Money may not be the root of all evil but it can be the root of a lot of problems, including mental health problems. But for clinicians, talking about it is taboo.
The amount of money we have and the way we manage it can greatly affect psychological wellbeing, with devastating consequences too frequently associated with financial stress. Between 2008 and 2010, more than 10,000 suicides across the U.S., Canada, and Europe were directly attributed to the global economic crisis.
Despite these numbers, therapists and physicians rarely ask their patients any questions about their financial status. It’s a taboo topic. In fact, and perhaps ironically, most clinicians will inquire about their patients’ sexual practices far more readily than about their financial practices.
The taboo about discussing finances makes this area of our patients’ lives—one too frequently fraught with worry—inaccessible to help from behavioral health and other clinicians. By not paying attention to our patients’ personal finances, we miss a key opportunity to link them to helpful services.
How money affects mental health In many ways, the world revolves around money. When facing financial insecurity, every aspect of life becomes more difficult. You can’t eat well if you’re broke; medication may be out of reach; paying the rent or mortgage can be a struggle — and not being able to meet these basic needs creates enormous stress.
And if you’re already stressed by financial issues, work performance is likely to suffer. You may have difficulty concentrating and focusing, thus placing your job (and income) at greater risk and further raising your anxiety. It can become a vicious cycle and a negative spiral. Consider recent graduates who’ve taken on a heavy burden of student loans. Many are reeling from the debt, which may affect their ability to look for work, hold down a job, or move forward with their lives in other important ways.
Income and work status also directly affect health care access. Even those who have health insurance may find copays and deductibles impossibly expensive.
Money has a huge impact on almost every aspect of health.
These problems aren’t limited to patients The fact that some therapists have money issues of their own can add to their reticence about asking their patients questions about personal finance.
During presentations, I’ll routinely ask behavioral health clinicians if they’re discussing money with their patients. They almost always answer with a resounding “no.” Then, I’ll ask about the state of their own personal finances: are they tracking their income and expenses, saving for an emergency fund, perhaps, if their incomes allow, investing in a retirement account? Generally, many will laugh nervously and say something like, “We’re social workers. We don’t make any money and neither do our clients.”
Like all human issues, paying attention to money concerns is the first step toward resolving them to the best extent possible—for both patients and therapists.
Expanding the paradigm Our health and wellness depends upon an array of factors; money is one of many. And while financial issues tend to have a particularly powerful influence on mental health, there are many other variables involved.
To help patients live their best lives, clinicians of all disciplines can questions that address the whole person. Not just, “Are you depressed?” But, “How are you sleeping? How are your relationships? What does your diet look like? How are you tending to your spirituality? What’s your financial situation?”
In addition, behavioral health providers can familiarize themselves with resources that may be available in the community or the workplace. Many large companies offer financial wellness programs, having recognized financial stress as one of the biggest issues for their employees.
Moving beyond money Financial troubles often intersect with other issues. Overspending can be a symptom of a serious mental health condition such as bipolar disorder. And many people simply live beyond their means as an attempt to cope with other problems or fill an inner emptiness.
In addition, we live in a culture that promotes consumption. Many people—even high earners—find themselves one or two paychecks away from financial disaster because they’re buying things they don’t need.
Mental health professionals can help by talking to our patients about the difference between wants and needs. We can share strategies for organizing life in a way less driven by unnecessary spending. This may be relatively new territory in the world of therapy, but it’s undeniably important.
Speak up and speak out At Prudential Health and Wellness, we acknowledge five dimensions of health: physical, emotional, social, spiritual, and financial. Financial issues—as well as these other aspects of health—need to become a normal part of clinician-patient conversations. The more we inquire about money matters as a routine part of assessment, the more we will be able to help our patients get the comprehensive assistance they deserve.
In what ways has money – or the lack thereof – affected your mental health?
How would you react if your provider asked you about your financial situation?
What pitfalls do you see to providers asking about finances? What benefits?
