The Centers for Disease Control (CDC) reported in March of 2023 that "1 in 5 adults (52.9 million) in the United States were living with a mental health disorder in 2020. However, fewer than one-half of adults living with a mental health disorder were able to receive mental health services. Mental health and substance use disorders (SUDs) are monitored together under the category of behavioral health care; therefore, it is also helpful to review the National Survey on Drug Use and Health (NSDUH) report that stated in 2021 46.3 million people in the U.S. had a SUD and 70% of illicit drug users are employed. This report further stated that in 2021, 94% of people with a SUD did not receive any treatment.

As a way to draw attention to the current health care crisis, the American Hospital Association (AHA) wrote a letter to Congress in December of 2022, stating that "the stresses of the COVID-19 public health emergency and its aftermath have exacerbated the already existing mental health crisis…(and) unfortunately, the nation is ill-prepared to respond to these needs due to severe shortages in the behavioral health workforce."

Behavioral health care:

The behavioral health care system describes the following general categories of care: Promotion, Prevention, Treatment, and After-care (also referred to as Maintenance or Recovery).

According to the Substance Abuse and Mental Health Services Association (SAMHSA), Promotion strategies are strengths-based interventions designed to create the environmental conditions needed to support behavioral health by promoting resilience, positive behaviors, attitudes and overall wellbeing.

Prevention interventions are designed and implemented with the intention of preventing or reducing an individual's risk of developing behavioral health problems. Behavioral health promotion and prevention strategies emphasize the importance of providing both education and awareness programs.

In the workplace today, the initiatives which most closely resemble behavioral health promotion and prevention activities are delivered through workplace wellness initiatives. Certified Health and Wellness professionals and coaches coordinate these activities. They focus on chronic disease and stress management, resilience, healthy work and life-style balance.

Human Resource managers are primarily concerned about employee satisfaction, productivity, absenteeism, and turnover. They classify employee mental health or substance misuse as employee relations or risk management issues and struggle to recognize the signs and symptoms of employee substance misuse. And, because many employees work remotely, these managers are even more ill-prepared to address these issues with home-based employees.

Employee assistance programs (EAP) can also provide employees with access to counseling services. These programs were originally established to provide alcohol treatment and recovery support services to employees facing alcohol-related challenges. While most employers (up to 97% of large employers and 75% of small employers) offer EAP services to their employees, many employees do not understand what EAP is. The current average utilization rate for EAP programs is 3-10%. This explains why such programs have now expanded to address a broader spectrum of issues including legal, financial, family or relationship matters AND support for mental and behavioral health needs.

Regarding treatment interventions, there are a variety of options available depending upon an individual's specific needs. Effective treatment considers the type, nature, and severity of the disorder, and can involve a combination of different approaches, including inpatient or residential treatment, outpatient treatment, cognitive-behavioral therapy and medication-assisted treatment (MAT).

Mental illness and SUDs are progressive, often chronic conditions. But with early intervention, appropriate treatment, and support from loving, caring individuals, recovery is possible. Recovery begins when hope for positive outcomes is kindled in the heart of a person who has been struggling with mental or behavioral health issues. It is an ongoing process of change in which individuals who suffer with SUDs improve their physical, psychological, social, and spiritual health and wellbeing.

Recovery from SUDs is a deeply personal, yet powerfully transformative process. The journey to recovery is not a linear process, including periods of forward momentum toward sobriety, only to be followed by seasons of setbacks (known as relapses). Sadly, many people do lose their battle with addiction and pay the ultimate price. Fortunately millions experience the life-changing "miracle of recovery" and are able to live self-directed lives.

Individuals in recovery have acquired resilience skills that enable them to cope with the pressures and challenges of life. Because recovery is holistic, individuals in recovery have regained control of their behavior, and are able to move forward to pursue goals in all dimensions of their lives. They live vibrant lives in recovery, including fulfilling their personal, occupational and career aspirations.

Workplace of the future: Bridges not barriers

T'Challa, Marvel Comic's fictional Black Panther, is quoted as saying "In times of crisis, the wise build bridges, while the foolish build barriers." Given that we are facing an unprecedented crisis in our behavioral health care system, employers seeking to help their employees struggling with mental illness and SUDs are exploring new and innovative solutions. They are wisely building bridges to the workplace of the future today.

The result of this work is an unprecedented and dramatic shift in workplaces across the country. These efforts are being facilitated by recovery-minded champions, heroes, their allies, peers, and coaches. Such individuals are passionate in their commitment to create Recovery-ready and Recovery-friendly workplaces. The seeds for these efforts have been sown for decades. The post-pandemic disrupted workplace is fertile ground, and the number of these workplaces is increasing at an accelerated rate.

What is a recovery-ready workplace?

Dr. Rahul Gupta is the director of the White House Office of National Drug Control Policy. In September 2022, the Biden-Harris Administration announced funding and actions to address the overdose epidemic and to provide support to individuals in recovery from SUDs.

In April of this year, Dr. Gupta spoke at a Brookings Institute webcast regarding "The economic impact of the opioid epidemic: Labor supply and the workplace." In that presentation, Dr. Gupta defined a "recovery-ready workplace" as one where those who are struggling with a substance-use disorder have people to talk to, where "they don't have to hide their disease … they can seek out help whenever they want to." In such an environment, he says, an individual will be bolstered by employment and its rewards—a sense of purpose and community.

