Supporting mental health: An employer's guide to a psychologically healthy workplace

By <i>Dr. Nicole Stelter,</i> PhD, LMFT, and Director of Behavioral Health for <i>Blue Shield of California</i>


Across industries, employers spend a great deal of time and resources making sure their workplaces don’t create risks to employee physical safety. These efforts usually include trainings, specialized equipment, and environmental risk management, just to name a few. Part of keeping workers safe also includes individual worker risk management — think hard hats and desk-specific ergonomic assessments.

There is an analogy for employers to pay attention to when we’re talking about employee mental health and psychologically healthy workplaces. If 84% of the U.S. workforce said at least one factor from their job caused a physical ailment, there is little doubt that employers would be searching for a solution. In a 2021 survey by Mind Share Partners, 84% of respondents said their mental health suffered because of at least one aspect of their job.¹ Moreover, 76% reported that they had at least one symptom of a mental health condition, putting these employees at greater risk of exacerbating their symptoms if they work in a psychologically unhealthy workplace.²

The bottom line is, behavioral health issues such as stress, anxiety, depression, and even substance abuse or addiction are impacting your workforce. And there’s a strong possibility that your workplace is either exacerbating these conditions — or worse, causing it.

That’s not good for your employees or your business. The American Psychiatric Association Foundation’s Center for Workplace Mental Health reports that the cost of depression alone to the U.S. economy is more than $210 billion annually in absenteeism and lost productivity.³

Most employers today recognize the importance of behavioral healthcare coverage. Employers who offer such coverage may feel like they’ve “checked the box” on mental health care for their workforce. But when 84% of workers say their mental health is suffering due to their job, it appears that employers might also need to make sure they’re not overlooking a major component affecting employees’ mental health: the workplace itself.

  • Workforce vs. workplace - Why it’s important to make the distinction

    If you’re providing behavioral health benefits to your workforce but not creating a psychologically healthy workplace, you may be undermining your efforts to improve the well-being of your employees and the business performance and health of your company.

    To help foster a psychologically healthy workplace, business leaders must first understand the difference between the psychological health of their workforce and the psychological health of their workplace.

    If you want to prevent your environment from exacerbating already-existing issues (or creating a risk of developing new ones), prioritize:

    Employee engagement

    Person/job fit

    Training opportunities

    Communications strategies

    Policies that address problematic personnel behavior (and especially enforcement of those policies)

    These efforts can help ensure your workplace environment encourages psychological safety, while your benefit plan encourages individual employee mental health care.

  • “A psychologically healthy workplace fosters employee health and well-being while enhancing organizational performance.”

    American Psychological Association

Understanding the pervasiveness of mental health struggles

It might be easy to miss workers who are fighting an internal battle. When addressing mental health within your workplace, consider:

  • 80%

    of workers said workplace stress affects their relationships both inside and outside of work⁴

  • 66%

    of employees hide their mental health condition from co-workers⁵

  • ONLY 38%

    of workers who are aware of the mental health services offered by their company would feel comfortable using them⁶

The price of an unhealthy workplace

The cost of an unhealthy workplace is multilayered, so your approach needs to be multilayered as well. Strategies should encompass both individual employee health (workforce) as well as psychological safety in the work environment (workplace). Employers don’t just lose money because of sick days and lost productivity; employees will also leave a company with an unhealthy culture, which adds to turnover costs.

Plus, mental health issues contribute indirectly to business health because they compound the impact of chronic medical health issues (e.g. cardiovascular disease or diabetes), increase the risk of acute medical costs, undermine the rehabilitation of disabling injuries and illnesses (e.g. longer disability and FMLA leaves), and increase risks for occupational injury/ illness (i.e. worker’s comp costs). Other risks include:

  • 1

    Retention: According to the APA Work and Well-Being Survey, employees who are stressed out at work are three times as likely to consider changing jobs.⁷

  • 2

    Lost productivity and absenteeism: The National Council on Alcoholism and Drug Dependence estimates that substance abuse costs U.S. employers an estimated $81 billion every year in lost productivity and absenteeism. Workers with a substance use disorder miss two more weeks of work per year because of illness or injury.⁸

  • 3

    Recruitment in a tough job market: Eight in 10 U.S. workers say the way an employer supports mental health efforts will be an important consideration in taking a job.⁹

Building a healthier workplace

The idea of creating a healthier workplace may be daunting. You are likely already doing some things that, with a little intention and planning, can serve to support psychologically healthy workplace goals. A good place to start is by conducting an informal audit of your workplace’s health and culture of wellbeing. A psychologically healthy workplace starts with an open, supportive culture that enables workers to speak up when something’s wrong and to seek mental health treatment without being penalized.