The silence that surrounds mental health issues is often the result of shame and fear. This is particularly true in the workplace, where many worry they will suffer professional consequences if their co-workers and supervisors learn of their behavioral health challenges.
Sometimes, however, people keep silent about behavioral health issues simply because there is no space for such conversations in their workplace. If there is no precedent for initiating these sorts of conversations and people are not invited to share information about behavioral health matters, they likely will not feel comfortable discussing them. And so they remain silent, unsure of how—or where—to raise the topic.
At Prudential, we have worked to create an environment where people can talk openly about their behavioral health issues without fear of reprisal or recrimination. By establishing and promoting policies that acknowledge mental health needs—and more specifically, policies related to discrimination, harassment, and the Americans with Disabilities Act—we laid the ground work. But fostering a workplace where employees truly feel safe mentioning their behavioral health problems and seeking appropriate assistance and accommodations requires something more.
The “something more” that we’ve added: an ongoing campaign of communications, webinars, and large-scale events that highlight the prevalence of mental health conditions, the importance of talking about mental health conditions in the same way you would physical illnesses, resources that are available, and the important role supervisors play in creating welcoming and helpful environments for all employees.
Included in this campaign is a series of “Profiles in Courage” videos highlighting employees’ personal experiences with depression, addiction, and intimate partner violence. The individuals featured on these videos have also spoken about their personal experiences at company events attended and/or video-streamed by thousands of employees. In each case, the employee told their own story, including how their supervisor and the company’s resources helped. All of these efforts build awareness and a culture of support. They create openings for people with mental health conditions to voice their needs, be responded to with respect and kindness, and get referred to resources as needed.
I am proud of the culture we’re building here, but admit it was not always this way. To get where we are today took a concerted commitment, the support of senior leadership, and the bravery of those first people who came forward to speak about their issues and need for help. Through a collective effort, we were able to shift our workplace culture to one that includes conversations about behavioral health.
This sort of environment may seem unachievable in your own workplace, but culture is dynamic. There are actions any leader, manager, or individual employee can take to move the culture in a positive direction. Here are five ways you can help shift your workplace culture and create a space for open dialogue about behavioral health.
1. Make the business case
To create a mental health-friendly workplace, you must have the support of organizational leaders. The best way to secure that support is to establish the connection between employees’ mental health and their performance and productivity. For example, depression is estimated to cause 200 million lost workdays each year. When leaders understand the connection between behavioral health and business success, they are more likely to encourage conversation about behavioral health.
That is why when we discuss behavioral health policies and programs with leaders here at Prudential, we make sure they understand we’re not talking about health as though it occurs in a vacuum. We emphasize optimal health, including mental health, as a significant contributor to top performance.
2. Work = health and health = work
In your workplace, you may encounter leaders who view health as a purely private matter; one that has nothing to do with the workplace. These leaders may feel sympathetic to their employees’ behavioral health challenges, but also believe the workplace is not where employees’ stress, isolation, depression, health issues, or financial challenges should be mentioned or addressed.
In taking what they presume to be a neutral position regarding the health of their employees, these leaders make two important errors:
They inadvertently reinforce the stigma that quiets all mention of mental health conditions, thereby reinforcing the likelihood that employees with these conditions will shy away from using resources that could help.
They miss a great opportunity for shaping culture and performance. People spend most of their waking hours at work and the work environment has an undeniably significant impact upon overall health. When leaders pay no attention to this, they lose the opportunity to promote optimal health and, with it, an opportunity to promote optimal performance.
The idea that a workplace can have a neutral impact on health, or that health is irrelevant to the workplace, is an illusion. Every workplace is either adding to the health of its employees or challenging the health of its employees. It doesn’t make sense to leave this to chance.
3. Establish behavioral health as an important piece of your overall health strategy
At Prudential, our health and wellness strategy is built upon a multi-dimensional view of health. Prudential Health and Wellness works to empower individuals to reach their greatest potential across five dimensions of health: physical, emotional, social, spiritual, and financial.
