An HR Guide for Mental Health: How to Address Mental Health at Work While Respecting Employees’ Privacy

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Mental health challenges like anxiety, excessive stress, and depression touch a large number of employees in the US. According to the U.S. Centers for Disease Control and Prevention (CDC), one-fourth of employees view their jobs as the number one stressor in their lives and 40% reported that their job was “very or extremely stressful” (survey by Northwestern National Life). Despite the impact stress and mental health issues have on productivity, performance, and retention, employers often don’t prioritize addressing mental health  workplace wellness. According to the American Psychological Association, Stress in America Report, 61% of adults reported that managing stress is extremely important, but only 35% report that they are managing stress well. This means only roughly half of individuals experiencing stress, burnout, and anxiety receive the care they need. So, why the massive gap? Research shows the stigma associated with seeking care is the foremost factor in play across many employer organizations.

Fortunately, human resources professionals are in a position to help close this gap and many innovative companies are starting to offer mental health benefits as part of workplace wellness programs. Yet, in order for mental health wellness benefits to move from “innovative” to mainstream, two things need to happen: 1) employees must feel that privacy and anonymity are guaranteed, and 2) employers should choose programs that deliver evidence-based results and lead to measurable, meaningful change, and not only “feel good now” impact.

Building awareness around mental health and normalizing workplace stress and anxiety is the first step in establishing a support program that employees feel safe using. HR leaders can move their organization in this direction by encouraging open discussion about the importance of mental health and emotional wellness at the workplace. Making mental health awareness and treatment an organization-wide focus and topic of discussion is one way to achieve this with both employees and management. What does that really mean?

Here are some actionable steps worth considering:

1. Promotional campaigns designed in collaboration with subject matter experts to raise awareness and challenge myths around stress and mental health.

2. Direct employees to an internal webpage where employees can complete anonymous and confidential screening that links employees to appropriate resources.

3. Offer employees evidence-based interventions that are shown to help prevent mental health problems and reduce symptoms (as opposed to those that promise quick fixes).

4. Change computer screens to prompt employees to take a screening.

5. Incentivize participation in wellness programming.

Leveraging the momentum generated from these promotional campaigns, HR and talent teams can align at-risk employees with mental health support programs. But first, how can HR and talent teams reassure at-risk employees that the programs are private and anonymous, and can be used securely during times that work best for them?

When confirming the privacy of a program, it’s helpful for employers to consider the challenge in two ways: 1) protecting employee information from external parties, and 2) protecting employee information from the HR team. While employees want to know their information is safe from the outside world, they also want to know their information will not be shared with their management teams.

Let’s start with external parties. This can be addressed by identifying partners with a track record of data security and clear protection methods in place. Internal privacy (#2 above) can be achieved by finding partners that offer account anonymization as a part of their process.  “Account anonymization” is a bit of a mouth-full, but the idea is pretty simple. Basically, some programs can remove personal identifiers from data, like an employee’s name, so the resulting information isn’t personally identifiable. Make sense? Employers can also make it clear that any employee information sharing will only occur in the form of aggregate, company-level reports.

When discussing privacy, questions about when and where an employee can access their support program might come up. Employees should have the choice to use programs at a time and place when they feel comfortable, whether it’s at the worksite, on their commute, or at home. By providing this flexibility, employees can access programs at a time that feels convenient and private for them, which results in greater engagement and better outcomes compared to more rigid programs. At Lantern, our mobile app provides quick, easy access for employees. Yet, it isn’t a “quick fix”; Lantern involves daily 10 minute long practice sessions that are proven to lead to long-term, meaningful changes. In our app, one can listen to a podcast explaining research-backed cognitive behavioral techniques, engage in relaxation training, and check in on goals with their coach all within 10 minutes, at a time and place that’s best for them. We find most employees use Lantern during times when mental health care providers typically aren’t available, like during lunch, on their commute, and right before bed.

Overall, HR professionals have an incredible opportunity to create a culture of acceptance around mental health, while providing adequate privacy standards to protect users and make them feel comfortable using support programs. At Lantern, we’re excited about the focus many talent leaders are placing on mental health programs in 2016. We’re looking forward to being a part of their journey to deliver evidence-based programs that employees feel safe using, when and where they need them most.


