Danielle Lamphier
Good afternoon and welcome. My name is Danielle Lamphier. I'm the Vice President for our direct-to-employer services for Atrium Health in the Southeast. And on behalf of Atrium Health, Atrium Health Wake Forest Baptist, Atrium Health Madison, and Atrium Health Floyd, I just want to welcome you to our forum on stress, burnout and resiliency in the workplace. We have three phenomenal speakers for you today that I want to really quickly introduce, and then I'm going to turn it over to our first speaker.
So first of all, we have Dr. Lindsay Peral, who is going to be sharing with us stress, burnout and resiliency. And then Karla Lever who oversees our program for EAP, I don't know why I can't say that today, but employee assistance programs for Atrium Health in our Charlotte region who's going to talk about how to help your employees dealing with stress. And then finally, we'll finish up with Kyla Montes, who is the leader on our team for all of our direct-to-employer services in the Southeast as it relates to behavioral health services. She's also a instructor for Mental Health First Aid. So some of you may be familiar with Kyla from those programs, but she's going to be talking about tools and services to support mentally healthy workforce.
So we hope that you will interact with us during this forum. And so we encourage you to ask questions. So just a little bit of housekeeping. If you do have questions during the forum, please do put those in the chat and then we will get them at the end. We do have a Q&A period already set aside for that to happen. And if you have additional questions as well, you can email those to us. You can email them two different ways. So one way would be to send those over to your client leads. So if you work with Grady Hardiman or Katie Ivers or Chris Butler or Sarah Pellegrino, reach out to that person that you normally reach out to on our team and they can certainly get you some answers or connect you to the right resources. Or you can send them to the email address on the screen, which is employerservices@atriumhealth.org.
And without further ado, I'm going to turn it over to Dr. Lindsay Peral, who's a family medicine physician on our team. She also works with our executive health program and with the Wake Forest School of Medicine students. And she is going to be sharing with us today her presentation on stress, resiliency and well-being. So turn it over to Lindsay.
Dr. Lindsay Seawright Peral
Thank you, Danielle. As Danielle said, I'm a North Carolina board certified family physician. I'm super passionate about mental health, holistic wellness, preventative medicine, and just compassionate community care. And today I'm thrilled to have the opportunity to be with you, but our time as brief, so I'm going to provide just kind of a high level overview of some of the important factors that impact our health and well-being both inside and outside of the workplace.
So as you can see on this screen, we are all familiar with stress and burnout. As you can see, these are all based on the latest statistics at the end of 2022, but at least 83% of workers suffer from work-related stress. And at least 25% of those say that their job is actually the number one stressor in their lives. About three quarters or 75% of our workers say that workplace stress affects their relationship. Actually, 63% of our workers were ready to quit their job just to avoid work-related stress. And about 1 million Americans each day miss work because of stress. And then 50% of workers are actually not fully engaged at work as a result of stress obviously having tremendous impact on productivity. And it's estimated that employers spend about $300 billion each year on healthcare and missed workdays related to the stress. So obviously it is a very significant issue in our lives and in our workforce.
So I want to just bring this, I guess a little bit more personal to all of us. And I just want you to think just quietly in your own head, or you can write down on a piece of paper, but just think in broad categories, what areas are causing stress in your life?
We are all familiar with the concept of different levels of stress, there's the positive stress, the excitement of the first day on a new job or the first day of school. And that can be beneficial, that can enhance performance. But then you can see on the continuum there's tolerable stress, which is where you really get activation of the body's stress response to a long-lasting or even possibly severe situation, but it's somehow tolerable. And so an example of that would be the loss of a family member. And one of the biggest things about tolerable stress that differentiates it from toxic stress is often supportive buffers are in place. So you've lost a loved family member, but you still have support.
And then we go on the other end of the spectrum, this toxic stress, and this is of course, prolonged activation of the body's response to stress, but often it's frequent and intense situations. So you can think of chronic domestic violence, chronic neglect. And typically what we found is that when someone is living on the spectrum of toxic stress, that's when we tend to see a lot of traumatic body responses. And what's interesting about this continuum is that many of us actually, believe it or not, we can be anywhere on this spectrum at any point in the day. So this is fluid, but it's important to be aware of the impact of stress in our bodies.
So just take a moment, and once again, I think it's important that we relate to this material, and I just want you to reflect, what are the first signs of stress in your body? I'm not talking about you feeling stressed, right? I'm not talking about the emotion. I'm talking about how it manifests in your body. Can you think of what is the first sign, the second sign, the third sign? I just want you to think about that.
And here, this is a picture of the kind of classic, what we call sympathetic response. So if you've heard about fight, flight, freeze, there are more responses than that actually, but we're going to simplify it. And when we look at acute stress in the body, this picture kind of represents a classic sympathetic body response, meaning kind of a fight or flight body response. So often people, when they're in a very stressful situation, their pupils will dilate, their mouth can feel dry and cottony. Often people will notice their breathing becomes more shallow, their heart rate becomes more elevated. A lot of times people will notice that they start sweating more. Tremulousness, shaking is quite common. A lot of times people will notice in their gut, right? Because essentially you have slowing of digestion, you have more blood pumping to the muscles and you have less going to your digestive system. And so a lot of times nausea can happen.
