Workplace Behavioral Health – Connecting the Dots Between What You SAY And What You DO

Date: 02-21-2022 • Runtime: 1:04:13

Unsurprisingly, 3 in 5 employees have experienced negative impacts of work-related stress within the last 30 days. Reason: excessive workload, hybrid work culture, and financial stress. Are you prepared to manage a 71% workforce turnover within the next year of those who typically feel tense or stressed out during the workday?

Resilient workforces are not developed by chance. They build “people first” cultures. The question is HOW?

Learn from the experts as Axiom Medical’s Vice President of Behavior Health, Dr. Les Kertay, discusses Workplace Mental Health.

Holly Foxworth [00:00]

Hello, and welcome to the Workplace Behavioral Health, Connecting the Dots Between What You Say And What You Do Webinar. In case we haven’t met, my name is Holly Foxworth. I’m a registered nurse. I am the marketing manager for content here at Axiom. And then I’m also the host of our Best Practice Webinar series. But I’m also joined by the dynamic duo here from Axiom. We have the senior vice president for Behavioral Health, Dr. Les Kertay. I will tell you that most people, whenever they listen to him, they say that they talk to him for five minutes and they feel like they’ve been in therapy for five years. So he has this amazing voice and we just love him. And I know that you will as well. We also have the lady that knows it all. She does it all, and she continues to do it all every single day. Chief Marketing Officer Dara Wheeler. So they’re going to be joining us in this conversation. To say that I am pumped up for this conversation at this event today, I think would probably be the understatement of the century. Bluntly stated, the last two years have been somewhat of, I guess you just kind of have to say, a really hot mess.

Holly Foxworth [01:13]

We’ve had everything from COVID. We’ve all become teachers. We had to pretend like that we knew how to do the schoolwork for our kids and think about things like trigonometry that you haven’t looked at in years where you’ve got your kids in one room, you’re sneaking to the back and Googling it, trying to find the answer for all of the uncles, the aunts, the mothers, the dad, my daughter golden retriever Maggie as well. But anyway, it’s been a lot, to say the least. There’s been a lot that’s been going on. So it shouldn’t be a surprise that we’ve all struggled in our own ways. And if you haven’t, I hope that you’ll send us your name, your number so that we can learn to be a unicorn like what you would be. But this is all about real-life conversations, about what it is that we can do, how it is that we can work to build that resilient workforce and bring everybody back together in that harmonious theme there. So several things I did want to mention before we jump into the introductions. First of all, we love to talk, as I’m sure you figured that out, but we really like to talk about what your problems or your struggles may be.

Holly Foxworth [02:30]

And then also any questions that you may have. So the way that you would do that, would be simply typing in your question, located there on the right-hand side of your screen at the very top box. And so you would type that in. We like to incorporate those within the discussion as that’s actually going on. However, if we can’t do so, then we’ll try to roll those in at the very end. The second thing I wanted to mention was at the bottom of your screen, you’ll see that there is a section there that says, I think it says demo or it says try now, something of that sort. But basically, that is for our new contagious illness case management program. And so for those of you that say, Hey, Holly, I thought we’re done with COVID. I get it. I get what you’re saying. But however, what I will tell you is that continuous illness is not new. It’s been going on for years and years and years. You’ve got everything from flu to strip, everything in between. And the last thing that you want is to have an outbreak at your organization. So very much like what we utilize this for, which I can work for COVID, it would function many of the same ways.

Holly Foxworth [03:37]

So it’s not a sales pitch. It’s simply a demonstration of what that product is. I know that every HR and risk manager would probably jump for joy with the idea of not having the responsibility to keep up for the health data management that sometimes all the hats are being worn these days. So if you would like to attend that, we would encourage you to do so. Just click on that button. It will send you to the page where you can register for the day that you would like to come. We do host those daily, and that’s Monday through Friday at 11:00 A.m. Central. So I think that would probably sum up the announcements I wanted to go over there. Why don’t we go ahead and just introduce our panel? I’ll start with you, Dr.Kertay, if you want to go first.

Dr. Les Kertay [04:25]

Sure, I’m Dr. Les Kertay. I’m a psychologist by training. I have been in and around mental health for about 45 years, which is kind of horrifying to get to the point where you said. I spent the last 20 years really in the workplace mental health, workspace in disability insurance, workers compensation, trying to help employers really manage their employee productivity around mental health. So that’s me.

Holly Foxworth [04:59]

Awesome. Well, I’m so glad that you’re here. We’re thrilled to death. Dara, how about you?

Dara Wheeler [05:04]

Thank you, Holly. Hi, everybody. My name’s Dara Wheeler. I am Axiom’s chief marketing officer, and I’ve been with Axiom, this is my 17th year, and I can’t under express how enthusiastic I am about what we do and how we help employers and employees through these really difficult situations. And having somebody like Dr. Kertay on the team has been amazing, mostly for like Holly said my own therapy use.

Dara Wheeler [05:34]

I’m just kidding.

