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State of Play: Using Digital Technology for Employee Mental Health

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The facts are these:

Over half of those of us from middle and high income countries are likely to suffer from one mental health condition at some point in their life. With the stresses, strains and collective grief of the last year, the mental health landscape is only set to get more and more bleak. In the last year, 39% of employees experienced work-related poor mental health, and poor mental health cost UK employers £42 billion. In fact, in the last year Google has seen a 24% uptick in the amount of search queries for the term “burnout”.

 

As a society and as businesses, this trajectory is massively unsustainable. 

 

We’re now aware that mental health is something that we all have, much like physical health, and it’s something that we have to look after in good times and bad. We also know that mental health conditions aren’t limited to those of us who are diagnosed by a doctor or have been prescribed medication. Stress and burnout are commonly seen in offices and organisations across the world and can lead to further mental health issues such as depression or anxiety. Add into the mix that both absenteeism and presenteeism are rife within the workplace, and it becomes more difficult to ascertain when someone is struggling. 

 

Increasingly, individuals are turning to the digital world for assistance. Whether this is due to anonymity concerns with current workplace mental health interventions, a lack of them altogether, a feeling that they’re not “bad enough” to see a doctor or therapist in person, or that they feel too ashamed to admit they’re struggling due to the stigma that unfortunately still surrounds mental health, the amount of mental health and wellbeing related digital tools are on the rise, especially as a business-provided intervention.

Geoff McDonald, a global advocate, campaigner, and consultant for mental health, observed that “We are still at base camp in breaking stigma. Even though progress has been made, a lot needs to be done.”

 

Why digital tools are the solution

Whilst there are a multitude of digital tools and interventions that have been touted as the next big thing in mental health over the past few years, few actually succeed in being a solution that suits everyone. Much like our physical health, there isn’t a one size fits all approach. Digital solutions, however, are scalable, more accessible and can offer an anonymous shelter from perceived stigma. Already, this style of solution solves many of the common issues such as waitlists for public mental health services, location-based deficits in therapeutic funding, and the financial toll of private sector in-person therapy. 

 

Even in the NHS, cCBT and video-chat based therapy has been utilised with successful outcomes. It seems, for mild-to-moderate cases of poor mental health at least, that digital interventions are increasingly the way forward, successfully balancing the tricky factors of accessibility, cost and effectiveness. This being said, it’s important to note that different digital interventions have different specialisms and consequently varying results of efficacy.

 

Meditation, Journaling & Mindfulness Apps

The growth in meditation, mindfulness and journaling apps signal a shift towards practical action over traditional talking therapy. Although having their therapeutic roots firmly in Cognitive Behavioural Therapy (CBT), the act of writing down thoughts in an unstructured way is something that can be a cathartic process, allowing the individual to gain space from their thoughts and feelings. Similarly, the practices of meditation and mindfulness allow users to ground themselves and be present in the moment, something that CBT promotes so that individuals don’t get lost in negative rumination spirals. 

 

Despite these practices having their individual merit, it’s not a holistic, comprehensive approach that works for everyone. Not everyone is going to feel the benefits of meditation, just as others won’t feel better by pouring their heart out on the page. Although many businesses do utilise apps such as Calm, Headspace and Worrytree, they may only serve a small segment of the employee base, reducing the return on investment for the organisation and further emphasising a fragmented approach to mental health in the workplace.

 

Traditional approaches to health and wellbeing within the workplace have typically focused on physical aspects of wellbeing. Whether this is through free fruit in the office or through the more digitally-inspired FitBit step leaderboards, the use of these wearable solutions miss a trick by not integrating the stress and heart rate monitors that these products also include, which would therefore create a more combined wellbeing approach. 

 

Although it has been proven time and time again that good quality physical health and exercise has a positive impact on improved mental health and wellbeing, solely focusing on numeric metrics such as calories burnt or steps walked can represent a siloed approach which alienates those with disabilities or who aren’t as sporty as their colleagues. Much like the meditation and journaling apps, by only focusing on a single facet of health and wellbeing, these workplace mental health interventions fail to comprehensively offer a service that appeals to the diverse needs of a workplace population.  

