Literature Review: Mental Health in the Workplace

Based on the paper titled “Introduction and Literature Review” by Misty Smith. Originally Published for PSY444 at Southern New Hampshire University.

Introduction and Literature Review

     The subject of mental health may not be a priority in most business plans, however, numerous mental health professionals believe that it should be (Walsh, 2011). There have been numerous studies showing how employers can benefit from hiring individuals with pre-existing, but treatable/treated mental illnesses, and numerous more studies that show the benefits to employers who implement programs to safeguard their employees from future mental stress. However, are there failproof programs that fit every company as one? Should companies go beyond what is required by rules and regulations to ensure the mental well-being of their employees? What benefits are to be had for employers? It is this student’s hypothesis that employers do not need to steer away from the topic of mental health; instead, they should embrace it by giving opportunities to individuals with treated mental health issues while at the same time implementing programs that address the complete mental health needs of all of their employees as a whole, which will result in increased productivity, better physical health, and overall morale.

Literature Review

Mental health in the workplace: Towards evidence-based practice

Studies have shown that when employees are not aware of the benefits their employer provides that they are more likely to not use them; this is especially true when it comes to mental health benefits (Kelloway, 2017). According to research conducted by Kelloway and reported in the article Mental health in the workplace: Towards evidence-based practice (2017), the economic impacts to companies who have employees who are suffering from untreated mental health issues is vast and may include “…absenteeism, presenteeism, reduced productivity, increased turnover, and host of other organizational behaviors” (Kelloway, 2017). In fact, according to Kelloway, insurance companies have reported that upwards of 70% of claims in regard to both long-term and short-term disabilities can be attributed to mental-health related illnesses (Kelloway, 2017).

     However, as Kelloway points out, although more experts are attempting to address mental health issues within the workforce, there are few empirically studied and confirmed programs that can be used by companies as a standard of prevention or care (Kelloway, 2017). One such attempt, discussed in the article, as a standard which companies could go by was implemented in 2013 by the title of Promulgation of the CSA Z1003 which was based upon four common pillars of interest. The pillars included, “…requiring organizations to have a corporate commitment to improving psychological health and safety, to have leadership commitment to the issue, to involve employees in the identification of workplace issues and the design of workplace programs, and to ensure the confidentiality of individuals” (Kelloway, 2017). However, according to Kelloway, the standard was flawed in various ways, including, “..there is not a strong evidence base that provides guidance as to what are the most effective workplace strategies…[and] much of the focus has been on what occupational health psychologists refer to as primary prevention activities…” (Kelloway, 2017). Kelloway suggests that more than prevention needs to be addressed, and programs must be designed to intervene in non-workplace mental-health situations that may arise with employees, and programs must also be developed to accommodate employees with pre-existing mental health problems (Kelloway, 2017). It is of this student’s opinion that Kelloway’s suggestions for improvements in the standards of mental-wellbeing programs within companies are valid and should be studied further.

Discrimination and positive treatment toward people with mental health problems in workplace and education settings: Findings from an Australian National Survey.

     In the article Discrimination and positive treatment toward people with mental health problems in workplace and education settings: Findings from an Australian National Survey, the authors set out to discuss the findings of research surveys conducted in Australia pertaining to the topic of mental health discrimination in the workplace (Reavley, Jorm, & Morgan, 2017). The survey was conducted via telephone and had a total of 5,220 participants, all over the age of 18. Of the 5,220 total participants, it was found that 1,381 self-reported that they suffered from a mental health issue or were found to be at a high risk of having a mental health issue at the time of the survey (Reavley, Jorm, & Morgan, 2017).

     The research conducted by the authors consisted of sociodemographics questions such as “…age, gender, marital status, postcode, country of birth, language spoken at home, level of education…” (Reavley, Jorm, & Morgan, 2017) using the Kessler 6 (K6) mental health symptom screening Questionnaire. The K6 uses a 12-month scale and questions pertaining to depression, anxiety, confirmed mental problems, or the feeling of emotional stress in any one particular month in the previous 12-month time frame (Reavley, Jorm, & Morgan, 2017). Furthermore, participants were asked if they had felt the need to avoid social situations or had been discriminated against because of any mental well-being issues they had reported (Reavley, Jorm, & Morgan, 2017). If the participants had not experienced any mental health issues during the time allotment of the K6 survey they were asked about any individuals they may have known or been in contact with who had mental health issues, and if they had been the subject of discrimination in the workplace to their knowledge.