Dara Wheeler [05:35]

But it has been very wonderful to kind of start thinking a little differently about behavioral health in the workplace and how we can help employers through that process. So excited to be here today. Thank you, Holly.

Holly Foxworth [05:50]

Awesome. Well, just to kind of give you an idea of what it is that we’re going to go through today. So we’re going to go through everything from the employer, to the evolution of what that looks like for behavioral health. We’re going to talk about some of the trends that we’ve seen. We’ll go through some of the workplace culture beliefs, what we’re seeing there, the consequences of failing to fix some of those issues, talk about some of the post-pandemic behavioral health support initiatives that you may want to implement, and then finally wrap that up with connecting those dots between what it is that you’re actually saying to your employees and what they’re hearing. So is that say, don’t do as I say but do as I do. And so we want to make sure that you have a clear pathway on how it is that you can bring those together. So, Dr. Kertay, I’m going to come to you first, but before we jump into the slides, I would like to ask you if you kind of talk to us a little bit about the difference between behavioral health versus mental health. Are those terms interchangeable, or could you give us the difference of what makes those two things different there?

Dr. Les Kertay [06:55]

Yes, although it’s a little unusual and people aren’t used to it. I’ve been pushing us to use the term behavioral health because mental health really implies and I tend to reserve it for diagnosable psychiatric conditions that benefit from, you know, either require or would really benefit from treatment. Whereas really what we’re looking at, especially post-pandemic, we’re looking at both mental health conditions, but we’re also looking at stress. We’re having discussions about burnout. It’s a much bigger piece of the picture. So although the language is a little different, I want us to understand that we’re really talking about something that’s much larger than just major depressive disorder or an anxiety disorder that we’re going to treat. We’re talking about a bigger picture than that.

Holly Foxworth [07:54]

Makes a lot of sense. Well, thank you for sharing that. Talk us through then kind of what we were referring to as the evolution of how things are changing from the employer perspective.

Dr. Les Kertay [08:06]

Well, it’s interesting that I mean, we could have started this timeline ten or 15 years back. Mental health diagnoses have been increasing, suicide rates have been increasing, the stress in the workplace has been going up for quite some time before we ever got to the pandemic. When you look at the literature on burnout, for example, starting around 2008, 2009, you see this rapidly increasing number of articles written about burnout in health care providers. So now we’re all talking about it. I want to put this evolution in that context. I think what happened, you know, in 2019, we were already seeing this. We’ve known for a long time that it’s a problem for employers and employees. And then the pandemic came and we all had to adjust, and we had to adjust at a time. We had to adjust to a new set of circumstances, and we had to give up all of our usual coping mechanisms, you know, go out and spend some time with some friends. Well, that all of a sudden felt dangerous. So the things that we normally did to cope went away. So I think that what’s changed is that we have seen an increase in people talking about mental health.

Dr. Les Kertay [10:00]

We’ve seen an increase in the number of diagnoses throughout the pandemic, some of which in some sense is being attributed to the infection itself, to COVID-19. Some of it is related to the pandemic, and some of it is related to a changing workforce that’s accelerating patterns that have already been going on. And now what we’re talking about is the great resignation, people leaving. And we’re going to talk about turnover in a little bit. These are not small numbers. These are not small numbers of people who are leaving the workforce specifically related to stress, and what I’m calling behavioral health is the bigger picture, and wanting support. So I think that’s the pattern, I mean in a way for those of us who are really passionate about workplace mental health, the pandemic has presented an opportunity because now we can talk about it. We can talk about something that we couldn’t talk about before, and that’s really changed the dynamic. It has also really changed what employers need to pay attention to. And we’ll talk about that as we go along.

Holly Foxworth [11:29]

Yeah, for sure. And then whenever we look at some of the trends, it feels like sometimes that we try to put people in bubbles by their age groups. You know, you have your Gen z or you have your millennials, and is there a difference there, et cetera. And so looking at those numbers, what is it that we’re seeing now? What types of patterns are we recognizing within the different generations?

Dr. Les Kertay [11:56]

Well, we’re seeing a lot of job turnover in general. If you look at the overall survey of responders, which include all age groups, it has jumped 16% from 2019 to 2021. That is even higher for millennials and Gen Z. That’s partly generational, and that’s partly simply an aged cohort. You know, younger workers are more likely to move. And that’s always been true. That seems especially true now. So there’s a combination of generation and just age in general in the workforce. But I said we’re not talking about small numbers. Just to put this in perspective, it’s estimated that turnover costs, in order to replace a worker, is somewhere between 50% and 200% of their total compensation, depending on where they are kind of developmentally. Obviously, you’re higher skilled, longer duration people cost more to replace. But if you do the math around median or average salary, total comp with 50% turnover, which is that number over in 2021 for all age groups, that means that turnover costs are between 4 and $16 trillion.

Holly Foxworth [13:37]


Dr. Les Kertay [13:40]

And these numbers get to the point where you can’t, people have probably heard this before, so I’ll do it really quick. But the difference between a million seconds and a billion seconds. A million seconds is 11.6 days. A billion seconds is 31.7 years. And a trillion seconds is 31.7 centuries.