These five pillars help us to build more complete health and wellness programs and services that more adequately address the full spectrum of wellness. We emphasize this philosophy through ongoing messaging to employees at all organizational levels. The more our workforce hears that emotional health is part of the larger health pie, the more discussion of behavioral health becomes normalized and accepted.
Here, we even go one step further, articulating that mental health is more than just one aspect of the health puzzle; it is a foundation piece that supports all five dimensions of health. That’s because optimal health results from our daily habits: what we choose to eat, how active we are, our compliance with recommended health screenings, how much rest we allow ourselves, our ability to emphasize pleasurable thoughts and feelings, the time we spend with our families and loved ones, the ways that we celebrate our connection to that which is greater than ourselves, and the ways we manage our money, for example. All of these “behaviors” together determine the extent to which we achieve our overall health potential.
Mental health conditions can undermine all of the healthy habits mentioned above. Mental wellness, on the other hand, supports our ability to maintain these habits. Mental health, therefore, affects overall health in a significant way.
4. Jumpstart the conversation
As mentioned above, Prudential team members, including senior leaders, have shared their stories of depression, domestic violence, and addiction at major company events and via widely-viewed videos. They did so with the hope that others would recognize themselves in these stories and feel empowered to seek help. Their accounts were personal, powerful, and deeply appreciated.
If there is an employee at your own workplace who is already open about mental health issues or their recovery from addiction, ask if they might consider addressing co-workers about the topic. And if there is not an in-house person able to stand up and share his or her story, invite a community member to do so. Just hearing these topics discussed in the work setting may prompt people suffering with similar issues to seek help.
5. Talk, talk, talk
Perhaps the simplest, but most significant, action you can take is to talk about behavioral health conditions with your co-workers the same way you might discuss other medical concerns. For example, it would not be unusual for someone to tell a co-worker, “My mom is having a hard time with her chemotherapy and we’re all really pulling for her” or “My brother just had a heart attack and he’s on the mend.”
Yet, few people feel comfortable discussing behavioral health conditions in the work environment because of the stigma these conditions still carry. Each of us can help break that stigma by inserting more of the truth of our lives into casual conversations. It can be as simple as one co-worker saying to another: “My mom got mugged last year and her PTSD flares up now and then, making it hard for her to sleep and a bit anxious overall—we’re all pulling for her” or “My brother is such a great guy, and he’s been struggling with serious depression. Fortunately, he now seems to be on the mend.”
When we start discussing behavioral health openly and honestly, we pave the way for those who live with mental health conditions to feel as visible and welcome as those who live with diabetes, back pain, hypertension, and other health conditions.
As Mr. Rogers used to say, “If it’s mentionable it’s manageable.” Let’s make mental health conditions mentionable at work so more of us can get connected to the resources that make mental health conditions manageable.
Under what circumstances have or would you speak about mental health conditions at the workplace?
What has been your reaction from co-workers when speaking about mental health conditions at the workplace?
Bio As a member of the Prudential Financial Inc. Health and Wellness’ leadership team, Ken Dolan-Del Vecchio is responsible for behavioral health and employee assistance program (EAP) services, implementation of Prudential’s work-life resource and referral services, and coordinating Prudential’s Incident Oversight Team. He provides consultation to managers, HR professionals, and work groups on issues related to leadership skills, interpersonal behavior, addictions, and violence prevention. Ken is a member of the American Family Therapy Academy, a national association for family therapy educators, clinicians, and researchers, a member of the boards of directors of The Multicultural Family Institute in Highland Park, New Jersey, and the Corporate Alliance to End Partner Violence. He is a past member of the board of directors of the New Jersey Association of Domestic Violence Professionals. Ken is the author of two nonfiction books, a family therapy textbook, and several articles/chapters in family therapy texts and journals.
Five tips to shift workplace culture and create a space for open dialogue about mental health
Kenneth Dolan-Del Vecchio, MSWis an author, health and wellness executive, family therapist, organizational consultant, and human resources leader. As Vice President, Health and Wellness, at Prudential Financial, Ken holds responsibility for behavioral health services provided to 20,000 domestic employees, cross-functional workplace violence prevention, and collaborative development/delivery of leadership skills and health-promotion initiatives.