     According to the authors, employment can play a vital role in the mental wellbeing of any individual, as employment provides a determining factor in social settings such as connecting with other individuals, self-esteem, and a means to prevent economic-based stress (Reavley, Jorm, & Morgan, 2017). Statistics discussed by the authors show that only 62% of individuals who self-reported mental illness was unemployed, whereas 80% of individuals who reported no cases of mental illness were employed (Reavley, Jorm, & Morgan, 2017). “Studies of employers’ attitudes toward employees with mental health problems have shown relatively low levels of awareness and limited capacity to deal with these issues in the workplace” (Reavley, Jorm, & Morgan, 2017). Correspondingly, the conducted research showed that 26.9% of the participants suggested that mental health issues were dismissed in the workplace due to a lack of understanding that the “…illness was real, or that it was serious and caused suffering, or did not understand how mental health problems can affect behavior and work performance…” (Reavley, Jorm, & Morgan, 2017). Other reported issues in the workplace from those suffering from mental health related issues included being denied opportunities (51.4%), being fired or demoted from their positions (15.1%), and isolation from the other employees (5.0%) (Reavley, Jorm, & Morgan, 2017).

     On the other hand, the research suggested that not all workplace experiences were on the negative side of the scale. 54.3% of the research respondents reported that they had received help or support in relation to their mental wellbeing by their employer (Reavley, Jorm, & Morgan, 2017). 19.4% had received a leave of absence and 18.1% reported that their schedules had been made more flexible in order to alleviate any stressors (Reavley, Jorm, & Morgan, 2017). Furthermore, 7.3% reported that they were encouraged to receive professional help outside of the workplace using their benefits (Reavley, Jorm, & Morgan, 2017).

    The study provided a starting point for further research into the discrimination of employees and potential employees within company settings. However, the study was one-sided as it was conducted only via the answers of unvetted phone participants and did not include any verified facts or company statistics. This student suggests that such research should be expanded to include the policies the benefit packages, the turnaround, and profit/loss reports of the companies in question.

The Interconnection between Mental Health, Work and Belonging: A Phenomenological Investigation. 

     The article The Interconnection between Mental Health, Work and Belonging: A Phenomenological Investigation discusses research on the topic of belonging and mental health, with particular emphasis on workplace settings. According to the authors, employment “…helps to secure personal finances, gives structure to everyday life, creates belonging and increases self-esteem…” (Tangvald-Pedersen & Bongaardt, 2017). However, the author admits that the research into how a person with pre-existing mental health issues and their needs of belonging manifest in workplace settings is lacking, and that is what they set out to investigate (Tangvald-Pedersen & Bongaardt, 2017).

     The authors state that belonging in society creates a pathway to healing for individuals who may suffer from mental illness; however, their question was does a sense of belonging in a workplace have similar, positive results? The research was conducted from a pool of individuals who were, or had received, mental health support and services on a professional level. Furthermore, the participants in the research were sought by using an online Norweigein website that was designed to cater to individuals who suffered from mental illness who were seeking employment opportunities. The number of responses to the research request was thirteen individuals, with three individuals completing a detailed interview with the researchers (Tangvald-Pedersen & Bongaardt, 2017).

     By using phenomenology techniques the researchers were able to analyze the information obtained by the participants and condense it into 135 pages of text. The researchers were then able to decipher if the participants benefited from a sense of belongingness within the workplace setting. “When feeling fragile, one appeals to those trusted for care and intimacy; when feeling underrated, one insists on being appreciated on the basis of common standards of professionalism” (Tangvald-Pedersen & Bongaardt, 2017). However, the researchers learned that many of the participants had not always felt acceptance and belonging, but had been treated badly in previous work settings with statements such as, “I skipped lunch. I withdrew from the others because of all the negative talking; I couldn’t fix it. I wasn’t strong enough” (Tangvald-Pedersen & Bongaardt, 2017). On the other hand, some participants noted that they had held positions where they had been made to feel accepted and needed, which in turn boosted their self-esteem and sense of overall well-being, “I’ve never before been so relieved, never felt so at ease, and most of all, never been so sure that I belonged” (Tangvald-Pedersen & Bongaardt, 2017). In each case of being made to feel accepted the participant had reported an increased desire to express pride in the tasks they had been assigned, hence increasing overall productivity (Tangvald-Pedersen & Bongaardt, 2017).  As a result of their research, the authors conclude that the leadership in workplaces need to be trained to handle situations with sensitivity, which results in a better sense of belonging for the employees when situations arise that may need to be corrected (Tangvald-Pedersen & Bongaardt, 2017). However, the research conducted and reported in this article could be considered incomplete due to the small pool of research participants. In the future, further studies should be conducted that would include a much larger population.