Holly Foxworth [14:04]


Dr. Les Kertay [14:05]

So if you start to talk about 4 to $16 trillion in just turnover costs, right. We’re not even talking about lost productivity costs. The estimate for a major depressive disorder is that it cost employers roughly $55 billion a year. That’s just major depressive disorder by itself, which isn’t even the most commonly diagnosed psychiatric condition. So we are talking huge numbers and ignoring this has never made any sense. It especially doesn’t make sense now when we have employees who are all talking about this.

Dara Wheeler [14:50]

I wanted to pick up on something you said, too. I think these numbers are stark. And as you said, there are some generational differences that existed before the pandemic. And I do think the difference between the overall survey respondents versus the generational survey respondents. Of course, there’s some wiggle room there. But I do think when you think about these generational differences and you look at some of our younger workforce and their look for meaning in work, do you feel like that’s shifted over time? And then has the pandemic then highlighted for them that stark realization that if there’s no meaning in this work, then why are they still there?

Dr. Les Kertay [15:30]

Right. I do think that, when we first started talking about generational differences, I remember going to conferences and we’re starting to talk about millennials, and I feel like people were talking about millennials who didn’t have the same work ethic as boomers or whatever. And in my mind, every single generation has put their hands on their hips and said, these kids these days, right?

Holly Foxworth [16:06]


Dr. Les Kertay [16:06]

And it turns out that that’s not really true. Millennials and Gen Z do not have different work ethics. They’re just as focused on work. What they’re less willing to put up with, is work that lacks meaning and they’re less willing to give up other aspects of their life. I’m an old Boomer. I grew up thinking that work meant drudgery, by the way, that’s one of the things I love about being an Axiom because I’m having the time of my life doing something I really am passionate about. But I think that that’s less and less true. Some of that’s driven by social media, some of that’s driven by culture in general. But the big thing is that I think the younger workforce, which is, by the way, now the dominant portion of the workforce, the younger workforce is less willing to put up with things that older workers have gotten used to.

Dara Wheeler [17:20]

I heard a leadership speaker discuss this a little bit, too. And the social contract between employers and employees has shifted pretty significantly over time. And so typically, as you said in these conferences, you always hear derogatory comments about the millennials, all these millennials, like you said, everybody’s got their hands on their hips and talking about the younger generation. But what’s shifted in the workforce and I think we can dig into this a little bit. And we think about this over time is that historically, even before your generation and the Baby Boomer generation, there was a social contract with an employer. You put up with the Drudgery because you got something at the end of the Drudgery, you got your retirement paid for, right. You got all of these benefits. That meant you stuck with this company for the duration of that end result. And I do think that shifted a lot. And so when we think about what we give our employees and the cultures we create, the demand for a different way of having an employer-employee relationship has really changed over the last couple of generations.

Dr. Les Kertay [18:25]

Right. And with that employee’s expectations of what their employers are providing. And we’ll get into this more later. But one of the reasons to be having this conversation, I think that’s really worthwhile. And one of the reasons to talk about behavioral health generally is that a lot of what we have done in talking about mental health, wellness in general, we focused on the individual, and that is an important piece. We want to help individuals become more resilient, become more able to cope. But part of this is not in the individual. Part of this is in the culture. Hence the title of this presentation today, of this webinar.

Holly Foxworth [19:22]

Yeah. Well, in speaking with that, of the company’s cultural beliefs, we kind of looked at what the difference was, and you can see that there is a significant shift. I actually expect it to be a little bit wider than what this was. Not that this is insignificant, but I expected it to be a little bit wider than what it was. Was that your take as well, or did you feel like this has kind of been a gradual thing that we’ll just continue to see that rise?

Dr. Les Kertay [19:48]

Yeah. I think that this is more related to age and expectations in that social contract with the employer. I think that people have been asking for this for a long time. I think one of the things that happened during the pandemic, as you pointed out, was we all had this shift on a dime. If you had small kids at home, you had to manage kids who are remotely schooling, plus your job. For some people who were working in offices, now we’re working from home, at the same time, all of our normal coping mechanisms went away. I think it’s, again, much more in our awareness. And here’s an interesting kind of parallel to this. I would talk about the difference between, in my mind, behavioral health and mental health. The youngest workers are the most likely to express these opinions, that workplaces should support behavioral health. They are the least likely to actually go see a psychotherapist. Right. So it’s not about treatment. It’s about culture. That’s not fair. It’s not an either-or proposition. It’s both, right?

Holly Foxworth [21:18]

Yeah, definitely. Well, the next one I know we’ve already had quite a few questions that came in, and I definitely want to address those. But maybe if you could, please feel free to jump in on this as well. But just come talk us through what some of those workplace factors are that are negatively affecting the behavioral and mental health of our workforce these days.