Number of years in management: More than 10 years
Degree/Institution: MSW, Hunter College of the City University of NY; BA Biopsychology, Cornell University
Tell us about your path to management: I worked for a number of years as a psychiatric social worker/therapist in various hospital settings and then in independent practice and family therapy institute-based practice. I joined Prudential’s Health and Wellness team because dealing with managed care as an independent practitioner was an increasingly enraging experience. After coming to Prudential, 18 years ago, I began shaping my family therapy/social work skills to fit the role of not only therapist, but also organizational/leadership consultant and people-manager. Some thoughts on how I advanced from associate manager to vice president follow. In what I hope was a diplomatic and reasonably humble fashion I continuously enlarged my contributions, creating programs and consulting with organizational leaders in order to foster healthy workplaces and healthy relationships among team members within the company’s business groups and across levels of hierarchy. I made a practice of being exceptionally prompt in my responses to requests for help and giving the most comprehensive, multi-systems focused guidance I could muster. I was assertive in seeking promotions, although I never behaved in an entitled fashion. I did my best to treat everybody at all organizational levels with the same degree of respect. I was respectful to my supervisors, always keeping in mind the realities of organizational hierarchy. On the other hand, I made a point of assertively bringing forward my own thoughts. I cultivated my skill at public speaking, seeing this as extremely important to increasing the visibility of my contributions. I also read extensively–in subjects within and beyond the borders of my field– and wrote for publication articles, book chapters, and books that synthesized the information I was gathering. In this way I’ve both contributed to my fields of practice and raised the visibility of my own voice. Also, I’ve always understood that we have two jobs: We have the job that we’re doing today, and we have the job of stewarding our career. We owe it to ourselves and others to do them both well. The job of stewarding our careers requires us to understand our own personal mission in life (I urge you to craft one if you don’t already have one–mine is to use my voice, my talents as a therapist, and my skills as a writer to bring more health, sanity, and justice to the world so that I leave it a better place for my son and his generation), stay alert to new opportunities, continuously work to expand our skills, read widely in our field and beyond, recognize that we undoubtedly a role model for others, and demonstrate belief in our own competence.
What leadership qualities do you find to be the most effective in reaching your organizational or career goals? I believe the most important leadership quality we can have is the determination to use whatever institutional power we have as power with rather than power over.Power withmeans experiencing power as responsibility. Power over means experiencing power as the right to dominate people and resources. We exercisepower with when we work to orchestrate shared success, viewing others as human beings who work with us to share in achieving that success. Power with helps others build their competence and confidence, stretch in order to reach their full potential, and function together as a team within a workplace environment that feels consistently safe, respectful, encouraging, supportive, welcoming to differences of background and thought, and helpful. Power with never loses sight of the fact that a leader embodies the group’s culture, setting the tone, expectations, and values through his or her actions. Power with provides clarity of mission, vision, and strategy; and helps team members know how their work contributes to these.
Key leadership skills include listening, courage, assertiveness, diplomacy, accepting constructive criticism with gratitude (constructive criticism is not an arrow to one’s heart but rather an effort to improve one’s work), giving constructive criticism with great regard for the dignity and value of others, seeing everyone I work with as a customer who deserves quick and extraordinarily helpful service, passionate commitment to helping others, careful assessment of the power dynamics within every interpersonal interaction and striving to empower those with less power than me and positively influence those who have more, giving others the benefit of the doubt, valuing those who think differently than I do and those who come from backgrounds different from mine, seeing every introduction as an opportunity for learning and collaboration, sharing my talents and ideas freely across disciplinary and organizational boundaries, approaching others at all organizational levels with certainty regarding my own competence and equal certainty of theirs, and, perhaps most important of all, practicing kindness even when holding others accountable for raising their performance, and even on those occasions when a team member must be terminated from employment.
