Introduction
The COVID-19 pandemic—and the trauma, stress, anxiety and isolation it has caused—has forced employers to recognize and respond to workplace mental health.
For small business owners already dealing with the challenges of keeping a business afloat amid rising prices, a difficult labor market and an ongoing pandemic, this responsibility to their employees adds to their own stress.
It’s hardly surprising that 42% of small business owners say that they have recently felt burned out—a number that rose to 62% for small business owners from communities of color. Another 45% said running a business during the pandemic has impacted their mental well-being. And 32% say their work has disrupted their sleep.
All of this should give small business owners insight into the trauma and stress their employees are bringing to work from the pandemic, world events and whatever personal struggles they may be experiencing.
The good news is, great gains don’t have to come at great cost. In fact, according to a 2021 Mind Share Partners survey, the mental health resource employees wanted most was a “more open” mental health culture at work. In a separate survey by the American Psychological Association, “regularly recognizing employees” was just as important to workers as additional mental health resources. And, as this guide will show you, there are free and affordable options for connecting your employees to the care they need.
As a small business owner, the trust and close relationships you have with your team allow you to make a direct impact on their work environment. You’re in a strong position to shape your workplace culture and reinforce positive mental health habits—or recognize troubling changes in behavior and respond accordingly.
This guide is designed to help you get started by:
1. Communicating to reduce the stigma around mental health.
2. Building connection within your team and offering support.
3. Prioritizing equity.
4. Exploring options for affordable coverage and care.
Need help developing your workplace mental health strategy? Our team of experts offers free coaching and training to help employers develop or evaluate their program. Contact us at hello@healthaction.org to schedule a free consultation.
I: Communicate to Reduce the Stigma Around Mental Health
Mental health conditions are common and treatable. Yet, eight in 10 workers say shame and stigma prevent them from seeking the treatment and care they need. That’s because negative stereotypes about mental illness persist both in and out of the workplace.
Many employees keep their conditions secret. They may be afraid that being open about them will hurt their reputation, compromise work relationships or even jeopardize their job. Stigma can prevent employees from seeking help and getting better.
Employers can reduce stigma by creating a supportive workplace culture. That includes normalizing discussions about mental health struggles, leading caring conversations and letting employees know they’ll be recognized, not penalized, for taking care of themselves.
Options for Small Businesses
- Share your own story in order to make it okay for others to do the same. There’s no way people on the front line will feel vulnerable if you act like you’re invincible. Our Leadership Storytelling Guide will help you share your own experience in a way that’s empowering and inclusive.
- Normalize mental health in everyday conversations. Check in with your team about their mental health and well-being during team meetings or one-on-ones.
- Create space for group discussions about mental health and support options.
- Have an open-door policy. Let your team know they can come to you when they need support. It will help them feel supported and let you know if there is a way you can assist them directly or direct them to professional care.
- Understand, practice and encourage self-care. Self-care is a valuable, protective factor that you should be prepared to encourage for others and demonstrate yourself.
- Treat time off for mental health reasons the same way you do for other sick leave. Make it a policy and make sure your teams know about it.
- Practice supportive conversations. Our Conversation Guide for Managers offers tips to prepare, conversation starters, language do’s and don’ts and ways to keep the dialogue going.
- Get to know the mental health needs of your team. Set up one-on-one meetings or anonymous surveys to ask about sources of stress in the workplace and challenges accessing treatment. You can adapt this tool, developed by One Mind at Work and Quantum Workplace, for questions to ask.
- Designate a wellness space in your workplace. Regular breaks help people build resilience and perform at their best. A calm room where employees can go, lock the door if possible (and hang a sign saying the room is use) can help them recharge.
II: Build Connection and Offer Support
You don’t have to maintain a supportive workplace culture all on your own. In fact, employees supporting each other is a great indicator of a healthy workplace culture. Team members who engage in open dialogue about mental health will reduce stigma and foster a more resilient culture.
Both you and members of your team should be equipped to offer support in conversation and also recognize when a co-worker needs professional care.
Options for Small Businesses
- Encourage team members to check in with each other. In the same way that you check in regularly on your workers’ mental health, encourage team members to do the same.
- Involve your team in building a supportive culture. Get their ideas for how to make check-ins a recurring feature of your workplace, identifying causes of workplace stress and solutions to address them, how to build team dynamics and what changes they’d like to see. Where possible, make those suggestions a reality.
- Encourage team-building to foster connection. Team lunches, coffee meet-ups (in person or virtual) and group self-care activities create ways for people to connect personally, open up to each other about their challenges and feel a stronger attachment to their job.
