Evidence: You’re foot is on fire — what do you do?

in Employee Wellness Programs, Uncategorized, Wellbeing

feet in shoes that are on fire

In an online discussion, Don McCreary, the senior consultant of Donald McCreary Scientific Consulting, and someone for whom I have the utmost respect, was making a case for “a scientific publishing paradigm that supported the publication and dissemination of negative findings.” To exemplify this need, he offered the example of workplace mental health prevention:

There are so many programs that say they are evidence-based, but there’s no evidence that they actually do what they say they do. Are they marketing us snake oil by relying on the phrase “evidence-based” because they’re too lazy to collect the evidence or is it because they have data to show that the program they’re selling or marketing doesn’t work?”

Claims of “evidence based” in all aspects of wellbeing warrant closer scrutiny.

“Are they marketing us snake oil?” I offered my take:

There are other possibilities, though they may be variations of those Dr. McCreary identified:

  1. Buyers and sellers are naive and/or ill-informed, and believe their products/services are evidence-based, even when they’re not. They feel it’s accurate to call something evidence-based because it draws on a framework for which there’s evidence, because they have internal data demonstrating positive outcomes, or even because they can cite a study showing that an intervention like theirs was effective—none of which justifies calling their program evidence-based.
  2. Employers/purchasers don’t care about evidence and aren’t persuaded by it. But they like buying stuff they can say is evidence-based.
  3. Consumers of services, including many employees, also deem evidence uncompelling. This is borne out by a simple glance at the self-help bestseller list or health food section of a grocery store — endless claims of science-ishness (including mental health benefits!), with no real evidence.

All that said, to make evidence a prerequisite for all employee wellbeing interventions might be an unnecessary and unachievable burden. Someone once said:

If my foot is on fire, I don’t need a meta-analysis of randomized controlled studies before I ask someone to throw a bucket of water on it.

Or, as I wrote to Dr. McCreary:

Instead of calling everything evidence-based just to fuel the wellbeing marketplace, there’d be value in broad discussion about “when should a workplace intervention be limited to evidence-based programs/strategies?”

I’ve come to believe it’s okay to implement an intervention if it’s something employees want and we have good reason to believe it will do no harm. This might include, for example, mindfulness programs and physical fitness opportunities, as well as organizational interventions to reduce psychosocial risk factors.

Most HR managers and business leaders don’t know the first thing about evidence — nor should they, any more than a research methodologist should be able to, say, describe the details of workers’ comp regulations and practices.

It will be better to promote education about evidence and the role it should (or should not) play in employee wellbeing strategies, rather than just pretending programs are evidence-based when they probably aren’t.

Bargain Basement: The Future of EAPs?

in EAPs, Uncategorized

I’ve often argued that EAPs have gotten a free pass —complacently marketing limited, outdated, poor-quality services, albeit at a relatively low price. Employers have willingly played along, readily purchasing this relatively cheap employee benefit so that they can check the box. “We have a mental health strategy.” Utilization is notoriously low, and most employers do little to promote the service beyond handing out a brochure or sending a link to new hires.

Recently, a client asked me, “What will become the key driver in the next 5 years moving employers away from EAPs?”

At a time when a lot of change is going on in mental health services, and market conditions are unprecedented, I can only guess 5 years ahead.

One possibility: EAPs survive as a bargain basement option. I can imagine benefit to more innovative, quality driven mental health service providers—those that may charge many times more than EAPs—helping clarify this distinction for employers.

I don’t foresee employers demanding more of EAPs, unless some jumbo employers collaboratively lead the way—for example, by setting standards thru purchasing consortiums.

Keep an eye on increased influence of organized labor. Maybe they will demand better quality. If I were running a mental health company, I might consider promotion direct to labor organizations as part of the long game. Not sure—it’s not my area of expertise.

A lot depends on consolidation. Do the newer solution providers consolidate and leverage their expanded resources to distinguish themselves from EAPs? Or do jumbo EAPs acquire and merge with some of the newer companies, in which case the future—in terms of quality and pricing—is anyone’s guess?

PS: I’m referring only to external EAPs (vendors). Not the internal employee assistance programs that health care organizations and universities sometimes provide for their employees.

Burn-Washing Job Burnout: Close, But No Cigar

in burnout, Uncategorized, Wellbeing

 

Cigar with smoke

A lot of employers offer pseudo-interventions I call “burn-washing” — they give employees a week off, for example, and proclaim themselves mental health heroes — to deflect accountability for job burnout.

I’m all for time off, but it doesn’t do anything for burnout if workers return to the same job conditions — or conditions that are worse because workload accumulated while everyone was kicking back for a week.

In a recent post, I shared the American Psychiatric Association’s latest tips on how to burn-wash. Yeesh.

A new vision of burnout solutions will have to address not just individual treatments and not just organizational interventions… but requisite changes in how our society views work, merit, and leisure. More on this in a future post.

“The Structure of Work Could Be Damaging Employee Well-Being”

in burnout, Featured, Uncategorized, Wellbeing

BandAid

 

“While some employees may benefit from using a meditation app, text therapy or other digital solutions, she cautions employers against stopping there without investigating how the structure of work itself could be damaging to employee well-being”:

From our perspective, you can’t tackle something this significant and immense just by simple Band-Aid solutions.