There are two quotes that stick in my mind—one’s about kindness and the other, courage—and I sometimes write them on any available white board at the start of meetings. I think they offer key guidance for leaders (and I think everybody is a leader, whether by formal designation or by virtue of the fact that each of us is a role model):
“In the end only kindness matters.” –Jewel Kilcher
“Your silence will not protect you.” – Audre Lorde
Incidentally, my boss sometimes comes into the room, looks at what I’ve written, crosses out “kindness” and replaces it with “results.” Go figure.
How do you motivate your team members? I listen to them with great care and respect, thank them regularly for their work and mention how much I appreciate the way their work helps their clients/customers, say please and thank you with every request, encourage their creativity and risk taking, celebrate their contributions by sending news of their achievements up to my supervisor (Prudential’s Chief Medical Officer), give credit both privately and publicly for the work they’ve done (I hate when leaders claim credit without spotlighting the individual(s) who actually did the work), take personal responsibility for things that go wrong (without identifying up the chain of command the team member who may have made an error), admit and apologize when I’m wrong and say what I plan to do differently in order to prevent it happening again, provide encouragement to do things beyond what they’re comfortable with and then make sure to commend such efforts, do my share of the work, stay mindful of their workload and negotiate deadlines and priorities accordingly, always remember that I’m interacting with human beings with feelings, aspirations, and outside commitments; keep a good humored attitude, try to be a good role model for a balanced approach to work and life outside work and other aspects of healthy living, treat them with kindness and maintain positive expectations. Finally, I speak with team members directly and promptly when I see a performance issue that needs addressing. It never helps to avoid such crucial conversations.
Is there a leader or mentor who has inspired or assisted you along your professional journey? I’ve had several mentors and worked for great leaders, and I’ve worked for some really bad leaders too. All have provided valuable learning experiences.
How has networking impacted your career? It’s hard for me to overstate the impact that networking has had on my career. As I mentioned earlier, I see every introduction as an opportunity for collaboration–and the more introductions, the more opportunities come your way. I love people and learning about what they do and what matters most to them. Currently, I work from my home in Massachusetts every other week and from my office in Newark, NJ, on the alternate weeks. I try to schedule lunch with a colleague from another area of the business or another workplace entirely every day when I’m in Newark and I frequently have dinner with colleagues as well. I have a habit of making colleagues into friends. What are you reading and/or following now (e.g. book, blog, social media groups, etc.)? I’m always reading. I just finished Johann Hari’s Chasing the Scream: The First and Last Days of the Drug War. I’m just finishing Michael Kimmel’s Angry White Men. I’m nearly done reading David Talbots The Devil’s Chessboard: Allen Dulles, the CIA, and the Rise of America’s Secret Government. I’m also studying a number of books on permaculture, the nurturing of a regenerative, food producing, landscape. This reading informs my growing avocation of developing such a landscape where I live. I also love reading William Trevor’s short stories and novels. My favorite author is Alice Walker and her book The Temple of My Familiaris my all time favorite novel. Right up there also is Barbara Kingsolver’s The Poisonwood Bible. (Once you get me on this subject of reading it’s hard for me to stop.) I also make a habit of catchingAmy Goodman’s Democracy Now every time I can.
What advice do you have for those beginning their professional journey or who are already in leadership positions? Think big, act big, go for it! We need more well-meaning people with strong moral compasses in leadership positions. Often the people who fit this description are also very humble and choose not to step forward to claim leadership roles. Sociopaths have no such trouble, and there are far too many of them in high places.
Do you have an initiative or project you would like to tell our readers about? Right now I’m finishing my fourth book, this one for parents. It should be released sometime this year.
What do you wish you had known before you started your career? I wish I’d known what a satisfying and educational ride this would be. I’ve grown and learned so much through my experiences at work. I’ve also met so many special people, many of whom mean the world to me.
