Improving mental health: An interview with One Mind’s Garen Staglin

The COVID-19 pandemic has exacted a severe toll on mental health globally. Even as the pandemic is receding, millions of people may confront yet another wave of stress and anxiety as they return to the workplace. While a third of respondents in a recent McKinsey survey who had not yet returned to work anticipate that doing so will have a positive impact on their mental health, 44 percent anticipate the opposite: a negative impact. Looking at a few employee cohorts more specifically, roughly 50 percent of Black respondents, respondents with children, and millennial respondents reported anticipating a negative mental-health impact from returning to work. These same respondents are nearly 3.5 times less likely to anticipate being engaged at work upon return.1COVID-19 Consumer Healthcare Insights: What 2021 may hold,” June 24, 2021 Among those who have already returned to in-person working, 36 percent reported that the return negatively affected their mental health.

In this interview, Erica Coe and Kana Enomoto, coleaders of McKinsey’s Center for Societal Benefit through Healthcare, lead a discussion with Garen Staglin, the chairman and cofounder of One Mind, a nonprofit whose mission is to accelerate brain health research and advocacy to enable all individuals with mental-health challenges to build healthy, productive lives. In 2016, One Mind launched One Mind at Work, with a specific focus on workplace mental health. Staglin shares his lived experience coping with his son’s mental illness, his perspectives on actions employers can take to eliminate stigma and support their employees, and more. The following are edited excerpts of their conversation.

Kana Enomoto: Mental health, like physical health, affects all of our lives; however, we may talk or think about it differently. Can you share what mental health means to you?

Garen Staglin: Given the wide spectrum of behavioral health conditions—from autism to addiction—and the fact that one in three people in the US is affected by one during their lifetimes, everybody knows somebody with a behavioral-health condition. It’s a friend. It’s a neighbor. It’s yourself. It’s a loved one. It’s my son with schizophrenia. Our mission at One Mind is to normalize conversations about mental health, or brain health as we often call it, and to help us all understand it is a continuum—and we’re all on it.

The devastating impact of a mental-health crisis becomes much more personal when your own son suffers a psychotic break. That’s what happened to us 27 years ago. We were very fortunate to get an accurate diagnosis and get him back on track. But my wife and I decided we could either run away from this problem or run toward it. We chose the latter.

As a parent, it happens when your superstar—bright, 1600 on his SAT scores—suffers a psychotic break. We were away when this happened. He was at home by himself. He wouldn’t let us help him get a job between his freshman and sophomore years and was feeling incredible stress. I think [that’s] something we all need to understand. These diseases do have the basis in genetic mutation, but they’re often environmentally triggered. Stress was his environmental trigger.

We flew home and took him out of the psych ward. He was clearly in a very difficult situation. We were able to get him to a doctor who gave us a diagnosis. That alone is very difficult for most people. It often takes, on average, more than a year to get an accurate diagnosis, and many people never do.

And then the story continues. The precision to deliver the right medications and treatments to allow people to lead “a normal life” is not very good. It’s a trial-and-error process. Brandon went through all that process, graduated on time with honors at Dartmouth, got a job as a rocket scientist at Space Systems/Loral. He also got accepted to MIT for a master’s degree program in aeronautical engineering, but then had a relapse because he cut back on his medication. Today his is a story of tragedy to triumph. He leads One Mind as our president. He’s an incredible advocate because it’s personal for him. It’s personal for me but not in the same way it is for Brandon. So that’s our story. And we’re happy to share that story.

Erica Coe: In addition to individuals and families grappling with serious mental illnesses, the pandemic has seen more Americans experiencing challenges with their mental health. What role do employers play in fostering mental health in the workplace?

Garen Staglin: Prior to the pandemic, many people experienced mental illnesses, and that number has only grown with each successive wave of COVID-19. Many people are experiencing mental-health challenges for the first time in their lives, and these conditions are likely to persist. That’s why mental health must be a priority for every employer.

