For a lot of small business owners, fostering an open dialogue about mental health in the workplace can pose a real challenge. On the one hand you don’t want to ignore such an important issue, but at the same time, you don’t want to cross any personal boundaries. So, how do you broach such a sensitive subject with your employees? You start by removing all the stigma attached to it. In this episode, Jon Aidukonis, Gene Marks and Mental Health America CEO, Paul Gionfriddo, discuss how small business owners can create a nonjudgmental environment that supports the mental well-being of their workforce.

Executive Summary

0:38—Today’s Topic: How Can I Normalize Conversations about Mental Health Issues at My Small Business?

1:12—As their name suggests, Mental Health America focuses on the prevention, intervention and treatment of individuals who are struggling with their mental health.

3:07—Despite more awareness regarding mental illnesses, society still does not view or prioritize these conditions the same way they regard physical illnesses.

4:21—One reason there is so much stigma surrounding mental health within our work culture is because our society tends to approach this topic as a public safety concern rather than a mental health concern.

6:48—In order to promote an open dialogue about mental health at your workplace, small business owners must lead by example and be open about their own mental health experiences.

9:14—It’s time to acknowledge that everyone struggles with some form of mental health condition so that we can finally destigmatize these conversations within the workplace.

12:03—As a business owner, you need to set an example for the rest of your staff by tending to both your physical and mental well-being. Rather than overworking yourself, draw boundaries that demonstrate a healthy work life balance.

14:17—If you are struggling with your own mental health issues, delegate some of your duties to your other employees. This decision will not only lighten your workload, but it will also ensure that your business continues to run efficiently.

16:47—The more mental health support we provide our employees, the better their work quality will be.

18:51—Business owners should get employee feedback regarding the mental health services they provide; these surveys ensure that your workforce is actually benefiting from these resources.

19:21—Encourage your employees to get regular mental health screenings or provide them with the resources to do so. If they seem reluctant, remind them that they have complete control over their privacy as well as their choice of treatment.

24:05—Some indications that your employees are struggling with their mental health are as follows: a decline in their productivity; frequent complaints; an increase in absences; and significant changes in their normal lifestyle habits.

25:07—If you suspect that your employee has a mental health issue, the most important thing you can do is to create an environment where they feel comfortable and supported.



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Jon: You’re listening to the Small Biz Ahead Podcast brought to you by the Hartford.

Jon: Good morning and welcome back to Small Biz Ahead, The Small Business Podcast presented by the Hartford. I am Jon Aidukonis joined today by my cohost as usual, Gene Marks and a very special guest, Paul Gionfriddo, CEO of Mental Health America. How’s everybody doing today?

Paul: I’m great.

Gene: And Jon, I want you to know that I’m doing well too. Thank you so much for asking.

Jon: Awesome. Thank you. Well, thank you all for making time to join us today. Paul, you are the president of an organization called Mental Health America. Mental health I feel like is a word that is becoming more and more used in everyday vernacular. And I think we’ve had a lot of conversation the past I’d say four or five years around what that really means, the difference between things like mental illness and mental wellness, how to preserve your own mental health and things like self care are becoming more regularly discussed and accepted topics. So when we think about your role in your organization, Mental Health America, you guys are a community nonprofit. How is it that you fit into that equation?

Paul: We are the organization of all of the national advocacy organizations that has focused throughout our entire lifespan, which is now more than 111 years on mental health, as opposed to mental illness, either in general or specific mental illnesses. And it is important to recognize that mental health is everybody’s concern and maintaining our mental health is as important as maintaining our overall health. So for us, the paradigm revolves around prevention, early identification and intervention for people at risk, integrated services with recovery as the goal, just as it would be with any other health condition.

Jon: Awesome. What sparked the need for you to found this organization and how did it kind of come to be?

Paul: The organization was founded actually by a young man in his 20s, Clifford Beers, who had lived in Connecticut with a lived experience of a mental illness. And he had been institutionalized, seeing the conditions in the early 1900s in the institutions that were serving people with serious mental health conditions. And many times people with non-serious, what we would call traditionally non-serious mental health conditions, and really felt that something needed to be done about it.

Paul: Now for me, I came to Mental Health America seven years ago, pretty much as somebody who had gotten my start in public policy in the Connecticut State Legislature, who had learned on the job about behavioral health policy in particular, and then learned also on the job as the parent of a son who had a serious mental illness that he developed the age of five and lived with until he died earlier this year at the age of 35.

