Why you should think twice before investing in wellness programs or wellness employees

The value of the workplace wellness industry today is an astonishing $53 billion globally, and is expected to grow to $96 billion by 2030. Company leaders are being urged to invest in a vast array of wellness programs and practices ranging from home yoga to nap rooms to supporting better preventive health practices.

Some of these efforts have important goals and may be worth a significant investment if they can deliver on their promises. Most obviously, reducing employee smoking, weight, drinking, blood pressure, and blood sugar by all available means, if successful, will result in significant reductions in absenteeism and health care costs for the company. “If it succeeds” is the key here. Behavioral change is extremely difficult to achieve.

Things get a little murkier when it comes to programs designed to promote mental health and reduce or prevent stress and burnout. Some serious questions surface and need to be answered.

What is mental health anyway? Can workplace programs improve it? And what exactly is burnout? Can a Chief Wellness Officer prevent it? Could programs touted as promoting mental health and preventing burnout actually do more harm than good?

What is mental health?

The simplest and perhaps the best definition of mental health is attributed to Sigmund Freud – mental health is “the ability to love and work.” The ability to love and work implies the absence of severe mental suffering. The capacity to love includes the capacity for meaningful human connections and commitments, a set of values, and the maturity to respect them. The ability to work means that a person can map out a job or career path that they find satisfying or meaningful, concentrate while working, and mobilize the cognitive, physical, and emotional resources needed to perform them. But no one lives, loves or works in a vacuum. The ability to work does not depend only on the individual. There must be an environment that allows them to work, providing them with the necessary structure and support.

For example, a trained trauma nurse can make a vital contribution to a disaster – an earthquake, fire or crime scene. But they can only maintain this level of work for a few hours, maybe a day or two at most. Inevitably, fatigue cannot be avoided, defenses against the impact of trauma break down, and the sustaining adrenaline rush collapses. The trauma nurse is usually supported by the structures of the hospital and emergency department in which they work, where there are support staff, team members, supervisors, equipment, shift restrictions, and so on—the practices, people, and policies that enable the nurse to works effectively for extended periods of time.

Mental health is also the absence of severe and debilitating mental illness. Businesses should help their employees avoid or treat serious mental illness by providing them with the necessary intervention services, adequate and flexible leave policies, and premium health insurance. Enormous problems remain with fulfilling the promise of parity in mental health care, but these problems are beyond the scope of this article. And they are generally not the goal of wellness programs.

What is Burnout?

Burnout is not a psychiatric diagnosis, although in 2019 the World Health Organization gave it the status of a “syndrome”. This is not a medical term, but arises from the observations of social and organizational psychologists. Dr. Kristina Maslach, a social psychologist and major researcher in the field, defines burnout as a state of “overwhelming exhaustion, feelings of cynicism and detachment from work, as well as feelings of ineffectiveness and lack of accomplishment.”

According to researchers, burnout results from a three-part sequence: (1) workplace stress due to demands exceeding individual resources, leading to (2) exhaustion and anxiety, leading to (3) attitudinal changes such as cynicism to cope.

How can a wellness program help prevent burnout?

To have a positive effect, an intervention program will need to radically change at least one of the three parts in the above sequence. Most wellness programs that claim to increase worker satisfaction or reduce burnout focus on the second step—the individual response to exhaustion and anxiety. Provide employees with meditation tools or places to play or even flex time. Create peer support groups and affinity groups.

This may be structurally and ethically wrong. The first state of burnout, when the workplace makes demands that exceed the individual’s resources, needs attention first. There are still too many cases of fabricated emergencies, young lawyers expected to work 16-hour days to prove their commitment, teachers bringing their own crayons and toilet paper to work, and health workers who are loaded beyond their ability to function.

Employers should do their best to research the demands they place on workers. Look at meetings, deadlines, urgent expectations that aren’t really urgent. Eliminate what can be eliminated and add flexibility when possible. Continue to examine the balance between job demands and human capacity and adjust accordingly.

Beyond the balance between demands and personal resources, key elements that create mental health in the workplace are

1. Feeling heard.

2. Meaningful say in operations when appropriate (giving the employee a sense of agency).

3. A sense of meaning and purpose.

4. A work life that is compatible with a rich personal life. In practice, this means you get home in time to spend time with your little ones before they go to bed.

Creating a chief health officer in a hospital or law firm is a pointless investment unless they have the power to tell leaders that young workers should be able to go home to their families at a reasonable hour – and to enforce that message.

Anything an employer can do to enhance employees’ sense of meaning, purpose, and agency will shift the balance of demand and resources in a positive direction.

In a hospital setting, ask transporters for their opinion on improving patient transport. At a law firm, ask junior associates for their thoughts on how to make their workloads and schedules manageable. Too often it is the manager who is questioned about the procedures, if any, rather than the people who actually deal with the day-to-day operations. And, of course, follow suggestions and guidance from frontline workers whenever possible. And explain why you can’t when that’s the case.

A must-read by organizational psychologist Peter Leys and community psychoanalyst Marie Rudden, From the ground up: How frontline staff can save America’s health caremakes a fascinating and compelling case that the only effective path to improving organizational operations involves listening to front-line staff and letting them take the lead in charting a more effective and efficient course.

While Lazes and Rudden’s research is on organizational change rather than individual employee satisfaction, retention, or burnout, their focus goes right to the heart of medicine. No amount of feel-good amenities or well-intentioned wellness staff will reduce employee burnout and increase efficiency and retention when the systems they work in are stupid, archaic, inefficient, brutal, or inhumane.

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