Installment IV of VI

Changing Landscape of Healthcare
Changing Landscape
23 Aug 2019

Installment IV: Changing Landscape of Healthcare White Paper

In Part IV, we discuss the financial impact of stress on the workforce. We offer alternative therapeutic options for those who are burdened with stress-related costs in the workforce.

Society is Stressed

Modern society is stressful. Stress causes worry and fear, which lead to anxiety and pain – both physical and emotional. Chronic stress can affect a person’s overall well-being and induce physical ailments, causing a variety of symptoms, including irritability, anxiety, headaches and insomnia. Some of the other harmful health effects that can be caused from excessive stress include:

  • Damage to key brain structures and circuitry (McEwen & Morrison, 2013)
  • Reduced ability to cope with future stress, which can lead to increased anxiety and chronic
    depression (Miller & Hen, 2015)
  • Reduced immune system functioning (Dhabhar, 2014)
  • Increased inflammation and depression (Slavich, George M., and Michael R. Irwin, 2014)
  • The onset of post-traumatic stress disorder (Arnsten, Raskind, Taylor, & Connor, 2015)

Stress in the Workplace

We work 24 hours, 7 days a week and pressures are high. Numerous studies show that job stress has escalated progressively over the past few decades and is now the major source of stress for American adults today. According to the American Institute of Stress, “Increased levels of job stress, as assessed by the perception of having little control but lots of demands, have been demonstrated to be associated with increased rates of heart attack, hypertension, and other disorders” (2018). It is also associated with increased issues of violence in the workplace and job stress-related suicides. In fact, the suicide rate for police officers has increased dramatically over the past five years. In 2018, 167 American officers died by suicide, nearly 10 percent more than the total number of line-of-duty deaths resulting from 15 other causes such as felonious assault, patrol vehicle accident, heart attack, duty-related illness, according to BlueH.E.L.P. (2019). So far, as of July 29, 2019, 111 U.S. officers have taken their own life (Today Show, 2019); this includes the newest addition of fifth suicide by a New York City police officer since June 2019. These numbers are already on track to exceed 2018.

In New York, Los Angeles and other municipalities, the relationship between job stress and heart attacks is so well acknowledged, that any police officer who suffers a coronary event on or off the job is assumed to have a work-related injury and is compensated accordingly (including heart attack sustained while fishing on vacation or gambling in Las Vegas).

American Institute of Stress

Stress is a highly personalized phenomenon and can vary widely even in identical situations for different reasons. According to The American Institute of Stress, one survey showed that having to complete paperwork was more stressful for many police officers than the dangers associated with pursuing criminals. “The severity of job stress depends on the magnitude of the demands that are being made and the individual’s sense of control or decision-making latitude he or she has in dealing with them” (AIS, 2018). Scientific studies support this claim that workers who perceive that they are subjected to high demands – yet have little control – are at increased risk for cardiovascular disease.

Excessive workplace stress causes a staggering 120,000 deaths and results in nearly $190 billion in health care costs each year. (Goh, Pfeffer & Zenios, 2015). According to the Center for Workplace Mental Health, this represents five to eight percent of national health care spending, derived primarily from high demands at work ($48 billion), lack of insurance ($40 billion), and work-family conflict ($24 billion).
High on-the-job demands and insufficient resources contribute to stress (Demerouti & Bakker, 2011). In addition, an effort-rewards imbalance with perceptions of high effort and low compensation or recognition can also contribute to work stress (Siegrist, 2012). Goals perceived as exceedingly difficult, rather than achievable challenges, are also factors in excessive stress, anger, anxiety (Mawritz, Folger & Latham, 2014) and even depression services (Tan, Wang, Modini, Joyce, Mykletun, Christensen & Harvey, 2014).

Workplace Stress: Prevention and Reduction Strategies

Workplace stress can significantly impact the bottom line but employers can develop several organization-wide policies and practices to help prevent stress in the workplace while also helping to improve productivity, employee health and to create a more positive workplace climate and culture.

Some options include providing the following stress reduction services:

  • Information on stress reduction and the early warning signs of mental health conditions
  • Web-based and mobile stress management programs offer employers cost-effective options
  • Stress screenings and intervention programs for stress management
  • Programs that encourage mindfulness and relaxation and encourage exercise, emphasizing the value to mental and physical health, such as:
    • Massage; Meditation; Reflexology; Tai Chi and Yoga, to name a few.
      The City of St. Paul, MN recently initiated one such program and found out that despite the great effort required, there were big rewards in focusing more attention on workplace mental health. The city employs nearly 3,000 people and concerns with stress, depression and suicide created a call to action. The Healthy Saint Paul Committee, made up of representatives from all City departments and headed by HR Benefits, was formed in 2011 to address the health and well-being of the City and its employees. The committee became concerned about suicides, with at least one occurring each year for several years in departments from Fire to Libraries. Much of the committee’s focus had been on physical health, but for this initiative, the Committee focused on education through tools, resources and training; addressed Employee Assistance Programs (EAP) knowledge and use; developed key partnerships; and encouraged visible leadership engagement. According to the case study released by the American Psychiatric Association’s (APA) Center for Workplace Mental Health (June, 2019), the City of St. Paul found that most people were not aware that resilience is a skill that can be taught and are benefitting from skill building in that area and in learning more about mental health in general (2019). St. Paul found that despite challenges, there are big rewards in focusing greater attention on workplace mental health (APA, 2019).
    • Another APA study conducted from April 4-7, 2019 of 1,0005 adults revealed that the vast majority of workers say their employers offer some type of mental health resources, such as an employee assistance program, mental health days, wellness programs or onsite mental health services.
    • In addition, more than 60% of respondents of this national public opinion poll said they feel their employers are providing sufficient mental health coverage. About a quarter (27%) say their employer does not offer sufficient coverage and 13% are unsure.
    • The poll also reported that most workers with benefits know how to access mental health services (70%) and are at least somewhat comfortable accessing services (62%) through their employer if needed. However, the poll also revealed that mental health stigma is still a major challenge in the workplace as more than one-quarter of workers are uncertain about how to access mental health care through their employer and more than one-third are worried about job consequences or retaliation if
      they seek mental health care (APA, 2019). The poll also revealed that younger workers are much more likely to feel they can discuss their mental health at work, as more millennials were comfortable (62%) discussing mental health with coworkers and supervisors than baby boomers (32%). And while most workers say they would recognize signs of anxiety, distress or depression in co-workers and would reach out to help, about one in four respondents said they would not know where to guide their co-worker for mental health help (APA, 2019). “These results show both encouraging and concerning aspects of mental health in the workplace,” said APA President, Altha Stewart, M.D. “The extent to which people are willing to reach out and help colleagues is encouraging. However, the continued hesitancy among many to talk about mental health concerns in the workplace
      is troubling.”

Resources for Employers:

  • Center for Workplace Mental Health – A Working Well toolkit for employers on leading a mentally healthy business ( – Search for the term “Working Well toolkit”).
  • American Psychological Association – Resources for creating a psychologically healthy workplace (
  • Centers for Disease Control & Prevention – Workplace health resources on stress (
  • Workplace Strategies for Mental Health – Tools and resources for employers

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