Across the Generations - Mental Health

First and foremost, we need to be very specific about what we’re talking about in this blog. There is a large difference between an individual who struggles with a clinical mental illness and one who is struggling with their mental health. According to 2022 data accessible through Mental Health America (MHA), 19.86% of adults in the United States are experiencing a mental illness which equates to nearly 50 million Americans. That’s a lot, but I can guarantee 100% of people in the world will struggle with their mental health at some point in their life.

The benefits we are going to discuss here are addressing mental health resources a company can provide to their employees to support their mental wellness. We are not talking about clinical programs. Individuals seeking care for chronic, diagnosed mental illness should be able to access the care they need through your medical plan. In fact, the Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 to prevent group health plans from being able to impose less favorable benefits for health care addressing mental illness than for other medical services. The Affordable Care Act (ACA) amended the law to extend the requirement to individualized plans, as well. In December of 2020, Congress signed the Consolidated Appropriations Act (CAA), which included a provision requiring insurers and health plans to perform comparative analysis showing they comply with MHPAEA. We have a ways to go to ensure those struggling with mental illness can receive the care they deserve, but we are not addressing that specific aspect of mental wellness in this blog.

It is extremely important the difference is understood as someone requesting services to manage a mental illness being referred to a mental health resource could be very dangerous. Mental health resources may add another tool to the arsenal for those diagnosed with a chronic, persistent mental illness, but will not address their needs adequately on their own. The best example is counseling services available through the Employee Assistance Program (EAP). Most companies provide access to an EAP at no cost to their employees. Basic access is usually granted to the employer as a supplemental benefit provided by a vendor/insurance carrier. This benefit typically provides 3-6 visits per episode per year, depending on the design of the benefit or if the employer is paying to increase the number of visits. For a person going through an acute mental health struggle or who has not previously had a diagnosed mental illness, this is a great place to start. EAP mental health professionals are typically local counselors, therapists, or social workers within the carrier’s network. This is likely not adequate care for someone struggling with a diagnosed chronic mental illness. As a side note, it is worth the employee checking if an ongoing provider they are seeing is listed in the free EAP resource network. The free visits would still apply each year and could save the employee money on copays, coinsurance, or deductibles, depending on the medical plan in which they are enrolled.

Equating someone struggling with an environmental mental health crisis (albeit very serious) to an individual who is struggling with a severe chronic mental illness is inadvertently belittling the latter. Think of it as comparing a severe sprain during vigorous exercise (still serious and needing care) with phantom limb pain experienced by someone who has undergone an amputation. This may seem like a dramatic comparison but it is accurate. In an effort to destigmatize mental illness (which is absolutely necessary), we’ve normalized it to a point that everyone identifies their own situation as a mental illness which requires a far different approach and actually reduces empathy toward those with mental illness when they are exhibiting symptoms of the actual disorder versus feelings relatable to the disorder.

Resources for both should be provided by an employer and accessible to all employees to support the holistic well-being of their population. Under this specific topic, we are addressing challenges and benefits to support someone struggling with their mental health due to environmental circumstances and benefits that promote maintaining mental health as a proactive approach to healthcare. If you watched our video “Stop Using the Oxygen Mask Analogy to Promote Well-being” (condensed version available here), we’ll be looking at preventive and acute care resources to aid in supporting better mental health.

Supporting your employees’ mental well-being does not start at the resources you provide. It starts with ensuring the work environment within your company promotes mental wellness and allows individuals to feel empowered to bring their whole self to work. This starts with your leadership. We no longer live in a society where “do what I say not as I do” works. Older generations were more likely to do whatever was needed for a paycheck to take care of their families. They were less concerned with what the company and leadership were doing, as long as they received adequate compensation. Younger generations are holding companies to a whole new standard. They are far more skeptical of what is being said if they are not seeing action that confirms it. They will cut ties with a company completely if the organization does not satisfy their expectations, and have the means of bringing it to the public’s attention through social media.

Training needs to be provided to educate leaders as to how to create and promote a healthy work environment from the C-suite to any individual who has a direct report. Companies have placed the onus on their employees to create an environment that supports mental health while managers have often created the opposite conditions. A successful holistic well-being strategy must start at the top and cascade down to be effective. Ensuring leadership is also trained in Mental Health First Aid is extremely important and empowers your leaders to recognize a mental health concern before it becomes a crisis. All leaders should be fully aware of what resources the company provides to be able to direct an employee needing assistance with the least amount of internal interaction. Managers should never try to address a mental health issue themselves, but should feel equipped to point them to a resource that can, efficiently. If your leadership education and development does not include well-being, you are not preparing your managers to be successful in their role.

