After Germanwings, More Attention Needed on Employee Mental Health

The Germanwings tragedy catapulted the issues of mental health and corporate risk and responsibility into the world's headlines. Professor John Quelch argues it's time for companies to make employee mental health more than an afterthought.
by Michael Blanding

When news broke March 24 that a young co-pilot for Lufthansa's low cost-airline Germanwings had intentionally crashed a passenger jet into the French Alps, killing himself and 149 others, people struggled for answers. What would make someone take his own life along with those of so many innocent people?

One possible answer came this past week when the airline revealed that the pilot, Andreas Lubitz, had previously suffered from deep depression. Debates began about how Lubitz's mental health played into the tragedy, what treatment he might have received, and whether Lufthansa should have let him fly at all.

That discussion is a rare surfacing of an issue too often ignored—the problem of mental health in the workplace.

“A very interesting question to ask is whether the tragedy will be good or bad for treatment and management of mental health in the workplace”

"To date, companies have focused on physical health much more than they have on mental health," says Professor John A. Quelch, Charles Wilson Professor of Business Administration at Harvard Business School. In collaboration with Carin-Isabel Knoop, executive director of the HBS Case Research & Writing Group, he recently wrote the note, Mental Health and the American Workplace, exploring the extent of the phenomenon, its cost to organizations and employees, and some managerial responses.

In some ways, it makes sense that mental health issues get buried. "Most physical conditions are visible, either to the naked eye or on an X-ray," says Quelch, who holds a joint appointment as Professor in Health Policy and Management at the Harvard T.H. Chan School of Public Health. "Mental health conditions aren't so readily identifiable."

It's clear from Quelch and Knoop's research that most companies treat mental health as an afterthought.

"If you look at the allocation of resources in corporate wellness programs, you will find it heavily weighted towards physical health," says Quelch. Only rarely does a tragedy, such as a suicide of a top management executive or workplace shooting by a disgruntled current or former employee, make the issue part of global debate; the Germanwings crash provides both an opportunity and a warning on the issue.

"A very interesting question to ask is whether the German pilot tragedy will be good or bad for treatment and management of mental health in the workplace," says Quelch. "On the one hand, it focuses tremendous attention on mental health in the workplace. " But an overreaction to the issue could result in costly ramp-ups of mental health screening of questionable effectiveness. Such screenings may do more harm than good by stigmatizing those who legitimately suffer from mental health issues that are entirely manageable, and by making it more costly for them to come forward.

"You can imagine a fallout from this tragedy, subjecting everyone from crane operators to Uber drivers to random mental health checks," says Quelch. "You can imagine a vicious cycle of stigmatization and dysfunctional finger-pointing being the result."

Stress Or Mental Illness?

A culture of 3 a.m. emails and competition in the conference rooms can contribute to workplace stress. A 2013 survey by the American Psychiatric Association found that one-third of working Americans experienced chronic work stress, while only 36 percent reported their employers provided adequate support to manage it. According to the National Institute of Mental Health, some 6.7 percent of American adults experience "major depressive disorder; antidepressants are the most prescribed class of drugs in the United States.

That depression has taken its toll on employers and even taxpayers. Research by Harvard Business School Assistant Professor Joel Goh estimates that workplace stress is responsible for up to 8 percent of national spending on health care and contributes to 120,000 deaths a year. According to the Gallup-Healthways Well-Being Index, absenteeism from workers diagnosed with depression costs US workplaces an estimated $23 billion annually in lost productivity. That number, however, only calculates losses based on days employees miss, not on the lowered productivity on days they come in to work.

"When it comes to mental health, the main issue for organizations is 'presenteeism' more than absenteeism," says Quelch. And that cost is borne not just by the employee suffering from mental illness. "If I am bringing a mental health problem to the office, I am probably going to impact the office atmosphere and affect other colleagues who will have to pick up the slack."

Perhaps because of the social effects of mental health problems, workers are often reluctant to admit they are suffering from problems—sometimes even to themselves. "There is a pick-yourself-up-by-your-bootstraps philosophy that is still prevalent in many companies," says Quelch. "We develop other words to talk about mental health—we call it 'stress' or call on people to be 'resilient.'"

