The World Health Organization estimates that depression and anxiety — among the more prominent mental health issues — cost the global economy $1 trillion a year in lost productivity. Given this harrowing backdrop, why are only a minuscule fraction of Indian companies concerned about the mental health of their employees?
She was a go-getter and had been promoted within a year of joining — a rather rare feat at the media organization where she worked as a writer. There would be weeks of productivity, when she would pursue articles with passion and mirth. Her chirpiness would suddenly fizzle into spells of depressive lows, aggravated by all manner of accusations she hurled at everyone around. As she swung between manic highs and lows, her co-workers remained flummoxed spectators. She’s ‘mad’, they decided.
Looking back on his high-performing employee’s struggles with bipolar disorder at the workplace, Allen John (name changed) wonders whether things could have been handled better if his company had a mental health policy in place. It’s been nearly two years since she left the job, and she hasn’t been able to hold on to another job elsewhere either.
Mental health remains the elephant in the room in the formidable corridors of corporate India. Of the country’s 1.1 million active registered companies, only 1,000 are estimated to have a structured employee assistance programme (EAP) for mental health, according to Optum Health International, a leading EAP service provider belonging to the Minnesota (US)-based UnitedHealth Group.
An EAP typically includes both preventive — workshops and awareness programmes on mental health — and counselling services — whether telephonic, face-to-face or via online chat — for employees and their family members.
In India, Optum’s Prevention and Wellbeing, EAP and Wellbeing Services segment is headquartered in Bengaluru and active in over 65 cities. Its country head, Amber Alam explains that there are about four prominent EAP providers in the country, each catering to 200-300 employers. So, aside from a few other companies offering mental health support in bits and pieces, only a handful of Indian companies have a structured EAP, he says.
To emphasise the magnitude of the problem, Alam cites a 2015 study by industry body Assocham that found 42.5 per cent of employees in the private sector showed signs of general anxiety disorder or depression. The study — involving 1,250 employees from 150 companies — further found that the incidence of anxiety and depression among corporate employees increased 45-50 per cent during 2008-15, and nearly 38.5 per cent of those surveyed slept less than six hours — which is a major contributing factor for depression and hypertension.
Stress, anxiety, depression, marital discord, substance abuse disorders, personality problems, psychiatric problems, trauma and bereavement are some of the commonly cited mental health issues among corporate workers, says Alam.
Another disquieting reality is that, more often than not, employees facing mental health issues end up quitting on their own, as happened with John’s employee, says Kunal Sen, managing director of consulting firm Korn Ferry’s recruitment services in India.
What is more, the World Health Organization estimates that depression and anxiety — among the more prominent mental health issues — cost the global economy $1 trillion a year in lost productivity.
Given this harrowing backdrop, can India Inc afford to have a minuscule fraction its companies concerned about the mental health of employees?
On the other hand, WHO points out that for every $1 invested in treating common mental disorders, there is a return of $4 in improved health and productivity.
“It makes sense for organisations to nurture employees’ mental health, not just from an ethical perspective, but also economic. The benefits to the employee cannot, of course, be quantified in economic terms, but are potentially life-saving,” says physician and psychiatrist Shyam Bhat, who heads Mindfit, the multi-city mental health and wellness service of cure.fit healthcare.
Mental health is just as important a factor for productivity as physical health, affirm all the experts BLink spoke with.
Andrew Simoes, manager at recruitment agency Michael Page India, vouches for the improved positivity at his workplace after he spearheaded a few mental health initiatives last year, timed with the World Mental Health Day week. Besides creating awareness about the pervasiveness of mental health issues in society, the initiatives stressed the importance of addressing these issues and developing strategies to cope with them.
“I think it was like this monster which was buried until then,” he says with a wry laugh, recalling the positive reception the effort garnered. “Once it was brought out, people started acknowledging it and saying, ‘yes, this is something that needs to be looked at’. A lot of people have actually taken up counselling sessions post that,” he says.
He points out that, often, even if a company has effective measures to deal with mental health issues at a global level, it may be missing at its Indian unit. For instance, his company’s global operations use Optum’s services, but in India, though the services were available on paper, a lot of people were unaware of it, he says. “This has to do with the fact that mental health is still pretty much a developing idea in India. We don’t take it seriously,” he says.
Lack of awareness and stigma are among the barriers to improving employees’ mental health, affirms Bhat. Employees often worry that seeking help for mental health can jeopardise their career growth, he adds.
The prevailing taboo forces people to shove mental health issues under the carpet, says Nicolas Dumoulin, managing director of Michael Page India. If someone takes a hiatus from work owing to a mental health issue, it ends up being frowned on as lack of motivation. The solution lies in creating an environment of trust, he adds. “You need to have policies in place to say, look, this is something we can do if someone has a burnout, and this is what the trajectory would be, this is how we could integrate them back into the company, so on and so forth,” he explains.
In the current scenario, the looming fear of job losses and retrenchment can by itself have a bearing on employees’ mental health, says Korn Ferry’s Sen.
He then underlines a pertinent fact — mental health issues are far more widely prevalent than most people think. If nearly half the employees are affected, then there’s a larger malaise at play, and people do not feel they have to hide it as they are not the only ones facing mental health problems. A company’s approach towards an employee dealing with mental health issues simply needs to be the same as its approach in the case of a physical illness — give time off to sort out the illness and provide support, where necessary, Sen says.