 —  Tara Thiagarajan, founder of nonprofit Sapien Labs

From CNBC:

Companies Prioritized Mental Health During Covid, So Why Are We Still So Burned Out?

 

 

 

 

 

 

2020’s Trends and Transactions Foretell the Wellness Industry’s Future

in business, Employee Wellness Programs, Uncategorized, Wellbeing

Work-from-home, social connection, telehealth, social justice, mental health… and, of course, the COVID-19 disease itself have been the hot topics of 2020 in the employee wellbeing world.

Meanwhile, the US wellness industry — the business of employee wellbeing — grinds on, with a slew of trends and transactions that foretell its future. Here, I’ve summarized the commercial patterns and milestones that signal which doors are closing and which may open. Continue reading »

Here’s How Employee Mental Health Strategies Can Perpetuate Stigma

in Featured, Uncategorized, Wellbeing

Mental HealthWell-meaning employee mental health advocates, including wellness leaders, may — in our zeal to address mental health — inadvertently reinforce or perpetuate mental health stigma. Here’s how:

1) Viewing stigma too narrowly, especially seeing it only as failure to seek treatment. Mental health stigma includes public stigma, characterized by lack of information (and stereotyping), prejudice, and discrimination, and self stigma, which includes internalization of social stigma stereotypes, reduced self-esteem, and reduced self-efficacy. Reluctance to seek treatment (or not being aware of treatment opportunities) is a critical consequence of stigma. But people who receive treatment, and people who don’t need treatment, experience stigma, too.

2) Not understanding how to address stigma. Anti-stigma campaigns are based on protest (e.g. speaking up against stereotyping); education (like the communication tactics employers commonly implement); and contact (interacting with people who have “lived experience” with mental health problems). Continue reading »

Wellness Doesn’t Work. And It Won’t Work. Until It Does.

in Employee Wellness Programs, Uncategorized

Out of OrderNew study findings from the University of Illinois confirm that an employee wellness program doesn’t improve health or healthcare costs.

Here’s what will happen next:

  • Wellness critics will argue that wellness programs must cease at once.
  • Wellness profiteers will, once again, falsely claim that the studied program was atypical and that the researchers failed to report on measures such as mental health, energy levels, quality of life, or job satisfaction.

Here’s what should happen next:

  • We should be prepared to accept, based on a growing body of evidence, that typical wellness programs don’t deliver on their promise.
  • We should collaborate with employees to figure out how we can effectively support their wellbeing.

Research should be leveraged to improve employee wellbeing strategies. Circling the wagons around the status quo or interpreting studies simply as a yay/nay on employee wellbeing are both unproductive.

See the abstract/article:

Effects of a Workplace Wellness Program on Employee Health, Health Beliefs, and Medical Use: A Randomized Trial

 

Employee Well-being, COVID-19, and the Future of Work

in Uncategorized, Wellbeing

Bus driver during COVID-19 (coronavirus) epidemicI don’t know what’s going to happen to the economy or what course the coronavirus pandemic will take. But I’ve had time to reflect on what a new world order may mean for employee wellness and the future of work.

Here are 10 hopes, fears, and questions (not predictions):

1) We’ll re-frame “meaningful work” — I recently heard, in an interview, a worker who delivers tortillas to grocery stores poignantly articulate what will prevail as a fresh take on meaning and work: Continue reading »

My 2 Biggest Employee Mental Health Flops

in humor, Stress, Uncategorized, Wellbeing

What Were You Thinking?

Podcast interviewers and conference organizers often ask me to talk about my mistakes and failures. Thank you very much.

It’s okay; I get it. Others can learn from our mistakes and also take solace in the fact that we all make them. Listening to some presenter prattle on about how perfect their programs are  especially when they’re from companies with nearly unlimited resources  can be discouraging rather than inspiring. (Besides, if our professional social media is pervaded exclusively by self-promotion and ungrounded thought leadership, it’s hard to grow in a way that’s relevant to the real-life work environment.)

For some reason, two of my professional flops fell in the realms of mental health and emotional well-being. Continue reading »

Free e-book: Now We’re Talking! Transform Your Wellness Program With an All-Out Communication Strategy

in Communications, Uncategorized

Wellness Program communication e-book

There’s no need to be either frustrated or complacent with low engagement in whatever you offer employees. Download the free ebook, Now We’re Talking!, written by Jozito’s Bob Merberg and published by HES, to learn how it’s done.

It’s not just for walking clubs and smoking cessation programs. For example: Everyone’s talking about mental health, and lots of employers name EAP as their main mental health at work intervention. But EAP utilization is typically 4% or less (sadly, 7% is often considered good). When I oversaw EAP for an employer, utilization averaged between 14% and 18%… because, once we had excellent program pieces in place (integrating it with wellness, absence management, and other functions; implementing proactive EAP outreach to at-risk employees rather than just passively waiting to be contacted by those in crisis), we communicated about it: All the time. Everywhere.

Download the ebook and get started achieving the participation, engagement, and results you’ve always wanted.