The Therapist Will See You In Your Cubicle

In a human capital dependent economy, in-house counseling, like free meals and places to workout or relax, can improve productivity and overall performance. JL


Rachel Feintzeig reports in the Wall Street Journal:

In the past, discussion of mental-health issues at the office was uncommon. Workers were expected to leave their personal struggles at home. That's changing. The popular understanding of “mental health” encompasses anxiety and stress. Companies say the benefit can improve employee performance and retention. Employees want mental-health care but often struggle to find the help they need that fits their schedule or is included in their insurance coverage. In-house counseling can save time and money and boost workers’ resilience and productivity.

The therapist will see you now—in your office.

Companies from Dell Technologies Inc. DELL 0.94% to Delta Air Lines Inc. DAL 1.60% are bringing mental-health professionals into the workplace to offer on-site counseling for employees. One-third of large employers—those with 5,000 or more employees—plan to offer on-site behavioral-health counseling this year, up from a quarter of those companies in 2019 and less than one-fifth in 2018, according to a survey from the Business Group on Health.

Companies say the benefit can be a tool for improving employee performance and, ultimately retention. Employees want mental-health care but often struggle to find the help they need that fits their schedule or is included in their insurance coverage, say executives at several companies. In-house counseling can save time and money and boost workers’ resilience and productivity, as well as their overall health and well-being, say health-care experts and human-resources executives.

In the past, discussion of mental-health issues at the office was uncommon. Workers were largely expected to leave their personal struggles at home. Crying was confined to the bathroom stall.

Today, that’s changing. One reason is a broadening of the popular understanding of “mental health” to encompass anxiety, stress and other widespread issues.

It’s also a reflection of a changing workplace. Younger workers are more comfortable talking about their struggles and expect their employers to take emotional distress seriously, says Jeffrey Pfeffer, a professor of organizational behavior at the Stanford Graduate School of Business.

Senior leaders are responding, rolling out mental-health services and sometimes speaking about their own experiences. Lloyds Banking Group Plc chief executive António Horta-Osório has said publicly in recent years that the pressure he felt around the bank’s financial situation in 2011 dominated his thoughts, leaving him unable to sleep and exhausted. He took eight weeks off from the company to recover, working with a psychiatrist. The psychiatrist later helped him devise a mental-health program for Lloyds employees.

Brynn Brichet, a lead product manager at Cerner Corp., a maker of electronic medical-records systems, said she sometimes returns from her counseling appointments with an on-site therapist red-faced from crying. (The therapist sits a few floors down.) If colleagues ask, she tells them that she just got out of an intense therapy session. Some are taken aback when she mentions her therapy, she said. But she thinks it’s important to be open.

“We all are terrified. We all are struggling,” she said. “If we don’t talk about it, it can run our lives.”

Ms. Brichet, 34 years old, sought counseling after realizing she had grown anxious about certain work tasks, like giving big presentations, and started to feel like an impostor in her job.

“Corporate America is a pretty scary place to work,” she said. “After a while that can weigh on you.” Executives at Delta concluded workers needed help, in part, because employees started posting on the company’s internal social-networking site complaining about difficulties getting appointments with counselors on the company’s insurance. In November, Delta started stationing 42 behavioral-health professionals in airports around the world, as well as its offices.

The on-site psychologists, social workers and marriage and family therapists are meant to help employees only on a short-term basis, said Kelley Elliott, a Delta benefits executive. If anyone from pilots to flight attendants to customer-service agents need more help, coaches will connect them with outside therapists.

“We go to work, we go home, and we don’t have the time to take care of ourselves,” Ms. Elliott said of employees’ mental-health struggles. “We need to get ahead of this.” Delta refers to its on-site therapists as “coaches,” but says they are all licensed behavioral-health professionals and subject to the same confidentiality rules as any other mental-health professional.

Scott Shreeve, the CEO of Crossover Health, which staffs clinics at companies like LinkedIn Corp. and Visa Inc. with doctors and nurses, says behavioral health is the fastest-growing piece of his business. In-person mental-health appointments at Crossover’s clinics more than doubled from 15,000 in 2017 to 32,000 in 2019.

“Everywhere we go, it’s a service that everyone wants,” he said.

A 2019 survey by the American Psychological Association found the bulk of Americans say they are stressed by everything from the political climate to mass shootings to the cost of health care. The most commonly named personal stressors: work and money. In a separate study by the organization, 35% of more than 1,500 employed adults reported chronic work stress.

