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February 24, 2021

By Brooke Valle, Chief Strategy and Innovation Officer, Research by Daniel Enemark, Ph.D., Senior Economist @danielenemark


The struggle to maintain mental health is a universal experience in the American workplace. Before the pandemic, one in four American workers had been diagnosed with depression[1] and one in three reported having experienced some form of depression[2]. This is even more relevant in this current crisis.   

As February comes to a close, we are approaching 12 months of the battle against COVID-19 and the upending of what work, safety or even community looks like. We are bombarded daily with stats on infections and lives and jobs lost, but even that does not show us the full picture.  

What is often unspoken, and likely not fully understood, is the mental toll, which cuts across sectors, business size, geography and even socio-demographic statistics. If we are honest, we are waging a war on three fronts—physical, financial and emotional—and winning will require not just successful vaccines, stimulus packages, and widespread equity and inclusion, but a new approach to supporting and developing our workers. 

Job loss is forcing workers to make tough decisions between providing for basic needs and putting their own health at risk to generate an income. Racial and gender inequities place extreme burden on BIPOC (Black, Indigenous and people of color) individuals, often forcing them to carry the weight for broken and fractured systems. Women and mothers have also been hard-hit by unemployment during the pandemic and have been expected to fill the child care gaps created by school closures. 

The mental toll of this crisis is not reserved for those who have lost work or even loved ones. It shows up in surprising ways, such as guilt that we are still working or able to pay bills when others are not, pressure to minimize Zoom appearances of children or pets lest we seem unprofessional or uncommitted, embarrassment at letting others down or leaving things unfinished, concern when taking leave that we are being left behind, fear that we are not doing enough to help or protect others, physical sickness, and even terror at saying out loud that we are not okay.  

Personal Perspective 

I am Type A professional driven by a desire to impact others for good. From my early days as a CIA employee, I learned to put mission above self. As a woman who has risen in the leadership ranks in both the private and nonprofit sectors, I felt an innate responsibility to demonstrate that women can tackle any challenge they choose and win 

From the outside, you might say I was successful. In fact, the words inspirational, transformational and impactful have all been uttered. And yet, I am not okayI have been struggling to maintain my own mental health. Struggling with the realization that after a series of deaths and serious COVID-19 illness of my husband, I could not be a fully present caregiver and fully committed to my work. Not because my employer wasn’t supportive but because I simply did not have the mental bandwidth and was racked with anxiety.  

This is not an unusual situation; eight million workers in America are caregivers for adult family members (nearly one in five of those caregivers are Hispanic). And while a third of American workers report experiencing some form of depression, among those with family caregiving responsibilities more than half do.[3] 

Struggling with the pain of loss, the fear of missing an important moment, manifested as physical ailments. I regularly awoke with panic attacks, constant headaches and hormonal imbalance over a growing sense that I could not be a good leader and keep staff energized, encouraged and supported as I felt personally drained.  

Struggling to be a good example to others of how to keep going and stay positive while feeling like a fraud. But most of all, struggling to say it aloud because as a white, middle class professional who has been blessed to work during this pandemic it seemed ungrateful. Talking about own my mental health simply felt like it required more courage than I could muster. This stigma is one of the main reasons the average American waits several years—sometimes even decades—between onset of mental-health symptoms and seeking treatment.[4]

With the help of counselors, friends and my faith community, I arrived at a personal decision to step out of the workforce for a time to focus on family and health. As someone who is all in on my work, I realized that I needed to be all in on recovery.  

This decision is personal and certainly not the only solution to address mental health needs; however, I share it because in deciding, I was struck by the fact that maybe uttering my own struggles aloud would serve others. Maybe the kind of leadership actually needed in this moment wasn’t well-intended encouragement to “take care,” but rather vulnerable self-disclosure and tangible examples. 

Leaders strike the tone; imagine how we can shift perceptions when we demonstrate that mental healing is as important and valued as physical healing, and that neither type of struggle needs to prevent workers from contributing in real ways.  

For me, this was not an easy decision—I love my work and the people I do it with. It forms part of my identity. Thoughts crossed my mind about what this change might say about me as a leader. Stepping out of the workforce for a period might be perceived as failure. Saying aloud that my stress was creating physical challenges from panic attacks to sickness might shatter others’ trust in me. Admitting that I can’t do my best work if I’m worried about whether my husband was breathing might not seem professional. And articulating that family matters more than the important work of workforce development in the midst of a pandemic might seem selfish and inhuman—and yet, it is the honest truth. The kind of truth that is often felt but afraid to be uttered. In fact, these kinds of concerns lead many American workers to conceal mental health challenges from employers, which can prevent them from obtaining support and accommodations.[5] Concealing mental illness is a pervasive practice even in the health care industry itself.[6] And the fear of discrimination can be especially strong among workers who know they are already unfairly judged based on gender, race, ethnicity, sexuality, disability and other elements of their identity.

Supporting Worker’s Mental Health 

In my experience, as leaders, we often encourage each other to practice selfcare, call the employee assistance hotline or take a long weekend to catch up on Netflix, while personally apologizing for having to balance creative caregiving, say we are fine while pressing on with aggressive goals, and logging in while on leave. I am personally guilty of all of these.  

But I believe these approaches, while well intended, perpetuate the idea that it is not okay to be not okay. That it isn’t safe for our professional lives, for that job we are applying for or the promotion we want, to be transparent about mental health. 

And yet, if leaders, both in title and influence, do not create a safe space to acknowledge our humanity, how will we rebuild better?  