Beyond Willpower: Developing Eating and Exercise Goals From a Place of Kindness Rather Than Punishment

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We’ve all heard that healthy eating and getting exercise can be beneficial for reducing stress and anxiety, as well as  supporting overall emotional well-being.  Yet, as anyone who has ever set a New Year’s resolution can attest to, keeping up a diet and exercise routine year-round is harder than it seems. In fact, studies show that most people who diet regain their weight in the long run.  Additional studies suggest that drastic diet and exercise measures do more harm than good for overall health.  

Having previously dieted for many years, and, now, working with others as a weight-neutral body-positive personal trainer and coach, I’ve seen that not meeting a particular weight loss or exercise goal often leads to feelings of shame, guilt, and failure.  These negative emotions cause more stress and anxiety, which ironically has the opposite effect of the goal’s intention.

So, why is it so hard to follow through?

Many of us were taught from a young age (either by family or by society) that the way to make change is by gritting our teeth and exerting our willpower.

Yet, psychologists who study behavior change show that the concept of willpower only takes us so far. Willpower can help us achieve important things in the short term, like waking up early to go to work after a bad night of sleep or getting in an assignment on a tight deadline.  Eventually, we get exhausted exerting so much self-control to do something we’d rather not be doing, and we can’t sustain it in the long run.  With regards to habit change, we’re often working to fight against habits that have been deeply ingrained for years, if not our entire lifetimes.  So, it makes sense that fighting against these ingrained habits would feel like a losing battle.  

If you are someone who struggles with maintaining diet and exercise habits, this is not your fault. The good news is: We don’t have to fight ourselves in order to make change.  In fact, sustainable change comes when we aren’t wrestling with our willpower.  

How can we develop and sustain positive habits without punishing ourselves?  Here are a few ideas based on my experience as a coach.  

 

1. Take should out of the equation.

We are surrounded by so many messages about what we “should” be doing for our health and well-being.  One day, we hear about the benefits of aerobic exercise; the next, we hear that strength training is actually better for us.  We’re sold on the benefits of low-fat diets, only to have this information debunked years later.  How are we supposed to stay on top of this ever-changing information overload?  

I encourage you to forget what you think you should do, even if it’s for just one, brief moment.  Instead, take a moment to reflect inwardly and identify what is important to you.  Ask yourself: Do I want this for myself, or does someone else want it for me?  When I think about taking on this goal, does it fill me with: misery and dread? Joy and excitement?  Determination?  Fear or nervousness? What do I want more of in my life?  

 

2. Pick one small, achievable thing to work on.

Ok, great, so you have a goal that you feel excited about and motivated to get started on. If you’re anything like me, you have a strong temptation to set the bar really high on your new goal only to be disappointed or to give up entirely when things don’t go as planned. I recommend letting go of perfectionism and lowering the bar.  Start with one incredibly small thing that you know you can do.  Maybe it’s exercising for five minutes a day or practicing mindfulness during a meal once a  week. Make it specific, and make it something you are likely to succeed in and feel good about.  Once you are successful, you’re likely to want to build on this success.  

 

3. Hold it as an experiment.

Say you’ve taken on a goal, and you can’t seem to get yourself do it. This is a perfect time to reevaluate and see if that goal is right for you.  Perhaps you’ve committed yourself to exercising seven days a week, and it’s just not working.  Would taking on two days work for you?  Do you really not want to exercise at all? Do you only like to exercise with other people? If you take it all as an experiment, there is more room to try on different things and figure out what actually works for you and your own individual needs.  Sometimes, it takes a few tries to figure it out.  If your goal is derived from what you truly want and desire, you will be more motivated to follow through.  

 

4. Befriend your resistance.

We often receive the message that we’re failures or we’re lazy if we can’t stick to our goals.  In reality, our resistance to making a change is often teaching us something.  Try asking yourself: What is good about taking on this goal?  What is good about not doing it?  

Facing a fear is a common reason why we don’t tackle new things.  It’s scary to try to develop a new habit or let go of an old one; it’s scary to step outside the comfort zone.  For people who are working on changing their relationship to food, being able to sit mindfully with a meal and really feel the sensations of the food going into their body, can be really new, uncomfortable, and vulnerable.  If you notice your resistance to something is coming from a place of fear, can you take a step that’s slightly outside your comfort zone, but not unbearable?

If you’re experiencing resistance because the goal just isn’t benefiting you that much, know that you can always reevaluate and change your goal.  It’s your wellness goal, after all.  