The mental health portion of a holistic well-being program is truly the segment that proves how important it is to consider physical, mental, financial, social, and emotional health. Every other segment is feeding the mental health pillar. If any of the five elements of holistic well-being are lacking for an individual, their mental health will decline. For someone who is not struggling with a true clinical mental illness, mental health is most often a symptom (good or bad) of how the well-being balance is going. Unfortunately, during bad times, this is often compounded with coping mechanisms or self-medication that can make bad symptoms worse, and add new symptoms requiring more serious intervention. The old adage “you are what you eat”, is more true than we realized but should be modified to “you are what you consume” as what we eat, see, and hear affects us every day and impacts our holistic well-being.

At the very basic level, an individual needs food, water, air, shelter, and sleep to survive. The quality and quantity of each of these can affect mental health the fastest. Regardless of which generation we are considering, the core of your well-being strategy needs to provide access to resources to promote physical and financial wellness, at the very least, allowing employees to be able to address their basic needs sufficiently. Remember that mental illness is included in physical wellness as it is a medical condition. If your company is smaller and you aren’t sure where to start and have limited funds to support your benefits program, focus on these first to allow for the greatest impact. Adding a standalone mental health platform as a resource if your employees are not adequately supported with access to healthcare and financial literacy tools will not be beneficial to anyone. Learning to meditate and box breathe will not address the root cause of their issues. I think nearly everyone has seen headlines indicating the world is in a mental health crisis, with the U.S. seemingly worse off than most countries. We’re not in a mental health crisis. Our crisis involves never learning how to stay mentally well, and reaching for quick fixes that actually exacerbate the issue.

Let’s review where we see each generation currently struggling the most with their mental health and resources you can provide to assist. We have added information regarding the typical historical perspective of each generation on mental health as they were growing up as it will affect the type of resources they are willing to use, and the strategy the company should use to communicate the resource. One encouraging note is that we’re starting to see more people of every generation willing to access mental health resources where most of the older generations had previously refused. The younger generations are seeking companies who foster a healthy mental well-being workplace to the point it can be a determining factor whether they join or remain with a company.

Traditionalists

Traditionalists are less likely to ask for mental health resources, though many are beginning to become open to utilizing them. This population will benefit from bringing resources to them in a physical setting, allowing for opportunities to learn more about mental health and ways to support it. Most EAP vendors offer onsite training on a number of different mental health topics. If you are utilizing an EAP that is embedded in a different benefit you offer your employees for free, onsite training may incur a fee. If you are leveraging a buy-up EAP program or a standalone EAP, you likely have training hours built into your contract that can be used for this purpose. Make use of these valuable training sessions that can often accommodate in-person and virtual formats. If your EAP does not offer mental health training, or your budget can not support additional costs that may apply, consider partnering with one of many organizations who offer free onsite education in an effort to improve mental health within businesses. Leverage posters, table tents, internal TVs, or notice boards for onsite locations to communicate services available and change them routinely to keep them fresh and engaging.

As mentioned in our physical wellness blog, traditionalists often struggle with arthritis or may be afflicted by other chronic pain which has an immense impact on mental health. A chronic care management program may be beneficial to add, and should be a multifaceted program that focuses on pain management from many perspectives including nutrition, exercise, and even talk therapy. This population has had experienced significant traumatic event during their lives which have been proven to increase risks for chronic pain. Don’t forget, this generation is known to stay silent and suffer through pain without complaining. Make sure benefits addressing chronic pain are proactively communicated and easily accessible. Your EAP may also have resources available in regard to supporting mental health for those experiencing chronic pain.

Traditionalists are typically very private when it comes to personal matters and prefer to keep work and life completely separate (work-life segregation). Due to age, they are impacted by loss on a more regular basis and the loss is more commonly someone with whom they’ve had longer relationships. Though they have had far more experience with death than other generations due to war and other historical events, grief as you age has a different effect. Ensuring direct managers have resources to easily and discreetly share grief counseling services available to the employee and are well versed in bereavement policies will assure they are able to properly support the employee without having to direct them elsewhere. Referring a member of this generation to Human Resources for assistance may induce anxiety. Putting an internal process that is clear and easy to follow will limit how much an employee (or surviving family) needs to remember to do in the event of a death, allowing for a more gracious experience at a difficult time. Consider automating a “death process”, if possible, where the death of an individual affects a company’s benefit plans to initiate required processes which will help the employee (or surviving family) feel supported by the company, while increasing efficiency and effectiveness of the program. In addition, it should not be assumed that it is okay to share a death with team members, for any generation. Respecting the individual’s right to mourn as they need to is paramount. It’s important to ask permission to share such a personal event, and not doing so could lead to a compliance violation in some circumstances.