Share a mistake or failure that provided the most growth in your career. Not exactly a mistake, but I got laid off from my job as a psychiatric social worker in 1992. This was very painful for me as I identified strongly with the role and with the hospital where I was employed. Thereafter, I resolved to never hitch my identity to an employer or professional title. I love my work and my profession but I’ve been true to that commitment. I’ve achieved more than I ever thought possible since being laid off, and I don’t believe much of it would have happened if I hadn’t suffered that loss.
Care for Your Mind kicks off a new series on workplace issues. Given that depression is the number one cause of disability in the United States, more needs to be done to accommodate employees’ mental health in the workplace. In the first post, Ken Dolan-Del Vecchio explains the value of work and the role employers can play in supporting good mental health.
Ken Dolan-Del Vecchio, LMFT, LCSW, DVS, CEAP, SPHR Vice President, Health and Wellness, Prudential Financial, Inc.
Because most of us spend the majority of our waking hours at work, what happens there greatly affects many dimensions of our lives, including our mental health. For some, work can be a source of stress. But for many, work also provides stability, structure, and a sense of purpose. In addition, work creates important social connections and friendships. Most people become emotionally invested in their workplace and feel a sense of community with their co-workers. In fact, research shows that unemployment negatively affects mental health. Presumably, this results not only from economic stress, but also from the assault to self-esteem and social relationships that disconnection from the workplace brings.
Many years ago, an esteemed colleague declared during a lecture that when we face unplanned disability—whether it’s due to a mental health condition, physical ailment, or to provide care for someone else—the life disruption can be so momentous that it amounts to a psychiatric emergency. Such is the significance of our work.
Yet work—with all its implications for mental health—is often not fully considered nor adequately addressed by many health care professionals, including mental health clinicians and, as a result, few spend much time addressing their clients’ relationships with the world of work.
We all—mental health professionals, employers, and employees living with mental illness—can benefit from adjusting our view of work to recognize the major, often positive, influence it can have on mental health. In fact, preserving the ability to work (sometimes through workplace accommodations or a flexible schedule) can enhance treatment plans and promote recovery by allowing individuals to maintain their employment status, workplace productivity and income, daily structure, and an important aspect of their identity.
How we ignore work Typically, mental health clinicians focus a great deal on their client’s social network, family, and relationship history. Whenever a therapist assesses a new client, it makes sense to also include questions and prompts such as
Tell me about your work.
How long have you been at it?
How long have you been with your present employer? (Or, if self-employed, it’s important to learn about the client’s business, exploring how it’s doing financially, who else is involved, how important work relationships are faring, what number of hours the client puts in, how their schedule affects others with whom they live, etc.)
How are things between you and your supervisor? How about between you and your co-workers?
Tell me about your work environment: What’s good about it? How is your work helping you to do as well as you’re doing right now? Have you noticed any changes in your work performance and productivity? What kinds of changes might make things at work better for you?”
Unfortunately, these questions are not always asked, so important discussions don’t happen. Without such exploration, the therapist gains little understanding of how work may contribute to the current challenges facing their client and how it may also play a role in their healing.
How work can be integrated into treatment Even in cases where the workplace is a primary source of anxiety, there still may be benefits that argue for a continuation of work at some level. A complete separation from the work environment may not be the best solution. We know that the longer people stay away from the workplace, the more they feel disconnected from it. The value of a daily routine and the emotional satisfaction derived from working should be considered in every treatment plan.
At Prudential, we have a Return to Work/Accommodations program for employees experiencing health challenges and we encourage those who are on disability to talk with their treating clinicians about the relevance of workplace accommodations. A workplace accommodation changes some aspects of the way an employee performs his or her job in order to help them continue to perform the essential functions. The accommodation allows them to continue their treatment and recovery without losing their identity as an employed person.
For example, if work can be performed remotely, we ask the manager of that employee if their business can function with the person working remotely for a period of time. If an employee suffers from an anxiety disorder and has been overstimulated by their current work setting, we might move their cubicle, desk, or office to a quieter location. Sometimes people struggling with a mood disorder find that they are better able to work at particular times of day. A flexible schedule, shifting work hours toward a later start time, for example, may prove helpful.
