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A one-size-fits-all approach to global workforce mental health can’t meet the diverse needs of employees based in different parts of the world. To improve employee satisfaction and quality of life as well as minimize issues such as turnover and reduced productivity in your global workforce, company benefits leaders need a more personalized approach to workforce mental health solutions. So how can organizations make sure that employees in all corners of the world have access to mental health support?
Mental health around the world: global mental health statistics
Rates of mental health disorders are escalating worldwide, especially in the wake of the COVID-19 pandemic. One in eight people worldwide has a mental health disorder, according to the World Health Organization (WHO). In a study of global employees, 41 percent of respondents reported declines in mental health due to the pandemic. “The mental health and well-being of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently,” said Devora Kestel, director of the WHO’s mental health department. Mental health disorders are the leading cause of disability worldwide. The WHO estimates that the loss in productivity due to depression and anxiety alone costs the global economy $1 trillion each year. Some of the countries with the highest rates of mental disorders include China, India, and the U.S.
Barriers to global mental health care
Although effective treatments exist, few people receive the care they need. Globally, more than 70 percent of people with mental health disorders don’t have access to care. The 26 million people worldwide with severe mental illness face some of the heaviest challenges; nearly 90 percent of people who need treatment for schizophrenia in low-income countries do not receive it. Common barriers to care include:
Discrimination and stigma against people with mental disorders
Seeking mental health care remains taboo throughout much of the world. Many developing countries lack funding for mental health, primarily delivering care through psychiatric institutions. This drives many people to keep their struggles secret. Research shows that people in Eastern countries are more likely to view mental illness as shameful or a moral failing than Western countries. People in Asian countries face especially heavy stigma; for example, as many as 80 percent of psychiatric patients in China experience discrimination.
Shortage of trained mental health care workers
With just 1 percent of the global health workforce choosing to work in mental health, there is a glaring shortage of mental health professionals worldwide that severely limits access to treatment. Almost half (45 percent) of the world’s population lives in a country with less than one psychiatrist for every 100,000 people.
Limited education, awareness, and research related to mental illness
Just as there is a shortage of mental health professionals, there is a lack of trained mental health researchers, leaving gaps in understanding mental illness. In developing countries, limited education about mental illness as a health condition that requires treatment prevents people from seeking help.
Geographical distance from providers
In many low- and middle-income countries, mental health conditions are treated in centralized psychiatric hospitals rather than primary care or community health centers. This makes it difficult for people who live far away from a facility to access care.
Fragmented delivery models
In both developing and developed countries, the health care system typically deals with mental health care separately from physical health, creating a confusing maze for people to navigate. Rather than taking a holistic approach, mental health treatment options are often limited, with long wait times.
Cost
Costs and not having health insurance are barriers to mental health services. Even for those who do have insurance, mental health treatment may not be covered in some countries. In addition, many mental health providers are out-of-network, which is expensive.
Inadequate preventive services
The challenge of addressing global mental health can’t be addressed through treatment alone. Prevention is key. Mental disorders typically emerge in childhood and adolescence. Identifying and treating these issues early in life can help prevent disability and improve outcomes in adults. Yet in many countries, child mental health care is still in early stages of development.
Tips for supporting your global workforce’s mental health
Faced with different barriers and needs across a variety of locations, what can managers and company leaders do to support their global workforce? Developing specific programs and messaging to decrease stigma is a good place to start. Employers play an important role in destigmatizing mental illness and nurturing a positive work environment. When managers and company leaders talk openly about mental health, they send a message that employees are safe talking about their challenges, too. Research shows this type of authentic leadership builds trust and improves employee performance. Here are a few ways you can make mental health part of an ongoing conversation in your workplace:
- Be conscious of the language you and others use, and respond quickly to inappropriate remarks about mental illness
- Share internal videos of company leaders discussing their mental health
- Develop a team of “mental health champions” who build awareness of mental health and are non-judgmental sources of support
- Create ongoing mental health awareness campaigns, trainings, or workshops that educate employees about mental illness and encourage them to seek help
- Talk about mental health on all-company calls
- Model healthy behaviors by using paid time off (PTO) or telling employees you took time for a mid-day walk, therapy appointment, or other form of self-care
- Develop and enforce anti-discrimination policies
The importance of localized care
Global workforces require easy access to professional, confidential, consistently high-quality mental health care regardless of where they are in the world. To be effective, that care must also be locally nuanced and relevant.