But it's interesting in my own body in terms of when I'm acutely stressed, I've paid more and more attention to what are my signs. And for me, sequentially, I've noticed the typical thing is I will first, when I'm feeling stressed, I'll episodically start taking deep breaths. So I was breathing normal, then. Right? So that's my first sign. My second sign is I notice my heart rate becomes elevated if I feel this persistent stress. The third is typically I notice I'm sweating more. And the final one is I start shaking. So I just think if anyone who's has ever read, The Body Keeps the Score by Dr. Bessel van der Kolk, it's an amazing book, but I think it's worthwhile thinking about how does your body respond to stress? Because the earlier you can identify it, the earlier you can potentially make some changes.
Okay, this is about a four-minute video, super fascinating about how chronic stress affects your brain.
Speaker 3
Are you sleeping restlessly, feeling irritable or moody, forgetting little things and feeling overwhelmed and isolated? Don't worry, we've all been there. You're probably just stressed out. Stress isn't always a bad thing. It can be handy for a burst of extra energy and focus like when you're playing a competitive sport or have to speak in public. But when it's continuous, the kind most of us face day in and day out, it actually begins to change your brain. Chronic stress, like being overworked or having arguments at home, can affect brain size, its structure and how it functions right down to the level of your genes. Stress begins with something called the hypothalamus pituitary adrenal axis. A series of interactions between endocrine glands in the brain and on the kidney, which controls your body's reaction to stress. When your brain detects a stressful situation, your HPA axis is instantly activated and releases a hormone called cortisol, which primes your body for instant action.
But high levels of cortisol over long periods of time wreak havoc on your brain. For example, chronic stress increases the activity level and number of neural connections in the amygdala, your brain's fear center. And as levels of cortisol rise, electric signals in your hippocampus, the part of the brain associated with learning memories and stress control, deteriorate. The hippocampus also inhibits the activity of the HPA axis. So when it weakens, so does your ability to control your stress. That's not all though. Cortisol can literally cause your brain to shrink in size. Too much of it results in the loss of synaptic connections between neurons and the shrinking of your prefrontal cortex. The part of your brain that regulates behaviors like concentration, decision-making judgment and social interaction. It also leads to fewer new brain cells being made in the hippocampus. This means chronic stress might make it harder for you to learn and remember things and also set the stage for more serious mental problems like depression and eventually Alzheimer's disease.
The effects of stress may filter right down to your brain's DNA. An experiment showed that the amount of nurturing a mother rat provides its newborn baby plays a part in determining how that baby responds to stress later in life. The pups of nurturing moms turned out less sensitive to stress because their brains developed more cortisol receptors, which stick to cortisol and dampen the stress response. The pups of negligent moms had the opposite outcome, and so became more sensitive to stress throughout life. These are considered epigenetic changes, meaning that they affect which genes are expressed without directly changing the genetic code. And these changes can be reversed if the moms are swapped.
But there's a surprising result. The epigenetic changes caused by one single mother rat were passed down to many generations of rats after her. In other words, the results of these actions were inheritable. It's not all bad news though. There are many ways to reverse what cortisol does to your stressed brain. The most powerful weapons are exercise and meditation, which involves breathing deeply and being aware and focused on your surroundings. Both of these activities decrease your stress and increase the size of the hippocampus, thereby improving your memory. So don't feel defeated by the pressures of daily life. Get in control of your stress before it takes control of you.
Dr. Lindsay Seawright Peral
So I think that's a pretty good overview, a little simplification of how to overcome chronic stress. But I think it's a lovely introduction, just really pointing out that the size and the function of our brain is very much impacted by our daily level of stress. So this is going to be a real fast deep dive into the neuroscience of chronic stress. And so if you guys will go along with me, this is Dr. Dan Siegel, this is his introduction of the hand model of the brain. The brain is a super complex organ, obviously. But if you guys can go along with me, I want you to use your own hand to kind of represent your brain.
So go ahead and make a fist, and this is what our brain kind of looks like and functions in kind of an integrated way when we feel safe, when we don't feel overly stressed. Okay? Now go ahead and open up your hand. This is what we call flipping our lid, but I want us to look at the inside of the brain. So our wrist is our spinal cord that sends messages from our body to our brain. The next area here, and if you want to go ahead and touch these areas, I always find multisensory learning works. But here's the brainstem, which is at the base of the palm. And think about what the brainstem does, think about what a newborn can do. So that's what the brainstem really controls. So a newborn can control its temperature, its heart rate, its respiratory rate, can know if it's hungry, it can cry, it can control bowel and bladder. So this is our brainstem, our most primitive and also essential part of our brain.
