With around one in four workers reporting symptoms of burnout, employee mental health and well-being is rapidly rising up organizations’ agendas. In this episode, we explore how to build a mentally resilient workforce, and what leaders can do to support their employees’ mental well-being. McKinsey’s Alistair Carmichael chats to Sam Harvey, the professor of psychiatry from University of New South Wales and executive director of the Black Dog Institute (the only medical research institute focused on mental health in Australia) and Phil Davis, managing director of Amazon Web Services (AWS) in Asia-Pacific and Japan, who has over 30 years of experience in the industry.
Gautam Kumra: I am Gautam Kumra, chairman of McKinsey Asia, and you're listening to the Future of Asia Podcast series. The Asian century has begun, the region is now the world's largest economy. As economies evolve further, the region has the potential to fuel and shape the next normal. In each episode, we are going to feature conversations with leaders from across the region, to discuss what Asia's rise means for businesses across the globe. Join us.
Alistair Carmichael: Welcome to the Future of Asia Podcast, where today we're going to be discussing how you can build a mentally resilient workforce. I'm joined by two folks today: Sam Harvey, the professor of psychiatry at the University of New South Wales and executive director of the Black Dog Institute, a research focus institution focused on mental health. I'm also joined by Phil Davis who is the managing director of Amazon Web Services (AWS) in Asia-Pacific and Japan, and joins us with over 30 years of experience in the industry. Welcome, Phil and Sam.
Phil Davis: Thank you, Alistair.
Samuel Harvey: Thanks for having me, Alistair.
Alistair Carmichael: The discussion today is an important one about employee mental health and resilience—a critical topic that has risen up the agendas of business leaders around the world. Our recent global research shows that about one in four employees report signs of burnout. That is also happening here in Asia. Sam, what do we mean when we talk about workplace mental health and well-being?
Samuel Harvey: I think that how we define it has changed over time. The first part of the definition is to answer, “What do we mean by mental health?” Clearly, part of mental health is the absence of mental disorder. It means that someone is not suffering from depression or anxiety. But increasingly, we've realized that the definition goes beyond that. It's also about feeling content and satisfied in your life, feeling that there is meaning in daily activities. So really, it's a combination of those broader concepts of well-being and the absence of disorder.
In terms of your question about how this links in with the workplace, we know there's a variety of things that can influence our mental health—what's going on in our personal life, our genetics, biology; all of these can affect us at work. And we have decades of research showing that there are certain workplace situations that can increase the risk of a worker suffering from mental ill health. On the flip side, we know that a workplace where people feel supported, do work they feel is meaningful, and are rewarded with financial stability is good for mental health. So, the workplace is increasingly becoming an important predictor of where people are going to sit on the mental health spectrum.
Alistair Carmichael: One of the things that is emerging in the research is the impact of stigma on people within the workplace. Phil, could you share how you've seen stigma play out?
Phil Davis: With regard to what Sam was saying about how things have evolved, I've seen that same evolution in business. If you go back 20 or 25 years ago, that was when we started to see more focus on diversity in the workplace. And, while there's still work to be done, I think we've made progress in that area. About ten years ago, we started to see less stigma being attached to mental health issues, and organizations being more inclusive of people with disabilities and those from the LGBTQI+ community.
If you look at the past few years, there's also been a focus on how to create a more equitable workforce, so that everybody has access to the same opportunities and feel included and supported. The workplace has become more open. That has to start with the top leadership. Not that Amazon is in any way perfect, but if you've ever watched Jeff Bezos, or now Andy Jassy, they're very open about what's working in the company, what's not, and what concerns them. They are authentic and transparent, and bring their whole selves to the team. This then enables other people to feel comfortable to do that as well.
Alistair Carmichael: It sounds like that for AWS and even the workforce more generally, it is important that the tone comes from the top in creating a space to overcome stigma. I wonder, Sam, if you'd like to share your thoughts on stigma and the role of leaders.
Samuel Harvey: What's emerging is a more nuanced view about stigma. The high levels of stigma that mental health has had for many years, and still continues to have in many situations, is bad—especially for those who have suffered from mental ill health, because on top of the burden of dealing with a really difficult and challenging group of disorders, there's the shame around it because of stigma. This means that they may not be able to get the level of support they want. Someone who is away from work for three weeks with a broken leg after a sporting accident will be inundated with get-well cards. When someone takes three weeks off for depression, the same thing doesn't happen. I think we have to challenge ourselves about why.
