The big picture counts in mental health, too

The entire company could be impacted

EAPs (employee assistance programs) and similar services are available in many organizations to help employees with mental health issues, but not nearly enough attention is paid to mental health at the organizational level, says Jeffrey P. Kahn, president of New York City-based WorkPsych Associates. And just as mental health issues can impact the productivity of an individual, they also can impact overall productivity and the performance of an organization.

"Everybody has seen the effects of emotional problems on productivity — from the depressed worker who can’t concentrate on the job to the guy with marital problems who ends up arguing with the boss, too," notes Kahn, whose services, which include individual and corporate consultation, policy development, prevention programs and management training, are designed to complement existing management and mental health programs. "What people don’t realize is that what is obvious on a small scale is just as real
on a large scale, too."

In other words, mental health issues do not occur in a vacuum. "Employees who are happier people tend to be more productive workers. Everybody knows that on the micro side, but not surprisingly it’s equally important on the macro side," Kahn explains.

Organizational problems

There are a variety of ways to look at mental health, ranging from individual problems to organization problems — from bad office politics to dilemmas of organizational change, notes Kahn, who is co-editor of a new book called Mental Health and Productivity in the Workplace: A Handbook for Organizations and Clinicians (Jossey-Bass, San Francisco). Common organizational issues can include:

  • issues of ethics;
  • workplace violence;
  • leadership and organizational structure;
  • organizational change;
  • emotional crises in the workplace;
  • executive distress;
  • job loss and uncertainty;
  • working abroad;
  • office politics

"All of these can leave workers unhappy and not as effective as they might want to be," says Kahn, adding, "What happens at the top makes a huge difference in terms of corporate culture."

To maximize the productivity at your company, you need pay attention to a number of different potential problem areas, he says. "For example, you need to look at the corporate culture — if the company is seen as fair or whether people feel trusting in that environment."

It’s very important to look at management leadership style, Kahn adds. "Managers who act like [General] George Patton can certainly get things done well and quickly, but only at great emotional cost to employees, and in a situation where it’s not easy for them to quit," he points out. "For instance, some unhappy workers on Wall Street are paid an enormous amount of money, so they feel they cannot quit."

Understand your people

In the long run, the most effective and productive approach is to try and understand what makes your people tick and what works for them, Kahn says. "From an occupational medicine perspective, if people turn up in your department, there’s a high likelihood that an emotional problem is one of the reasons," he asserts.

The emotional component is even important for people with physical medical problems, Kahn asserts. "One recent study shows that if you tried to predict the length of disability for workers with back problems, the best predictor is the level of stress and anxiety they’re experiencing," he observes.

Thus, he says, it’s useful to keep in mind when certain health issues turn up in the workplace that you may need to understand the psychiatric aspects that can be associated with those illnesses — for example, absenteeism, violence in the workplace, or critical incidents.

Kahn also is a strong advocate of what he refers to as quality mental health care. "It’s important to front-load the system with the most skilled clinicians you can for initial diagnosis," he says. "Most companies do the opposite and use a low-level approach. Often, employee/patients get lost in the shuffle, not getting the help they need, or getting it much later than they should."

[For more information, contact:

  • Jeffrey P. Kahn, president, WorkPsych Associates, Suite 1C, 300 Central Park West, New York, NY 10024. Telephone: (212) 362-4099. Internet:]