The healthy workplace audit

Things to consider:

  • What is your company’s philosophy on mental health care? How do you communicate that to employees?

    Do you have mental healthcare coverage options that match the needs of your specific workforce and industry? How do you communicate those benefits to employees?

    Are your managers trained to support their reporting employees when they need time off for mental health appointments?

    Are your managers and leaders trained to have difficult conversations about employee mental health, e.g., “mental health first aid training?”

  • Does your culture stigmatize seeking treatment, either directly (strict attendance policies) or indirectly (not having infrastructure in place to cover missed shifts)?

    Do you make conversations about mental health part of your larger culture?

    Are employees included in decisions about mental wellness programs?

    Do you take complaints of potentially toxic co-workers and managers, difficult clients, or an unhealthy workplace environment seriously? If so, how do you address concerns?

Healthy workplace essentials

The Surgeon General developed Five Essentials for Workplace Mental Health and Well-Being. This is one of many frameworks that can help you and your colleagues identify organizational changes that can lead to a healthier workplace as well as give your employees a voice in shaping their day-to-day experience at work.

Tips for a healthier workplace

  • Protection from harm

    (Safety and security)

    • Prioritizing physical and mental workplace safety
    • Enabling adequate rest
    • Normalizing and supporting mental health care
    • Operationalizing diversity, equity, inclusion, and accessibility policies and programs
  • Opportunity for growth

    (Learning and accomplishment)

    • Offering quality training, education, and mentoring
    • Fostering clear, equitable pathways for advancement
    • Ensuring relevant, reciprocal feedback
  • Connection and community

    (Social support and belonging)

    • Creating cultures of inclusion and belonging
    • Cultivating trusted relationships
    • Fostering collaboration and teamwork
  • Mattering at work

    (Dignity and meaning)

    • Providing a living wage
    • Engaging workers in workplace decisions
    • Building a culture of gratitude and recognition
    • Connecting individual work with organizational mission
  • Work-life harmony

    (Autonomy and flexibility)

    • Providing more autonomy over how work is done
    • Making schedules as flexible and predictable as possible
    • Increasing access to paid leave
    • Respecting boundaries between work and non-work time

For more information on how to address these essentials, see the Surgeon General’s Framework for Workplace Mental Health and Well-Being. And for more information on developing a healthy workplace that is psychologically safe and doesn’t put your employees at risk, check out Guarding Minds at Work. Hosted by the Canadian Centre for Occupational Health, this site provides free resources that help organizations examine and improve psychological health and safety in their workplace.

How Blue Shield of California can help

Blue Shield is committed to helping companies manage the complete healthcare needs of employees, including behavioral health. We have numerous mental health benefits options to fit different workforce needs, and people who can help you build a psychologically healthier workplace overall.

The healthy workplace consultation

Looking for ways to enhance the psychological health of your workplace? We can provide strategies to help address individual worker needs and support your efforts to design and sustain a psychologically safe workplace.


Mental health challenges in the workplace can negatively impact both your employees and your bottom line. In addition to addressing individual employee needs through benefit design, there are concrete steps you can take to also improve the psychological health and safety of your workplace environment. Health benefits that are supported by a psychologically healthy workplace can lead to a healthier, more productive business for all.

<b>Nicole Stelter</b> has a Ph.D. in industrial/organizational psychology, a master’s degree in counseling psychology, and 30 years of experience in managed behavioral healthcare, specializing in psychologically healthy workplaces, clinical psychotherapy, employee assistance programs, occupational behavioral health, and behavioral health program evaluation. She is a licensed psychotherapist (LMFT, State of California) and a clinical trauma professional.