Buck Bond Group
Caught in the undertow: mental health, emotional wellbeing, and COVID-19

Caught in the undertow: mental health, emotional wellbeing, and COVID-19

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COVID-19 spares no one. While its impacts vary—with location, work obligations, home and family, health, and finances all playing a role—everyone is touched by the pandemic in some way, usually across all four dimensions of wellbeing (physical, financial, emotional, and social).

People are doing their best to manage through the virus’s waves, personally and on the job. But the situation is fluid, and it’s going to be enduring—an economic downturn and public health crisis combined. It’s causing emotional distress and disruption to daily life, in some cases rising to a level of clinical significance.

For employees caught in the undertow, how their employer responds is critical. Here are some tips and tactics to keep in mind as you navigate mental health and emotional wellbeing in the time of COVID-19. 

Mental health and emotional wellbeing challenges aren’t a second wave of the pandemic—they’re concurrent, they’re likely to get worse, and many are here to stay.

A recent Harvard Business Review article—That Discomfort You’re Feeling Is Grief—put a name and psychological principles to the loss of control and normalcy that’s been impacting all of us, acknowledging that even if your situation isn’t objectively the worst, your suffering is valid.

We’ve all seen, heard, or lived examples: balancing working from home with childcare, worrying about elderly parents, or loneliness. Health care providers are risking their own lives in sometimes overwhelming conditions. Other essential workers, like grocery and delivery staff, also risk exposure, and fear bringing the virus home. Families can’t be with loved ones as they die in hospitals or care facilities. Survivors may face guilt. Job losses and challenges to small businesses continue to build.

In short, there’s daily stress and worry across the board. It’s not surprising that we’re seeing evidence of new or worsened cases of clinical grade anxiety or depression and reported increases in substance abuse and domestic violence.

What to do:

  • Acknowledge the reality of the situation, on a societal, local, workplace, and individual level. Understand the confounding considerations your people are facing—while we’re all living through the same times, the specifics of what people are experiencing, and how they’re experiencing and coping with them, vary dramatically.
  • Encourage managers and leaders to engage in open, honest, human dialogue with their teams. Company culture matters, and there’s power in vulnerability—in an authority figure acknowledging personal impacts and challenges.
  • Equip managers to be the first line of support, directing employees to resources like an EAP, having detailed knowledge of company health benefits and leave policies, and being able to identify and escalate situations if an employee feels they are in danger.
  • Use compassion and flexibility in policies and working arrangements. For example, an employee who loses a loved one may need bereavement time now and for a future memorial service. Let them know it will be okay.

The social determinants of health are very real, and very much in play.

The physical, economic, and social conditions in which people live and work have a known impact on individual and population health. Consider access to health care, local food markets, public safety, education, transportation, employment, social norms and attitudes, proximity to pollutants, and more. At a time like this, when so many things are out of control, the social determinants of health and their impacts are exacerbated. We see this in the disproportionate effect of COVID-19 on minority communities, where environmental risk factors are higher, people are less able to isolate from COVID-19 exposure, and job loss and economic pain are greater. Implicit bias in our health care system is likely also playing a role in outcomes. BenefitsPRO has a good summation of considerations for employers.

What to do:

  • Know your population. Run aggregate and segmented reports on claims data, income, and location.
  • Recognize barriers to access to care—cost, location, time, even previous negative experiences—and do what you can to minimize them. This could be through promoting lower-cost, time-sensitive resources like your telemedicine and your EAP programs; but it also requires an organizational culture that prioritizes the health of employees, making coverage affordable and understandable, and allowing time off for medical care without workplace repercussions.
  • Bear in mind that you may not understand what people are experiencing. Consider holding virtual focus groups or creating an advisory council to hear from your people about what it is that they need. If you do this, it’s imperative to follow up with substantive changes to benefits and communications.
  • Empower managers to model behaviors, to serve as resources for information about benefits, and to act as listeners who can share feedback up the organization.
  • Consider broad and/or targeted communications to encourage general wellness and prevention, with easy links to resources including fitness and healthy eating programs, trusted news sources, your EAP and telemedicine vendors, and local crisis hotlines. Frame your communications appropriately—again, acknowledge the reality of the situation, have empathy, and connect on a human level.

Mental health and emotional wellbeing aren’t synonymous.

That doesn’t mean you shouldn’t take both seriously; we know chronic stress and worry can have detrimental effects on physical health, including hypertension, and may exacerbate diseases such as diabetes, heart disease, and cancer—not to mention the potential for workplace disengagement.

An abundance of apps (many of which offer free introductions), articles, webinars, and other resources lately have covered emotional wellbeing during the pandemic. They offer guidance including meditation, regular exercise, creating a productive work environment and defining working and non-working hours, positivity, virtual social connections, and more. All of those tactics are beneficial.

But, for people with new or existing clinically diagnosed mental health conditions such as anxiety, depression, and other mental health disorders that require clinical intervention, they aren’t enough. Bipolar disorder isn’t managed with meditation—it typically requires medication.

What to do:

  • Re-promote your EAP and other emotional wellbeing resources and the behavioral health benefits offered under your medical plans—what’s covered, costs, and claims procedures for in- and out-of-network care. Reinforce the concept of parity and laws surrounding confidentiality.
  • Put your EAP to work guiding employees and their families to EAP counseling or to mental health providers.
  • Review the behavioral health benefits in your medical plan, and make sure your employees understand what’s available. Given the pandemic, many providers are now working with insurers to cover video consultations with a patient’s designated care provider at the cost of an office visit. This is separate from telemedicine, which may be a short-term option for those who don’t currently have a mental health care provider.
  • Ensure HR and managers understand your company’s leave policies and how they’ve been impacted by the Families First Coronavirus Response Act (FFCRA). If an employee needs to take leave, act with empathy and sensitivity.
  • Minimize stigma. Employees don’t need to share what they’re going through with anyone at work, but a culture of sensitivity and support matter now more than ever. Starting conversations or noticing when someone doesn’t seem like themselves and asking genuinely, “How are you?”, then being a supportive listener, can make a huge difference in the moment and in employees feeling comfortable accessing the help they need.

Wellbeing is holistic.

Most of us can probably cite at least some psychosomatic effects of COVID-19-related stress on our daily lives—sleep disturbances, headaches, changes to appetite, and more. With the physical, financial, emotional, and social pillars of our wellbeing all tested by this pandemic, it would be foolish to not expect health consequences.

We know that health rests on the four pillars of wellbeing and their interdependencies, and that in the long-term, total wellbeing is at least partially predictive of physical health morbidity and outcomes. Employers have taken steps to address this over the past several years. Still, it’s wise to re-visit your commitment in the light of the current pandemic.

What to do:

  • Continue to encourage wellness and at-home preventive measures like healthy eating, exercise, mindfulness, and virtual socializing. Task your leaders with modeling behaviors.
  • Point people to the resources you offer, including those offered through your medical plans.
  • Prepare for a potential jump in future health care costs. Deferred routine, non-emergency, and elective care will likely be rescheduled in the months ahead, and claims may swell due to aggravated chronic conditions and new physical and mental health diagnoses. Be ready by predictively modeling claims and thinking through 2021 plan design with those projections in mind.

COVID-19 and the resulting economic downturn aren’t going away any time soon. The same is true for the emotional wellbeing and mental health challenges they’ve brought about. As an employer, the social contract is never more critical than it is during a time of crisis. Are your benefits and practices up to the task?