When two rounds of layoffs left an employee at advertising firm Droga5 anxious and overwhelmed, she turned to an in-office therapist brought in by her employer. She said she was comforted when the therapist told her she wasn’t alone in her struggles.

“I felt a bit less insane,” said the employee.

Julian McBride, a Droga5 spokesman, said the company is always exploring different ways to support employee well-being.

Stressed Out

What's worrying Americans at home and at work

What Americans say causes significant stress

71%

Mass shootings

69%

Health care

64%

Work

62%

Current political climate

60%

Money

60%

Terrorism

56%

Climate change

56%

2020 U.S. presidential election

Sources of work stress

Share reporting these are somewhat or very significant sources of stress

49%

46%

42%

39%

39%

Low

salaries

Lack of

opportunity

for advancement

Heavy

workload

Unrealistic

job

expectations

Long

hours

Employees report feeling burned out at work

Always or

very often

28%

Sometimes

48%

Rarely or

never

24%

Sources: American Psychological Association: Stress in America survey of 3,617 adults conducted August to September 2019 (significant stress), Work & Well-Being survey of 1,512 working adults conducted February and March 2018 (work stress); Gallup 2019 study of 12,658 full-time employees (burnout)

Cerner, the medical-records system company based in Kansas City, Mo., first tested on-site mental-health care in 2012 with two therapists working on a contract basis.

“Within six months they were completely full with a wait list,” says Libby Even, who oversees the company’s behavioral-health and wellbeing initiatives.

Now five therapists, employed by Cerner, treat 750 patients a year. Hourlong sessions are offered at no cost for employees, as is antidepressant and antianxiety medication.

The setup comes with some quirks and tension: Workers might run into the keeper of their deepest secrets in the cafeteria or share a therapist with their boss. But by virtue of being embedded, counselors are also up to speed on the nuances of employees’ work lives and the company culture.

“We already understand. We work here too,” says Laura Tuohy, a senior behavioral therapist at Cerner. She explains to patients that if she sees them in the lunchroom, she won’t acknowledge them unless they approach her first, and that she won’t disclose how they know each other.

And then there are the privacy implications. Therapy at the office should still be subject to the same privacy protections—like the Health Insurance Portability and Accountability Act, known as HIPAA—as other health information, said Frank Pasquale, a law professor at the University of Maryland who studies health privacy. Mental-health information is considered especially sensitive under federal and state laws, earning it extra protections, though these can vary from state to state.

“It’s hard for me to imagine a situation in which the employer can actually say, ‘Yeah, I want to see the notes of these therapy encounters,’” Mr. Pasquale said.

Ms. Even at Cerner said that company management isn’t privy to details from individual employees’ therapy sessions but that therapists might share general themes that employees are raising in counseling, and then the company might pilot a workplace program on the topic—“resilience” was one example.

In 2018, Hyland Software Inc., a technology company based in Westlake, Ohio, started bringing in a therapist two days a week for individual sessions for employees.

Lisa Weingart, a 28-year-old recruiter at Hyland, started seeing the office therapist last year after struggling with the transition back to work following the birth of her son.

“Without having it here, I wouldn’t go. A lot of that stuff I feel would be untouched,” she said. “Therapy has helped me bring my best self to work.”

At Hyland, employees pay for at-work therapy using their insurance coverage, just as they would if seeing a therapist outside the office. The therapist, who is contracted, stores all her counseling records on the systems of her own employer, a health-care system, and doesn’t keep physical records at Hyland’s office, according to Kathleen Vegh, Hyland’s director of employee experience.

Hyland also spends $20,000 annually on its at-work therapy services, including paying the therapist to lead occasional group sessions for 10 to 30 people. Ms. Vegh says the therapist relays to the company themes that are cropping up in sessions, like stress, anxiety and depression. The company then asks her to roll out larger group sessions on those topics for more employees. The company also pays the therapist for unbooked sessions on her days at Hyland.

Dell views benefits like on-site therapy as part of an evolving social contract between employers and employees.

“As companies, we continue to ask more and more and more [of workers], so I think it’s really important to be front and center about where we feel we are also trying to support them,” said Amy Green, who oversees Dell’s benefits strategy in the U.S. “We need to demonstrate the commitment to them so they’re inspired to do what we need them to do.”

Dell now has on-site therapists at 11 locations in six states and is considering expanding the program, Ms. Green said. Workers get eight visits for free, then are referred outside the company if they need more. Anxiety and depression are among the top concerns, she added.