- Look out for warning signs. You and your teams should learn to recognize early signs of burnout, as well as more urgent signs of emotional distress like a troubling change in appearance, behavior and mood. These might show up at work as a drop in performance, being chronically late, social withdrawal, irritability, or difficulty concentrating. A concerned conversation could be the first step to getting that person the help they need.
- Offer mental health first aid. Much like CPR for physical emergencies, low-cost training is available to instruct you or your team to recognize a mental health crisis and assist until professional help can be accessed.
- Cultivate mental health allies. See if there is someone on your team willing to be an ally to their co-workers if they don’t feel comfortable sharing their needs with you.
- Share workplace resources. If you offer mental health benefits and employee assistance program (EAP) resources, promote them to your employees and make sure they know how to access care.
- Share outside resources. Post and share information such as national hotlines for 24/7 support, including the National Suicide Prevention Lifeline, which offers 24-hour, toll-free, confidential support for people in distress.
Call 1-800-273-TALK (8255) or text TALK to 741741
Spanish: 1-888-628-9454
TTY: 1-800-799-4889
suicidepreventionlifeline.org
Beginning July 16, 2022, everyone in the United States can access the National Suicide Prevention Lifeline by calling or texting 988.
III: Prioritize Equity
Workers representing certain communities may have unique mental health challenges. These may be the product of cultural stigmas, discrimination, harmful experiences when accessing medical care or larger, systemic inequities in the conditions that shape our mental health. No matter what size your workforce, your mental health strategy should prioritize equity.
Options for Small Businesses
- Provide equitable pay. Low wages are the top cause of work-related stress. And people of color, women, LGBTQ+ people and people with disabilities are significantly more likely to work in low-wage positions. Identify any disparities in opportunity, experience and pay, then act to close these gaps.
- Familiarize yourself with communities’ unique challenges. You can learn a lot, quickly, from fact sheets by the American Psychiatric Association, then tailor your approach accordingly.
- Lead with kindness, curiosity and understanding for conditions you may have no experience with personally.
- Use inclusive language. Four in five managers say they worry about using the wrong words when addressing issues like mental health. Over 90% of workplace leaders want access to tools on inclusive language that will draw people together by making them feel safe, respected and welcomed.
- Prevent and correct discrimination in the workplace. Discrimination at work is a major source of stress. Educate your team to recognize, prevent and correct microaggressions and bias.
- Invite trusted messengers who can speak personally to the unique concerns and culturally specific experiences of your staff.
- Embrace authenticity. When employees do not feel accepted for their identities in the workplace, they may feel pressured to “code-switch”—or consciously monitor and adjust their style of speech, appearance or behavior, which, day after day, can take a toll on mental health. Inviting people to share whether this is part of their daily work lives and changes you can make to support them.
IV: Explore Options for Affordable Coverage and Care
While there is much you can do to encourage a psychologically safe workplace, your team’s mental health is influenced by many factors outside of your control—or even theirs. These factors include genetics, brain chemistry, personal history, as well as our relationships, circumstances and the places where we live.
You are not a therapist, and you are not responsible for diagnosing individual conditions or providing psychological care. What you are responsible for is creating a psychologically safe work environment, reducing workplace stressors, fostering supportive relationships and helping employees access treatment.
The good news is that mental health treatment works. Eighty percent of employees who pursue treatment report an improvement in symptoms, workplace satisfaction and productivity. Unfortunately, many employees are unable to access the care they need without some form of mental health coverage or benefits. Whether your small business currently offers health coverage, there are affordable options to connect your teams to care.
Options for Small Businesses
- Offer health insurance. Along with group insurance and self-insurance plans, for small businesses with fewer than 50 employees, the Small Business Health Options Program (SHOP) can help you offer health insurance to your employees—affordably, flexibly, and conveniently. Enrolling in SHOP insurance also allows employers to take advantage of the Small Business Health Care Tax Credit.
- Review the insurance you do offer. If your business does offer insurance, work with your insurance broker to assess the quality of your mental health coverage. Working with a professional employer organization (PEO) to administer your human resources functions may allow you to access better benefits, as the PEO can negotiate rates in the same way as large providers.
- Offer a health reimbursement arrangement. Small businesses with fewer than 50 employees and no health plan or SHOP insurance can assist employees with maintaining their own coverage by offering a tax-free reimbursement of qualifying healthcare expenses.
- Help your workers access mental health services through other plans. The Affordable Care Act requires that plans offered through the health insurance exchanges cover services for mental health and substance-use disorders. If your small business doesn’t offer a health plan, help your workers sign up for coverage through the exchange. Most state Medicaid programs also cover mental health services.
- Direct employees to community-, state-funded or federally funded mental health centers with free or low-cost services. FindTreatment.gov offers a confidential and anonymous source of information for persons seeking treatment facilities in the United States for substance use, addiction and/or mental health problems.