A Belgian, Dumoulin jokes that in a country like India, especially in cities such as Mumbai, merely the task of getting to office every day can trigger stress, what with the long, gruelling commutes and heightened traffic woes. This stress is compounded by thoughts of the work and targets awaiting them once they reach office. Many are forced to stay back late in office, which means returning home late, and sleeping and eating less. This kind of work-life not only harms physical health but directly impacts one’s mental health as well, he says.
“It’s a vicious cycle which a lot of people have fallen into, especially in the metro cities… so it becomes more and more important to ensure your employees get support or at least get a platform to show how they feel,” he says.
What’s your policy?
Given the rising incidence of mental health issues, companies must necessarily have mental health policies, yet only a few have them, says Sen.
Such policies should entail creating awareness or reducing stigma around mental health as well as providing access to mental health services, he says.
Interventions should be designed as part of an integrated health and well-being strategy that includes prevention, early identification, support and rehabilitation, says Vijay Chandramohan, French multinational company Capgemini’s head of Health, Safety and Environment in India.
It could cover areas such as financial and legal counselling, sensitisation to alternative sexual preferences, suicide prevention, psychological first aid (basic support care), he adds.
Organisations should have counselling and psychiatry services provided to all employees with the assurance of confidentiality, says Bhat. Leave should be provided for mental health issues, besides promoting a culture of openness around mental health.
Stressing the importance of a preventive approach, he says, “Companies should foster healthy lifestyle practices that are known to improve mental health, including exercise, proper nutrition, work-life balance, and yoga and meditation.”
Alam rues that Indians don’t take preventive care seriously, even for physical well-being. Just as you have health insurance to take care of hospitalisations during a physical illness, you now have mental illness covered.
“The Insurance Regulatory and Development Authority of India is trying to regulate that; it’s a great step. But, honestly speaking, do you think anybody at a workplace will call out and say, ‘You know what? I went to a psychiatrist and I am on medication. Here’s the prescription and the invoice, can you reimburse it?’ It’s going to take some time for anybody to do that confession, and for the company to develop a large heart to accept them and not fire them,” he says. IRDAI is regulating mental health illness, not EAP or psychological support, he adds.
Seconding the need for preventive care, Sen makes a revealing observation: “There is a physical checkup in a lot of firms before you get employment, but rarely do you have a mental health checkup.”
Asked whether mental health checkups should be mandated, he replies, “Maybe sometime in the future. We are still at a very early stage in the evolution. A lot of millennials and Gen Z are entering the workforce and they are ill-equipped to handle some of these mental health problems. It is a worrying situation.”
The task of devising a corporate mental health policy has its own share of difficulties as each person’s struggle with mental health, as well as their coping strategy can vary significantly from another’s, says Dumoulin.
At Michael Page India, rather than a policy per se, the company is focused on fostering a culture that allows employees to speak freely about mental health and normalise it.
He, however, believes that in larger organisations with over 10,000 employees, a structured policy may work better.
Reaching out informally
Many of the companies BLink contacted for this story affirm that they are proactively taking steps to ensure employees’ mental wellbeing. However, they do not have a mental health policy as such.
Many of them offer free counselling services through tie-ups with external service providers. Alam says the number of companies seeking EAP or mental health programmes has been increasing by 45-55 per cent year-on-year.
Corporate houses such as JSW Group, Capgemini India and Mahindra & Mahindra (M&M) have EAPs that include free counselling to employees and their families.
At its steel manufacturing plants around the country, JSW Group had, between May and October last year, conducted 25–30 face-to-face counselling sessions as part of its EAP called We Care, says Ajanta Chatterjee, vice-president — human resources.
Capgemini India’s employee mental health awareness programme comes under an overarching framework of ISO-45001, an international standard for occupational health and safety management systems.
At M&M, employees are provided with counselling services as part of its ‘M Happy initiative’. Rajeshwar Tripathi, chief people officer, says: “We realised that one of the biggest ingredients of employees’ productivity is their mental well-being, although it’s not very easily admitted by the individual. There is still a taboo — that if I were to disclose I have a problem with my mental well-being, then it will go against me and my career.”
Ensuring employees’ mental well-being is inevitable and not a matter of choice, he adds.
Oyo, Uber India, Google India, Mondelez India, American Express India and Panasonic India are some of the other companies which provide similar services.
In some instances, companies have stepped in to help employees grapple with mental health issues. Korn Ferry’s Sen mentions how a senior employee who was grappling with depression after being laid-off was helped by the company not only in dealing with the illness but also finding a new job.
JSW Group’s Chatterjee recalls an instance of an employee at their steel plant who was facing a marital issue. Through the company’s manager referral service, the human resources department arranged for on-site counselling at the steel plant.
“The employee was encouraged to learn and practise alternative coping strategies. After the on-site counselling, the couple continue to work on their personal issues through telephonic counselling,” Chatterjee says.
She points out that while JSW may not have a mental health policy, it offers help on a case-to-case basis. “Not only JSW, but most companies would help the employee tide over the period until they are able to come back to work,” she says.
Would they though? One can only hope that this indeed becomes the norm.
“Organizations will play a crucial role in our society’s overall mental well-being since much of our time and energy is spent in the workplace. The workplace is often the source of stress, but it can also be the source of the solution,” Bhat explain