Jon: I’m so sorry for your loss.

Paul: Thank you. It’s been, been difficult and for many people, they really don’t understand I think how much mental health conditions affect families of the same way that physical health conditions affect families. I had the misfortune a couple of years ago to lose an adult daughter to cancer. And the way people reacted to my adult daughter having cancer was so different than the way people reacted in general in society to my adult son living with schizophrenia. Both of them dealt with what I call stage four illnesses during the latter part of their lives. And each of them lived a life that meant a lot to the people who loved them and frankly meant a lot to the world around them. I think each of them have helped change these dialogues, even though people look at those conditions very differently.

Jon: Right. What’s kind of interesting is how you put it in a perspective there, right? Because I think that people do oftentimes try and separate how you accept and treat and interact with someone with a physical health condition versus how you treat and interact and really respect somebody with a mental health condition. So our audience here tends to be small business owners, so do you find that there’s a disparity in even the work culture or in the workplace, or how might someone who who is employing folks think about that too? Because I think it must be a challenge to think about the policies or the practices that you might have to have in place, or really understand where to get more information or how to start to learn or understand so you can actually deal with those types of issues appropriately in a supervisory role.

Paul: I think that there are some biases built into the way we approach mental health conditions versus physical health conditions. And it’s not the fault of anybody who’s trying to run a small business for example, that they may worry more about the impact on the business as somebody with a mental health condition. And that’s just because this bias has been built in because we really approached mental health conditions really from a public safety perspective. If you think about it during all of our lifetimes, the trigger to treatment is a matter of public policy on the mental health side has been danger to self or others. And what that’s done is not only apply to public safety model instead of public health model to mental health conditions, but it’s actually made them the only chronic diseases in America that we wait until stage four to treat and then often inappropriately through incarceration or dealing with the public safety system.

Paul: So it’s no surprise that somebody, a small business owner, for example, or any employer would be thinking when somebody discloses that they might have a mental health condition that this means that they may become a danger in my workplace. So they may affect my customers, or they may affect themselves in some ways differently from the way somebody might disclose having heart disease or having diabetes or having cancer, for example. And so I think we do need to bring those things together and recognize that, in fact, if we do early identification intervention, if somebody is willing to disclose that they’ve got a problem and seek care, treatment or support for that medical condition, they’re more likely to move to recovery more quickly and they’re more likely to be more productive throughout.

Paul: So my encouragement, mine is a small business as well. We have 32 people working at Mental Health America at the national level. We actually value the lived experience of people having mental health conditions who come to work for us. But the truth is that people can be remarkably productive if we foster a climate where people can talk more openly about their mental health. And certainly this last year has taught us all that we need to be more open about the mental health impacts of this pandemic has had on us.

Jon: Right. Well, it’s interesting, because it really fits into this notion of inclusion, which I feel is something a lot of business leaders have been thinking about too. How do I really define diversity on different dimensions and how do I let people bring their whole self and whole experience to work. And how do I use that as a contributing factor to my business model? So I ask you a little bit, because you made an interesting comment about the early warning signs. And how sometimes people wait until they’re in a progressed state to really even recognize that something’s happening. Are there things that from an employer perspective you might pick up on or that might signal, hey, I have an employee or a partner here who might need the opportunity to talk or maybe I need to think about what crisis intervention might look like if it’s not something that as clearly disclosed.

Paul: I think the challenge always is to act before stage four, and with mental health conditions in particular, where people are in the workplace already and something is going on, most of the time what happens is the mental health conditions that people are feeling they’re very private about, they actually make people feel different and make people feel more alone. So in some respects, I would say that employers have to be attuned to the things that aren’t overt when they begin to happen. And part of that is getting to know people, but that can feel awfully much like you’re prying at various times. So what I do when I suggest to any people, any employer, the small or large, is talk about these things myself and make the dialogue acceptable within my workplace.

Paul: If I’m willing to talk about the mental health impacts that I’m feeling from things that are happening and let people know it’s okay to talk about those things, that’s really a good way, not only to help people talk about their own worries, their own concerns or anxieties, depression, and other things, it’s actually a good way to get support for yourself, because people tend to react in a very favorable way, in a very supportive way to people who do speak more openly about anything that’s eating at them in the course of their lives.

