It's not Just Mental Health if it's not Just
Imagine you're in a relationship with a partner who:
Makes joint plans based on their schedule, forcing you to adjust yours
Expects you to meet all their needs without reciprocating
Blames and punishes you if you don’t meet their needs, even when it's impossible or unreasonable to do so
Controls your money and financial security without giving you access to theirs
If you complain or push back, tell you they love you, that you’ll never have it as good with anyone else, and that you’re just misunderstanding or imagining what you think are problems
If this is the person you spend the most time with every day, how mentally healthy would you be?
If your best friend was in this relationship, what advice would you give them?
You probably know where I’m going with this…
If you have a job, chances are you’re in exactly this kind of relationship…with your employer. And because almost everyone is in the same boat, we’ve accepted it as normal. Spending the majority of our days under constant stress, afraid of failure, without the power to make it stop – it’s no wonder that:
“More than half (59%) of American workers are experiencing at least moderate levels of burnout, a notable increase over 2021 (52%) and on par with the levels reported in 2020 at the height of the COVID-19 pandemic”
“Mental health negatively affected job performances of nearly half (46%) of the U.S. workforce in the past year — a significant increase over 2021 (34%).
(Source: 2022-2023 Aflac WorkForces Report)
...and...
“Employees who are burned out reported 22-times worse stress and anxiety at work compared with employees who aren’t. Burnout was closely associated with degraded employee performance, including 32% worse productivity and 60% worse ability to focus.”
(Source: Future Forum Global Survey)
It’s not “just stress”
Those stats are for people who self-reported being burnt-out. How many more kept silent due to stigma? How many didn’t even believe they were burnt out, that they were “just stressed” or “this is just how work is”?
It should go without saying that it doesn’t require reaching burn out to be sick. Stress – especially continuous stress – is medically associated with many diseases, and not just “mental” ones. As the medical doctor and trauma and addictions expert Gabor Maté says in his book, The Myth of Normal: “A signature marker of stress is inflammation. Inflammation is implicated in an extensive range of pathologies, from autoimmune conditions to vascular disease of heart and brain, from cancer to depression.”
In the same book, he quotes scientist Dr. Steven Cole as saying: “A theme that comes up over and over and again is this increase in inflammatory gene activity in people confronting a sense of threat or insecurity for more than a short period of time…the more stress or threat or uncertainty you’re exposed to, the more the body turns on this defensive program that involves more inflammation.” [emphasis mine]
Even before COVID, before working parents and online-schooled children were imprisoned together in their homes, before people either lost their jobs or risked their lives going to work – work in capitalist Western society was and is extremely stressful. The abusive, power-imbalanced, transactional relationship between employers-employees that is foundational to capitalism is emotionally toxic to our human natures that crave connection, affirmation, and mutuality. Add on top of that continuous job instability, financial insecurity, and unpredictable futures – these are powerful forms of the “threat or uncertainty” that lead to stress and mind-body illness.
Inequity adds to illness
Companies who profess to support mental health and diversity, equity, and inclusion (DEI) for their employees, but who silo their efforts or treat them as unrelated initiatives, are missing yet another intersectional aspect of DEI. Medical practitioners who wear a JEDI lens (my acronym for Justice, Equity, Decolonization and Inclusion) have long advocated the awareness of “social determinants of health”, i.e., that illness or wellness is inextricably linked to a person’s socio-economic situation, not just their physiology. The same socio-economic inequities are also present within companies, both as a member of the society they’re in, and as mini-societies themselves.
Some of these inequities came to the forefront during COVID lockdown, such as the utter insufficiency of wages for the lowest paid employees, especially (but not only) for front-line employees. Common sense should easily make the connection between wealth and health, but the link between racism/discrimination and health may be less obvious, especially when it’s systemically embedded more than individually perpetrated.
In the same study that found burnt-out employees reported 22-times worse stress and anxiety, it also found that “female workers [showed] 32 per cent more burnout than their male counterparts”.