 

5. Celebrate your success.

We tend to be our own harshest critics.  What if, instead, we could celebrate all of the small and awesome things that we’re already doing?  This could include simple things like waking up early to walk the dog, eating breakfast, getting the kids ready for school, connecting with an old friend, smiling at somebody as we walk down the street.  When you achieve a goal, take some time and congratulate yourself, even if it’s for something that seems small.  

With regards to body image, many of us spend a lot of time feeling dissatisfied with and critical of our bodies.  At the same time, our bodies already support us in so many ways.  We breathe and take in air, which allows our body to carry out all of the many functions that get us through the day.  We have the ability to move around from place to place, which looks different for different people.  We have the ability to communicate with loved ones, to show support, to express emotion.  What’s one small thing that you appreciate about your body today?  

If you’re looking for individualized support in setting goals from a place of kindness, whether it’s around body image, stress, anxiety, or mood, a Lantern coach can help motivate you in choosing the goals that are right for you.  

 

Rachel Marcus has been a body-positive personal trainer and running coach for the past four years. She views emotional well-being as a cornerstone of overall physical health.  She is delighted to be part of Lantern’s Coaching Team.  When she is not coaching, you can find her enjoying nature, trying new recipes, or relaxing with her cat by her side.


Preliminary Research Suggests Lantern Anxiety Program Clinically Effective in Randomized Controlled Trial

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These preliminary findings were presented at the Anxiety and Depression Association of America Conference on April 2nd, 2016 by Dr. Michelle G. Newman, PhD, Lead Project Investigator, Professor, Penn State University.

 

The World Health Organization found that 1 in 4 people will suffer from a mental health disorder in their lives. In the U.S., that is estimated around 80 million people. In India, this is roughly 310 million people. However, the number of mental health professionals in the U.S. is roughly 550,000, while it is only 5,000 in India (Fairburn & Patel 2014). Given this significant gap in treatment opportunities and the pressing need for support, an alternative way to deliver mental health care is critical.

 

April 8th, 2016 — San Francisco, CA — Lantern together with our research partners announce the preliminary results of a randomized controlled trial evaluating the efficacy of Lantern’s Anxiety Program. For the past two years, Lantern has been involved in a research study, Mana Maali (meaning gardener of the mind in Hindi).

 

Goals of research initiative

The study is designed as a randomized controlled trial (RCT), a research method in which people are randomly assigned to different treatment groups. RCTs are considered the gold standard for clinical trials. The present trial described below is part of an ongoing study aimed to assess the feasibility, acceptability, and efficacy of online, CBT-based guided self-help programs to reduce anxiety among students in Indian Universities.

 

Why focus on universities in India?

Generalized Anxiety Disorder (GAD) is one of the most common disorders on college campuses and reflects the wide treatment gap between the U.S. and India: 7% GAD prevalence across 26 U.S. college campuses (Eisenberg et al., 2013) and 19% GAD prevalence in male Indian university students (Sahoo and Khess, 2010). In 2012, the Indian government assembled a task force for the Prevention of Suicide and Promotion of Wellness as only 1.6% of all students across 86 institutions (specifically central government funded technical universities) received counseling. A number of factors drives the treatment gap in university settings including stigma, treatment cost, availability of treatment, and confidentiality (research suggests Indian students prefer self-management options).

 

“One third of the population in India are youth and a quarter among them experience significant mental health problems resulting in distress and dysfunction. However, a very less percentage seek help due to lack of knowledge, stigma, and lack of facilities. As the internet is the most frequently used medium for most of their activities, it offers a safe and potential way of delivering mental health care to this population.”  Dr. M. Manjula, Additional Professor, Department of Clinical Psychology, NIMHANS, Bangalore, India (Research collaborator)

 

The study design and preliminary results

The research team implemented a university-wide, online diagnostic survey across 4 universities to identify interested students that were in need of treatment (both clinical and subclinical Generalized Anxiety Disorder) across four campuses. Thus far, 167 students have been randomized into one of the three following conditions: 1) Lantern Anxiety program 2) Mental Health Online (an un-coached online CBT program) 3) a wait list control group (no treatment). However, randomization to the self-help condition was discontinued after noting a significant lack of student engagement, therefore, that sample is smaller than the others. Outcomes measures include the Generalized Anxiety Disorder Questionnaire for DSM-IV, the Penn State Worry Questionnaire, and a Depression scale, in addition to a number of other measures of anxiety and overall quality of life. Compared to no treatment, both Lantern and Mental Health Online showed a greater reduction in overall GAD symptoms. Based on analysis of the preliminary data, Lantern led to a significant decline in worry (p<.001), GAD (p<.001) and depression symptoms (p<.001). Lantern also had the highest engagement, meaning students were more likely to follow-through with the study from pre-screening to completion of the follow-up survey. Of course, many more factors contribute to the effectiveness of digital health interventions in various populations, such as stakeholder support, user engagement, and such factors should be given similar evaluation when considering the external validity of these findings. Research on these factors is still underway.