 

cCBT options

Conversely, there are several apps such as Leafyard, Thrive and WoeBot that offer a more scientific approach to employee wellbeing and mental health by utilising computerised CBT (cCBT), an approach that has also been used by the NHS. Whilst this does offer a solid alternative to in-person therapy by using the same techniques qualified mental health professionals employ, the onus is on the individual to actually put these techniques and strategies into practice. Additionally, many individuals who don’t suffer from diagnosed mental health conditions, but do want to improve their mental resilience to be able to manage future stressful circumstances, may view cCBT as too extreme for their needs  – that they’re not “bad enough”. Once again, solely using a cCBT app as your business’s mental health intervention only offers one piece of a larger mental health puzzle.

 

This idea of “not being bad enough” to warrant mental health support offers up an interesting paradox. Preventative action, such as resilience training, understanding the role of sleep, diet and exercise on our mental health and having awareness of our emotions and recognising the limits of our control are all excellent skills that translate into invaluable workplace attributes. However, until mental health becomes a problem, we’re unmotivated both as individuals or businesses to invest time and money in our personal upkeep. Therefore, we wait until there is an issue and turn to reactive interventions that are often more time and cost intensive as well as more disruptive to our daily life. Think of it like never bothering to spend a small amount of time stretching before exercising and then being out of action for much longer when you inevitably get injured. 

 

By having a digital mental health intervention that offers both preventative and reactive solutions, you can successfully cater to your entire workforce. Interventions such as Leafyard, a new behavioural science informed mental health intervention currently undergoing clinical trials, use artificial intelligence (AI) to adjust the user journey not only according to the individual’s needs in terms of subject matter, but also the strength of intervention that’s needed, ranging from mental fitness (resilience, diet, sleep, mindfulness etc.) all the way to a full cCBT course. This kind of adaptability whilst simultaneously offering a wide variety of techniques and strategies make Leafyard the ideal type of intervention for businesses.

 

Combination digital & in-person solutions

A final semi-digital offering that has appeared in the marketplace, especially during the last 18 months where face-to-face therapy sessions were limited, if not altogether abandoned, is a hybrid of digital and in-person solutions. Mental health professionals are increasingly offering video-based solutions such as Silvercloud for patients to use between in-person sessions as waitlists and capacity continue to be an issue. It allows individuals to manage their own mental health without losing the human, personal aspect that many find reassuring. 

 

Companies such as Sanctus offer digital journaling and meditation classes alongside in-house mental health coaches that help signpost individuals to the level of help they need. Although seemingly the perfect balance between digital and physical mental health interventions, the physical aspect is still reliant on waitlists, extra costs, location-based funding as well as a lack of anonymity. These are all prevalent issues that employees have expressed when discussing mental health interventions, especially since the rise of remote working and office-based services such as Sanctus aren’t universally accessible. 

 

What makes a practical mental health solution?

So, when we look at mental health interventions for workplaces, there are a number of practical aspects we need to consider, separate to just cost. Of course, price point is a massive concern, but with mental health investment offering anywhere between £5-11 for every £1 spent, there is a huge gap in efficacy when it comes to return on investment (ROI). By opting for a single technique offering, such as a meditation app or a journaling app, your ROI is  more likely to be closer to the £5 mark than the £11. Instead, opting for a solution that offers a multitude of techniques and strategies to suit a wider variety of users, such as Leafyard, Silvercloud or Unmind, you’re more likely to hit that higher ROI in the long term.

 

Time is also a factor that needs careful consideration, after all if the intervention is being paid for by the business, you don’t necessarily want your employees having to take time off for appointments or one-to-ones if it can be avoided. Similarly, if your intervention is going to lead to long waitlists with no mitigation in the meantime, it probably isn’t going to be overly beneficial for your employees. Instead, using a digital intervention that empowers the user to take control and manage of their own mental health straightaway, rather than being reliant on the schedules or expertise of in-person or real time video sessions, ultimately creates a more maintainable, positive outcome.

