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Mental health at work — why stigma is a workforce health issue

About 75% of employees have struggled with an issue that affected their mental health.¹ Yet, 8 out of 10 workers with a mental health condition say shame and stigma prevent them from seeking mental health care.² That’s a problem for individuals, but it’s also a problem for employers — because untreated mental health conditions cost American companies billions every year.

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Mental health is a workforce health issue. Untreated depression costs $9,450 per employee, per year in absenteeism and lost productivity. Mental illness is the single greatest cause of worker disability worldwide.

What stigma looks like — and why it’s a problem

Mental health conditions are common and treatable. So why don’t we talk about them as openly as physical conditions like diabetes or asthma? Because of stigma — negative stereotypes about mental illness that persist both in and out of the workplace.

Even in the most progressive workplaces, 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. This can prevent employees from seeking help and getting better.

The cost of staying silent

Because stigma drives silence, employers simply can’t afford not to talk about this issue. The mental health of your workforce and your company’s bottom line are inextricably linked.

  • Employees with untreated mental health conditions use nonpsychiatric health care services 3 times more than those who do get treatment.³
  • Mental illness is the single greatest cause of worker disability worldwide.⁴
  • 62% of missed work days can be attributed to mental health conditions.⁵
  • Turnover rates are higher for depressed employees, who are 20% to 40% more likely to become unemployed because of their condition.⁶

Compounding costs add up quickly

Mental health conditions are associated with the prevalence, progression, and outcome of certain physical conditions. Employees with untreated mental health conditions tend to have more serious and costly health issues in general. For example, their risk for heart attacks and strokes is twice as high — and cardiovascular disease is America’s most costly and prevalent chronic condition.7,8 And people with severe mental health issues are twice as likely to develop type 2 diabetes, which adds $13,241 per employee, per year in medical costs and lost productivity.9,10

Consider this: Depression intervention vs. flu prevention

Nearly 60% of employers offer on-site flu shots.11 Yet, the impact of the flu on American businesses pales in comparison to the impact of depression. Why do so many employers encourage their workers to get a flu shot when they don’t have any strategy to tackle depression in the workforce?

The flu costs employers $1,000 and depression costs employers $9,450 in absenteeism and lost productivity per employee, per year. The flu costs employers $10.4 billion and depression costs employers $110 billion in direct medical costs per year. The flu costs employers $1,000 and depression costs employers $9,450 in absenteeism and lost productivity per employee, per year. The flu costs employers $10.4 billion and depression costs employers $110 billion in direct medical costs per year.
Depression plus physical health problems can lead to a vicious cycle. The cycle of depression, difficulty managing those conditions, diminished quality of life, and new or worsening symptoms is continuous.

Taking a stand against stigma

It’s clear that stigma is a significant barrier to mental health care, but it doesn’t have to be. And it shouldn’t be — because most people who get help get better. For example, treatment works for more than 8 in 10 people who get help for depression, and as many as 9 in 10 people who get help for panic attacks.12 To help more people get the care they need, it’s essential to understand stigma and take action to overcome it. Employers have an opportunity to address stigma head-on — to make sure employees feel supported, and to help set the tone for a productive and mentally healthy workforce.

Learn how you can support a stigma-free company culture >

About our expert

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Don Mordecai, MD

Don Mordecai, MD, is the Kaiser Permanente National Leader for Mental Health and Wellness. He’s been with Kaiser Permanente since 2003. Dr. Mordecai trained at Stanford University School of Medicine in child, adolescent, and adult psychiatry. His clinical work is with patients with developmental disorders, ADHD, and a range of general psychiatry issues. Dr. Mordecai also serves as adjunct clinical associate professor of psychiatry at Stanford University School of Medicine.

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  • 1

    “Mental Health: A Workforce Crisis,” American Heart Association CEO Roundtable, 2018.

  • 2

    “StigmaFree Company,” National Alliance on Mental Illness, NAMI.org, accessed January 31, 2019.

  • 3

    “Bad for Business: The Business Case for Overcoming Stigma in the Workplace,” National Alliance on Mental Illness of Massachusetts, 2015.

  • 4

    See note 1.

  • 5

    See note 3.

  • 6

    See note 3.

  • 7

    Whiteman, “Mental illness linked to increased risk of heart disease, stroke,” Medical News Today, October 27, 2014.

  • 8

    Cardiovascular Disease: A Costly Burden for America,” American Heart Association, February 14, 2017.

  • 9

    Mangurian et al., “Diabetes and Prediabetes Prevalence by Race and Ethnicity Among People With Severe Mental Illness” Diabetes Care, June 2018.

  • 10

    Economic Costs of Diabetes in the U.S. in 2017,” Diabetes Care, May 2018.

  • 11

    2017 Employee Benefits,” Society for Human Resource Management, 2017.

  • 12

    Mental Health America, mentalhealthamerica.net/get-professional-help-if-you-need-it, accessed February 12, 2019.