Baby Boomers

Baby Boomers have lived to work and are very loyal to their careers. As they attain/approach retirement age, they may be struggling with processing the transition which can trigger feelings of depression and anxiety. EAP resources including access to counseling and financial services can help alleviate the effects of transitional stresses, and help them feel better prepared. If you offer access to a 401(k) plan, your provider will likely include resources and access to financial advisors to assist in retirement planning.

Similar to the traditionalists, due to increased age, they are more likely to begin experiencing more frequent death with loss of spouses, family, and close friends. Ensuring they have adequate knowledge of and access to available grief services is important. Though more open to sharing their experiences, Baby Boomers still appreciate work-life segregation. Efforts should still be made to protect their privacy and allow time to grieve, as needed. Managers should be the main point of contact for the employee and should be well versed in resources available, as well as initiating internal processes, as needed.

Though statistics show that Millennials and Gen Z are more likely to have gym memberships, Baby Boomers are more likely to use their gym memberships. Because of the universal benefits of exercise to an individual’s well-being, including mental health, many group health plans and EAPs offer discounts to nationwide gym facilities. Make sure you are communicating any embedded perks within your plans to ensure your participants are getting the most out of the plans in which they are enrolled. Standalone programs or stipends provided for gym membership are additional options to explore to support Baby Boomers looking to increase their holistic well-being through exercise.

Generation X

Generation X has been known since their childhood as a resilient and independent generation, mostly out of necessity. As “latchkey kids”, they were the first generation where it was far more common for both parents to work out of the home for long periods of time, leaving them to care for themselves and their siblings in the afternoons and early evenings during the school year, and during the day in the summer. This had a lasting effect on how they handle every aspect of their life, including their mental health.

Witnessing the long hours their parents worked led them to appreciate work-life balance more, though they often struggle in obtaining it. Generation X is willing to leave a company if promised better work-life balance. Most EAPs offer resources to assist with improving work-life balance. Online accessibility is a must to engage this population in your EAP benefits to help them manage work-life challenges. If they can’t find resources with your company, they’ll seek it elsewhere. As they work to find better work-life balance, this population values greater Paid Time Off (PTO) benefits more than any other generation and will sacrifice pay for time off.

From caring for themselves as children to caring for everyone as adults, this generation is the current “sandwich” generation. They are caring for their own children and caring for their aging parents. Caregiver benefits are of peak interest to Generation X and can assist greatly in relieving stress and supporting mental health. At the very basic level, EAPs often provide access to resources to assist in finding child and/or elder care for family members. EAPs also offer limited legal assistance for common situations that arise in caring for elderly individuals, such as creating healthcare proxy and/or power of attorney, as well as estate planning. It should be noted that most EAPs provide services to anyone in the household (versus only dependents deemed eligible under an employer sponsored plan). Extending counseling sessions to elderly parents they are caring for may be very helpful to your employees with no additional cost to your company. Flexible work schedules are also greatly valued by individuals with caregiver responsibilities to alleviate added stress from trying to manage work and caregiver duties at home. For those caring for family members with an illness, make sure your teams are aware of Family Medical Leave Act (FMLA) requirements at a high level. Individual state legislation, as well as some city ordinances, also may apply to the employee and must be considered. We do not recommend managers handle the FMLA or state leave processes due to the complexities, but they should have clear direction from the teams managing FMLA eligible leaves as to how to initiate the process sharing only as much information as required to protect the privacy of the employee and their family. Caregiver Employee Resource Groups (ERGs) have had great success in providing community support within organizations. Depending on the size of your organization, it may be beneficial to have sub groups within the Caregiver ERG as caring for elderly, caring for children, and caring for individuals with special needs all present different challenges. Lastly, supplemental caregiving services have gained popularity in recent years, though they may not be affordable for all companies. The added cost of the benefit may be worth considering given the value to your employees. These can range greatly from programs that find and manage respite, in-home care, emergency backup care, to employer funded dependent care spending accounts (DCSA). 78% of Americans expect their company to offer some type of caregiving benefits to help alleviate the stress and expense to support mental health, allowing for the employee to be more productive and engaged at work.