And from the 2022 Gallup report, this graphic on the daily stress of U.S. and Canadian employees highlights that:
Daily stress increased by 7% from 2020 to 2021 to 50%, a new record high
Globally, daily stress levels also reached an all-time high (44%), but not as high as in the U.S. and Canada
A gender gap exists in daily stress (as it does in almost everything): 7% more women reported daily stress than men
Neither of these reports provides stress data by race, but there’s plenty of evidence elsewhere that racism – among its many harms – further increases stress and illness among racialized people. In The Myth of Normal, Dr. Maté notes that “Another study observed higher rates of inflammation in African-Americans than in Caucasians, an epigenetic effect that remained even when comparing those of the same socioeconomic level.” [emphasis mine]
In Dr. April Thames’ article entitled “Racism Shortens Lives and Hurts Health of Blacks by Promoting Genes That Lead to Inflammation and Illness”, she reports that “experiences with racism and discrimination accounted for more than 50% of the black/white difference in the activity of genes that increase inflammation.”
And as it does in everything, within the gender gap exists the race gap. In this article entitled “Do US Black Women Experience Stress-Related Accelerated Biological Aging?”, researchers reported that “at ages 49–55, black women are 7.5 years biologically ‘older’ than white women. Indicators of perceived stress and poverty account for 27% of this difference.”
Mental health requires Justice, Equity, Decolonization, and Inclusion (JEDI)
Societal awareness and acceptance of mental health has come a long way in a relatively short time, similar to the awareness and acceptance of systemic racism and discrimination. But when it comes to our collective understanding of the causes, impacts, and inter-relatedness of these issues, we’re still at the very beginning. How can it be otherwise, when Western medical doctors – historically (and currently) a mostly-homogenous population of high-income white men – haven’t acknowledged the systemic inequities that exist within their own profession and institutions, let alone recognized the diseases and ill-health that result?
So if employers and companies are truly committed to “creating positive change for mental health”, as promoted by mega-corporation Bell Canada in its “Bell Let’s Talk” campaign – they should start by taking an honest, trauma-aware, JEDI-informed view of how they work.
I’m not referring to “company culture”, i.e. social events, mentoring programs, or insurance benefits. If we’re talking about mental health, we have to talk about all the socio-economic determinants of health, such as:
Security
Are you paying living wages to employees? Not just “market” wages, but wages that provide financial security for current needs (a comfortable home, the high cost of food, children’s education and caregiving, elder care) as well as future needs (self-funded health care, aging-at-home)?
Relaxation (i.e. not stress)
Are performance goals and company targets realistically achievable without inflaming people (physiologically and figuratively)? Can the work get done with the current staff complement and within 35 hours a week (the realistic amount of time a person has available outside of family care, house care, cooking, eating, sleeping, and even having fun – all necessary components for mental health)?
Love
Is your employer-employee relationship one that is affirming, nurturing, accepting, and reciprocal? This isn’t about the latest leadership theory or emotional intelligence. All human beings have two fundamental needs: authenticity and attachment. There’s no such thing as “just business” when it comes to our human nature. Our human nature needs love and care, and to love and care for others in return.
Unfortunately, our nature has been mostly overridden by the capitalist norms of production and profit. That’s what makes it so insidious. It’s not that any individual manager wants to abuse their team, it’s that the work systems we’ve created demand it. Managers and even CEOs want authenticity and attachment for themselves and for their colleagues, but there’s reward for that on their performance reviews.
Embed Your Equity and Anti-Oppression Efforts
“Security”, “Relaxation” and “Love” aren't usually part of corporate DEI initiatives, precisely because they're corporate. If DEI is treated like an organizational project or strategy, it’s more likely to include anti-racism training than affirmation as a key objective.
Who says those two are unrelated? Do you really believe it’s just a “performance issue” when a Black woman who’s continually told she’s “too aggressive”, gets evaluated as lacking “executive presence” and self-confidence? Do you really think there's no glass ceiling, while telling overworked women that they should “get childcare help” and “show more commitment to the job”?
“Mental health” is impossible if employers do not actively integrate anti-racism, anti-oppression, anti-patriarchy, and anti-capitalism in everything they do, every day.
For your reflection:
50% of U.S. and Canadian employees say they’re stressed every day at work.
Employers have power and control over key factors contributing to employee stress.
How many days per year do you provide affirmation, reassurance, and relaxation to your teams?
What extra supports do you offer to people who identify as racialized and/or equity-seeking?