But normalizing the issue in the workplace can create even more barriers for employees to speak up and admit they have a problem, for fear of being accused of not being able to help themselves. "If someone has diabetes and they have to manage that chronic condition, no one bats an eyelid," says Quelch. "But if I say I have to manage a mental health problem, co-workers and the human resource department may start getting nervous. It's presumed that mental health issues are more under an individual's control."

Changing Cultures

As Quelch and Knoop explore in their note, some companies are taking a different tack, being proactive about integrating mental health into their wellness programs alongside physical health. One approach is through Employee Assistance Programs (EAPs), a resource that enables employees to reach out confidentially for assistance on any number of issues—stress management, finances, or life changes, alongside more serious issues such as depression or suicidal thoughts.

By integrating life management programs with mental health, companies can both address stigmas and provide coping strategies to address issues before they become chronic problems. Johnson & Johnson has created a culture in which employees are welcome to use the corporate gym any time without penalty in order to relieve stress. (The company's approaches to wellness are described in Johnson & Johnson: The Promotion of Wellness.) General Mills offers mindfulness training with on-site meditation to help employees focus as part of its programs to promote mental and physical wellness.

Of course, implementing such a culture change starts at the top. "As always, an expression of support from leadership is very important," says Quelch. "Leaders can set good examples by not sending emails at 3 a.m. or showing up in the office on Saturday mornings, and by implementing a good EAP and encouraging employees and their family members to use it."

To remove the stigma, employers need to educate workers about mental illness and distinguish it from normal levels of stress. At the same time, managers must learn the legal restrictions about asking about mental illness, and the rules around the need for accommodation. Often, this requires formal training programs. "Companies hold numerous meetings related to diversity training to make the workplace comfortable for people of different races, genders, or sexual orientations," says Quelch. "Employees should be educated in the same way about how to deal with mental health issues."

In some lines of work in which the public is put at risk —such as air travel or police service—regular mental health testing may be warranted, says Quelch. In those cases, employers should look into finding the most effective ways of diagnosing potential problems to ensure that cases of mental illness are caught early and-if they do not respond to treatment-then removing those employees who could do others harm.

For the majority of employers, however, an ounce of prevention is worth a pound of cure. Diagnosing mental health issues early and creating a culture in which employees feel supported and free to seek help can help ensure a healthy and productive workplace across all industries.

About the Author

Michael Blanding is a writer based in Brookline, Massachusetts

Post A Comment

In order to be published, comments must be on-topic and civil in tone, with no name calling or personal attacks. Your comment may be edited for clarity and length.
    • Sridhar
    • Product Manager, Sunquest Information Systems
    This is quite true in IT organisations where the Brain Power is the key to success of individuals and organisation.

    Care should be taken to ensure that no undue pressure or stress mounts on the employees which will yield negative results and spread negative energy among the Peers.

    HR needs to play a vital role in this entire strategy and many HR's completely are ignorant to handle such situations
    • Bernie Dyme
    • President & CEO, Perspectives Ltd.
    Boy, do I agree with your premise. Leaders in organizations must take this seriously, step up to the plate and treat mental health with the same importance as they do physical health. We need to make it easier for employees to seek help for both stress and mental health issues and remove the stigma.
    • Kamal Gupta
    • Co Founder, Energized Solutions India Pltd
    I have had this experience, way back in 1999. The CxO Sales we had employed seemed capable enough, was delivering results. But we sometimes found him staring at his wife's pic on his table with moist eyes.

    When I asked him once, he gave an out of place sentimental answer, which made me suspect something was wrong with his mental balance. But we kept quiet since there were no complaints from his team or co-workers.

    And then, one day, all hell broke loose during an annual sales conference. He seemed to simply go berserk, and we had to literally subdue him. Later on, he broke down and narrated his own personal problems. But that incident drove away some key people from our organization and it took months to recover from that.
    • Wendy Grondzil
    • Assistant Secretary-Treasurer, School District #38 (Richmond)
    Let's start with the top.

    It's not a simple matter, to change an organization's culture. That is because culture itself is a result of something; it is not an end in itself. What really needs a closer examination is leadership itself, where "leadership" is not defined as qualities or traits of a leader, but as Padilla has argued: a dialectic between leaders, followers, and the environments they create.