Employer attitudes toward hiring applicants with mental illness and criminal justice involvement. 

     The authors of the article Bias in hiring applicants with mental illness and criminal justice involvement: A follow-up study with employers discuss the research on the subject of bias by employers in relation to individuals who suffer from mental illness and criminal activities. With specific emphasis on,

“…examine[ing] the effects of psychoeducation and personal experience on the probability that a job applicant with mental illness and/or prior CJ involvement will be considered for hire, and (2) evaluate the possible cumulative disadvantages associated with the labels “offender” and “mentally ill” among a sample of raters with experience in human resources” (Batastini, Bolaños, Morgan, & Mitchell, 2017).

     Research participants were selected from the Society for Human Resource Management (SHRM) membership and consisted of a pool of 70 individuals (84.5% female, 15.5% male) (Batastini, Bolaños, Morgan, & Mitchell, 2017). The research was conducted online in a survey via Qualtrics and included four case stories in which the participants were instructed to read one. The first case selection was “..describing a hypothetical job applicant who is an individual with a mental illness…” (Batastini, Bolaños, Morgan, & Mitchell, 2017), the second case was in relation to “..an individual with prior CJ involvement” (Batastini, Bolaños, Morgan, & Mitchell, 2017), the third case involved “…an individual with a mental illness and prior CJ involvement…” (Batastini, Bolaños, Morgan, & Mitchell, 2017), and the final case selection consisted of “…an individual who has neither a mental illness nor a history of CJ involvement…” (Batastini, Bolaños, Morgan, & Mitchell, 2017).

     Analysis of the results shows that while there was little or no differences in the participants who selected the cases with criminal justice, the same could not be stated for the cases of mental illness (Batastini, Bolaños, Morgan, & Mitchell, 2017). Familiarity with criminal justice cases was normal, however, “…participants who read about an applicant with MI [mental illness] did differ with respect to how familiar they were with this population…” (Batastini, Bolaños, Morgan, & Mitchell, 2017). Furthermore, results of the research project showed that individuals with mental illness and criminal justice backgrounds were less desirable as a hiring pool, with only the participants who had also received psychoeducational materials in addition to the case studies more likely to hire those individuals (Batastini, Bolaños, Morgan, & Mitchell, 2017).

     The study shows that a lack of education on the subject of mental illness and employees does have an impact on the hiring process. Therefore, one could conclude that companies train their human resource departments on various mental health issues, as to provide a familiarity with the hiring process. This study could be continued in the future with follow up surveys of human resource personnel who could be given a psychoeducational model to go by during the hiring process.

The stigma of mental illness in the labor market.

The authors of the article The stigma of mental illness in the labor market set out to prove or disprove the lasting stigma of mental illness in the workplace. According to the authors, “A body of research on the stigmatization of mental illness focuses on perceptions of those who have been stigmatized (stigma targets), finding that those with mental illness diagnoses generally believe that they face negative treatment based on their illnesses” (Hipes, Lucas, & Phelan, 2016).  Many studies, according to the authors, have used self-reported data as indications of discrimination based on mental illness issues in the workplace. However, in-field research on mental illness stigmas and bias have been hard to locate or are hard to come by. One main reason that is normally used for a lack of consideration when hiring individuals with pre-existing mental health issues comes from a lack of understanding on the issues which can lead to a false belief that the potential employee could be a danger to themselves or others (Hipes, Lucas, & Phelan, 2016).  

     The researchers proposed two hypotheses: first, “Applicants with a history of mental illness will receive fewer callbacks from employers than applicants with a history of physical injury” (Hipes, Lucas, & Phelan, 2016) and second, “…the negative effect of mental illness on an applicant’s chances of being called back will be lower if the job may be performed away from the office” (Hipes, Lucas, & Phelan, 2016). The method of research conducted consisted of applications for employment being submitted under the false pretense of the applicant having a pre-existing mental health issue. The application that was submitted was for a male whose profile had been designed to be one that was prestigious and overly qualified, with his ethnic background being kept ambiguous. Four conditions were to be met with the application process which consisted of,

“Condition 1: The candidate had a history of mental illness and was applying for a standard job posting; Condition 2: The candidate had a history of mental illness and was applying for a job that could be done mostly from home; Condition 3: The candidate had a history of physical injury and was applying for a standard job posting; Condition 4: The candidate had a history of physical injury and was applying for a job that could be done mostly from home” (Hipes, Lucas, & Phelan, 2016).