Dr. Les Kertay [21:42]

Well, I think they’re all here. One of the things I’ll start by pointing to the stigma around mental health conditions. There’s a lot of conversation about how that’s breaking down, that we’re talking about it. Honestly, in my experience, what we’re talking about a lot is stress. And there never was that much stigma around talking about stress. I’m not so sure that we’ve really come that far in our ability to talk about serious depression, serious anxiety disorders. We’re starting to, there are more celebrities who are beginning to own it. But the very fact that we have to point to celebrities who are talking about their experience of depression and that’s so unusual, that really points to that we still have a lot of barriers to having serious conversations about accommodating people, taking care of people who have serious mental health conditions, again, that’s one thing, stress is another. We have to have the conversation across the whole board. Dara, anything here jumps out to you?

Dara Wheeler [23:06]

Yeah. And again, as I think about what the pandemic has done to shift our mindset about our workforce, I also think one of the things that highlights here and I know this is more about these different workplace factors, but if you think about the highlight for us all in what really was our critical infrastructure versus what was a nice to have, and when you drill it down to that critical infrastructure and those workers that we probably didn’t value all that much prior to meeting our Amazon deliveries and our food deliveries, or like Holly said at the beginning, those teachers, I can tell you, I have never valued teachers. And I came from a family of teachers. I have always valued teachers. I have never valued an elementary school teacher more than I did in the last two years. And when we think about that value of where we placed value within our workforce, we’ve typically probably gotten it a little wrong. And I do think when you think about where we place value and monotonous tasks up there at the top, we do know over time that the more people feel that they have control over their work, their work environment, their work tasks, the more they find value and meaning in that work.

Dara Wheeler [24:28]

And so I do think the design of work, you know Axiom, not Axiom, but the United States has been really when you look at the history of work and workplaces and organizational design, we’ve always been really innovative in organizational design in the United States. We had Ford and we had the manufacturing plants and we had the industrial, the way we’ve handled the industrial revolution, and then the way we’ve handled our technology revolution, there’s been so much innovation. But I wonder if maybe we’ve not paid enough attention to innovation around how we do work. And so I do think that some of these things, again, to Dr. Kertay’s point, we do pay attention to the individual, how they’re feeling these different things. But maybe it’s even a bigger conversation about how our workforces do work.

Dr. Les Kertay [25:21]

Right. We learned a lot. I’ve worked from home for years. But for a lot of people used to go into offices, we suddenly discovered that we were perfectly capable of working remotely. Unfortunately, what we didn’t do is pay attention to that. Okay. So now how do we have a culture that really supports that and doesn’t allow for remote workaholism? How many times do you get emails at 11:00 at night? Because that’s when somebody has time to send it and we feel obligated to respond. I’m totally with you. I think it’s really about well, I mean, it’s right in the title. Connect the thoughts between what you say and what you do, and it’s less, you know,  do what I say and not what I do. It’s more like say what you actually do and do what you actually say.

Holly Foxworth [26:37]

Yeah, for sure. One of the things that we shared, we do it in services internally with our own employees. And Dr. Kertay did an amazing job this last week whenever we were speaking about setting boundaries and what that looks like. And I was going to ask if you would actually share that. It was just such a perfect example of where it is that you need to set boundaries, not only inside of work but also outside of work, especially when you’re in your case, where you’re raising five and six kids and what that looks like to you and what your wife had said, you know, her own time there. Would you mind sharing that?

Dr. Les Kertay [27:25]

Yeah, I don’t mind sharing it. We were talking about the webinar or the seminar we did the last couple of weeks. I think one of the things that we tend to do, and this is particularly true when people get to the point of feeling burnt out, right? Where you just had it. And let’s not turn burnout into something that it isn’t. I mean, we’ve all experienced that point where you’ve had it. The problem is the more burnt out you feel, the more you feel like what you need is a huge solution. In order for me to feel better and get less stress, I need four weeks in Puerto Vallarta. But given that most of us can’t get it right now, we think that we can’t get anything. But in point of fact, just carving out really small things, having a workspace that’s separate. You know, the story about my wife is that we raised six kids. We all had a rule that we understood is you don’t talk to mom through the bathroom door. That was for three minutes of absolute quiet, right.

Holly Foxworth [28:55]


Dr. Les Kertay [29:00]

And the kids got really good at it. But the thing is, it’s three minutes of privacy that allows you to actually get a little bit of recharge. One of the ways to fix stress and burnout is to understand that we need small, one of the things that we need is just small solutions, small steps towards a solution. It’s just a huge skill to learn how to do little things that make you feel better.

Holly Foxworth [29:34]

Absolutely. We did have some questions that I wanted to get to that I think really related to these particular slides that we’ve gone through. The first was Beverly, where Beverly mentioned that I’ve been working from home for two years, and I’ve set boundaries in a finished time. And I think Brittany is answering here, so I can’t see the slide.

Dara Wheeler [30:00]

But she said my phone has a voice, but she sets and out of office so that it’s clear what her boundaries are. So she said she’s had burnout in the past and she’s learned some lessons from that burnout.

Dr. Les Kertay [30:14]

That’s great.