As we go up higher, so if you touch your thumb, this area is what we call our emotional brain, and it consists of the hippocampus and the amygdala. Now, let me start with the amygdala first, because this is the one that has most impact on our brain. It is our fear center, or it is our alarmer, our fire alarm center. When our amygdala is activated, it tells us I am not safe, I am not safe, I am not safe. That could be physical, that could be emotional. Next to the amygdala is the hippocampus, and that is the part that you've probably heard is responsible often for learning and for memory. But what's interesting is that the amygdala gets activated. Essentially, things go to the amygdala first, and if a brain says, I do not feel safe, it is impossible, the hippocampus kind goes offline. And memory and learning are nowhere near as effective.
So go ahead and take your hand and go ahead and bring your fingers down over your fist. If you look at the outside of the brain, this is what we call the cortex, which is the thinking part of the brain. The very tip is called the prefrontal cortex, where our fingers are. And this is where we are able to do our most complex thinking. So this is about how we make decisions. It's involved in compassion, creativity, social behavior. And so what happens is when we feel under chronic stress or if we feel unsafe, what happens is we literally flip our lid. So our hand opens up. And you can see what happens is unfortunately we lose the connection with our ability to do our deep level thinking. So when someone is chronically stressed or feels unsafe and the amygdala is activated, we're only able to use about 15% of our thinking brain as opposed to when our lid is not flipped, we're able to use about 85% of our thinking brain.
So that just is really helpful to when you wake up, when you go into a meeting or just going into the job, you might think, okay, am I integrated? How is my brain feeling? And you can kind of use your own hand as a model. Have I already flipped my lid before I'm going to this meeting? Or am I partially flipped? But I think this is a nice way for us to get in touch with our feelings and also our body.
I do want to mention real quickly, this is a very quick neuroscientific overview, but what's interesting about our chronic stress and trauma is that my stress and trauma affects your stress and trauma. So we are built forth connection, have these mirroring neurons that help us not only mirror what other people do physically, but we mirror each other's emotions. And so if you've ever noticed, that's why it's so impossible, if you're just having the best day ever and you come home and your partner spouse is in a really foul mood, it's really hard to remain upbeat. And that's because your neuroception, you are actually feeling their neurologic system and you're getting in tune with them. And so it's something important to remember is that you want to be genuine in your feelings, but just know that positivity can spread as can negativity. And so just know that we are connected to each other in our emotions.
And the final thing I want to say is the good news about this, we talked about changes in the brain that can happen with chronic stress, but our brain is neuroplastic, meaning that our brain can change its size and function depending on what we focus on. Next slide.
So the big picture is that recovering from chronic stress and trauma is possible because our brain is ever-changing, we're able to grow new neurons, even in the end-stage disease. And so once again, if we're trying to heal and take care of ourselves, we can actually rewire and retrain the brain to reverse the effects of stress and trauma, but often that can require professional support. Next.
So we're quickly going to touch on professional quality of life. Obviously this is a simplistic take, but obviously it's a balance of the positives that come with your job versus the negatives. And the thing that we want to focus on today is burnout, right? So Dr. Christina Maslach, she was the co-author of The Maslach Burnout Inventory. And she says, "Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job." And there are three main clinical symptoms of burnout. Number one, exhaustion. That can be physical, that can be emotional, or both. Number two is cynicism. And number three is reduced efficacy on the job.
And what Dr. Maslach proposes is that burnout is really the result of a chronic mismatch between a person and one of these six dimensions of the job. So there's a discrepancy of at least one out of six of these areas. One is workload, right? The second is control. How much control do you have over your schedule, over your advancement, over what you're passionate about? And then of course, fairness and equity is also a huge piece that can contribute to occupational burnout. And when we consider rewards, a lot of times we think of financial, but actually what are the emotional rewards? What are the intrinsic rewards? Is this a rewarding, meaningful job? The other thing that's critically important is community. Do you feel safe? Do you feel valued? Do you feel seen? Do you feel heard? And of course then what are the actual values that are being supported in the workplace? Next slide.
And so I think this is always important that often burnout is shown to be a sign of dysfunction within an organization, and it typically says much more about the workplace environment or the workplace as an organism than it does about the individual employee.
So like I said, we're doing a quick overview. I want to touch on resilience. So a quick definition of resilience is a person's ability to adapt successfully to acute stress, trauma and/or more chronic forms of adversity. I always want to also speak from an equity lens, that believe it or not, resilience can be a triggering word for many people because for individuals that have experienced a lot of systemic trauma, sometimes resilience has been required simply for survival. So I just want to make sure that we use our words always responsibly. You'll go to the next slide.
And so what are the four concepts that are often missing from most definitions of resilience? And the first one is that it takes time. It takes a lot of time to build resilience. And I think that that's where we can unintentionally offend someone, is look at someone's life or experience, say, "Oh, they're so resilient," as if it was something that they were just born with. And this is something that requires continuous work. And resilience is the interaction between the biology and the environment. So while certainly genetics play a role, it is something that requires work and effort and attention. And another thing about resilience is that it's often situation specific. So someone might be able to be very resilient at work, but then maybe in their relationship at home with their partner or with their kids or with their neighbors, they might not demonstrate that same level of resilience.