Employers used to think they couldn’t do anything to address workplace mental-health issues. But with a commitment from the C-suite, organizations can change their culture, benefit programs, and work environment so that neurodiversity can be celebrated alongside other forms of diversity.

Erica Coe: How important is it for company leaders to be involved in workplace mental-health efforts?

The single biggest influencer of a behavioral-health program’s success is the level of personal commitment from the CEO and other senior executives.

Garen Staglin: We believe that the single biggest influencer of a behavioral-health program’s success is the level of personal commitment from the CEO and other senior executives. Absent that level of commitment—to change the culture and to formally acknowledge and support behavioral health—these programs tend to lose momentum, often getting supplanted by new priorities over time.

Employee-assistance programs have a utilization rate in the 5 percent range. People are afraid to come forward because they believe they will be somehow marginalized. But if CEOs talk openly about their personal reasons for this commitment, and say to everyone, “It’s OK not to be OK,” that makes a huge difference.

Employers need to follow that up with constant communication. You need to look at benefit plans. And you, as the CEO, are in charge and liable, even if you rely on a benefits outsourcer. The American Psychiatric Association’s Center for Workplace Mental Health is leading The Path Forward for Mental Health and Substance Use Project, which is driving reforms to dramatically improve early detection and access to behavioral healthcare, incentivize the adoption of measurement-based care, and achieve parity with physical health benefits.2

Companies that have joined with us at One Mind at Work are finding that supporting mental health is not only the right thing to do, it’s good for business. Absenteeism goes down. Customer service goes up. Well-being and productivity go up. Healthcare costs in the long run will go down because people who don’t use services self-medicate with drugs or alcohol or use other ways to cope.

Kana Enomoto: We have discussed the disconnect between how well employers thought they were doing in meeting mental-health needs and what employees felt. For example, among employers with frontline workers, 71 percent felt they were supporting the mental health of their employees well or very well. But only 27 percent of frontline employees who responded agreed that their employers were supporting them well.

Moreover, only 20 percent of employers cited reducing mental-health stigma as a top priority, but close to 70 percent of employees said that a campaign to reduce stigma would make them feel more comfortable talking to their employers about their mental illnesses.

Given these disconnects, Garen, what are some of the most effective people changes you’ve seen organizations take to support mental health?

Garen Staglin: First, you need to recognize as a leader that if you are celebrating people who push the all-nighter and are working to exhaustion, are you doing that consciously, or do you have an unconscious reward system that allows those people to be the heroes of the organization? And shouldn’t you instead have appropriate staffing levels and project-assignment levels so you don’t require people to work at an exhaustive pace to get the job done?

Next is training frontline supervisors and giving them the authority to give people a mental health day off or take other appropriate actions. In many cases, that is where the rubber meets the road because the frontline is where the pressure is very high to deliver quarterly profits and returns. And if supervisors don’t feel they have the authority to allow people to move out of that pressure, then it just compounds itself.

Erica Coe: Those are great points, Garen. Building on them—we need a change of perspective to view mental health as just as important as cyberrisk or other enterprise risks. It is a risk to productivity. Employers need to educate themselves on how to provide support, how to talk to people, how to ask questions if they think someone may not be doing well, and how to do it in a way that people are not afraid they will be penalized, or their career will suffer, if they ask for help.

Garen Staglin: We also believe that neurodiversity merits inclusion3 as a diversity priority alongside gender, race, and sexual orientation. We are working hard on how employers can meaningfully measure and report the impact that mental-health support has on business outcomes. This reporting will make a difference to stakeholders across the board.

Erica Coe: Any closing thoughts for us?

Garen Staglin: Everybody has somebody. There is no reason why we can’t all be open and have this conversation. And I encourage you and deputize you to be your own ambassadors for brain health and understand that it’s a spectrum, and we are all on it.

Brain health and brain fitness are what we should all be striving for. And we can all get there. But we need to understand that mental illnesses are conditions of chemicals and not character. You need help with these illnesses, and you can get it. Treatments are there; better treatments are coming.

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