Our Return to Work/ Accommodations program acts as a confidential bridge between the employee working with her or his mental health service provider and the employee’s supervisor. The accommodations team takes information from the former and shares only functional requests with the employee’s supervisor. After all, a supervisor has no need to know their employee’s diagnosis. They only need to know the specific ways in which the employee’s work situation can be changed to help that employee return to or remain at work.
What employees can do Admittedly, not everyone works for Prudential, and accommodations of this kind may seem unattainable in your own work setting. However, many organizations do offer flexible work arrangements and there is no reason an employee can’t seek one when faced with a medical and/or mental health crisis. For example, an employee who has cancer may work with their supervisor to flex their work schedule around chemotherapy appointments. A similar flexible-work arrangement can be sought by someone managing a mental health condition.
While these may seem like difficult conversations to have and you might think your own work culture just isn’t this progressive, I counter that every culture is dynamic rather than static. We each have some ability to influence our organizational culture. So if you think your workplace isn’t where it ought to be in regard to mental health, perhaps you can seize the opportunity to influence your culture. Seek out an ally or HR contact who can work with you on the challenges you’re currently having completing your job. Then, working with your provider, you can strategize accommodations that would allow you to continue performing the essential functions of your job.
Remember, employers want employees to be healthy and productive, so anything that will help an employee be successful at his or her job is in everyone’s best interest.
What kinds of workplace accommodations have been helpful for you or someone you know dealing with a mental health condition?
In what ways do your mental health clinicians foster conversation about work and it’s role in your mental health?
What things can companies do to help employees living with a mood disorder be successful at their job?
Ken Dolan-Del Vecchio, LMFT, LCSW, DVS, CEAP, SPHR Vice President, Health and Wellness, Prudential Financial, Inc.
I read Carolyn Beauchamp’s recent post CFYM with interest, but not surprise. Ms. Beacuchamp discusses the inadequacies of insurers’ behavioral health networks and highlights the challenges that insured patients encounter when seeking mental health care. Often network information is outdated or incorrect, and it can be extremely time-consuming and frustrating to obtain an appointment. For someone in a worsening mental health state, such obstacles are frustrating at best, catastrophic at worst.
While Carolyn’s piece sheds light on this important issue, it is—unfortunately—not news to those of us who work in the behavioral health field. As a practitioner, I experienced the frustrations of patients struggling to find an in-network provider or schedule an appointment within a reasonable time frame. Now, in my current role as Vice President, Health and Wellness, at Prudential Financial, I work to combat these challenges and reduce obstacles to care.
Creating a culture of health at Prudential At Prudential, we know the health of a workforce is intrinsically linked to the health of the organization. In fact, an increasing body of research demonstrates that organizations that promote health achieve the best business results. Simply offering behavioral health benefits, however, is not the same as promotingmental health. Too many obstacles stand between an employee and covered mental health services, but Prudential is taking steps to remove barriers.
Boost provider networks To ensure our employees can access care, we became an early adopter of mental health parity. Further, we put a great deal of effort into verifying and fortifying our behavioral health network, boosting the number of in-network providers near our largest employee sites.
Our internal behavioral health team identifies highly effective providers who practice near our largest sites and confirms they are in-network for the employee plans in that area. If the providers are out of network, our team facilitates quick inclusion. Creating these “sub-panels” helps to counter the often inadequate number of in-network providers and protects against shortage challenges.
Offer employees an “on-ramp” to care People seeking mental health services are often overwhelmed by the pathway to obtaining care. For example, if you go online and search for therapists in your area, you will likely get a substantial list of therapists, some of whom are in network. But you likely won’t learn anything about them, and it could take numerous calls before you find someone who is both in network and accepting new patients.
