Top-down Strategy -Area Health-system CEOs Join Fight Against Mental-illness Stigma

Mental illness affects one in five adults and is the leading cause of workplace disability. Unlike physical illness, however, mental illness carries a stigma that prevents many people from discussing their condition at work — leading to high turnover, low productivity, and increased employer costs.

NAMI Massachusetts, the state chapter of the National Alliance on Mental Illness, launched a statewide campaign earlier this year called CEOs Against Stigma, with the goal of ending workplace stigma around mental illness and creating healthier, more productive workplaces. The CEOs of two of the region’s major healthcare organizations — Baystate Health and Cooley Dickinson Health Care — recently pledged their support of the campaign.

Dr. Mark Keroack, president and CEO of Baystate Health, said he wants to create a healthier, more productive work environment for the system’s 12,000 employees, making Baystate Health a leader in the effort to change attitudes about mental illness.

“It’s well-established that good mental and behavioral health are major contributors to a person’s and a community’s overall wellness,” he said. “Our team members play an essential and compassionate role in our community, and it’s our obligation to ensure they have any resources they need to maintain the best possible mental health and wellness.”

Meanwhile, Joanne Marqusee, president and CEO of Cooley Dickinson Health Care, hopes her pledge helps eliminate stigma concerning mental-health issues in the workplace and provide encouragement and support for employees to seek mental-health services.

“This is an important issue for any CEO, particularly those of us who work in healthcare,” said Marqusee, who oversees an organization of approximately 1,900 employees. “It is vital to show leadership in the area of mental-health services and to demonstrate a commitment to our employees.”

Funded through a two-year, $265,000 grant from the Massachusetts Attorney General’s office, CEOs Against Stigma argues that ending stigma requires top-down leadership to change misconceptions about mental illness — including depression and substance use — so employees have the opportunity to speak freely about the conditions that affect them and their immediate families, and seek support.

The campaign is open to all Massachusetts companies with at least 50 employees. CEOs are asked to sign a pledge that “encourages communication and understanding to foster a stigma-free workplace.” It also includes a commitment to bring NAMI’s In Our Own Voice (IOOV) presentations into the workplace. Recognized by a mental-health researchers as the an effective anti-stigma tool, IOOV presentations feature two people sharing their personal stories of recovery.

“Every day, we see how stigma interferes with a person’s willingness to get treatment,” said NAMI Mass Executive Director Laurie Martinelli. “The research shows that, in the workplace, stigma not only discourages people from getting help, it also has a huge impact on productivity.”

Survey Says

NAMI Mass chose to focus this anti-stigma campaign on the workplace, in part, based on results from a 2014 statewide survey of 800 Massachusetts voters, commissioned to gauge attitudes on mental illness.

The results show that, while 92{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of people would advise people with mental illness to tell their families about it, and 76{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} would advise telling their friends, only 27{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} would advise telling their co-workers.

The resulting stigma has tangible effects on the workplace. According to NAMI Mass:

• 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of U.S. adults are currently suffering from a depressive illness;

• Employees experiencing depression lose 35{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of productivity each week, and are 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} more likely to become unemployed due to their condition;

• Four of the 10 leading causes of disability in the U.S. are mental disorders, and mental illness is reported in 72{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of long-term disability cases;

• 71{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of U.S. adults with depression will not contact a mental-health professional, and only 57{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of employees with symptoms of major depressive disorder said they had received mental-health treatment in the previous 12 months; and

• Short-term disability claims related to mental illness are growing by 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} annually and can account for 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} or more of the corporate disability experience for the typical employer.

However, NAMI Mass notes, up to 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of individuals with a mental illness will improve with appropriate diagnosis, treatment, and monitoring. Furthermore, a 2014 report by PricewaterhouseCoopers notes that, for every dollar invested in creating a mentally healthy workplace, $2.30 is generated in benefits to a company — a 230{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} return.

“Eliminating the stigma of these health challenges is an important first step toward beating them,” said Keroack.

In addition to providing IOOV for its employees, Baystate Health will also examine the organization’s health and welfare benefits to make sure employee-assistance programs are welcoming and effective in addressing team members’ mental-health issues.

As for Cooley Dickinson, Marqusee said the organization will also encourage open dialogue about mental illness among employees to promote a stigma-free workplace and will provide helpful information for employees and managers so they are better informed.

Broad Reach

The goal for CEOs Against Stigma is to involve 250 executives and a half-million employees. Any Massachusetts company with at least 50 employees can join.

“Eliminating stigma creates a healthier workplace and increases the productivity of employees,” said Bernice Drumheller, president of NAMI Western Mass. “We hope CEOs Against Stigma will help people overcome isolation and the negative effect of stigma, transforming the way they think and act toward mental health conditions.”

Martinelli calls stigma the number-one challenge NAMI faces in the field of mental illness.

“Stigma surrounds the person who has the mental illness or substance abuse and may affect their ability to get treatment. Some people don’t want to get treatment, so that is one facet of stigma,” she explained. “Stigma also can affect family members. Family members may not want to disclose that they have a family member with mental illness or substance abuse because society judges them so harshly.”

Martinelli said mental illness and substance abuse are unlike many other diseases because those affected believe they did something to cause it. “Parents who we work with oftentimes come with a lot a guilt that, if only they had done this, their son or daughter wouldn’t have mental illness. Of course, that’s ridiculous because mental illness is a biological brain disorder. It’s not anything that any parent or anyone did or didn’t do.”

The hope is that, by talking about stigma — which is really another word for discrimination, she added — people will be able to overcome it and won’t be as hesitant to talk about mental illness. That’s where CEOs Against Stigma can play a major role.