- Search for online or local support groups. Someone in recovery or a trained therapist often leads these groups. You may find an in-person group at a church or community center in your area. Mental Health America and The National Alliance on Mental Illness have published lists of online support groups.
- Make use of free mindfulness apps you can share with employees. Note that many apps have never been studied or evaluated in clinical trials, and the Food & Drug Administration doesn’t regulate these services. But One Mind and the American Psychiatric Association offer app guides and professional reviews.
- Display posters and other materials about crisis hotline numbers, such as the National Suicide Prevention Lifeline, which offers 24-hour, toll-free, confidential support for people in distress.
Call 1-800-273-TALK (8255) or text TALK to 741741
Spanish: 1-888-628-9454
TTY: 1-800-799-4889
suicidepreventionlifeline.org
Beginning July 16, 2022, everyone in the United States can access the National Suicide Prevention Lifeline by calling or texting 988.
Understanding Accommodations for Mental Health Conditions
Under the Americans with Disabilities Act (ADA) and other nondiscrimination laws, employers with 15 or more employees must provide reasonable accommodations to qualified employees with disabilities, including mental health conditions. Some states may have additional laws that apply to even smaller businesses.
Reasonable accommodations are adjustments to a work setting that make it possible for qualified employees with disabilities to perform the essential functions of their jobs. The majority of accommodations can be made for minimal, if any, cost and a small investment of time and planning. Moreover, effective accommodations can be good for business because they help employees return to work more quickly after disability or medical leave, eliminate costs due to lost productivity, and help recruit and retain qualified employees.
Not all employees with mental health conditions need accommodations to perform their jobs. For those who do, it is important to remember that the process of developing and implementing accommodations is individualized and should begin with input from the employee. Accommodations vary, just as people's strengths, work environments and job duties vary.
Our Sample Accommodations for Mental Health Conditions offers examples from the U.S. Department of Labor and the Society for Human Resource Managers (SHRM) that have helped employees with mental health conditions to more effectively perform their jobs.
Additional Tools and Resources
Our Employer Resources
The Health Action Alliance—in collaboration with Ad Council, One Mind and Mental Health Action Day—has created a digital resource hub with free tools to help you lead conversations about mental health and build a culture of psychological safety.
We also offer free training, events and coaching to help you build your workplace mental health strategy. SIGN UP to receive our latest resources and event invitations, or reach out directly to schedule a consultation at hello@healthaction.org
Supporting Employees in Crisis
The National Suicide Prevention Lifeline offers 24-hour, toll-free, confidential support for people in distress.
Call 1-800-273-TALK (8255) or text TALK to 741741
Spanish: 1-888-628-9454
TTY: 1-800-799-4889
suicidepreventionlifeline.org
Beginning July 16, 2022, everyone in the United States can access the National Suicide Prevention Lifeline by calling or texting 988.
The SAMHSA National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Call 1-800-662-HELP (4357)
TTY: 1-800-487-4889
Online Treatment Locator
Crisis Hotlines for Specific Communities
National Domestic Violence Hotline: Call 1-800-799-SAFE (7233) or text START to 88788
National Sexual Assault Hotline – Call 1-800-656-HOPE (4673)
The Steve Fund (Supporting Young People of Color): Text STEVE to 741714
The Trevor Project (LGBTQ+ Crisis Hotline): Call 1-866-488-7386 or text START to 678678
Veteran Crisis Line: 1-800-273-TALK | Press 1
Additional Workplace Mental Health Resources
Additional resources and special topics in workplace mental health—including resources on the Americans with Disabilities Act, climate change and mental health, disordered eating, domestic violence, harassment and discrimination, substance abuse, suicide and workplace violence—can be accessed here.
DISCLAIMER: Public health guidance on workplace mental health is evolving. Health Action Alliance is committed to regularly updating our materials once we've engaged public health, business and communications experts about the implications of new guidance from the mental health community and effective business strategies that align with public health goals.
This Guide provides an overview of workplace mental health issues, and is not intended to be, and should not be construed as, legal, business, medical, scientific or any other advice for any particular situation.The content included herein is provided for informational purposes only and may not reflect the most current developments as the subject matter is extremely fluid.
This Guide contains links to third-party websites. Such links are only for the convenience of the reader, user or browser; the Health Action Alliance does not recommend or endorse the contents of the third-party sites.
Readers of this Guide should contact their attorney to obtain advice with respect to any particular legal matter. No reader, user, or browser of this material should act or refrain from acting on the basis of information in this Guide without first seeking legal advice from counsel in the relevant jurisdiction. Only your individual attorney can provide assurances that the information contained herein – and your interpretation of it – is applicable or appropriate to your particular situation.
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