To simplify this process, we offer employees an “on-ramp” to care via our Care Counselor program, available in plans chosen by the majority of our employees. The Care Counselors who are registered nurses and behavioral health specialists, are trained to assist employees in navigating the healthcare system and understanding treatment options. In the case of mental health issues, the Care Counselor team can make referrals and aid in scheduling appointments with conveniently located in-network psychiatrists, psychologists, counselors, and substance abuse treatment centers.
Bring behavioral health care to the workplace With a work force of nearly 20,000 and eight on-site health clinics, Prudential is in the unique position to offer a variety of workplace health services. A team of eight behavioral health specialists provides counseling to employees at the Prudential sites with the largest numbers of employees. The behavioral health specialists offer assessments, short-term counseling, and referrals. We consider this to be the earliest stage of care, and it ideally occurs even before the employee has received a diagnostic classification. We want to help people when issues are just beginning to arise, and we do that by making the services as convenient and easy-to-access as possible.
Provide interim care Our Employee Assistance Program (EAP), available to all employees and family members, provides another avenue for identifying and resolving behavioral health issues before they become serious problems for individuals and employers. An employee can call our EAP 24 hours a day and speak with a licensed behavioral health specialist who is skilled in assessment, early intervention techniques, and treatment. This specialist assesses all the important dimensions of health, specifically screening for work-related issues, intimate partner violence, addictions, and financial concerns. In most cases the specialist refers the employee or family member to a local EAP counselor for in-person assistance. People can receive up to four counseling sessions at no charge. In some cases, people only need interim support to get them through a short-term challenge; but if it’s determined that long-term counseling is appropriate, the counselor will make a referral to a therapist whose services are reimbursable by the health plan.
Create a culture of health We understand that people are busy and most are not likely to think about behavioral health services and programs until a need arises. That’s why we promote our behavioral health programs all year long through a variety of communication channels, including our health, life, and wellness intranet site; webinars; daily online employee newsletter; weekly video magazine; town halls and employee meetings; and on-site posters and flyers. Though we utilize a multi-channel strategy, our messaging is consistent: if you have any personal or family need, get in touch with our health and wellness team and we’ll help to connect you to the services you need.
What lends punch to our behavioral health messaging is that it is reinforced from the highest levels of leadership. Our leadership and management training emphasizes the importance of being attuned to a person’s whole health, supporting our corporate belief that the company is at its best when our employees are at their best health.
By inviting people to seek support when they’re facing personal, emotional, or behavioral challenges, we create a culture where people feel welcome and valued. And that lends itself to a more inspired workplace. A place where people feel free to share ideas and innovations.
Lessons learned Prudential is a leader when it comes to behavioral health programs and benefits, and I am fortunate to work in such an environment; but not everyone works at Prudential. If you have employer-sponsored insurance, you may not have access to such extensive programs and services, but you probably have access to some relevant resources. If there is a lesson from the Prudential experience, it is that employees should not be hesitant to ask what behavioral health assistance is available through employer-sponsored insurance or the employer itself. There might be more than you realize, and your employer may be able to point you to resources and care that will help you and your family.
What does your employer offer to its employees in the way of behavioral health services benefits? What changes do you think would be appropriate to better serve your company’s employees and their families?
What experiences – positive or negative – have you had with mental health services through your employer?
How can we ensure that more employers are offering workforce behavioral health services benefits?
Bio As a member of the Prudential Financial Inc. Health and Wellness’ leadership team, Ken is responsible for behavioral health and employee assistance program (EAP) services, implementation of Prudential’s work-life resource and referral services, and coordinating Prudential’s Incident Oversight Team. He provides consultation to managers, HR professionals, and work groups on issues related to leadership skills, interpersonal behavior, addictions, and violence prevention. Ken is a member of the American Family Therapy Academy, a national association for family therapy educators, clinicians, and researchers, a member of the boards of directors of The Multicultural Family Institute in Highland Park, New Jersey, and the Corporate Alliance to End Partner Violence. He is a past member of the board of directors of the New Jersey Association of Domestic Violence Professionals. Ken is the author of two nonfiction books, a family therapy textbook, and several articles/chapters in family therapy texts and journals.