Employee Wellness Programs Can’t Fix a Broken System
Whose goals are central to the therapeutic process – the employer’s, or the employee’s?
Saumya Gautam, 25, was burnt out. She worked from home like all her colleagues, which meant longer hours, fewer boundaries, and meeting work expectations after hours. Then, the company did an organizational restructure – without consulting anyone — and things quickly spiraled from there.
Besides feeling demotivated, Saumya and her colleagues in middle management were expected to take on the consequences of the restructure. “It all came down to us. We’re working from home, so we were accused of not working hard or being productive enough… My morale was down, and the work itself started giving me anxiety.”
That’s when she reached out to the organization’s employee assistance program (EAP). This is a setup used within many workplaces wherein employees – like Gautam – can access counseling free of charge, because employers partner with mental health service providers for the same.
But while EAPs are ostensibly for the well-being of employees, they’re ultimately a contract between an employer and the external counseling service. And therein lies the problem.
When corporates enter into partnerships with mental health companies, they are the client – not the person availing the counseling. There’s therefore an inherent conflict of interest at play that remains unaddressed: whose goals are central to the therapeutic process – the employer’s or the employee’s?
In the last decade, mental healthcare has seen a global shift toward the private sector. Thus, in lieu of unemployment benefits, public mental healthcare, or disability provisions, many private companies now offer arguably watered down counseling services through B2B partnerships with mental health organizations. The potential upside to this is that the onus is no longer on individuals to find and seek support at their own expense and time. Instead, the onus of ensuring employee well-being is on companies.
On the other hand, however, this is still an individualistic approach, and it doesn’t get to the root of why workers are unhappy at work to begin with. The structural problems with work culture thus remain unaddressed. It leaves employees like Gautam feeling even more alienated and out of options than when they began.
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At the heart of the problem is the fact that systems have failed people when it comes to addressing their mental health as a public health crisis. A considerable body of research has shown how systemic factors like discrimination, marginalization, poverty, inequality, unequal access to space, and poor working conditions all lead to bad mental health. Instead of tackling these at the root, however, the shift has been toward enabling mental health to be privatized as a work-related issue that can be resolved by employers. This ties someone’s labor and productivity to their self-worth in unhealthy ways.
In Gautam’s case, for instance, the counselor she approached offered four options: managing the anxiety through scheduling; talking to colleagues to see if others felt the same thing; speaking to her boss and if that didn’t work, her boss’s boss; and lastly, leaving the company if she wasn’t able to keep up. But there were power hierarchies and delicate workplace relationships to consider, which made these options mostly unrealistic. All of them, moreover, put the onus of managing a company-created environment on her.
Her lack of motivation wasn’t innate but due to the company’s actions – but in recommending she leave the company, the EAP not only reframed the issue as an individual one, but also inadvertently blamed the individual for being unable to cope.
“ There had to be a change from the organization, not from me. I think by the end of the second session, I felt that leaving the organization was the only doable option,” she said.
The idea of employers being obliged to provide mental health care to employees picked up steam during – and after – the pandemic. It also coincides with more conversations globally about mental health, burnout, and an overall reckoning with work culture itself. But there’s a catch with how the problem is framed: when companies start caring about the mental health of their employees, it’s often framed as an economic problem. Take one EAP site that listed out all the ways that companies can save money by offering mental health services to their employees: more employee productivity, more retention, lesser costs of poor performance. “Behavioral health problems such as anxiety, stress, and depression were widespread, constituting a leading cause of diminished well-being and exacting an enormous toll in the form of absenteeism, reduced productivity, and increased healthcare costs,” noted one McKinsey analysis.
“The costs of poor mental health are high: the total cost of mental illness is estimated at around 3.5% of GDP,” notes another report by the OECD. Among its recommendations: “promote greater awareness of the potential labour productivity losses due to mental health conditions”
In other words, a mentally unwell employee isn’t profitable to organizations.
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“Capitalism depends on the majority of people earning their living through wage labour, and to be of use to capitalists, workers have to generate more wealth or value than they earn… If an individual falls below a certain level of productivity, it is no longer worth the expense of employing them,” notes one analysis.
