staff reported that during COVID, even just having the opportunity to talk to other employees beyond work was exceptionally helpful. The online social gatherings helped replace the free talk that would have occurred in hallways or the lunchroom before COVID. Employees reported that the check-ins allowed them to share challenges and struggles as well as all the good in their lives.
Now that some employees have returned to the office, the online games and lunch events have been supplemented by in-person games, and lunch and walks and will be permanent. What this team has learned can be a lesson for many – it is important to talk to each other not about work. Having meetings and moments and gatherings that are simply an opportunity to talk to each other, get to know each other better and create a safe space for people to share with each other can be nurturing and supportive of employee wellbeing, particularly during times of ongoing uncertainty and change.
Discussion
While these 5 organizations differ in size and industry, there are several important lessons that emerge from their experiences. In each of these cases, the policies and practices put in place were tied to the specific needs of employees. Several of these organizations found that financial support was a key to mental well-being. For example, The Morris’s strategy was to first make sure that staff would have stability while the restaurant was closed, and then secondarily to make sure the work environment was positive and supportive. Goodway Group similarly incorporated a mechanism to secure and provide money to team members who were struggling.
Across these and so many organizations, COVID has brought a shift toward recognizing the importance of accommodating the family system to support employee well-being. Balancing the competing demands of work and family is a well-known challenge for many organizations, but the pandemic required more explicit policies and practices, such as allowing more flexible work hours at Jackson Health and Goodway Group, and a range of ways of incorporating family traditions and activities at Jackson Health. With continuing labor shortages affecting access to child care, these changes may signify an important cultural shift toward more open dialogue about work-family balance.
These organizations varied in the costliness of their COVID-related practices. The social activities and “check ins” that were added by Prevention Insights, and sharing good news at Jackson Health, for example, were no- or extremely low-cost. At the other end of the spectrum, the technology solution of providing VR devices implemented by Goodway Group may not be feasible for many companies. In some cases, it will take time for the cost-benefit analyses to be complete, and even then, the value of certain policies may be hard to quantify. For example, continued support for employees as they take time to attend a rehab program or undergo some other type of substance use treatment may not be cost effective if that specific employee does not come back to work, but simply having the program in place may be considered attractive by other employees and help retention in that respect.
Two organizations approached employee mental health through leave policies. Unlimited leave policies, which are in place at Goodway Group and FMG, are sometimes criticized because employees may not take as much vacation time as when they have set leave, and in unlimited PTO situations, companies are not required to pay out unused time. However, the FMG implementation of this practice was different in that they strongly encourage employees to take multiple weeks off, and if they do not, their managers engage in discussions with them to understand why they have not.
Conclusion
The COVID era has brought unprecedented changes to the way business is conducted across a variety of industries and economic sectors, and each of these changes has brought challenges to employee well-being in its wake. Furthermore, as the acute phase of the pandemic recedes and a “new normal” takes hold, many of the changes to business remain in place. Policies that center employees’ physical and mental health and wellness, recognize the precarious nature of financial well-being for many American workers, and acknowledge that employees exist within larger family systems were well-received by workers and perceived as valuable by employers in 2020-2021. More research is needed to quantify the benefits of these policies, but the present sample suggests that those benefits are real, and that they will continue to be so in 2022 and beyond.
Footnotes
Acknowledgments
We gratefully acknowledge Goodway Group, Morris, Jackson Healthcare, Fors Marsh, and Prevention Insight for sharing their organizations experience supporting their employees during the pandemic.