Holly Foxworth [30:16]

That’s a great idea. Yeah. And then we had another one that was asking about setting boundaries that start with time limits with emails after work hours.

Dr. Les Kertay [30:30]

Yeah. I mean, I think that that’s a really helpful skill. And it’s a really important skill for executives, for leaders, for managers to not send stuff, you know, because your team is going to respond to you. There’s a little trick that a lot of people don’t know about is that most mail programs will allow you to send an email later. So that was a skill I learned a long time ago when I had a remote workforce. You know, people who reported to me were, if I didn’t write it down, I would lose it, but I would set it to send it in the morning.

Dara Wheeler [31:15]

That’s a great idea.

Dr. Les Kertay [31:18]

Just little things that people can do. I think it is really important. But that also has to be part of the company culture, right? It has to be part of the company culture to say, it’s okay, I’m out on a date with my wife or my partner, right. I’m not going to answer that email right now, and it’s got to be okay to do that.

Holly Foxworth [31:46]

And then I think Scott was asking, what are some quick wins that companies can do to improve the behavioral health environment in the workplace?

Dr. Les Kertay [32:02]

Here’s one from me, and it tends to be an unsatisfying answer because it’s not short and simple, but it isn’t. The issue is to ask, what is it that people need, I mean, and be ready for the answer. What is it about your job in this setting? What is it that’s stressful? And then help figure out what those solutions look like. There are certainly programmatic things that, you know, there are things that we’re trying to build to help employers change a culture over time. But it really starts with asking. And it’s easy for leaders and companies to lose sight of what it’s like to be on the front line. And so we might make assumptions about what’s stressful for people, and it might not be what we think, and it often isn’t. Yeah.

Dara Wheeler [33:08]

I go back to the millennial example, too. You know you said that we’ve talked a little bit about what people want from work. And I do think in the early days of, especially the tech revolution, what people wanted from work was the Ping pong table and the pool table at work. I think we’ve all learned over time that maybe that wasn’t quite what employees meant when they said that they want a different culture or different engagement from their employer. So I think asking is always a great place to start. And sometimes you get answers that surprise you. So your assumptions really aren’t maybe the right assumptions. There is something there that may actually be pretty simple to implement. Maybe it’ll be something like telling everybody it’s okay to set their email out of office at certain times of the day. Maybe it’s something really simple that can be instituted.

Holly Foxworth [34:02]

Yeah. We’ve got a few more questions, and I think we can pick those up in the other slides, but we’ll kind of keep moving here. But talk to us a little bit about what that looks like whenever you fail to fix this, whenever you’ve got the problems that are there, but you can’t seem to find a fix for that solution.

Dr. Les Kertay [34:22]

Well, I think what happens is the end result is turnover. And we’ve already talked about how much that costs. What we haven’t yet talked about is, and I know it will be a little bit in the next slide, is the impact on productivity. I mean in 2000 and the Integrated Benefits Institute IBI did a study lost productivity cost employers, according to their analysis, $575 billion. I think it was 2017. In any case, it was before the pandemic. An individual with major depressive disorder on average spends more $3,300 a year on healthcare than a person who’s not depressed. And here’s the thing, you get that person treatment, they’re likely to get better. The cost of that treatment pays itself back a hundred times over. So the first thing that I would say is its turnover. What happens if you don’t address it is turnover and a lot of it is what we call presenteeism. It’s like showing up to work and not working. I think that’s the big thing. And I’m surprised those who typically feel tense or stressed out during the day is only 71%. I’m surprised it’s not 99%, frankly.

Holly Foxworth [36:20]

And who knows if they’re telling the truth.

Dr. Les Kertay [36:24]

This is just for people who are bidding for it, right?

Holly Foxworth [36:29]

Yeah. All right. Well, let’s go through then kind of what we were speaking about the experiences that are related to the work-related stress within the past month and what that kind of looks like, what type of experiences is that they’re having?

Dr. Les Kertay [36:53]

Well, these numbers can sort of speak for themselves. Interestingly, some of them are symptoms of diagnosable psychiatric conditions. You know loss of interest, motivation, or energy is a classic symptom of a depressive disorder, difficulty focusing. But look at, 19% lack of effort at work, 18% low productivity, 17% desire to quit. That’s significant, that’s a fifth of your productivity. Even assuming that these are all the same people who are endorsing these things, you’re losing 20% of your productivity to people who are stressed and aren’t producing as much. And we’ve all done it, we’ve all showed up at work when we’re not having a good day and we know that we’re not as productive. I spend time staring at the screen, trying to figure out what I’m going to do next, right. So building in something to address that, building in more flexibility around work hours, building in flexibility to take a walk. I mentioned in an internal webinar, that my coping mechanism is, I always have my walking shoes on and I can walk out the front door. It takes me 45 seconds to go downstairs, walk out the front door, and take a walk around the park outside.

Dr. Les Kertay [38:35]

Taking that five minutes makes a huge difference in my productivity. Again, we’re relatively simple solutions. But what I want people to think about is you’re losing, you know, 20% of your bottom line is going away because people are less productive.