I do want to talk about the relationship between sleep and resiliency, because I think in the medical field we don't do a good job talking about how critically important sleep is for our health and well-being. And I love this quote, this is from Dr. Russell Foster's 2013 TED talk, but he says, "Sleep, in a single behavior, is the most important thing that we do." And if you look at medical outcomes and data, it's absolutely true. Sleep is far more important than what you eat, your exercise level and even more, even perhaps in how you're acutely dealing with stress. Next.
So I want to talk a little bit about sleep deprivation in the United States. And once again, I always like to bring equity into the picture. I do have to say that a lot of sleep deprivation is out of people's control. So we have a lot of sleep inequality in our country, and so we have to acknowledge that. But this is looking at just sleep deprivation as a whole. And currently over one out of every three adults in the US sleeps less than the recommended seven hours a night. So if you're between the ages of 18 and 65, the optimal sleep is between seven hours and nine hours at night. When you look at school-aged children, one out of two, so we're over 52% of our kids are sleeping less than the necessary nine hours of sleep at night. And these statistics, once we talk a little bit more about sleep, you can see how these statistics support that we're really in that epidemic of sleep deprivation. Next slide.
This just has some of the common symptoms of sleep deprivation. Of course, all of us are familiar with these, because we've lived them, right? There's the obvious fatigue, drowsy, irritable, harder to focus and concentrate, maybe increased migraines, maybe increased irritable bowel syndromes, slowed reaction times. I did college health for multiple years. Then it was interesting to see that because the sleep deprivation was often so severe, that we did see people having visual and tactile hallucinations, definitely impaired judgment, definitely impulsive, reckless behavior. We saw significant changes in speech. We even saw changes in eye movements. And so it is real. It is real, and sleep deprivation can have devastating impacts on health.
I want to talk a little bit more about the medical impacts of sleep deprivation because I feel like we don't always take the time or have the time in the typical primary care setting. And so with chronic sleep deprivation, it really impacts so many different organs in our body. So one of the major one is a significant decline in our immune function. So if adults are sleeping less than seven hours at night, you can get up to 50% reduction in your response to vaccines. So studies have been done showing this with influenza, with the COVID-19 vaccines with hepatitis A, with hepatitis B, right? So multiple studies have been done. And so often they'll speak to the importance of getting adequate sleep, especially within 48 hours before and 72 hours after vaccine.
There's significant data also talking about the impact that chronic sleep deprivation has on metabolism. So we see we're between a 6% up to a 40% increased risk of obesity, and that has to do because it really affects your level of hunger hormones and your satiety hormones and even makes you, sleep deprivation specifically makes you crave high fatty high carbohydrate foods. We see about a 20% those that are chronically sleep-deprived, we see about a 20% increased risk of heart disease. We see elevations in blood pressure, heart rate, and about 20% increased risk of coronary artery calcifications. Well, 20% to 30% depending. We see about a 30% increased risk of diabetes. So I became a chronic pre-diabetic just from chronic 20 years of chronic sleep deprivation.
We see about 20% to 30% increased risk of dementia and cognitive decline. And the reason that being in the deep sleep, when we get into our non-REM stage three sleep, what happens is you actually get molecules for immune system come in and they kind of clear out these inflammatory molecules in our brain. So if you're missing that deep sleep, your brain is in this kind of chronic pro-inflammatory state. And then finally, of course, we see much higher risk of mood disorders with chronic insomnia. So about five times percent increased risk of depression, about 20 times increased risk of anxiety.
Quickly, since we're focusing also on mental health and stress and resiliency in the workplace, I just want to review some strategies that have been shown to be effective to build resilience in the workplace. So number one is to pay attention to your physical health. Sorry for that cough. The second one is to try and get adequate sleep. The third is trying to practice relaxation techniques. And then mentally trying to see can we reframe threats or difficulties as challenges rather than setbacks? And then obviously paying attention to our mindset. How are we even feeling? Going back to your brain, is your lid flipped before you walk into work or not? Perhaps the most important thing that builds resilience is connection. That's connection to your community, that's connection to your coworkers, that's connection to your loved ones. And even connection to your own inner self. Practicing self-awareness is super important, especially because we talked about the influence of mirroring neurons. So if my neurologic system is unregulated, that's going to unregulate your neurologic system. So practicing self-awareness is important, and once again, paying attention to our stress levels.
Thank you for your time.
Danielle Lamphier
Yeah, thank you Dr. Peral. I appreciate the time you've spent with us. I feel like I've learned a lot and I'm really concerned about managing my stress now. So I appreciate those tips and tricks because I don't want my brain to shrink. That part might've been the scariest part of all to me, but thank you so much for those wonderful tips. We are ready to move on to Dr. Karla Lever, who is a PhD and a licensed clinical mental health counselor who oversees our EAP programs here at Atrium Health in Charlotte, and she's going to be sharing how to help your employees deal with stress.