    Kets de Vries has written several outstanding works that deal with the psychodynamics of the workplace, specifically the neuroses that can be introduced and that shape our organizational cultures today, because of unresolved issues, psychoses or fixations of leaders. He explores and exposes the psychological complexities of leaders, (who are 'people' first!) that can be magnified by the ways followers hand over their own personal power, as well as perhaps over-attributing leader agency with respect to the overall success or failure of organizations. Kets de Vries also demonstrates just how the results of these frailties can cascade throughout and organization creating environments rife with everything from toxicity to stagnation.

    Unfortunately, this aspect of leadership training is not part of the curriculum in business school. In many senses, it's not really a course about leaders that we need, but leaders as people, with all of the hurts, hang-ups and complexes that come with one's membership card into the human race. Because many leaders play to the theatre of their "divine right to lead", introspection rarely finds its way to the executive office.

    Further, there is a basic element to our humanity: and that is meaning. Pava (1999) argues that meaning in organizations is ubiquitous. He paraphrases German sociologist Robert Michels: 'Who says "organization" says "meaning,"'

    He goes on to say: "Meaning is like air; if human beings are to survive as human beings, meaning must be everywhere...Managers and other key employees who insist that the organization is simply a utilitarian tool and that 'business is business' are either misguided, lying, or both. For better or for worse, business is also a location where human beings constantly and forever interpret life's meanings."

    We should never underestimate the ability of leadership to create cultures that stifle human meaning, significance, voice and value. Organizational silence should be deafening to leaders: if they stopped talking for just minute or two, they just might hear the sounds of anguish.
    • Roger Sterling
    • President, Sterling, Cooper & Partners
    Better awareness of employee mental health is fine but awareness (and application of) best practices in public safety is better. The mass-murderer co-pilot could have been thwarted with the cockpit protocols common to U.S. carriers. His employer was fully "aware" that it had a suicidal co-pilot in the air.
    • Vicki Townsley
    • Director, Ethical Quest
    I agree. We need to humanise organisations and place some value around Emotion. I've just written a blog about the need for authetic leadership development which elaborates on this
    • Ganiyu A Ogunleye
    • Managing Partner, Jaffa Consulting
    Hardly do employers pay attention to employee's mental health. Identified cases of mental health challenges often elicit stigmatization. The Germanwings tragedy should serve as an eye opener to all employers. Henceforth, employers should pay gReater attention to emplyees' mental health, assist in rehabilitating identified cases and withdraw affected staff from risky tasks where necessary.
    • Rob Houck
    • Partner, Eaton & Van WInkle
    This brief analysis does not touch on the very different views Germans have (from Americans) about personal information. This is not to say that privacy should trump passenger safety. But the author seems to assume we all feel the same way about this topic. Ask a German about American gun laws. That will begin to give you an idea of how different our two cultures are.
    • William Gary Ward
    • Retired, nuclear industry, Nuclear industry
    The nuclear industry in the US has been monitoring employees' mental health for decades. Its Continual Behavior Observation (CBO) program could be a model.
    • Dr Amy Armstrong
    • Faculty, Ashridge Business School
    I was really interested to read your article John and many of the points you make resonate with me. My recent doctoral research focused on the 'suffering overspill' caused by traumatic life experiences, such as critical illness or bereavement, on the work of managers in the UK. One overwhelming message to come out of the research was the expectation that things would be 'business as usual' when individuals returned to work, particularly when there is no physical manifestation of trauma, such as in bereavement situations. In my study, individuals saw themselves growing professionally as a result of their personal trauma experiences, yet their developmental value was not realised. In the UK at least, it seems that these experiences often remain hidden at work, as the workplace is not seen as an appropriate forum in which difficult life experiences should be shared.
    • H
    • L, Consultant
    A word of caution though. Let us not mess up with people who are perfectly fit to work. Because it impacts people's lifestyle.
    • Srinivasan
    • Independent Consultant, Independent
    The headline itself is interesting for this article - After Germanwings... do we need to pay attention to mental health.

    That's the challenge we are faced with in our address of the various challenges - we just move from one issue to another. A new headline in another 18 months - and we are going to look at fixing that...

    We need to look at the whole eco-system holistically at all points and handle it all the time, if we are to have a fair chance to make it work in the long haul.

    If this is a systemic issue - why has it not been taken up this far? So do we lack pro-active systems to find the issues that face us? Or are we too timid to raise such issues - until we find an opportune (or unfortunate) event to surface it? Or are we over-reacting to an aberration? Or is this the proverbial last straw that broke the camel's back (forcing us to look at it now)?

