Positive Approaches Journal, Volume 11, Issue 3

Volume 11 ► Issue 3 ► November 2022

The Contribution of Psychological Safety to Employees Mental Health

Kate Price, D. Clin. Psych, Organizational Culture Consultant, Author

Introduction

The issue of mental health in the workforce is increasingly coming to the fore in the wake of the pandemic. We are seeing huge numbers of employees changing jobs, suffering from stress, anxiety, burnout and even leaving the workforce entirely.

In 2019, the World Health Organization updated its definition of burnout as a syndrome resulting from unsuccessfully managed workplace stress.¹ The American Institute of Stress tells us that within the US, 83 percent of workers suffer from work-related stress, 53 percent are disengaged, and one million miss work each day due to stress.² This has a huge cost to organizations, with depression-induced absence alone, costing US businesses $51 billion a year and billions more in healthcare costs.

With chronic stress being a predisposing factor for mental ill health, as well as substance abuse and other diseases, this is clearly a major cause for concern.

Perhaps the biggest question this raises is, where does the responsibility for mental health lie? Is it an individual issue or a systemic one? What role does our environment play? And what responsibility do employers have to support the well-being of their employees?

Organizations and society as a whole tend to view mental health as an individual issue, suggesting those who are not in perfect mental health are somehow deficient or weak. As a clinical psychologist, I would instead suggest that it is the environments in which we expect people to live and work that bear at least some of the responsibility.

To exemplify this idea, I would like to introduce you to Jeff, a client of mine that had two very different experiences in the workplace.

A Tale of Two Workplaces

As an employee of a large hierarchical organization, Jeff felt that he was unable to express his views or tell anyone when he noticed problems in work processes. The culture was one of blame from the top down and layoffs were becoming the norm. He described feeling unable to be himself at work. He felt he was always having to present the right image to avoid being judged, criticized, or potentially even being demoted or losing his job. Over time he shut down and became more and more withdrawn. He interacted less with his colleagues and felt that he was unable to ask for help with either work tasks or personal needs.

Without any support in the environment where he spent a large part of his waking hours, he began to fear going to work where he felt alone and at times despairing. His sleep was affected leading to, not just a reduced capacity to manage his workload, but also a reduced ability to manage his emotions, which at times felt overwhelming. As he withdrew, his boss assumed Jeff was disengaged and his criticism increased. His boss’s comments in front of Jeff’s colleagues and team provoked feelings of shame and doubt in his own abilities. As his stress levels mounted and he attempted to deal with his toxic work environment, his feelings of anxiety and depression increased. Jeff’s risk of a serious mental health crisis increased significantly.

When I first met Jeff, he had reached out for help after finding none was available within his organization. As we discussed what was happening, he came to the realization that his workplace was toxic. He was struggling to make changes within a system that did not care about his needs but was instead focused solely on business output and efficiencies. In the midst of his emotional and mental struggles, Jeff had put the blame firmly on himself and had not recognized the impact his environment was having on him. Within a couple of months, he was able to find a new job. His new organization supported and invested in his coaching relationship with me. Initially, Jeff was fearful of offending his new boss and held back in case he said something wrong. He made an effort to fit in with his new colleagues but did not want to stand out and so did not share his creative ideas or challenge the status quo. In the past, his confidence enabled him to challenge existing beliefs and team norms and he reflected that people had appreciated his original thoughts.

So why was he holding himself back? The fears and self-doubt that are created in a toxic environment, and the associated stress and anxiety do not magically disappear when we find ourselves in a new and more positive situation. The effects of feeling shame, unvalued, or at risk of rejection linger. We must learn to trust that our new environment is different. As Jeff was encouraged by his new colleagues, treated with empathy, and accepted by the group, he began to share his thoughts and ideas. He gained confidence in reporting mistakes knowing this would lead to solutions, could ask questions, and expect to receive thoughtful answers. He came to trust and respect his colleagues and know they felt the same about him. When his mother died, he didn’t hesitate to tell his coworkers and boss and received both the practical and emotional support he needed in that moment.

In this workplace, unlike his previous one, Jeff felt psychologically safe.

What is Psychological Safety?

