American workers today face psychological challenges on every front. A Pew Research survey found that 25 percent of US adults report that someone in their household lost their job because of the coronavirus outbreak, and 32 percent report having reduced hours or a pay cut. Although the economy has partially rebounded, research has shown that just the fear of unemployment, of not being able to pay our bills or care for ourselves and our loved ones, carries a lasting and significant threat to our physical and mental wellbeing.
For those fortunate enough to have jobs, many are now working under changed and trying conditions—sharing tight quarters or caring for children or parents while trying to maintain job performance. For those workers on the frontlines, anxiety over contracting coronavirus adds more pressure even as safety precautions add layers of complication and discomfort to the work of serving the public and caring for others. The policies they must follow continue to change. Many are cut off from normal contact with extended family and friends and the usual routines that bring joy, promote physical health, and re-establish equilibrium. Uncertainty and weariness thread our daily lives.
In our 10th month of lockdown, heading into the dark of winter as a surge of Covid-19 cases upends holiday plans, we’re stretched thin. In some ways, we’ve proven ourselves resilient and more adaptable than we might have guessed. But for many, optimism is low and loneliness increasing.
Without intervention, the costs of these psychological stressors will be severe. In May, the Well Being Trust estimated we’ll see 75,000 deaths from suicide and drug overdose as an indirect result of COVID-19. Even that doesn’t count the hospitalizations, the disease recurrence, and the lifelong morbidity triggered by the millions of new or deepening cases of depression, anxiety, and more. Each of those cases has the potential to spiral outward, negatively affecting family members, friends, and co-workers.
These disastrous outcomes are by no means a foregone conclusion. As the global community has witnessed, prevention is the most potent weapon in the public health arsenal. And prevention can work against this collateral psychological damage. Preventative practices and tools can arm workers with the psychological skills they need to navigate and withstand the challenges they now face.
Corporate leaders are seeking solutions. Pre-pandemic, many were becoming aware of the need to make mental wellbeing part of the conversation -- now it is. Unfortunately, with good intention, many are looking in exactly the wrong place: clinical psychotherapy and psychiatry. These services, covered by insurance, are critical for those who are experiencing mental illness and require clinical care.
Making clinical services more accessible to those who need them is admirable. But the vast majority of our workers do not need clinical care. They need mental health support. They are not experiencing mental illness. They are having normal reactions to extraordinary stressors. They need help developing the skills and mindsets that can preserve—and even strengthen—their wellbeing in these unusual times. Pathologizing their reasonable reactions to unreasonable conditions, sending them for clinical help even though they lack a clinical condition, isn’t the answer.
Psychotherapy and other clinical treatments are designed to treat diagnosed disorders. Misdiagnosis, in order to meet insurance requirements or receive care, may result in confusion, overtreatment, unnecessary cost, and stigma. According to the National Alliance on Mental Illness (NAMI), 8 out of 10 workers in need of therapy won’t access it. They worry they will be seen as psychologically disordered by their employers, or otherwise penalized. As a result, employee utilization rates of clinical mental health services are dismayingly low.
What employees need most today are primary prevention services—services that can help them avoid developing a mental disorder to begin with. Psychological primary prevention comes in the form of strengthening coping skills and developing resilience to come out of this challenging time unharmed, or, better yet, stronger for it. These skills support greater physical and psychological health, but also better workplace outcomes including improved interpersonal relationships and increased productivity and innovation. These outcomes are well documented and well within reach for most organizations.
Consider an analogy from physical health. Membership in a gym and sessions with a personal trainer can be instrumental in helping employees get fit and avoid negative health outcomes. A company concerned about rising healthcare costs and health-related absenteeism wouldn’t send all their employees to a cardiologist to get fit and strong. It would be too expensive, and it wouldn’t produce the desired outcomes -- cardiologists are not expert in exercise.
Similarly, psychotherapists and psychiatrists are not expert in mental wellbeing. Psychotherapy and psychiatry are best suited to diagnose and treat those already suffering with mental disorders, not for preventative care.
Instead, workers today need the equivalent of that gym membership for mental fitness. They need to learn new practices and exercises to strengthen and build their psychological core — resilience, stress management, coping skills -- to buffer against depression and panic. Just like physical fitness programs, the practices for mental fitness become the foundation for sustained improvements in health and wellbeing that ripple into all areas of life. Workers need the same mix of one-on-one support and accountability that has proven effective in developing new skills and habits in other areas.
Over the last thirty years, the field of positive psychology, alongside parallel developments in behavioral economics and neuroscience, has provided the science for this mental gym: evidence-based exercises that measurably improve core psychological skills. The service providers—the equivalent of personal trainers or yoga teachers—are not therapists, but coaches. Coaches help people achieve their personal and professional goals.
As with the birth of any new profession, there is a fair amount of confusion around the term coach. And just as there are many types of therapy, there are many types of coaching. Positive psychology coaching, or mental wellbeing coaches, is the form of coaching that we, with our combined backgrounds in psychology and psychiatry, now endorse. These coaches create space for people to show vulnerability, a state that enables deep personal growth, and they help people connect that personal growth to the tangible goals, requirements and challenges of their professional lives.
Workers of the Great Depression, the Industrial Revolution, or previous major labor transformations did not have the benefit of a psychological science of wellbeing. Too many suffered as a result. We have a window now—a brief, but critical window—in which we can intervene, positively and preventively, for our workforce.
And it’s not just whether we choose to intervene, but how, that will determine whether we avoid the negative outcomes experienced by previous generations and the dire predictions of statisticians. The path of least resistance is to ensure treatment is accessible once disease has started. But the bar has been raised. Companies that prioritize the prevention of psychological illness, that lay the groundwork for mental wellbeing, will reap the rewards, both as fellow humans -- in the form of lives saved, and illness and suffering averted -- and as business leaders -- in the form of innovation and performance, building organizations where workers can be productive and grow.
About the Authors
Gabriella Rosen Kellerman MD is a behavioral health physician, researcher, and Chief Product Officer at BetterUp; Alexi Robichaux is CEO and Co-Founder of BetterUp; Prof Martin Seligman is the Zellerbach Family Professor of Psychology at University of Pennsylvania and one of the founders of Positive Psychology.