To support the expansion of Recovery-Ready Workplaces nationwide, the U.S. Department of Labor established a Recovery-Ready Workplace Resource Hub. This website provides employers with the information and resources needed to move toward the creation of a recovery-ready workplace. One of the most important characteristics of a recovery-ready workplace is the commitment by senior managers and HR personnel to become knowledgeable about and supportive of the establishment of recovery-ready workplace initiatives.

In addition to making a public declaration of the company's commitment to recovery-ready initiatives, the company also provides training on recovery-ready policies and procedures as part of the new employee orientation and annually to all employees.

Another vitally important aspect of the recovery-ready workplace is the creation of psychological safety in the workplace for people who want to learn about, access or discuss substance use disorder or recovery topics. Psychological safety is the term first coined by Amy Edmondson, a Harvard Business school professor. According to Edmondson, when psychological safety exists, team members are comfortable taking risks and sharing their ideas and concerns with one another. They are willing to admit mistakes and ask questions without fear of negative consequences.

Employees who need help to navigate personal or family issues relating to mental or behavioral health issues are often uncomfortable or unwilling to proactively approach their supervisor, manager, or HR representative. This behavior occurs regularly in workplaces that suffer from the sickness of silence, which is caused by fear and misinformation. Fear is reportedly one of the systemic barriers that prevents proactive prevention intervention in the workplace. This fact was validated by a 2020 global study conducted by Oracle that revealed 68% of employees would prefer to talk to a robot than their manager about stress and anxiety at work. That is particularly alarming given that the National Institute on Drug Abuse estimates up to 50% of individuals diagnosed with mental health disorders have co-occurring SUDs.

Recovery-friendly workplaces

New Hampshire Governor Chris Sununu launched the Recovery-Friendly Workplace (RFW) initiative in 2018 to combat the growing opioid overdose epidemic. As it turns out, in addition to benefiting employees, establishing a recovery-friendly workplace is good for the company's bottom line.

In an article titled Recovery-Friendly Workplaces published in Journey Magazine, author Samantha Lewandowski cited research conducted by the NORC at the University of Chicago and the National Safety Council (NSC) that found employers save an average of over $8,500 for each employee who recovers from a SUD. In addition, employees in recovery miss significantly fewer days each year as compared to other employees.

The recovery-friendly workplace model encourages the establishment of collaborative partnerships among business, government, behavioral health treatment providers and others committed to supporting employees to achieve and maintain recovery.

DEI, ERG and affinity groups:

Another exciting trend in the workplace relating to recovery is the growing expansion of employee resource and affinity groups to support a company's recovery-ready or recovery-friendly workplace initiatives.

Employee resource and affinity groups are company sanctioned, but employee led. These groups are typically formed around common characteristics like race, ethnicity, gender, disability or veterans' status, or around shared interests or career goals. The primary purpose of these groups is to provide a supportive community for employees who have similar backgrounds or experiences.

Employees who participate in employee resource and affinity groups help to foster collaboration with leaders to create a more inclusive workplace environment.

Recovery peer support:

While there are many paths to recovery, employees often find their way to recovery with the help of peers. In the field of behavioral health, peers are individuals who have personal, or lived experience with mental health or SUDs.

Recovery peers play a vital role in providing support to employees seeking to achieve or maintain long-term sobriety. Because they have experience navigating a recovery journey either for themselves or others, peers are well qualified to provide emotional support, information about substance use or mental health issues, or how to access resources or services.

Recovery allies:

Recovery-ready and recovery-friendly workplaces also engage and embrace the help of recovery allies to create and sustain their initiatives. A recovery ally is an individual who supports individuals on their recovery journey even though they may not have personal or lived experience with mental or SUDs.

Allies are empathetic, seek to educate themselves about mental health and SUDs and are committed to advocate on behalf of recovery-ready and recovery-friendly workplace initiatives.

Professional recovery coaches:

Professional coaches have long been used in the workplace to work with managers, leaders, and other high-value employees. Individuals who work with coaches are known to enhance their skills, improve their overall performance and add more value to the organization.

Related: Employers should look deeper to address mental health

Within the coaching industry, certified professional recovery coaches (CPRCs) are considered 'specialty coaches' because they have been trained to provide non-clinical coaching support to individuals who are seeking to achieve or maintain long-term recovery from a SUD.

Professional recovery coaches must complete an internationally recognized competency-based training program that combines proven protocols of professional coaching with the best practices in drug, alcohol and addiction recovery.

Summary:

In summary, the Workplace of the Future exists today thanks to the combined and often sacrificial efforts of recovery champions, heroes, peers, allies, coaches, and countless others worldwide. Whether they are in the same workplace, community, state, scattered around the country or across national borders, they are not alone.

They are a fellowship of kindred spirits working together to remove barriers, build bridges, heal the sickness of silence, transform lives and ultimately futures by creating recovery-ready and recovery-friendly workplaces.

And at a time when disruption, disease, distress, disharmony, and disunity, seem to utterly abound, I am encouraged by the words of Helen Keller. "Alone, we can do so little; together we can do so much."

Cheryl Brown Merriwether, SHRM-SCP, SPHR, CPRC, CRSS, CM; CoFounder, Vice President, Executive Director, International Center for Addiction & Recovery Education™ (ICARE)