“There’s an extraordinary difference in how people think about mental health concepts in different countries, from how we describe illness to how we ask people if they’re OK,” says Gus Booth-Clibborn, chief technology officer at ICAS World, a Lyra Health company. In some parts of the world, people express mental health challenges through physical symptoms rather than talking openly. Or people may ask for help with practical concerns like housing or legal status rather than asking directly for mental health support. Understanding these different manifestations can be powerful in getting people the care they need.
With 35 years of experience providing mental health services on a global scale, leaders at ICAS have found that care has to be delivered at a local level to achieve the best outcomes. “And when it comes to local, we mean much more than just language,” says Andrew Davies, chief executive officer at ICAS World. “Language is absolutely critical, but it also involves an understanding of local culture, health care infrastructure, legislation, and geo-political and socioeconomic situations.”
For example, in some countries being part of the LGBTQIA+ community is illegal and members of that community are persecuted. In other countries, suicide is criminalized. In these areas, it’s critical for care providers to offer support that doesn’t put people at risk. Even small actions, like the “thumbs up” symbol, eating during meetings, or calling someone on a Friday can be significant because they may be considered offensive in some regions.
And while it’s critical for global workforce mental health to understand these differences, it’s also important to remember the similarities we all share. “Thinking globally is essentially about cultural competence. At the heart of it is awareness, but awareness isn’t enough,” says Davies. “Sometimes we think too much about how we’re different and not how we’re the same. Certain fundamentals traverse almost every culture—showing respect, listening, acknowledging others, asking questions, being tolerant, expressing interest and gratitude, and finding something in common.”
Balancing global parity with local concerns
Most organizations strive for parity in their global mental health benefits, so that there’s a similar standard everywhere in the world for the types of services available, wait time to access those services, and quality of care. But what does global parity look like?
“It’s critical to realize that the world is not the same,” says Davies. “And it’s a mistake to try and treat it as the same because different countries have different languages, cultures, religions, health care systems, legislative environments, geographical challenges, and attitudes towards mental health. A great global mental health program is one that’s able to recognize, respect, and accommodate those differences.”
At Lyra, we do this by ensuring that our services are relevant and appropriate to every country. Care is not only provided in local languages, but also adapted to local conditions. For Lyra, parity means global operational consistency and ease of access, along with flexibility at the country level to accommodate important local considerations.
For example, in many Western countries, we often respond to a critical incident by running a group trauma debriefing session with those who are impacted. However, in countries such as Japan, where there’s a heavy stigma around mental health and expressing emotional distress can be perceived as a weakness and bring shame to an individual’s family, a group session is often contraindicated and we would need to intervene on an individual level more appropriately.
Some essential ways to achieve balance between global strategic alignment and local relevance are:
- Identify a strong in-country program champion or local custodian who understands the unique local needs and challenges and can communicate those to stakeholders
- Choose a global mental health benefit that understands the local environment and can work with a company custodian to position the program to meet those needs
- Make sure the benefit has a robust local clinical presence with providers who are equipped to deal with local issues and challenges
“Mental health is deeply bound to context and culture,” says Davies. “An employee in Germany isn’t too concerned about whether or not she has exactly the same service as her colleagues in the U.S. She’s more concerned about having easy access to high-quality care that’s relevant and appropriate to her needs. Seeking parity is a noble pursuit—one that should be about consistency in standards of care and an ability to manage local differences effectively.”
Learn more steps you can take to support your global workforce’s mental health. Download our guide.
CONTACT US
If you want help connecting with a therapist, Lyra can assist you. You can get started today if Lyra is offered by your employer. Sign up now. For employers who want to learn more about how Lyra addresses network adequacy and quality issues, download our white paper on quality or get in touch. And check in frequently here or follow us on Facebook, LinkedIn, and Twitter for more insights into supporting employees’ mental health.
ABOUT THE AUTHOR
Meghan Vivo is a content marketing strategy manager at Lyra Health, where she helps transform mental health care through education, outreach, and storytelling. She has worked in health care marketing for 15 years, specializing in behavioral health.