Holly Foxworth [38:56]


Dr. Les Kertay [38:57]

That’s an oversimplification of the numbers.

Holly Foxworth [39:00]

Yeah. Well, let’s talk about this people first culture, because looking at some of the surveys and even some that we’ve done ourselves, there’s a lot of statements here that make a lot of sense of how it is that people feel, that I want to feel that my employer understands that my mental health is important. I want to feel like I’m fairly compensated. I want to feel like I’m included in things that my employer practices. What is it that they preach? How do those things relate? How is it that, you know, these things have to exist in every single organization? What would be your recommendations as to how you could extract that information for your organization and then also make plans moving forward to be able to implement some measures for that?

Dr. Les Kertay [39:54]

Well, I’m going to go back to ask first, see what your workforce is experiencing and what they need, what they feel like they need. One thing I’ll point out about a lot of the statements on this list is it’s about how people feel. We found this out when we were looking at a return to work programs. One of the top five predictors of whether people would go back to work was whether they felt supported in returning to work. The number of programs did not make a difference. What mattered was that they felt like their employer wanted them back. And that was a huge insight because we tend to throw programs at things, right. So now we have mindfulness activities, we have morning yoga, we have programs. But are they really getting at the underlying issue? At Axiom, we are building programs that will help employers monitor the behavioral health of their workforce, very much like you monitor physical illness and then deliver content that will be helpful to that specific issue. But in addition to those kinds of programs, what we need is a culture that really cares. I’ll use one more example and Dara, maybe you have some additional ideas.

Dr. Les Kertay [41:46]

We’ve known for years that employee assistance programs, EAPs, are more effective when they have higher utilization. But that’s really rare, utilization typically hovers around 3%, which has very little impact on productivity. Interestingly enough, when we’ve looked at it over the years, one of the things that tend to drive increased utilization is when the executive suite gets involved. When an executive in a company, they’ve had suicide and it really affected them personally and they started to talk to their company about the importance of taking care of yourself. That tends to drive better mental health through the access to services. And I know that it feels like it’s an expense, but it’s actually the opposite. It saves money when you address those issues. Again, I think that it would be great if I had simple solutions for everybody. Part of this is having someone to talk with, who understands the workplace, who understands mental health and can help you design what’s going to work, in addition to programs that can help address it. I think it’s a combination of those two things. It is not a one-size-fits-all for everybody.

Dara Wheeler [43:23]

I was going to say something similar with your approach about the top-down CEO approach from the utilization concept, and I do think, with a question in the question box, and it was about I think we can address it. Kimberly talked about in a manufacturing environment, how do you recommend we teach our frontline supervisors to be sensitive to our employee’s mental behavioral health needs? And one of the things that strikes me as you’re talking, Dr. Kertay, for Kimberly, is that it won’t change in your cultural environment until you get top-down buy-in that this has to change. So if you’re an HR manager and you’re trying to teach your frontline supervisors to have an empathetic and sympathetic relationship with their employee base, unless you get that from the top-down, it probably won’t be very successful. You may have some small wins, you may shift the culture a little bit or in short bursts, or maybe you’ll get a certain group within one manufacturing site to adjust the way they do things. But from an overall company standpoint, you really have to take that top-down approach and make changes all the way up to your CEO.

Dr. Les Kertay [44:41]

Yes, I think another thing to think about is we tend to measure things that are easy to measure. We all have heard, be careful what you measure because you’ll get it. And I used to add, be careful what you count because you’ll get a lot of it. So if that manager is incentivised solely on productivity and taking 30 minutes to talk to an employee to just say, how are you doing? And having that conversation, that’s 30 minutes that that person is not producing a widget. If you don’t build that into what you do, that 30 minutes is really valuable and somehow find a way to measure it and value it. And you know what? I don’t really care if you measure it. You have to value it. You have to understand that it makes a difference. And your managers have to understand that taking that time, not only do they have permission to do it but that it’s part of their job. That’s a tough sell in a manufacturing environment, but over and over again, we see the loss in productivity when people don’t do it. No one wants to say that the pandemic had any positive results.

Dr. Les Kertay [46:16]

But if we can have this conversation, if we have a window in which we can start to really have this conversation, we’re going to change work cultures in a way that’s going to make a big difference. And that’s true whether it’s retail, manufacturing, office work, that’s true.

Holly Foxworth [46:34]

You bet. And it’s about being an individual. And I put there on the spot here. But I will say that we’ve worked together for ten years, and I will never forget that I had major dental surgery one time, and she knew I wouldn’t be able to eat. And she sent different ice creams on dry ice to my house. And I mean, like, I came home and I think my mom was in tears, too. It’s the little things like that that go so far that make such a big difference in knowing that you’re cared for and that you’re taking care of. And it’s that paying it forward, it’s taking those small little things, those small little interventions to say, Hey, you matter, Hey, I appreciate you. And that’s where it all begins. All right. I’ll get all so happy. Anyways, moving on to the post-pandemic, though, you know, part about the employer mental health support initiative. I think that what we’re seeing here is that there’s a lot of people that are trying a lot of different things. And Dr. Kertay, I’m open, I’m excited to hear what your thoughts are on these. I don’t know if they’re working. I think that some people are just kind of throwing things at the wall and just seeing what sticks. But, you know, we’re seeing that some say, Hey, maybe we need to look at incorporating some of these mental health days or looking at more frequent breaks. Is that the right way to go? Do you need to put something in place like that, or does it need to be individualized based on your particular environment and your particular workplace and what’s going on there?