 

Anonymity is a crucial aspect when it comes to mental health interventions in the workplace. Having the ability to sign up to workplace provided solutions using non-work based email addresses gives employees the reassurance that their data and their progress remains confidential. This therefore gives them the time and ability to improve their mental health in a “safe space” free from concerns over stigma at work. Employees who need help are less likely to sign up if it requires physically seeing a mental health first aider or therapeutic coach in the office environment for fear that it may adversely affect their standing within the team or chances of promotion. Although, as a leader, you may want to know who in your team is struggling, or you might want to measure the efficacy of your chosen mental health solution, foregoing anonymity fundamentally leads to a lower uptake and therefore simply doesn’t create a meaningful, helpful solution. 

 

This being said, having an anonymous solution doesn’t mean compromising on data. Most business to business mental health solutions have some form of analytics dashboard that collates data from across the entire business user base and creates reports based on that. For example, Leafyard operates on a token system wherein businesses buy a select amount of tokens for their employees who can then go away and anonymously sign up for the service. From the operational analytics dashboard, the manager or leader can see the uptake levels, as well as common collective themes that emerge from the mood surveys that the individual users fill in on a weekly basis. This might be that the majority of employees suffer with sleep problems, which can inform business-wide operational strategies or educational pieces the organisation might want to focus on. This gives the business the analytical data necessary to holistically improve mental wellbeing and company culture as a whole, without compromising on the necessary anonymity.

 

From a data point of view as well as a ROI point of view, uptake and engagement are key metrics by which companies and organisations measure the efficacy of the majority of their interventions and benefits, mental health related or otherwise. Improved mental health shows itself in a number of ways separate from having a sunnier disposition. It’s been linked to increased resilience, productivity, innovation and creativity, therefore investing in mental health will fundamentally improve your employees’ performances. 

  

These practical aspects help us as business owners and leaders to determine what we want out of our digital mental health interventions, however this means nothing if the existing company culture is toxic. Mental health interventions only work if there is buy-in from the very top and it’s cascaded and implemented in a controlled and consistent way. If certain managers don’t support the rollout, it’s unlikely that, even under anonymous circumstances, their team will sign up for the intervention. It’s important that everyone remains on the same page.

Lindsay Crittendon, senior strategy director of Headspace for Work, noted that, “If a company wants true behavior change, it starts at the top. Executive and stakeholder partnership from the beginning is absolutely critical for any mental well-being and mental-health employee program to be successful.”

 

Similarly, it’s important to consider what interventions and systems you already have in place and how this new solution will fit alongside it. For instance, if you already have physical exercise challenges and mental health first aiders, how will a mental health app work sympathetically alongside these existing, already embedded programmes? Otherwise, you end up with a lot of different policies which culminate in a messy, fragmented approach rather than a holistic one. Employees can tell when a strategy is confused and fragmented, and as a result are less likely to buy-in. You need to consider not only how you roll out this new benefit but how it integrates with existing services that your employees may have already bought into. 

 

It’s also important to remember that digital mental health interventions aren’t a tick box to say you’ve done your part to solve your employee’s mental health concerns. They need the communication strategies surrounding them to be caring and compelling in order to reassure employees that this is actually there to help them and not another wellbeing week designed to be used in recruitment propaganda. It starts and ends with the culture of the organisation. The employees need to know that organisations genuinely care about their mental and physical wellbeing, otherwise interventions such as the ones discussed in this report, although highly effective, will be met with cynicism and low uptake.  

 

The bottom line

To conclude, with poor mental health on the rise it falls to employers and employees alike to intervene to help solve this society-wide problem. The way in which organisations choose to do this may vary, but it’s clear that multi-discipline, action provoking, digital interventions such as Leafyard are at the forefront of mental health technology and look to dominate in the coming years as the service of choice to solve the ever-growing mental health crisis.