Another big effect of stigma is that there's often a long delay in people asking for help. We have really effective treatments for depression and anxiety now, but often, the patients I see in my clinic have delayed asking for help for years. Stigma plays a large role in that. I also think that some of the early attempts in the workplace to reduce stigma ended up with us getting the message slightly wrong—that being challenged or stressed at work was toxic and was going to result in everyone becoming unwell. So, I think what good organizations now do with stigma reduction or mental health interventions, they do in a way that helps and doesn't create additional problems. This has been a real step forward.
Alistair Carmichael: What else can leaders do to support their people with regard to mental ill health?
Samuel Harvey: What really matters in an organization is where mental health sits on the list of priorities. Any organization in the world can hold a barbecue for a mental health charity once a year, but if they spend the rest of the year behaving in a way that makes it clear that they're not valuing employees' well-being, then it's not going to have any impact. So realistically, the most important thing is to be honest about where mental health and well-being sits on the hierarchy. If it’s up among the top key priorities for business as I think it should be, then put structure and responsibility around it—as you would with other priorities for your business.
The most important thing is to be honest about where mental health and well-being sits on the hierarchy. If it’s up among the top key priorities for business as I think it should be, then put structure and responsibility around it—as you would with other priorities for your business
There are two other things that I would highlight. Number one, we discussed leadership and, given we've got a senior leader like Phil here, there will be an assumption that we're talking about the really top tiers of an organization. But what we have found from research is that making sure that managers are trained around mental health is probably the most effective thing you can do in terms of return on investment for mental health intervention. We've done studies here in Australia where we have given mid-level managers training about mental health and practical skills to talk about mental health, or how to spot when a worker is struggling and what to do about that. This took place over four hours. Then we followed up on these mid-managers after six months and saw that the training helped reduce the rates of sickness absence, showed measurable improvements in manager behavior, and that the workers felt more supported.
So, if an organization is going to do those two things, it needs to get the structure right for mental health. It has to make sure that its trainers and managers have had evidence-based training. Once those two things have been done, there's all sorts of other things organizations can look at, such as the latest research around how to improve resilience in workers, how to ensure that workers feel in control in their work environment, and so forth. But those two things have to be done first.
Phil Davis: There was one thing, Sam, that you said that really resonated with me. It was when you said, “Hey, it's not a one-day event. We did our wellness barbecue and checked ‘job done’.” I’ve seen that it's not one size fits all or one magic silver bullet that works. As well as the message coming from the top, it's also a lot of little things. That's particularly true in a region like Asia-Pacific and Japan, because you have so many diverse cultures and backgrounds. I think organizations need to become more customized and personalized to reflect the diversity of a region. This can be little things—access to life-coaching sessions with a certified wellness coach, one-on-one counseling for people who feel like they need more intensive help, crisis and suicide prevention support, or access to licensed mental health clinicians any time of the day.
A lot of pressures aren’t necessarily big ones. It's a collection of small pressures and a work-life balance. That became more prevalent when the barriers between work and life blurred as we started working from home in March 2020. So, how do you create an environment where people feel supported and know it's okay to say, “No”? Or that it's okay to say, “No, I'm not going to take that call at eight or nine o'clock in the evening, or four in the morning,” or whatever it may be? Those pressures didn't necessarily affect everybody the same way in the pandemic. As we saw by June of 2020, women had as much responsibility in the workforce as before, yet the vast majority of the home responsibilities fell on them. So, how do you give opportunities to different people to find out what they're going through, but also share tips and tricks and best practices?
I think it's a lot of little things that go together to make a difference. For example, towards the end of 2020, we implemented a Wellness Friday once a month where there were no Amazon meetings, and only a focus on mental well-being, exercise, reading, or training. We found that employees wanted to invest in themselves, but they never felt like they have the time. The feedback on the Wellness Fridays has been very positive.