Generation X also values mental health resources greatly, seeking out companies that provide insurance coverage specifically for mental health services, dedicated workplace counselors, office space set aside specific for mental health processing, and mental health workshops. Though basic EAPs may provide some of the desired services, a standalone EAP or a vendor specifically designed for workplace mental health would provide better resources for the population. Workplace mental health programs typically provide an expanded network of providers which can shorten wait times for therapy, various clinician led workshops, on-demand online courses, and access to mental health tools. The resources within a standalone EAP or vendor specializing in mental health often have better engagement rates than a basic EAP as the material accessible is updated more often, and technology is typically maintained better.

Millennials

Survey after survey shows that Millennials carry the most amount of stress leading to symptoms of anxiety and depression. This generation is also the most likely to use alcohol and drugs as a coping mechanism for their stress which can have the opposite effect in relieving their symptoms, and lead to greater issues. Substance abuse disorder is a clinical mental health disorder, however, this is likely not what is driving the increase of alcohol and drug use for this population. It’s important to ensure resources you are providing to address mental health (whether it be basic EAP or supplemental mental health resources) provide education on the difference between recreational use, substance misuse, and substance abuse disorder and lead the individual to the appropriate resource given their situation. Consider removing alcohol from work related social events. This will actually increase inclusivity in your population, reemphasize the importance of holistic well-being, avoid potential HR issues that can accompany workplace parties involving drinking, and save money to allow for more opportunities to increase team building. Not everyone struggles with substance use, but those that do, and those that struggle being around other people drinking, will appreciate being able to participate without the additional strain of having alcohol present. As mentioned earlier, providing managers with Mental Health First Aid will assist them in recognizing key identifiers for someone who may be misusing alcohol or drugs to provide necessary resources, or take action, if needed.

It’s important your company provide programs that address stressors that are commonly the root cause for increased anxiety and depression. The largest stressor reported by Millennials is financial stress due to student loan debt and rising cost of living expenses. Providing access to financial planning resources through your 401(k) provider, or a separate financial advisor is a great enhancement to your basic EAP financial services. Another option to consider is offering some form of student loan repayment support. As of the end of 2023, 34% of employers reported they offer student loan repayment in the form of a one-time lump sum, or monthly repayment as supplemental pay up to a specific lifetime maximum averaging between $15,000 and $30,000. Analyzing total compensation to ensure your company is staying competitive with salaries and benefits is critical in making sure your employees are being paid fairly. State laws requiring pay transparency, with many moving to total compensation reporting including benefits, will continue to be implemented so doing so sooner than later will keep your company ahead of the curve, while reinforcing fair pay practices which will build trust and increase employee engagement.

Many Millennials also report stress caused by relationship difficulties having a large impact on their well-being. Divorce rates have been consistently decreasing (for the most part) according to Center for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) data collected from 2000 to 2022, reporting a rate of 2.4 per 1,000 people in the U.S. in 2022. Some studies reveal that divorce rates are down because individuals can’t afford to get a divorce and are choosing to delay divorce proceedings, and even separations, until cost of living improves. This means many individuals are living in homes under relationship distress which causes a significant strain on mental health. 60% of all divorces involve individuals between the age of 25 - 39 putting Millennials in the middle of the impacted population. Marriage and family counseling is not covered under a medical plan and cannot be paid through a Flexible Spending Account (FSA) or Health Savings Account (HSA) as per regulations set by the Internal Revenue Service (IRS). However, most EAPs do provide access to marriage and family counseling under the plan. Making sure your employee education regarding included EAP services highlights the various types of counseling available will increase awareness in the event services are needed. Though counseling may not save a marriage, it can absolutely improve relational tensions, whether with a spouse or other family members.