Dr. Karla Lever
Well, hello everybody, and thank you so much. Dr. Peral. I loved all that information. I love that I'm flipping my lid. I think that's great. I'm going to use that with clients. And I also appreciate everybody who has joined us because it means that you really care for your employees as humans in addition to being assets for your company. And of course, the healthier they are, the better assets they are.
So here are some of the behavioral and emotional signs. I think we're familiar with most of these. I think the one that really stands out for me is social withdrawal. We are primates, and if you've ever been to the zoo and you've seen what monkeys do, they're not off by themselves happy. They are really all on top of each other. Now, that doesn't mean you have to be like this, like I'm doing with Kyla, but we do need to interact. And when people withdraw socially, it means that they are letting their stressors sort of overwhelm them, and it's hard for them to get out of it. So it's a warning sign.
And of course there are some other physical signs. I think on this list, the physical sign that people maybe don't think of is when people start coming to work and they're a little disheveled. Their hygiene isn't as good as it was. Abnormal weight loss or weight gain, unexplained cuts or burns. I think that's one that you wouldn't really notice unless people are really showing them off. But they are important signs to look for. I think we're most familiar with the psychological thoughts, when we hear people being really pessimistic, but certainly if you're hearing them have delusions or hallucinations. But all or nothing thinking I think is something that all of us can do. And when you get in the cycle of all or nothing thinking, it's a sort of a cycle of winning or failing. And you can fail, and if you're failing all day long, it really increases your stress level. Next slide.
So how do you identify a struggling employee? It is a lot easier if they're in the office, right? You're starting to see these differences in the way they look and the way they act. They're maybe not meeting deadlines, so they're socially withdrawing. It's a little more difficult with an employee who's working remotely. With that, I think you're looking for more of their electronic behavior. Are they participating in meetings? Are they showing up for the meetings? Are they involved in group chats? Are they also missing deadlines? It's important that you set up time to specifically reach out to all of your virtual employees to make sure that they're staying engaged and also because you care about them as a human being. Next slide.
I love this model because we're all on it. Just like the progressive stress model that Dr. Peral was talking about. When I woke up this morning and I knew this had presentation, I woke up on yellow. I did not wake up on green. I love doing these presentations, but there's a little stress behind it because I want to give you all that I can. I want to do a good job. So that's an example of maybe just reacting. Now, I was lucky, this morning, traffic was. The clothes I wanted to wear, I could find them. Nothing major happened, and so I didn't move into injured. But of course, there have been times in my life and in times of all of your lives where we've all moved up into ill, and like she said, it can happen within a day. But if it's happening for several days, that is a cue. If you're injured for several days, it's a cue that something's going wrong. Your brain isn't able to fix whatever this problem is that it's dealing with, and you may need to talk to somebody. Next slide.
So we're used to, I think, the emotional things. If somebody comes into your office and they're crying, clearly something is going on. But if somebody's just a little more forgetful, which is what happens to me, I'm so glad you talked about that, Dr. Peral, that's my first clue is that I can't find words. What is the word for that. And I think that's not just because I'm getting older, but because also stress in excess. But there's all the rest of these, there's these physical behaviors, behavioral things, it doesn't always look like stress. Next slide.
So most people want to just duck their head and keep plowing forward. And in order to do that, they use coping skills. Coping skills are great. Please hear me when I say it's really good to take moments, to take deep breaths. It's good to distract yourself. It's good to do things like spend time with friends, which is coping and healing. But that's not all it takes to rewire your brain. You also need to do some specific things like rephrasing your thoughts, thinking about is the way I'm thinking about this situation, it might be true, but is it helpful or is it harmful? Considering alternative meanings. Have you ever been in an argument with somebody and somebody says, "You meant that with what you said?" You're like, that's really not what I meant. That they won't believe that that isn't what you meant. That is something that is stressing their brain and stressing yours because you're in a relationship.
Third one is forgiveness of yourself and others. Forgiveness of someone else is really a gift to ourselves. And it's a hard process. It's not just something you can go, oh, well, I forgive. So sometimes you have to work through it. Intentionally seeing real positives. And I like the second to the last one, building a life that progresses intentionally towards joy. That's for you and for your staff. Next slide.
So what do we do when our employees are stressed? Be brave. Don't be afraid to ask them how they're doing because you do care about them as humans. And more importantly, people are amazing. So I'm a therapist, I've sat in the room with people who have told me just really heartbreaking and difficult stories, and yet they're there and they're still incredible in their own way. And so don't be afraid that if you ask them about what's going on that they aren't going to be able to move forward. Your belief in them just simply as a human being helps them move forward. And it's part of being a leader is that you know they're amazing.
