A recent comprehensive summit examining mental health in the workplace recommend establishing healthy company cultures that prevent work-related stress and support the identification and treatment of mental illness. Building cultures of health at the workplace should protect and promote health and safety, enhance performance and reduce socially harmful behaviours. Establishing a culture of health and well-being at work creates an environment where employees feel valued, supported and stimulated to perform at their best in work they find meaningful.

Currently among employed adults anxiety, depression and substance use disorders are the most common mental health problems. Approximately 50% to 60% of adults with mental illness do not receive the mental health services they need and those who do receive care often suffer for years, typically a decade or more, before receiving treatment, during which time additional problems may arise, including physical, social and other emotional impairments.

Productivity losses due to mental health problems have been quantified in several studies. For example, research shows that there are more workers absent from work because of stress and anxiety than because of physical illness or injury. Furthermore, more days of work loss and work impairment are caused by mental illness than other chronic conditions such as diabetes, asthma and arthritis. Employees with depression report their productivity at 70% of their peak performance and approximately 32 incremental workdays are lost to presenteeism for individuals with major depressive disorders.

The summit found that while physical health symptoms primarily affect absence, mental health problems tended to affect performance, and unsupportive work cultures exacerbated the effects of both. Harmful work cultures were characterized by unsafe working conditions, low respect and trust, lack of variety in tasks performed, high workloads and lack of control in decision making. Those working in unsupportive work cultures experienced higher absence rates and lower job performance.

The World Health Organization (WHO) declared that good health encompasses physical, emotional, social, financial, intellectual and spiritual well-being—a positive state whereby individuals thrive, unburdened by disease and disability. To achieve this aspirational state of health described by the WHO employers need to play an active role. To nurture a healthy workforce employers must recognize that their obligation to employees extends beyond making available, with minimal barriers, evidence-based clinical treatments for people with mental illnesses. It must first begin with primary prevention—focusing on reducing the onset of disease by addressing modifiable risk factors and bolstering protective factors in the workplace that are within the control of the employer.

Achieving health in the workplace begins by building and sustaining workplace cultures that enhance health and well-being and focusing on the protection of workers from safety and health hazards in the work environment. Importantly, the design of work needs to address worker safety, health and well-being as well as attending to the needs of individual workers. Physical and psychological job demands should be within the capabilities of the worker and workers should have an active role in deciding on how their work is to be done. The work environment should foster support from both co-workers and supervisors. Through health-enhancing supervision worker skills and job demands are constantly assessed and modified as appropriate. Workers are more productive when they perceive workplace health support from their employer and encouraged by an environment that rewards creativity, team work, safety and resilience to sudden organizational changes. These attributes of a healthy workplace can foster a heightened esprit de corp, and, in turn, act as a magnet to attract and retain top talent.

Beyond primary prevention employers should also have in place support for workers showing signs of mental health problems. Secondary prevention methods such as early detection of signs and symptoms of depression and other mental health problems (e.g., monitoring and screening tools) can help with diagnosis and proper referral for treatment before the disease becomes full-blown. Early intervention is vital and employers can provide these intervention through continuation of primary prevention efforts, such as increasing mental health literacy and reducing stigma, as well as providing resources such as EAPs. By increasing education about mental health, providing support and understanding to mitigate the stigma and fear related to exposing one’s mental health problems, employees exhibiting symptoms may be more likely to seek care.

Healthy company cultures acknowledge that human beings cannot function at 100% the entire workday—workers need breaks that ideally include access to healthy foods, opportunities for physical activity, a balance between job requirements and family obligations, sufficient rest and healthy social interactions with co-workers and supervisors. In short, to be effective, healthy company cultures address both individual and organizational concerns.

Mental and behavioural health are important public health issues affecting between a third and one half of all workers sometime in their life. Since most of life is spent in working years, the workplace is an ideal setting for public health-informed initiatives that promote mental and behavioural health and prevent illness. For businesses, improvement of employee mental health can save substantial resources by decreasing presenteeism, increasing productivity and encouraging retention. Mental health and well-being at the workplace are attainable if employers follow best and promising practices.