• Managing Mental Health in the Workplace: A Strategy to Retain Employees

    By Lisa A. Eramo Feb 25, 2019

    The head of a medical billing company implemented policies to support her employees’ mental health, including various accommodations as recommended by the Americans With Disabilities Act.

    Katie Fergus knew what it felt like to suffer in silence from depression and anxiety. She worked for more than a decade in jobs where she didn’t feel comfortable opening up about her mental health experiences. 

    Now, as the owner of PractiSynergy—an 18-employee, full-service medical billing company—she wanted to create an environment where individuals could thrive and be themselves. In doing so, she also hoped to: 

    • Foster employee retention
    • Increase employee satisfaction
    • Reduce absenteeism 

    Fergus spoke about how she created a supportive workplace during a presentation at the Medical Group Management Association’s (MGMA) 2018 annual conference.

    “I wanted to nurture my employees so they felt comfortable in the office,” Fergus said during a follow-up interview. “You never know who may or may not have a mental health diagnosis or crisis. It may be preexisting, or it could come on at any time. Being a supportive employer is critical.”

    Approximately 18 percent of workers in the United States report having a mental health condition in any given month, according to the Americans with Disabilities Act (ADA) National Network. Those working in the healthcare industry are particularly susceptible to mental health crises, Fergus said. According to WebMD.com, one physician commits suicide in the United States every day. That’s the highest suicide rate of any profession. 

    “And it’s not just providers. It’s anyone—especially those who put themselves before others,” said Fergus. “Mental health can be aggravated by stressful situations. As patients come in, you never know what you’re going to deal with. By the end of an especially difficult day, an employee might be at the end of what they can handle. It’s critical to give them tools they can use to deal with that.”

    Most employers offer employee assistance programs, but in many cases employees end up having to tap into this resource on their own time. Fergus wanted to provide daily support during work hours via:

    • Communication training to ensure all employees felt comfortable
    • Policies and procedures that supported employees who had mental health diagnoses
    • Wellness benefits that supported physical and mental health
    • Workplace accommodations that enabled productivity

    Learning About What Works

    Fergus, whose background and training were in healthcare finance, knew she needed to gain expertise in managing and accommodating individuals with mental health diagnoses. To build her knowledge, she did an online search for “mental health in the workplace” and says she quickly discovered a plethora of free resources, including case studies, PowerPoint presentations, ready-to-use email content, and more. 

    “There’s an immense amount of information on how managers can support their employees,” she said, adding that she spent an hour a day over the course of a month reading and gathering materials before making any changes within the company. 

    The first change she made was to talk about mental health topics and related news articles during staff meetings. She says employees were initially apprehensive, likely because they hadn’t ever engaged in this type of discussion—especially not in the workplace. “However, as I talked about myself openly, they became more comfortable with the topic,” she said. “I’ve had employees tell me that work is the first place they’ve ever felt comfortable talking about this.”

    Following are several other changes Fergus eventually made as a result of the knowledge she gained:

    Creating policies to support employees with mental health diagnoses. This step included policies pertaining to medical/sick leave, grievance and conflict resolution, and anti-bullying. 

    Implementing accommodations per the Americans with Disabilities Act (ADA). The ADA requires employers to accommodate individuals with psychiatric diagnoses (i.e., anxiety disorder, depression, attention deficit/hyperactivity disorder, bipolar disorder, and schizophrenia) unless doing so causes undue hardship for the employer. 

    Accommodations refer to any change in the work environment or in the way work is customarily done that enables an individual with a disability to enjoy equal employment opportunities. Fergus allowed employees to play music quietly at their desk or wear headphones. She also designed a room where employees could go to relax. 

    The ADA provides other examples of workplace accommodations for individuals with mental health diagnoses (Fergus offers many of these):

    • Flexible schedule to allow for appointments
    • More frequent breaks for medication
    • More frequent reminders of tasks and due dates
    • More frequent short breaks
    • Option to work from home part- or full-time or attend meetings remotely
    • Part-time schedule until medication plan stabilizes
    • Quieter work environment

    Choosing a health plan that includes mental-health wellness benefits. Fergus chose a plan that included coverage of fitness memberships, mental health appointments, and nutritionist consultations so employees could take care of themselves.

    Providing employee training on active listening. Active listening is a skill often taught to teachers, counselors, and priests; however, Fergus felt her employees could benefit as well. In particular, she felt that active listening would foster greater collaboration, respect, and communication among employees. 

    First, she taught these four steps of active listening:

    • Seek to understand before you seek to be understood.
    • Be nonjudgmental.
    • Give your undivided attention to the speaker.
    • Use silence effectively.

    Then she carved out time to conduct various exercises, many of which are available for free online, that helped staff practice using these skills. 

    The Payoff

    Although Fergus hasn’t quantified the effects of these changes, she hopes that employees are happy and comfortable at work. “I ask myself this question: How would I have wanted to be treated as an employee if I were to go back in time?” The answer to this question continues to inform her ability to support her employees and create a safe and productive environment.


    Lisa A. Eramo, MA, is a freelance healthcare journalist who contributes to various HIM and HIT trade publications and also assists clients with content marketing efforts. Read her work at www.lisaeramo.com.

    Interviewed for this article: Katie Fergus, CPA, FACMPE, owner of PractiSynergy and founder of FinanSynergy.

    This article is based in part on a presentation at the Medical Group Management Association’s 2018 annual conference in Boston.

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