So what do you say when people come to you? Some of you have the face. I have the face. That's why I'm a therapist. People like to tell me their problems. And frankly, if you're thinking about crying, you will cry. If you look into my eyes, that's what people tell me. But it's okay because I'm just creating a safe place for that. But I'm a therapist and you are an employer. It's different. You have some of the skills, but you have to make sure that while you're being supportive of them and listening to who they are as a human being, you're also not taking on too much. So what you want to do is let them know it's normal for them to feel stressed in this situation. We all feel stressed, and it's okay if their stress level about this situation is higher than someone else's. It's all very, very fluid.
Ask them things like, who would you talk to or who would you like to talk to because you're stressed? And then the next question is really important. What if that doesn't help? What's the next step? What does your family believe about that? Because a lot of us learn how to deal with stress from our families of origin. Many people may want to go to religious leaders, or they may go to therapists or they may keep it in house in their families. It's important that you send them to what their next level of support is. What do they do to feel peace or relaxed? And then think about if none of those things are working, do you need to make a referral and use your EAP if you need to do that? But look at statements about helplessness, helplessness, suicide, or homicide, because then you have to do something about that. You really have to make sure that they're safe in this moment. Next slide.
The hardest thing about being a leader is the hardest thing about being a parent. We can't just wish for other people to be healthy. We have to try to be as healthy as we can be. When I go on a vacation, I tell my staff all about my vacation and how happy I was to get away, how much I miss them, of course. But I want them to know that it's okay for them to go on vacation. I don't send them emails at three o'clock in the morning because I do have some staff that literally would get out of bed and respond because they really want to please me, and I don't want to put that added pressure on them. So I try to get enough rest, eat healthy foods. Also eat things like cheese dip and ice cream from time to time because that's healthy for your soul. Exercise regularly. Establish communication boundaries outside of regular work hours. Try just not to contact them on the weekends unless you need it.
This third bullet, create a space for them to be vulnerable. It also means that you have to allow them to see you vulnerable. Now, you don't go in and tell them your whole life story, but for instance, when I was going through a divorce... I'm super happy now, so don't feel sad for me. That's not the point of this. But when I was going through it, I went in and I had to tell people, "I'm going through a divorce. It's a little bit of a hard time." And I had my ups and downs. Now, did I unload on my employees? Absolutely not. Because complaints go where? They go up, they don't come down. But because I was able to share that, then they knew that I was a human, and then they feel free to come and share it with me. So just make sure it's safe for them to be vulnerable. And lastly, make time for activities that bring you joy. The more energy you have for your work, the more joy you have in your life, the better leader you will be and the more likely they will follow you.
Thank you very much.
Danielle Lamphier
Wonderful. Thank you, Karla. Again, I feel like I learned so much in that as well, and I feel like I've made some notes about reframing thoughts because I think that one's really in particular one that really resonates for me, and I feel like I've tried to encourage our team to do that as well. Criticism can always be turned around to, huh, you know what? Thank you for letting me know that I can fix it going forward. And I think that's really important.
We're now going to turn it over to Kyla Montes, who is again in charge of our behavioral health programming for all of our clients. And she's that connection point and resource for our team within the southeast and our direction, employer relationships. She's also an instructor for Mental Health First Aid and does a fantastic job. If you've not attended that class, I really would encourage you to do that. If you lead people or frankly, if you've got kids, I feel like as a parent of young adults and teenagers, this has been a really helpful tool for me as well, and just being a supportive parent and knowing when to ask questions about them or about their friends. And so I want to encourage you to think about that if you have the opportunity or to schedule that for your team. But Kyla's going to be sharing with us some services that support a mentally healthy workforce. So turn it over to you, Kyle.
Kyla Montes
Thank You. Dr. Peral and Karla spoke to a lot of things that can impact us individually and impact our employees at work. Mental health in the workplace we know is significant and it can negatively impact our workplace. Dr Peral and Karla both spoke to a few of these, but we see a high turnover. We see lower job performance and less productivity. They're not as engaged in enjoying their work. And then of course that impacts communication with their coworkers. And then physically and mentally their capability of just doing their daily work functions.
Dr. Peral mentioned Earlier that the economy loses billions of dollars every year in the United States due to mental health, and a lot of that has to do with the fact that people will call out because they just can't do it anymore, and they're just tired. They're very common, mental health, right now the statistic is one in five adults in the United States are diagnosed with a mental illness. So we know that whether people are speaking of it or not, they're living with something. And then they're costly. So we see that within the United States, our economy alone, the workplace suffers with billions of dollars. But they can be costly to the employee itself and the person itself because stress can impact our entire body, creating other issues and chronic illnesses that can develop from stress. So we're going to discuss just some solutions that can be brought to your workplace from Atrium and from other resources. There's a lot of resources that are out there, and we're going to share some of the best ones.