Samuel Harvey: I think one of the mistakes we sometimes make when thinking about mental health in the workplace is we think it's all about mental health and resilience training. Yet, that example of what AWS has done with meeting-free Fridays and giving people control over training, etcetera—that’s not only a mental health and wellness intervention. It’s also about looking at workplace risk factors and addressing them by doing an organizational-level intervention. There’s evidence that it’s more effective to deal with the issues at an organizational level than rolling out individual-level resilience training. Ideally, you can do both, but if you want the most bang for buck, then deal with it at an organizational level.
Alistair Carmichael: The critical point you made there, Sam, is that by looking at it at individual level and telling individual employees they need to be more resilient, you're putting all of the responsibility on them. We know that that's not the reality of how pressures exist in the workplace. It's equally true when it comes down to the performance of an organization, it's not all down to an individual. It’s the operating model, the ecosystem, the strategy. So, taking a more holistic view about workplace mental health makes a lot of sense.
Samuel Harvey: Yes, totally. If your workers get a lot of internal communication saying the organization cares about their mental health, when actually what they're doing is just saying, “You need to do this course to increase your resilience, but we don't need to change anything,” you undermine everything that you're doing. There is no magic bullet, but if you're doing things at an organizational level, at a team level with your managers, and then things at the individual level, then you're probably doing a good job.
Gautam Kumra: For years, observers have talked about Asia’s massive future potential, but the future has arrived faster than expected. The question is no longer how quickly Asia will rise, it is how Asia will lead. Keep listening to the Future of Asia Podcast.
Alistair Carmichael: I’m curious to hear from both of you about the impact of COVID-19 on mental health. Emerging from the pandemic, COVID-19 has cast a long shadow across our region. Sam, we'll start with you.
Samuel Harvey: There's a couple of macro trends that we've noticed. One is that there has been a lot more discussion about mental health, and idea of it being a shadow pandemic. By and large, I think that has been a good thing. When the pandemic is over, one of my hopes is that the escalation of discussion about mental health in the workplace will be a lasting legacy. There was definitely an increase in people reporting mental health, mood, and anxiety symptoms in countries that had long, strict lockdowns.
Interestingly, though, pretty much across the board, what we haven't seen is a rise in suicide rates, which was one of the big concerns. There are theories about why that is—how you can have an increased level of distress and not a corresponding increase in suicide. It might be about the time it takes to see the different parts of the picture emerge. It might be that there was a lot of stress, but that communities, families, and organizations pulled together and provided people with the support that was needed. I think we're beginning to see now that the real effect is different in different groups. And, as is so often the case with major events, there is a disproportionate impact on those with lower levels of resources.
We've seen a real increase in more tangible mental- health outcomes with younger people in insecure work. The groups that Phil was talking about before, with competing demands of trying to juggle homeschooling and work, and casual work in terms of female workforces in some countries, they're the ones in whom we’re seeing more problems. My personal view is that some of the financial consequences of COVID-19 are going to have more of an impact on mental health around the world than the acute stages of the pandemic, because we know that that's what really matters in terms of mental health. We haven’t seen a unifying picture emerge. What we've seen is different impacts on different groups, and I don't think we've seen the end of it.
Phil Davis: To add to that from an AWS perspective, the experience wasn't consistent over those two years; it evolved instead. If you go back to the start of the pandemic, there was mostly confusion and fear, right? Nobody knew how long it was going to last, what the death rates were going to be, when we'd have vaccines available. But as it continued to grind on, I think you got into much more of a fatigue type of a mode. In many regards, this was even more risky because it was somewhat insidious. You don't really see it happening, it just kind of creeps up on you. And AWS is a microcosm of all the communities in which we do business.
So, AWS went through the same things as other communities went through. We had loved ones on the team who passed away from COVID-19, we had friends and colleagues whose parents or other loved ones passed away. We had to try to deal with it virtually. In fact, I was part of a virtual funeral service for one of our beloved directors who had passed away—it was unbelievably emotional. It was really hard not being able to be in the same room as the others. That's when we really started to focus on how to create a sense of connectedness, and more of a sense of community in the virtual environment.