Lead with Vulnerability and Openness 

We must use our spheres of influence to create transparency, to share our own stories of adjusted schedules, career breaks, job sharing, dial downs and other innovative solutions instead of keeping them as closely held secrets. We must create cultural norms that don’t shame others for taking a different path but focus on contributions and how workers can quickly reengage after time away. We must equip managers with the tools they need to have meaningful conversations with their staff, reduce organizational stigma, and help workers access appropriate resources. This can be good for the bottom line—for example, research shows that training managers on mental health can increase employee use of assistance programs,[7] and use of those programs reduces absenteeism.[8] On the other hand, failure to support workers on their own mental health journey means failing to tap into the potential of our diverse community. 

Build Quality into Jobs

Job quality also plays an incredibly critical role in supporting the mental health of workers. Efforts to improve the quality of jobs are a cornerstone of equity as they help to shift centers of power by equipping workers, paying fair wages that sustain families and providing career ladders and employee ownership opportunities. For far too long, women and BIPOC have faced discrimination and disadvantage in the workplace, often suffering in silence.   

Living wages allow workers to save and build wealth so they can make necessary decisions in times of crisis.  

Benefits, such as leave and health insurance, provide access to professional care needed. 

Flexible schedules, dial down options or job sharing enable workers to explore ways to structure their workload to contribute meaningfully to both their work and their family.  

Employee resource groups provide space for employees to engage with others who may be experiencing similar challenges and collectively brainstorm or simply let others know they are not alone.  

Simply put, I was able to decide to step out of the workforce for a time because I have had the privilege over many years to work in a good job with a salary that allowed me to save, access to insurance that provided care, and leave that enabled me to flex my time.  

But this is not currently the case for so many workers in San Diego. The most recent Census data indicates that 44% of San Diego County workers made less than the local self-sufficiency wage of $36,700.[9] Many hourly workers get their schedules with so little notice that they cannot provide reliable childcare or keep medical appointments. The move to replace full-time employees with gig workers deprives many San Diegans of the opportunity to earn crucial benefits. The good news is it does not have to stay this way. 

We can collectively use this crisis to rebuild in a way that values workers and supports families.  

Create and Expand Systemic Supports 

Unemployment—especially long-term unemployment—can negatively affect mental health,[10] so mental health supports are a crucial component of any workforce development program. Just as we consider access to transportation or child care and food or utility subsidies, we must build systems that facilitate access to the mental health services workers need in the job search and transition to work. The leading evidence-based model of workforce development builds the entire employment process on the foundation of mental health support.[11]  

So, as we continue our quest to end the physical and financial impacts of the pandemic, let’s not forget the emotional toll. As individuals, let’s take time to listen to our colleagues, allowing our lives to be interrupted to enable our colleagues, friends and family to feel safe and seen. The emotional intelligence muscles you build will not only increase trust with others but are a key skill desired by employers. As leaders, let’s model transparency, create pathways that enable workers to engage in a variety of ways and build quality components into our jobs to attract and retain the best talent. As workforce practitioners, let’s build integrated systems with holistic supports that enable workers to feel supported and contribute their talents to the workforce.   


UCSD Center for Mindfulness: WorkLife Integration Program 

Mental Health America: Peer Support to Address Depression at Work 

Supported Employment / Work Well program 

Further reading: 

Harvard Business Review: How We Rewrote Our Company’s Mental Health Policy 

NAMI: Why Employers Need To Talk About Mental Illness In The Workplace 

How To Create A Workplace That Supports Mental Health 

[1] Evans-Lacko, S., & Knapp, M. (2016). Global patterns of workplace productivity for people with depression: absenteeism and presenteeism costs across eight diverse countries. Social psychiatry and psychiatric epidemiology, 51(11), 1525-1537.

[2] Hopps, M., Iadeluca, L., McDonald, M., & Makinson, G. T. (2017). The burden of family caregiving in the United States: work productivity, health care resource utilization, and mental health among employed adults. Journal of Multidisciplinary Healthcare, 10, 437.

[3] Hopps et al. 2017.

[4] Wang, P. S., Angermeyer, M., Borges, G., Bruffaerts, R., Chiu, W. T., De Girolamo, G., … & Uestuen, T. B. (2007). Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World psychiatry, 6(3), 177.

[5] Grice, T., Alcock, K., & Scior, K. (2018). Factors associated with mental health disclosure outside of the workplace: A systematic literature review. Stigma and Health, 3(2), 116.

[6] Moll, S., Eakin, J. M., Franche, R. L., & Strike, C. (2013). When health care workers experience mental ill health: institutional practices of silence. Qualitative Health Research, 23(2), 167-179.

[7] Dimoff, J. K., & Kelloway, E. K. (2019). With a little help from my boss: The impact of workplace mental health training on leader behaviors and employee resource utilization. Journal of occupational health psychology, 24(1), 4.

[8] Nunes, A. P., Richmond, M. K., Pampel, F. C., & Wood, R. C. (2018). The effect of employee assistance services on reductions in employee absenteeism. Journal of Business and Psychology, 33(6), 699-709.

[9] Workforce Partnership analysis of 2019 American Community Survey data. Self-sufficiency wage estimated by the University of Washington Center for Women’s Welfare (

[10] Marrone, J., & Swarbrick, M. A. (2020). Long-Term unemployment: a social determinant Underaddressed within community behavioral health programs. Psychiatric Services, 71(7), 745-748.

[11] Drake, R. E., Bond, G. R., & Becker, D. R. (2012). Individual placement and support: an evidence-based approach to supported employment. Oxford University Press.

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