Summary.    Novartis has trained more than 1,000 employees as Mental Health First Aiders to offer peer-to-peer support for their colleagues. While employees were eager for the training, uptake of the program remains low. To understand why, a team of researchers...

“I almost scheduled an appointment about a dozen times. But no, in the end I never went. I just wasn’t sure if my problems were big enough to warrant help and I didn’t want to take up someone else’s time unnecessarily.”

A friend, who had been struggling with symptoms of burnout, said this to us about on-site counseling that their workplace introduced in the aftermath of the pandemic. Our friend’s experience is not an isolated one: Mental health is a growing challenge for the workplace. The share of people around the globe who struggle with symptoms of anxiety or depression — leading factors undermining mental health — reached 41% in 2021; the figure was 11% in 2019. And employees are demanding greater mental health support: A 2022 report from the American Psychological Association found that 81% of employees view it as a key priority for their future employers.

In response to these trends, many organizations have invested in new mental health initiatives or ramped up their existing ones, such as mental health days, counseling benefits, peer-to-peer support programs, or mental health apps.

But, as the example above illustrates, many employees don’t use these well-intended initiatives.

We — a team of behavioral scientists and organizational behavior scholars — wondered: Why? Is something fundamentally wrong with these initiatives, or do employees not see their value?

Our ongoing research suggests another answer: that stigma around mental health at work can prevent employees from getting the support they need. Our initial findings also offer a simple solution to increase usage of mental health resources: We found that simply hearing about colleagues’ struggles can normalize access to mental health support at work and increase uptake of an existing peer-to-peer support mental health program by as much as 8%.

An Experiment at Novartis

We conducted a randomized control trial with 2,400 employees working at Novartis, a Swiss multinational pharmaceutical corporation. We recruited the sample in collaboration with local leaders from the United Kingdom, Ireland, India, and Malaysia. Over the last couple of years, Novartis has trained more than 1,000 Mental Health First Aiders (MHFA) to offer support in a peer-to-peer program. While employees were eager to become a first aider, uptake of the program remained low.

To test what might encourage people to reach out to a MHFA, we randomly assigned employees to see one of six framings of the peer-to-peer support program. We designed the framings to help overcome two key barriers that prevent employees from engaging with the program: privacy concerns and usage concerns.

• To deal with issues of privacy, we varied whether the framing emphasized the anonymity of the program, or it did not.
• To address usage concerns, we focused on normalizing the use of the peer-to-peer support program. We did so by crossing the anonymity framing with whether participants learned that a colleague had accessed the program because they were dealing with a mild issue or with a more severe issue. This allowed us to explore if the severity of the mental health challenge mattered for increasing the program We also crossed the anonymity framing with a control group that did not see a story about their colleague’s usage of the program.

The mild story focused on daily stresses and anxiety at work: “Recently I started to feel more stressed and anxious at work than usual. It was mostly small things such as a meeting with a client or constructive criticism from a colleague. I lost sleep and struggled to get rid of the knot in my stomach.”

The more severe story focused on depression and issues outside of work: “Recently I left an emotionally and psychologically abusive relationship. It had a major impact on my mental health. I struggled to get out of bed every day, and when I did, I was terrified to leave the house. I experienced debilitating panic attacks, weight loss and major disassociation.”

After seeing the framing, employees were asked to click on a link if they wanted to sign-up to the peer-to-peer support program (MHFA), which was our key metric of participation.

We found that employees who read a story about their colleague making use of the services (irrespective of the severity of the colleagues’ challenges) were more interested to learn about the mental health program compared to employees who did not read a story. When employees read the mild story about a colleague using the services for anxiety and stress, it increased the odds of clicking on the sign-up link by 8%, and when employees read the severe story about a colleague using the services to cope with an abusive relationship, it increased the odds by 6.6%. This means that relative to the no story group, in our sample of 2,400, reading the mild story encouraged 29 additional employees to engage with the services by clicking on the link, while reading the severe story encouraged 24 additional employees. These numbers might seem small, but Novartis is an organization with 78,000 employees and scaling up our intervention might encourage almost 2,000 employees to access mental health support.

Our findings illustrate the power of storytelling in encouraging seeking mental health support. They also align with prior research on stigma showing that employees might not access mental health resources because they (wrongly) assume that anxiety and worry are “normal” and do not warrant professional help. The different stories shared by other colleagues seemed to have helped expand the definition of mental health to include daily challenges such as anxiety and stress.

By contrast, emphasizing the anonymity of the peer-to-peer support program did not seem to increase sign-up clicks. This surprised us, given that one of the most-often cited reasons for the low uptake of mental health support resources is fear of being marginalized or treated differently. It’s possible that merely emphasizing privacy wasn’t strong enough to address the deep-rooted fear that lingers around mental health support in the workplace. Or perhaps anonymity is becoming less of an issue because the pandemic brought mental health concerns at work into the spotlight and enabled employees to be more open about their mental health.

One critical question is whether the different framings of the peer-to-peer support program worked better for some employees. Here we focused on gender and organizational role (i.e., individual contributor vs. people manager). To our surprise, we found no difference in sign-up rates based on these two demographics. However, we did find that men reported having on average 3% worse mental health than women. This interesting insight echoes existing research pointing at the need to normalize talking about men’s mental health as they are less likely to signal that they are struggling.

As mental health challenges at work become the norm, the time is ripe to conduct more research to understand how else to increase uptake of mental health resources, for whom these resources are most effective, and how long employees experience the benefits of accessing such resources. But overall, our findings suggests that one way to encourage employees to make use of existing mental health resources is by creating a support culture in which sharing about each other’s mental health challenges at work — no matter how small or large they are — is celebrated rather than judged.