Dr. Les Kertay [48:33]

Excuse me. I think there’s a combination here. There are things that we know generally work, increased flexibility, increased autonomy, and a focus on outcomes. We know it helps people to feel better about their work, and it improves the overall culture. If I were going to pick one of these, I would pick behavioral health training. And by that, I mean training people to have those conversations. You know, here, internally, we’re doing mental health first aid training to just help people get comfortable having that conversation. I think a lot of times we don’t ask our employees or our coworkers. We don’t ask people how they are because we’re afraid that what if they don’t say fine, right. We’re not used to that. Getting people trained in some way of being able to have those conversations, building it into the culture. I think that’s one thing that I would point out as, you know, we’re pretty clear that’s important. The single best intervention that a manager can do is to help shorten the duration of somebody being out of work on disability or workers compensation claim. The very best intervention is to call the employee and ask them how they’re doing. And notice that I said call the employee and ask them how they’re doing, not when are you coming back to work.

Holly Foxworth [50:26]

Bingo. Bingo.

Dr. Les Kertay [50:32]

That’s been studied. We know those things. So there are things that you can build into a culture that I think are general. Whether or not giving people more paid time off, work or not, probably depends on the environment. It probably depends on, do you already have a culture in which the focus is on getting your job done, you know, in whatever amount of time it takes, you know, focus on the outcome instead of production? Increasing PTO is probably not going to make much difference because a person already knows that they can take time if they figure it out. Removing barriers, right. On the other hand, if you’ve got somebody who’s got two weeks a year and they’re in a high stress, high-pressure environment, the other 50 weeks of the year, maybe increasing PTO is a good idea. So again, it depends a little bit on it, it’s a combination of these things. Some of these things will work in all circumstances, some of them will work in some.

Holly Foxworth [51:47]

And then we’ll kind of go through here is connecting the dots now. So I want to get to the additional questions that we had, but talk us through what that means. How is it you can get it from saying, I want to be here, we think we should be here, but we want to get to that final destination? How do you connect those dots and how do you make it actually work?

Dr. Les Kertay [52:10]

Well, here it is. I mean, it starts with knowing what your workforce needs, and that involves asking them. And ask them in a way and in a setting that gives them some confidence that they’re going to be heard. Don’t ask if you don’t want to know or if you’re not going to do something about it. So I think just understanding what the workforce is like, and a lot of that is, I mean one way to do that is formal surveys, the other way to do that is just having conversations with people, which, by the way, has gotten more difficult in a remote work environment. It used to be that you could walk around the office and talk to your team. Not so easy anymore. I think that one of the things that we’re trying to do, you know, there are mental health apps that are out there. But what we’re really focused on is building something that will also get information that helps us understand the behavioral health of the workforce. I’m not seeing a lot of that. That’s a solution that I think is coming and that we’re really working hard on. And then the last piece of this is don’t wait until it’s a crisis.

Dr. Les Kertay [53:37]

Part of the reason that EAP has not been as helpful in the long run is because it waits until a person self-identifies as needing help. So if you’ve got information about what your workforce is experiencing, how they’re doing, reaching out to them proactively, and keeping first aid first aid, that applies to mental health as well as physical health.

Holly Foxworth [54:02]


Dr. Les Kertay [54:02]

Those are really the key steps in my mind.

Holly Foxworth [54:06]

Yeah. One of the questions that Scott had asked about and I think it fits in perfectly here is, how can an employer identify employees that are at risk for behavioral health issues before they leave the company?

Dr. Les Kertay [54:26]

First thing, and then Dara, you might want to chime in with other things, but the first thing is just observed behavior. And particularly observe for changes in behavior that are atypical. I’ve got an employee who’s always on time, walks in on time or early, seems to be engaged. All of a sudden they’re starting to be late all the time. And again, we get this confused. You have to identify the behavior and that behavior, you don’t have to say that behavior is okay, right. What you do have to do is have a conversation that says, Hey, I noticed this. How are you doing? And ask the question.

Holly Foxworth [55:24]

Yeah, yeah.