And as we started to have people share their experiences, whether it was their own losses or the pressures they felt, the feedback was incredibly positive. People said, “Hey, I'm going through the exact same thing that you're going through; I didn't know it was everybody else. I thought it was just me.” I think that was when we started to think about how we could get employees to connect. The next phase of the pandemic is that now we're close to just living with COVID-19. I spent the last eight weeks on the road, to Seoul, Tokyo, Bangalore, Delhi, Sydney, and elsewhere in the region. There's a strong desire for people to get back together face to face and feel a sense of community in a real world. I think it's important right now that we see this as an opportunity, and that we make the investment in getting the teams together, whether it's socially, or in or outside the office. We can now focus on the good things we learned through the pandemic, but to do it in the physical world.
There's a strong desire for people to get back together face to face and feel a sense of community in a real world. I think it's important right now that we see this as an opportunity, and that we make the investment in getting the teams together, whether it's socially, or in or outside the office.
Alistair Carmichael: What is the one piece of advice that you would give a leader who asks, “How do I get started?”
Phil Davis: This is going to sound overly simplistic, but I think the one piece of advice that I would give every leader is to treat people the way you want to be treated. Think about what you've been going through in the last two years, and it's probably not that different from everybody else. My personal situation might be a little bit different. We had lived in Singapore for a long time, and my wife is Australian. So, when the older two children graduated, they came down to Australia to go to university. Then we got transferred back to Palo Alto, California, and the pandemic hit. We faced a very stressful situation where for an indeterminate period of time, as Australia closed its borders, we weren't able to see our children. That was a very difficult time.
So if I have empathy with other team members and colleagues, I can see there are similar stressors. I would strongly encourage people to consider what their team members are going through, think about how they would want to be treated in that situation, and then treat people that very same way. And part of that is understanding the personal impact, particularly as a leader in an organization, that you can have on your team members—that can be either positive or negative. I’m sure we've all had bosses who we've worked for who we learned a lot from and who we liked.
Yet there are many of us who have had the reverse experience, and have worked for people who we would never work for again. Think about how that impacted you. Both types of leaders have a profound effect on not just our professional well-being, but our personal and mental well-being as well. So, as a leader, I believe you have a duty of care. You hopefully went into leadership to help people develop, grow, and thrive. It's important to take a step back and understand that the way you treat people is going to have a strong impact on them personally outside of work as well as at the workplace.
Samuel Harvey: I'm going to stretch your question and give three bits of advice. One is that if you are going to be doing things to make a more mentally healthy workplace, you have to do it authentically. You've got to mean it, you can't just do it for one month; it’s an ongoing journey that is worth it in terms of the impact on people's lives, as well as on profit and performance. The second thing is that I'm always surprised when successful business leaders ask me, as a psychiatrist, how they should do this. The reason that you are a leader of an organization is because you're good at seeing a problem, planning how to fix it, and putting structures in place.
I think part of the stigma around mental health is that it makes us think that it doesn't obey those sorts of structures and rules. But it does. All the things that your organization does to deal with other issues, in terms of working groups, regular checks, etcetera, will work for mental health issues as well. The third thing, however, is you have to get advice from people who know what they're talking about. There's a lot of nonsense out there that is dressed up as interventions for workplace mental health. There are examples of programs that have been rolled out because they seem like a good idea, but end up generating more problems. Black Dog Institute has information on its website that people can use, and I'm sure there are other organizations that provide a similar service.
My experience is that when you do a podcast like this, some of the people who have tuned in to listen have done so because they are experiencing symptoms of depression and anxiety, or another mental health problem. I want to reiterate that there are really effective treatments now, but the earlier people get treatment, the better the results. If a listener is thinking, “Yeah, I am really struggling,” then go see your GEP, and go to a website like the Black Dog Institute for self-help resources and start the journey to recovery from there.
Alistair Carmichael: In this podcast, we've been joined by Sam Harvey and Phil Davis to share their experiences and insights into workplace mental health and well-being, and why now is a critical time to take action. We've heard what it is, why it matters, and how leaders can take action, starting today. We’re very grateful to Sam and Phil for having joined us today. We know that discussing mental health can impact people differently. If anything in this session has triggered something for you, please do reach out to your local health-care provider or go to a site such as the Black Dog Institute for more information.
Gautam Kumra: You have been listening to the Future of Asia Podcast by McKinsey & Company. To learn more about McKinsey, our people, and our latest thinking, visit us at mckinsey.com/FutureofAsia or find us on LinkedIn, Twitter, and Facebook.