 

What’s the value of this research?

Researchers suggest that online, guided self-help (GSH) programs are less stigmatizing and more acceptable to students and potentially more cost-effective. More specifically, researchers found many potential benefits of the Lantern Anxiety Program approach for students: privacy concerns – students can follow the program and receive mental health coaching anonymously; accessibility in that students can use the tools to reduce anxiety anytime throughout the day; and the emphasis on evidence-based techniques.

 

“Being a coach has been a tremendously rewarding experience for me. We form a bridge between the student and his mental health. With continued persistence I was able to break the hesitance of the students to open up and make them realise that there is no taboo attached and that anxiety and depression are prevalent amongst students and with help one can conquer it and lead a healthy productive life. We as coaches are able to customise the Lantern anxiety program and provide the necessary help and motivation for the individual needs of the students.” Kumudini Velanand, Mana Maali Lantern Program Coach

 

Our perspective

As the leader in evidence-based online mental health wellness, these results not only help to support the clinical effectiveness of our programs, but also demonstrate how we think about evidence generation in digital health. “The important thing to us is objectivity. We want to design all evidence to limit conflict of interest” Megan Jones, Chief Science Officer. Through collaboration with academic partners, the recruitment, data management, analysis, and authorship are handled externally to keep evaluations objective.  

 

We’d like to thank all key investigators and collaborators, including BITS Alumni Association International. BITSAA International has supported this project from the beginning.

 

“Alumni of BITS-Pilani from all corners of the world, represented by BITSAA International, have been enthusiastic supporters of Mana Maali; having recognized the need for a structured mental health support system for students living on campus and going through the rigors of a demanding curriculum. We are delighted to see the positive impact this program has had on the mental well being of our students in all of our campuses.” Jayan Ramankutty, Chairman of BITSAA International

 

Key Investigators and Collaborators:

This research initiative is led by Dr. C. Barr Taylor, MD, Dr. Michelle G. Newman, PhD, Nitya Kanuri, BA, Dr. Josef Ruzek, PhD, Dr. Eric Kuhn, PhD, Dr. M. Manjula, PhD, Dr. Smita Sharma, PhD, Dr. Megan Jones, PsyD, Dr. Neil Thomas, PhD, and Dr. Jo-Anne Abbott, PhD.

Done in collaboration with researchers at Stanford University, Pennsylvania State University, Birla Institute of Technology and Science Pilani (India), National Institute of Mental Health and Neuro Sciences (India), Palo Alto University, White Swan Foundation (India), Swinburne University of Technology (Australia) and Lantern. The research consortium partnered with BITS Pilani to better understand the prevalence of anxiety and stress among students in Indian universities. Their goal is to make mental health services more widely accessible in universities across India and, in doing so, embody Mana Maali.


Our Values

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Our Mission:

Mental health is for everyone. Lantern’s mission is to provide affordable and accessible services that empower people to live their healthiest and happiest lives. Ultimately, our relationships, our families, and our communities thrive when individuals prioritize their mental and emotional wellbeing.


Our Core Values:

Be Authentic: To make sure our product helps our users and coaches, be evidence-based and data-driven. In our office, and in our product, strive to be genuine.

Be Open: Be curious and motivated to keep learning and changing for the better. Value unexpected connections, creative solutions, and divergent thinking.

Be Driven: We expect intrinsic motivation and a commitment to Lantern’s mission, which allows us to trust each other to do our work and do it well.

Be Good to Each Other: Start with respect. From there, listen, engage, and keep trying to understand until you get it. Recognize that getting help and feedback is just as important as giving it.

“One of our values is simply ‘Be good to each other.’ I think that means starting from a place of respect; it’s amazing how easy it is to communicate when you start there.” Tali Beesley, Senior Content Strategist 


Our Goals and Aspirations:

IMG_3433Seek Balance: Work and life do not need to be at odds with one another. Maintain a flexible outlook on goals, objectives, and projects and strive to keep everything in balance.