Millennials are the generation least likely to take their PTO. In fact, they are the group most likely to participate in what’s being called quiet vacationing, or taking time off secretly without requesting it formally. Studies show that individuals are afraid to ask for time off due to manager perceptions and the amount of work that has been allotted to them with many companies downsizing their workforce. Recent trends for companies to offer unlimited PTO actually make the problem worse with a direct correlation with more PTO allotted by a company resulting in less PTO taken by employees. Many skeptical employees believe unlimited PTO is a strategy to get around state legislation in regards to PTO, but unlimited PTO does not remove many of the compliance requirements for tracking hours, including time off with pay. Millennials often have young children. If a PTO bank is offered that is intended to be used for any and all time out of the office, including sick days or time caring for families, this generation is more likely to save PTO to use when they need to be out to care for their children. This can result in a push at the end of the year to use PTO where use-it-or-lose-it policies exist which can cause scheduling issues and tension within teams during the holidays. Leaders should be reinforcing company support for PTO by example. Managers should be diligent about communicating their own PTO to their teams and encouraging direct reports to proactively schedule time off. Companies who opt to leverage unlimited PTO policies should mandate minimum PTO days to take each year, quarterly if possible. If your company applies a limit to your PTO days, consider if supplemental mental health days or family care days should be added to allow time off taken for reasons that would not allow the employee to reset and come back to work rejuvenated. Caring for sick family members is typically not relaxing and can cultivate feelings of jealousy towards employees able to use their PTO for more recreational purposes. Company wide days off may also be worth consideration. For some, the anxiety of coming back after several consecutive days off when the rest of the company is still working is far worse than the benefit of being out for a few days. Consider providing time off to the entire company during periods of time that many employees would typically be requesting time off, such as around Fourth of July or the Holiday season. Productivity is already decreased during those periods and may allow for better performance results leading into and coming back from periods the company would be on leave together, and allow for the employees to feel more supported by the company leading to greater job satisfaction. Company wide closures also allow for opportunities to enhance PTO policies for employees working in positions where added personal time off is not feasible, such as in a manufacturing setting, or a retail setting. Consider adding the extended break after the company’s busiest seasons to acknowledge the extra effort and consider rotating time off between employees in areas where everyone can’t fully disconnect at the same time to meet business needs.

Generation Z

Generation Z is the first generation where the importance of mental health was a consistent discussion point throughout their lives. Gen Z is very vocal in pointing out situations and environments that do not promote mental well-being, and will quickly choose to leave a company that does not support mental wellness or they do not believe champions diversity, equity, and inclusion. They are far more likely to identify ways to maintain their mental health on their own, but do expect employers to provide a psychologically safe workspace where mistakes are okay, individuals feel they can bring their authentic self to work without judgment, and concerns can be communicated openly without repercussions. Managers are essential in creating an environment in which Gen Z can thrive that will benefit all employees, regardless of generation. Leaders must model behaviors expected by the team that foster psychological safety including establishing a culture of trust, encouraging open communication ensuring everyone is heard, requesting frequent honest feedback, avoiding blame or criticism, and actively learning from failures. A company should provide clear policies, and encourage employees to report any violations in a secure manner which should be actively addressed.

Gen Z is known as the naturally anxious and depressed generation, largely thought to be a result of recent world events, having immediate, nonstop, unfiltered access to news, and always being “connected”. Many studies indicate Gen Z spends significant time on social media (average of 3 hours a day) with over 80% indicating they use various apps to connect with family and friends. This population is far more likely to look for escapist entertainment through virtual gaming in an effort to cope with stress and anxiety. Similar to Millennials using alcohol and drugs, what may be seen as a way to alleviate symptoms in moderation is actually exacerbating symptoms when used in excess and leading to greater issues, including financial strain due to overspending. Unfortunately, EAPs are lagging on addressing the effects of technology on mental health and most individuals will not associate resources for other substance use, though the same concepts may help. Increased focus by government agencies to the long term effects of digital overuse for recreational purposes on mental health have brought attention to monitoring electronics usage not related to education or work, including a request from the CDC earlier this year for evidence-based articles related to the topic. Consider adding an “unplug challenge” as an initiative under your wellness program at various times of the year, encouraging a day to fully disconnect from electronics highlighting the benefits to mental health by periodically taking a break from social media, news, and gaming. Timing the challenge to coincide with a team building event or a company wide experience, such as an off-site allows for an added sense of unity.

Similar to Millennials, Gen Z reports financial stress having a large impact on their mental health. Access to financial advisors and student loan repayment are also appreciated by this population.

Gen Z is far more likely to want to lead a company than the older generations were at a similar age. Their ambition is to be commended but they have been accustomed to instant gratification. Many report frustrations with how long it takes to move up in a company and unfulfilled salary expectations having a great affect on mental health which leads to disengagement and lack of productivity. Creating a clear career path with projected time frames to key milestones, training opportunities allowing for tangible learning development, and opportunities for mentorship by employees who have had a similar career trajectory will help set clear expectations, keeping the employee engaged and increase job satisfaction, promoting better mental health.

It’s important to step back and look at the full organization when considering if your company is supporting the mental health of all your employees. When it comes to mental wellness, it’s not just about the benefits and will take a cross functional approach in reviewing potential areas of improvement to address your population’s biggest stressors. Centurion At Work is happy to help and passionate in finding ways to promote a holistically well environment! Contact us to learn how we can help maximize the impact of your benefit programs to promote holistic well-being across the generations.