Dara Wheeler [55:26]

I’ve always told supervisors they don’t have to be experts in drug abuse or alcohol abuse or any of these conditions or concerns. What they have to be experts in is observing behavior and observing the patterns that are associated with that behavior. So even, you know, we always use the example of somebody who’s always on time, and all of a sudden being late. But actually, there are others on the flip side, if somebody’s always kind of cranky and that’s just kind of their natural state, and all of a sudden, maybe they start acting really happy, then maybe there’s something going on there that you should be concerned about, too. It’s changed in pattern and behavior. It’s not being an expert at any one of these things. It’s just asking good questions, observing the behavior, being really engaged with your employees so you can observe the behavior. I do think leading teams has gotten more difficult over time. One thing you do see is sometimes managers want to kind of like not ask the questions. They kind of back off. And it’s hard. These are hard conversations to have, but that’s the job of you as a manager and as a leader, to be present, to have those conversations, to be an observer, and to pay attention so that you can help build an organization that is sustainable and resilient through all of these situations.

Holly Foxworth [56:49]

Yeah. And you know, kind of speaking of the technology that we are in the process of building, you know, the goal in that is also to kind of be able to determine what some of those baselines would be, so that you can identify where there are some deviations there and you really can utilize some of that early intervention to keep the small things small. And you know what they say. Keep the small things small, so we’re not having to go to the bigger things that come next. Let’s see, there was another one about finding employees that are getting their feelings hurt, and this usually happens when they are corrected on errors that they make. Would this reason be because of behavioral health issues?

Dr. Les Kertay [57:40]

Well, it could be, but it also could be that the person who delivered the message did it badly. So the first thing is, I’m a psychologist. My wife tells me that I’m capable of having what she calls the toothpaste conversation. And I looked at her one day and said, what does that mean? And she said, well, you can tell people they have bad breath and have them thank you for it. There are ways of learning how to communicate those difficult messages that don’t engender that. So it could be that someone is very, I mean when we’re stressed, we don’t want to hear it, right? If I’m really stressed, I don’t want to hear corrective feedback, right then, because I can’t take it in. So certainly that’s about me. But also it could be about how the message is being delivered, and it could be that the only message we ever deliver is corrective. That’s a whole other thing, you know, about how people feel. We know that there are ratios that make a difference between positive and corrective feedback. So that’s a complicated question, but certainly, behavioral health could be one of them. You know, mental health conditions.

Holly Foxworth [59:07]

Yeah. And Andrea, I think we answered your question about the work-life balance from when work and life are in the same places and kind of setting some of those boundaries. But if you need some more information on that, please don’t hesitate to reach out and we can definitely get you some additional resources. I was looking to see if there are any others, I know that we’re at the very end of time here, but if there are any other questions that you have that we haven’t answered, I do have one more. Let me ask you this one. How do lower levels of management convince executive leadership to change from a company culture that values productivity over employee mental health? That’s a big one.

Dr. Les Kertay [59:54]

I wish I had an answer to that one, because that’s part of burnout in middle managers. Part of burnout in middle managers is, I see things that would make things better, but I don’t have any influence. So I’m steeped in the literature that says, well, if you don’t make those changes, you’re losing a lot. And by the way, given the shifts in the demographic in the workforce and what they expect, you’re not going to survive if you don’t change the culture. So I have lots of ideas about how to change that, but that’s a tough one.

Dara Wheeler [01:00:48]

Yeah. I think we could probably spend another webinar on how to do that. And I do think it’s tough. But to your point about listening to those middle managers and maybe not feeling like their opinions are valued. One, really, again, not simple, but maybe a little easier tool to implement would be something like an ENPs survey so that you can gather real data and those middle managers can express their challenges and frustrations through anonymized surveys. I do recommend that it is a good tool as long as the business is willing to do something with the feedback they get.

Dr. Les Kertay [01:01:37]

I’ve been scrolling through this. These are like fabulous questions, and I really want the opportunity to find a way to respond to them, you know, do a follow-up, because I feel bad we can’t get to them because some of these are really important. I love the level of engagement.

Holly Foxworth [01:01:56]

Absolutely. Well, what I can tell you is that these are not going away. We wouldn’t let Dr. Kertay run away from us. Even if we try, we would rope him down and bring him back. But yes, we are going to continue in this series. And I really also like that idea of the kind of talking through first aid mental health. That’s something that we’ve been training our people on. So we definitely please be on the lookout because we will be putting out more of these as well. Any closing remarks before we wrap up here? I know we’re two minutes out, and I apologize for going over that. Anything else from either of you?

Dr. Les Kertay [01:02:31]

No. I guess the really quick thing for me to say is, you know, the level of engagement in this audience tells us how important this is to get adjusted. And there are solutions that we’re building that I think can be helpful. So I’m certainly happy to try to respond to questions, you know, to do whatever we can to continue to be helpful and I’m sorry we didn’t get to them all.

Holly Foxworth [01:03:07]

Yeah, absolutely.

Dara Wheeler [01:03:10]

I agree. I want to thank everybody for their engagement questions. It’s been wonderful. So we’re happy to continue the conversation and we’ll follow up with everybody and make sure you get some answers.

Holly Foxworth [01:03:23]

Absolutely. Well, thank you for joining us and we will see you then at the next event. Thank you.

Dr. Les Kertay [01:03:29]

Thanks, everyone.


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