Psychological safety is a term used by William Kahn in 1990 as “being able to show and employ oneself without fear of negative consequences to self-image, status or career."³  It has since been researched in depth by Amy Edmondson, a Harvard professor, who describes it in her book The Fearless Organization as "a climate where people feel safe enough to take interpersonal risks by speaking up, and sharing concerns, questions, or ideas." ⁴

If we consider Jeff’s first experience, it is easy to see his fear of negative consequences if he spoke up and how this discouraged him from taking risks. In his second, psychologically safe workplace, we see how despite the negative impact of his former environment, Jeff rebounded and felt confident to be himself at work, knowing that his voice and diverse perspectives would be valued and that he was accepted by his colleagues. If we can create environments where people can be themselves, feel accepted, and be able to speak up then we reduce emotions that lead to both stress and other serious mental health issues.

Is Mental Health an Individual or a Systemic Issue?

I believe it is both and therefore must be addressed at both levels, as well as changing perceptions of mental illness at a societal level. As we saw with Jeff, the same person in two different environments can either thrive or struggle to survive. His situation was not just about individual resilience, it was about the impact the environment around him had on his ability to function, the way he felt about himself, and how he built relationships with others. These factors are core to our well-being and if we could design psychologically safe workplaces then we would be taking positive steps to preserve our employees’ health and well-being, as well as reducing the pressure on the mental healthcare system. From a business perspective, we would be facilitating productivity, collaboration, and business success which are typically the ultimate goals of most organizations.

If we think specifically about the pandemic, we can see the impact that the environment and our external circumstances have on our mental well-being. A high percentage of people struggled as we were forced to remain isolated, cooped up in our homes with huge uncertainty and fear about what was happening in the world, not knowing the risks to ourselves or our loved ones. As the pandemic continued, we saw increasing rates of mental health problems as a result of anxiety, loneliness, and isolation, as we were denied our usual outlets for self-care and relieving stress.

This is certainly not to say that the workplace, stress, or our environment are the only factors at play in mental health issues. Mental health is complex, with many and varied disorders, which have a multitude of underlying causes and factors in play. What I think is true to say is that our environment and negative experiences can contribute to, or exacerbate, the development of mental ill health.

A decline in an individual’s mental health affects many things including: their experience of and enjoyment of life; relationships with families and work colleagues as their ability to handle stress and emotions alters; work performance may suffer; and the levels of compassion for clients, patients and others whom we come into contact with - a condition often known in healthcare as compassion fatigue- is reduced. Beyond that it affects the outcomes for business, it can lead to high turnover, disengagement, reduced productivity, absenteeism, and spiraling healthcare costs, to name just a few.

Moving Forward

Supporting the mental health and well-being of employees does not detract from the goals of a business but instead enhances its success. If organizations understood this, they would be more likely to invest in these areas and intentionally create psychologically safe cultures to the benefit of all. Placing people as a priority supports both individual employees and the achievement of business goals because people are the lifeblood of your organization.

Recommendations for Organizations and Leaders

Some ideas for organizations and leaders to create a psychologically safe environment include:

Conclusion

My own experiences working in mental health services as a clinical psychologist led me to believe that as clinicians, we are tackling these issues too late. We only offer support to people once they are in crisis and often it is difficult to turn issues around at this stage. This is an ever-increasing issue as mental health services are simply overwhelmed. Staffing shortages, a lack of qualified professionals and reduced budgets, alongside a continually growing need for these services, has resulted in access being denied to all but those in the most severe need. This is clearly unsustainable and leads to the exacerbation of mental ill heath in populations which might be more simply addressed if professionals were readily available to meet those needs. The huge stress placed on the healthcare system often subjects healthcare professionals to psychologically unsafe working conditions, placing them at the same risk of stress and burnout that they are working to treat in others.

Psychological safety alone will not prevent difficulties with mental health, nor will it solve all problems in a workplace. However, it is one factor that can be addressed and is known to have a positive effect on workplace experiences, stress, and the development of mental health issues. By addressing some of the root causes of these difficulties we can take a proactive and preventative approach to health and wellbeing. This can change the experiences of individuals and transform the systems they function within.

Dr. Kate Price is an Organizational Culture Consultant. She has a Doctorate in Clinical Psychology and worked for over two decades in the UK's National Health Service. Kate is the author of "Taming the Culture Tiger: the art and science of transforming organizations and accelerating innovation" (Coming December 2022), Owner of DKP consulting she focuses on leadership and cultural change in healthcare and life science organizations.

Contact Information

Dr. Kate Price

Organizational Culture Consultant

DKP Consulting

kate@drkateprice.com