The question of intent comes into play here. “The real question is whether the organization is truly investing in doing three things: preventing mental health distress, promoting mental health at work, and supporting people’s mental health care needs,” says Jasmine Kalha, from the Center for Mental Health Law and Policy. “Mental health, in general, is not an individual problem that has be ‘fixed’, rather a psycho-social-structural concern,” Kalha adds.
“… the service agreement that is entered into with another organization needs to explicitly center around the best interests of the employees who will eventually avail these services. This is often not done by some organizations to increase their likelihood of landing a contract,” says Paras, the founder of AltStory.
Productivity and well-being aren’t necessarily mutually exclusive. But often, the former is upheld as the standard to aspire to, while using the language of the latter. It adds to the notion that mental health is important to make people better, more efficient workers. By the very language of EAPs and corporate analyses of mental health, there’s a clear goal in mind: improving mental health for better, more tangible results. But mental health doesn’t work that way, and it’s unrealistic to expect a linear recovery process. As a result – the way corporates approach mental health is in terms of a problem to be optimized financially, treating people as needing to be “fixed” in order to perform better at work.
As a result, employees who go the EAP route to address their health and come away feeling like they haven’t been helped, end up feeling defeated. “I had one option that I’ve used up, now I don’t know how to help myself,” says Gautam.
What people struggle with, in the process, goes overlooked. “mental health partners are told to not to bring up sticky issues like discrimination, burnout, leave policy, appraisal policy, burnout etc,” says Paras.
“I have personally worked with clients where we had strict diktats to not use terms like ‘mental health’, ‘suicide’, ‘burnout’, ‘harassment’ etc in counselling sessions and workshops and focus instead on ‘positive psychology’. Some mental health organizations too, unfortunately, have been more than enthusiastic to enforce these arbitrary diktats.”
Some companies try to work through these constraints, recognizing the importance of mental healthcare as an essential component of employment. “The basis for any therapy is confidentiality. We cannot break that unless there’s a potential threat of harm to self or harm to someone else… But we do provide insights to organizations that allows them to understand the stressors,” says Nilofar Sait, from Ambrosian Resources. “But unless an individual wishes us to escalate an issue to the organization, we cannot do that.”
In the absence of a larger legal apparatus mandating mental health policy, the future of people’s mental health is slowly appropriated by corporates, who in turn distort mental health into corporate-speak that loses its efficacy on real people.
Paras also notes that even the few provisions for mental healthcare made available by companies are undermined by their own restrictive usage limit policies – such as allowing only two to three sessions per year. “Stress may be stemming from the workplace or other areas of life too… these restrictions need not be there. Every person is unique,” Sait adds.
In all this, the end user is left out of the conversation – with no say in what they might expect to gain from the process.
Saumya’s company offers other wellness camps in the form of various lectures that are planned without consulting people about a preferred time. This leads to people being compelled to skip them if they have prior work commitments.
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The physical wellness programmes include recommendations for workplace ergonomics, yoga, zumba, good sleep, and healthy food. However, these remain verbal recommendations, with no provisions to act upon them.
All of it is “just happening for the sake of it,” as Gautam says.
“[T]here are other evidence-based practices such as peer support, enhancing skills of existing employees to provide mental health support, improved work policies, providing a safe working environment, making accommodations for people with mental health conditions that require an active intervention from employers that we often do not see,” says Kalha.
The much bigger problem at hand is that, increasingly, people’s self-worth and well-being are being put in the hands of their employers, who get to set the terms of the help that’s available.
“[N]eoliberal reforms have left many workers with progressively more precarious jobs and less protections, guaranteed benefits, and hours of employment—all of which have only aggravated loneliness,” writes David Matthews in Monthly Review. Under these conditions, mental health can scarcely be contained within the paradigm of labor – it’s a societal crisis.
“If the health of your employees is so important, show it in your actions,” Gautam says. “It’s all about productivity… The only contribution that an employee can make to an organization is being fit, that’s the only reason why they care about wellbeing. Otherwise they wouldn’t.”
Rohitha Naraharisetty is a Senior Associate Editor at The Swaddle. She writes about the intersection of gender, caste, social movements, and pop culture. She can be found on Instagram at @rohitha_97 or on Twitter at @romimacaronii.