    The questions in the article are important - will we stigmatize, will we politely start dropping the hiring of such people?

    We need to balance out everything in life.

    Until we take the bigger picture into account and proactively act, and then factor in the biases, and be willing to let aberrations stay as aberrations ... I don't believe we will be addressing the core of the matter.
    • bowlweevils
    • several meters above sea level, mammalian, with non-organic implants
    This is another issue that everyone will agree is a swell idea, especially the further they are from being able to be replaced.

    But let's be realistic. In terms of mental health, there is one extremely obvious way to improve it that has been known for untold eons. It's the same for physical health.

    Sleep. Get enough sleep. When the workplace ignores a basic human function like sleep, or actually places a positive value on going without sleep, the workplace is either saying "we think you are tools to us" or "we expect you to be superhumans".

    There is a basic problem, however, with addressing this issue. An employee seeks professional assistance dealing with mental illness substantially caused by lack of sleep. That employee feels that the demands on her time, in terms of number of hours and in terms of consistency of hours, means that her employer has little regard for her as a person.

    The professional she will seek assistance from will agree. However that professional will also probably be sleep deprived, and will come from a workplace culture where lack of sleep is prized as evidence that you are superhuman. Doctors are some of the most sleep-deprived people in the country.

    But they think that's ok, for them, though not you. Just like they aren't affected by pharmaceutical advertisements, though you are.

    And if holding an afternoon seminar on how to respect people with mental health concerns, similar to holding an afternoon seminar on how to respect people of different races or ethnicities is the patch for this problem...well, we'll have the same result: an afternoon where there is a room full people either getting annoyed that they're going to have to spend the evening working, or people semi-covertly working because they already know that they are going to have to spend the evening working.

    Most American professionals have reached their esteemed level of employment through a lifetime of denying their urges to succumb to basic mental and physical needs. And the professionals who would have the skill to persuade and aid the creation of an effective program, and to enforce compliance with that program are all too busy.
    • Endro Catur
    • Consultant
    One of the role of annual performance review is to also review (or in this case, assess) employees' wellness relevant to its job. While health screening is a general practice, I have not yet seen this as one, though. In addition, 360 degree feedback might also be useful to complement the professional assessment, to the least it provides clues of employees' counterproductive or negative behaviors at workplace. When both occurs - followed by intervention programs and done continuously (say, monthly) - this case should be minimized.
    • Aim
    • DSV, KOC
    From economics standpoint:

    When Big Blue collapsed in Milwaukee, Wisconsin, the company ended up paying punitive charges of $94 million for gross negligence. Three people died in the accident; cost/human: $31.3 million. (information in wikipedia is incorrect).

    Right around the same time a coal mine exploded in China killing over 200 people. Three million dollars were put aside for the families of victims. Cost/human: $15,000.

    Put differently, it is very cheap to have accidents in China; particularly in the mining sector.

    Unless the economics adds up, no disaster borne by mental anomaly shall receive enough respect and attention to amend the problem at individual level. However, plenty of lip service will definitely arise from Germanwings incident.
    • Kimmo Hintsanen
    • Managing Director, Senior Consultant, S.I.E Consulting Inc
    Managing an organization is managing its people and their behavior: managing the mind. Mental health is individually inside everyone's behavior even the top managers'. The more organization levels there are, the more challenging the chain reaction becomes. The top person, however, should always face the mirror.
    Basic management system must provide fair individual treatment for everybody: goals - means - rewards. Motivation aligned with organizational main goals.
    Every manager must be responsible for subordinates' mental health => motivation => behavior => results.
    In commercial airlines managing individuals and even teams is not easy to implement and therefore is often missing. This is the basic reason for other similar to Germanwings' incidents in the air, on land and at sea. Buss drivers, train engineers, ship captains are all without managerial support too. They just get their orders by computer.
    Healthcare and some other highly expert-dense organizations have the very same problem, though of different level of origin. Let's wonder who manages and how the behaviors of a psychiatric hospital doctors or university professors. All of them still have uniquely individual mental health problems.
    No tangible improvement will take place when just new rules on personnel medical records, cockpit staffing and technical changes are written.
    What should be done to this management problem globally? Should we start a development group in order to provide practical guidelines and implementation steps to improve managing practices!
    At least we have plenty of interested parties here.