Have Fun Every Day: Do the little thing that will make someone else’s day more joyful. When we have fun, we like each other more, are more productive, and are more likely to want to come to work.

Forget the Hierarchy: At Lantern, the best idea wins, no matter who it comes from. Collaborate with others as your equal.

Strive for Inclusivity: Mental health is for everyone. When interacting with current users, approaching new users, hiring new employees, and creating new content and experiences, make decisions that strive for inclusivity.

“I like working at Lantern because of the inclusive and collaborative environment.”

Megan Murk, Health Coaching Manager



Our Benefits:

  • Unlimited PTO
  • Flexible work-from-home policy
  • Weekly all-hands meetings
  • Team lunches, Thursday fun time, and team outings
  • Health focused office: healthy snacks, non-alcoholic beverage options at happy hours, adult coloring books, optional weekly planking or yoga breaks & Bananagrams
  • Company swag: David’s Tea mug, Happy Socks, and a Lantern hoodie + stickers
  • A dog-friendly office in SF’s SOMA, accessible by MUNI, BART, and CALTRAIN
  • Competitive salary and benefits

“Working at Lantern gives me a greater opportunity for impact and allows me to wake up everyday and feel like my work is meaningful.”  Megan Jones, Chief Science Officer

Check out our current openings & join our team!

 

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How to Build a Stronger Employee Benefits Program: Recognizing the Relationship between Mental Health & Heart Disease

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At Lantern, we believe it’s time to start thinking about new and different ways to support employee wellness. It’s time to embrace technology, and to break down barriers that keep employees from accessing care. Most of all, we believe it’s time to make mental health a core component of employee wellness programs. Because effective mental health programs not only improve employees’ sense of emotional well-being, but also reduce their susceptibility to common, life-threatening physical conditions. Today, we’re talking about one of those conditions in particular–heart disease–and its significant, often overlooked relationship to mental health.

Many of us know that heart disease is the leading cause of death in the U.S. Risk factors for heart disease like high cholesterol, high blood pressure, smoking, an unhealthy diet, excessive drinking, and a lack of exercise are common knowledge, but these only cover the physical risk factors and neglect the significant mental health component of cardiovascular disease.

Mental health challenges like anxiety, stress, and depression can increase the risk of developing a heart condition by changing how our cardiovascular system functions. For example, work stress can increase hormones like adrenaline and cortisol levels, which can impact both blood pressure and heart rate. It’s also hard to make conscious healthy choices (around food, exercise, smoking, and general self-care) if we have persistent feelings of low energy and depressed mood.

Anxiety and depression can not only accelerate the onset of heart disease, but also exacerbate an existing condition. To provide some context, the prevalence of major depressive disorder is remarkably high for people with heart disease and they are at a 56% higher risk of symptom exacerbation. Research shows between 30 and 40% of all people who’ve had coronary artery bypass graft (CAPG) surgery, a procedure used to treat coronary heart disease (CHD), are affected by depression. Imagine an employee suffers a heart attack, a stroke, or undergoes open heart surgery. Our immediate concern is that the physical damage is repaired, right? But it’s especially important for that employee to have access to mental health care to cope with the feelings of depression that often complicate the aftermath of a traumatic medical event.

Depression and anxiety can also act as barriers to care for people who need treatment for heart disease symptoms.  People experiencing both heart disease and mental health challenges could avoid medication or withdraw from treatment programs due to low motivation, lack of self-confidence, or a sense of hopelessness. These factors could simultaneously lead to heart disease progression and worsening mental health symptoms, reinforcing a negative cycle with poorer health outcomes. It’s important for employees to have access to appropriate mental health care, like early depression screenings, to ensure a highly preventive model of care.

Cardiac rehabilitation programs have shown to improve outcomes for people with previous cardiovascular disease. But lack of adherence to cardiac rehabilitation regimen and high dropout rates pose a significant problem in cardiology. And research shows that higher Hospital Anxiety Depression Scale scores, lower perceptions of consequences, and psychological distress, are key predictors of dropout. A randomized controlled trial found that a cardiac rehabilitation program that included CBT intervention, decreased the risk of recurrent heart disease and heart attack when compared to traditional care. This means that modifications to traditional CBT approaches have the potential to address the emotional and physical health challenges associated with cardiovascular disease.

When building a strong employee benefits program, it’s critical to think of health holistically to provide the best care possible and support employees’ physical and emotional well-being.