So the first one is having some form of an onsite behavioral health service for a provider. This person would be a designated person for your organization. They work on building relationships with your employees, kind of getting to know the culture of the organization, and they're typically going to be licensed to have really soft contact with your employees. They can provide brief therapeutic interventions. And depending on your level of service, right? So if you just want someone to provide those brief therapeutic interventions or do you want an onsite counselor for your employees? But these have been proven to help mitigate and eliminate some of our signs and symptoms that we see within the workplace. If you have this person on site, you can customize it to the employees. So maybe this person helps educate your employees. They help do more one-on-one with your employees. They can do group sessions. So they can have a lot of focus areas.
And then we're increasing awareness. And this can probably be the most important thing that we can do in the workplace. It's just increasing everyone's awareness about stress, resiliency and what is causing those stress and resiliencies. And then when we can bring awareness, it's going to lower our cost, it's going to increase productivity, and it is going to lower absenteeism.
Another great resource is going to be any online virtual or digital platform. So some of you may have heard of such platforms such as Talkspace or Lyra. These are platforms that can create one-on-one counseling services, but then they also may have a lot of self-help platforms to utilize as well. So they're going to have resources. They can connect individuals to a behavioral health expert or their resources usually telephonically, virtually or video. It's customizable to that employee. This is a great tool for companies who have gone remote, for companies who live in very rural areas. One of the things that we know from mental health is that we have a lack of professionals in the space. And so our online and digital resources can help these employees feel like they are still being served and have a resource. So they have also, they're accessible for people with physical limitations or even travel constrictions.
So one of the things that we see within a rural space is that we know that there's already a lack of professionals in the space nationwide. And so now we know that individuals who may have issues with travel can see these individuals from the comfort of their own home. And with this, they also provide greater availability and flexibility so they're not just bound to the eight to five. A lot of counselors and therapists that provide these services can be accessed really anytime and they can always find someone to fit the need of that employee.
And then of course, EAP program. This is going to be your first point of contact as an employer. They can help provide this brief initial encounter with employees. And typically employers have this already set in place. And so some of the things to reiterate and consider, one is that they partner with the organization to increase engagement in hopes to reduce absenteeism and burnout and increase the presenteeism.
So some things to consider every EAP program is going to be different. So some may be beneficial to have an in-person, brick and mortar location. Some may have to use our 1-800 EAPs. And so things to consider is do your EAPs have additional support for leadership? The one-on-one for support for employees is great, but is there additional leadership support to help regulate stressors that are in the workplace? What is the resolution rate? Lower is not always better, right? It's not always positive. And do they charge for crisis response? So this is something that is very, very important to keep in mind. Do they have someone that can be on site? How long is that turnaround time? We have crises that happen all the time within workplaces that are unexpected, and so does your EAP cover crisis response and what is their response time?
And so when do you use EAP? So this is used for brief encounters, right? Life stressors. Certainly if someone has gone through loss or grief or they're dealing with relationships or stress or work issues, all of those are great times to use EAP. And oftentimes people think this is the best time to use EAP, but EAP can also help in other situations. So any type of substance use, addictions, financial issues, and even leadership development. So find out what your EAP offers.
And the last, but this is probably one of my most favorite is certainly our training and educations. I think that this is something that everyone can benefit from. And there's different levels of education and training. So you have your in-depth education and crisis training. This of course includes a mental health first aid that Danielle mentioned. This is great for managers, team leads and supervisors, but really it is created for everyone to take and to learn. Notice that when you look at your in-depth education and crisis training, find out exactly what each one offers. Are we talking about mental health? Does it include suicide awareness? That can be an uncomfortable conversation. And so understand when to use each training.
Trauma-informed care. Trauma-informed care is a delivery approach that really does help understand the impact that trauma can have on one person, and it can help create culture around trauma. It's really great for first responders and healthcare professionals, teachers and caregivers. And then lastly, your educational seminars. So these can be very helpful for all employees and they're usually short. Usually your 30 minutes to an hour, your lunch and learns. And your sample topics are a plethora, right? There's so many different topics, but typically these are going to be led by subject matter experts in that field.
Thank you for your time today.
Danielle Lamphier
Awesome. Thank you, Kyla. So we have about 12 minutes. I haven't seen any questions pop up, so I do want to encourage you if you do have a question to go ahead and drop that in the chat. But we'll go ahead and get started on a couple of other questions while we're looking to that. So please do put those in there quickly and we'll get them answered. And then also if you have follow-up questions after this presentation, please do reach out again to your client lead. If you have one of those already associated with your particular business or organization, you can scan the QR code, you can reach out directly to Kyla or any of the other presenters. And then of course you can email us at the employersolutions@atriumhealth.org address.
So let me start with EAP since we were just talking about EAP. How can you really maximize what you get from your EAP services?
Dr. Karla Lever
I think you have to ask all of those questions. Figure out, do you have an account manager? Is there somebody designated that's helping to develop a relationship with your company to find out what your particular cultural struggles are? EAP should be able to help with engagement, with communication, with leadership skills. So just make sure you have regular contact with them and that you ask them to provide the things that they're supposed to provide for you.