     The applications were then submitted to a 22-city market to a total of “635 jobs from June 2011 to May 2012” (Hipes, Lucas, & Phelan, 2016). Results indicated a call back rate of in excess of 20% when no mental illness had been indicated on resumes, 14.81% for the resumes that listed mental illness, and 21.86% for the resumes that listed physical injuries only (Hipes, Lucas, & Phelan, 2016). The results showed that the second hypothesis could not be verified, however, the first hypothesis showed data correlation. For example, “Candidates with a history of mental illness – compared to those with a history of physical injury – were 45.6% less likely to elicit callbacks, controlling for other variables in the model”  (Hipes, Lucas, & Phelan, 2016).

     While this study provided data that stigma and bias were evident in the initial hiring process of companies, it did not provide details for any bias that may have occurred during a face-to-face interview process (Hipes, Lucas, & Phelan, 2016). Another restriction of the research study was that it was limited to one employment sector which used the same male candidate, albeit with slight differences in the resume. Therefore, it is this student’s opinion that further studies should include a broader spectrum of employment fields and a larger pool of candidates.

Research Design

Can employers design and implement programs that address invention, prevention, and accommodations in relation to their employees’ mental well-being? Will such programs be beneficial to all involved? Studies have shown that for individuals who suffer from mental illnesses, acceptance in the workplace can lead to a boost in both productivity in work-related tasks and lead toward the healing of numerous mental illness diagnoses (Tangvald-Pedersen & Bongaardt, 2017). Furthermore, studies have also shown that the hiring process of individuals with mental illness can be biased due to a lack of knowledge or understanding of mental illness by human resource professionals (Batastini, Bolaños, Morgan, & Mitchell, 2017).  

However, most studies have been limited in scope and design, with small populations being included which has not lead to global standardized practices. For example, there seems to be a gap in relation to research that would lead to effective hiring policies that start with mental health education and training for human resource professionals. Next, a standard set of recommendations that not only set the bar for protecting employees with pre-existing mental health conditions but also to safeguard all employees from undue stressors that could lead to mental health issues need to be explored. Therefore, the research design that this student proposes is an evaluation of companies current mental health policies and procedures in comparison to employee turnover and productivity. The study can be conducted via interviews and questionnaires including current employees, potential employees, and management. Further data used would consist of financial and productivity statistic reports. Sample questions can relate to the hiring policy concerning those with mental illness, the benefits offered to employees in relation to mental illness and wellbeing, turnover in personnel, and the overall happiness of employees. The results of the study can then be used to locate areas within company policies and programs that need improvement, which will lead to new more effective policies being implemented.

Conclusion

When employers bypass hiring individuals who have known mental illnesses, they could be passing by an opportunity of adding a valuable asset (Solomon, 1986).  Furthermore, employers who do not implement safeguards within their company structure that addresses the mental health of employees they could end up facing financial loss (Kelloway, 2017). Studies have shown that mental illness is a stigma that is haunting the majority of the job market worldwide. However, with further research and development, the stigmas can be disseminated and programs which benefit all employees and their employers could be developed.

References

Batastini, A. B., Bolaños, A. D., Morgan, R. D., & Mitchell, S. M. (2017). Bias in hiring applicants with mental illness and criminal justice involvement: A follow-up study with employers. Criminal Justice And     

Behavior, 44(6), 777-795. doi:10.1177/0093854817693663

Hipes, C., Lucas, J., & Phelan, J. C. (2016). The stigma of mental illness in the labor market. Social Science Research, 56, 16-25. doi:doi.org/10.1016/j.ssresearch.2015.12.001

Kelloway, E. K. (2017). Mental health in the workplace: Towards evidence-based practice. Canadian Psychology/Psychologie Canadienne, 58(1), 1-6. doi:10.1037/cap0000084

Reavley, N. J., Jorm, A. F., & Morgan, A. J. (2017). Discrimination and positive treatment toward people with mental health problems in workplace and education settings: Findings from an Australian National

Survey. Stigma And Health, 2(4), 254-265. doi:10.1037/sah0000059

Solomon, J. R. (1986). WHY HIRE THE REHABILITATED MENTALLY ILL?. Management Review, 75(9), 69.

Tangvald-Pedersen, O., & Bongaardt, R. (2017). The Interconnection between Mental Health, Work and Belonging: A Phenomenological Investigation. Indo-Pacific Journal Of Phenomenology, 17(2), 1-11.

doi:10.1080/20797222.2017.1392759

Walsh, L. (2011). The impact of mental health problems in the workplace. British Journal Of Wellbeing, 2(7), 32.




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