Danielle Lamphier
So hold them accountable?
Dr. Karla Lever
Hold them accountable.
Danielle Lamphier
I love that. Absolutely. Then if we think about different workforce situations, we have perhaps some city, county governments who have first responders as part of their population of employees or some of our manufacturing partners. What are some of the best training options for leaders and managers to really provide support for their employees?
Kyla Montes
So any type of training, and I get asked all the time, is there any way that we can shorten the trainings? And when it comes to mental health, for example, Mental Health First Aid is a six to eight hour program, depending on what delivery method you choose. And really you have to have the support from the top down in order for you to create a culture of awareness. And so your in-depth training, it takes one day, one day to really be able to identify your warning signs. And understand how to talk to someone. How do you talk to an employee who is having stressors in their life? We think that we can separate work and personal, but we know that that's not always possible and that makes us human, and that's okay. And so learning how to identify those signs and symptoms and how to talk to an employee.
And then speaking back to the crises, we see lots of crises that are always unexpected in the workplace. And how do you talk to an employee who's going through a crisis? How do you talk about suicide? It's a very taboo to topic, but oftentimes the workplace is where we see some of these stressors popping out, and we may be the first ones to identify it. So I do encourage you to go in with your more in-depth trainings for any type of managerial, supervisors, leadership. I know it seems like we can't figure out a day to do something, but it really is the most beneficial training.
Danielle Lamphier
It's a good investment it sounds like.
Kyla Montes
It is.
Danielle Lamphier
So, we talked a lot about what the right things to do are, but if we know that our team or a specific employee's really experiencing a crisis or high degree of stress, is really struggling with resiliency, what are some things we really need to avoid?
Dr. Karla Lever
Well, I think that the thing you really need to avoid is avoiding. You just pretend that nothing is happening and hoping that it's going to go away. That is really the worst thing you could do. The second thing is if an employee comes to you and in your mind you're thinking, gosh, I wonder if I can handle this. The answer is you can't. You need to really tie into whatever other supports your organization offers and make sure that they get that bridge for that connection.
Danielle Lamphier
Excellent. Dr. Peral or Kyla, do you have additional thoughts on what not to do?
Kyla Montes
I don't know if it's not what not to do, but one of the things that I always encourage people to do is making sure that you are taking care of yourself, right? Giving employees the space to take care of themselves and the time to do that. So again, allowing them to create work boundaries, not making them feel guilty for creating those work boundaries. One of the things I always have to compliment Danielle on is she may be one of those leaders who sends an email out late, but her emails always say, "Please don't respond." Right? This isn't an intent to get us to respond, it's just she's working and that's okay. We all have different work hours. But allowing your employees to take care of themselves, I think is something that we oftentimes miss.
Danielle Lamphier
Great point.
Dr. Lindsay Seawright Peral
I guess the only other thing I would mention is just that concept of what is leadership doing? And then what tone is leadership setting? What is the culture? What are the cultural expectations? And in many workplaces, unfortunately, you don't necessarily find that the executives or the top leaders, that their stress levels are even lower, right? And so how do you model self-care as a company in those organizations? And I think that it's that same sort of thing, you can't say watch what I say and not what I do, we all pay attention to the actions of others. So I just wanted to make sure that we look throughout, look at the individual, but we also look at the health of the organization and I guess walking the walk, shall we say.
Danielle Lamphier
I think too, that from a leadership standpoint, I really love what you said, Karla, about complaints go up. They don't go down. And I think the quickest way to stress out your team is to share all the insecurities or concerns you have. So as a leader, you're holding the ceiling up sometimes, and I think that's a good thing for us to remember too, that people feel uncertainty and you as a leader probably should experience that less than maybe what some of your staff may feel. But whatever you feel, they're going to feel more. So you got to be careful not to overshare perhaps is maybe a good lesson there.
I know there is a question about whether or not the slides will be available. They will be available. We'll be sending out a link to that after the presentation, so please do watch for that. Again, if you don't receive it, please reach out to one of us through the link provided, or again, reach out to your client lead if you have one. So I'd love to get connected with you.
Any final words or comments here in our last couple of minutes from any of our presenters on just how to create a healthy workforce that's resilient and maybe more joyful? I heard joyful a couple of times about creating joy.
Kyla Montes
I think the number one thing is lead by example. I really do. I think that as managers, you have to lead by example. If you set your boundaries, if you take care of yourself and encourage your employees too, they're far more likely to do that than if you don't.
Dr. Karla Lever
And remember that they're amazing, which also means that you must be amazing.
Danielle Lamphier
Oh, that's awesome. That's a great place to end. Well, again, thank you so much for spending your lunch hour with us. We are so grateful that you took the time on behalf of your employees and that you cared about them and yourself enough to spend time with us today, and we really appreciate it. Again, if you have any questions, watch for the slides and we look forward to seeing you again at our next seminar. Thank you so much. Have a great day.