Jon: No, it’s interesting because I think the first step is to build that rapport. Do you feel like mental health or the signs of someone who might be struggling with something always directly indicate something like mental illness or or maybe it’s something that’s more like a mental wellness concern, that’s a symptom of an actual moment in life. Are there other ways that folks might think about how they lead into some of those conversations where they’re not setting it up necessarily to make someone feel like they might be prying into something deeper than what it actually is?

Paul: Yeah. I think that up till this year, and everybody’s began to understand that something like one in five people at any given year, one in six people, one in four people, might have a diagnosable mental health condition. This past year based on the data that the federal government has collected at CDC, it’s more like one in two. Honestly I think that where we’re at here is in trying to, attempting to recognize that everybody is being faced with challenges to their mental health, whether or not they get a formal diagnosis of a mental illness. Typically that’ll be something like anxiety, depression, be the most common, but it could be anxiety. It could be psychosis. Psychosis really isn’t as scary as a lot of people think it is who have never had any experience with it.

Paul: But I think that the real important thing here is to recognize that this is so common, that we should deal with them in the same way we deal with blood pressure screening, high blood pressure being very common and try to normalize the conversation around them within the workplace. Because again, we’re not doing treatment within the workplace. So long as we have our employees present, they’re getting their clinical care and a lot of times their more formal services elsewhere that really all we need to do is provide an environment where everybody thrives. We don’t even have to focus so much on those people might have this year, a new serious mental health condition like depression. You don’t have to focus on people who are having assaults to their mental health.

Paul: We really can, some people say lift all boats. We really can do well for everybody, five in five, not just the one in five or the two in five. We can do all well for the five in five by normalizing these conversations and by really putting into effect the kinds of things that improve everybody’s mental health, not just mitigate specific mental illnesses, people may have.

Paul: Awesome. No, thank you so much for that. I think that’s really good insight. Gene, I’m wondering, you’re a small business owner, you deal with a lot of people. Wondering if you had any thoughts on this topic as well, or some questions.

Gene: I do and happy to take it over. I do run a 10 person company, and I have questions that pertain to not only myself, but also to a lot of my clients, but let’s talk about me first, because that’s my favorite topic. Listen, we talked about employees being under a lot of strain, but I know you know this ,because you’re a CEO of a company and you’ve had your challenges. Business owners have also been under a lot of strain because of COVID and even without COVID, it is very stressful to run a small business. And I’m wondering, first of all what advice you have for the business owner, for them to maintain their own mental health so that they could have a better outlook and be in a better mood and a better attitude when running their businesses.

Paul: Yeah, first of all, I think that advice I try to give to myself also, because I’m late, is to take care of yourself. You can’t really take care of others and employees if you’re not taking care of yourself. And so that’s the most important thing. And I think attendant to that is not feeling as if you’ve always got to work harder than everybody else who works for you, to set that example of being the one who is always first in the morning, last out at night kind of thing. And particularly as people working around the clock these days, I think it becomes really important in taking care of oneself, to send an example that says, it’s okay to have work-life balance. It’s not easy to do that of course, because the bottom line’s become so important in some way, shape or form for-profit or not-for-profit. You’ve got to raise enough money, you’ve got to bring in enough money to pay everybody and to provide the benefits that you want to provide to them and to allow them to take the vacations you want them to have.

Paul: But it’s really important not to set an example of overworking yourself into the ground in order to do that or the small business won’t survive.

Jon: So Paul, listen, you brought it up. You yourself have had some significant challenges over the past few years and you’re running a business. And I know that obviously the loss of a child, children, can have extreme impacts on someone’s mental health. Meanwhile, you’ve got to show up at work and you still got a business to run and you have employees that look up to you. I’m wondering what specific things did you do? You talk about not working, having more balance and that’s fine generally, but can you share any things you did to help you through those days and to help you manage your business so that your employees knew that they still had a leader at the helm that was focused on the job?

Paul: Yeah, it’s a good question, because I haven’t actually worked through all of this yet. I mean, these are very recent events in my life. And so it’s a real challenge to be dealing with those, but then trying to go to work every day, and everybody’s dealing with their challenges. These are just mine and everybody’s dealing with something that get gets in the way of being able always to give full attention. And it’s so important to continue to come in with a smile and to continue to come in in a way that looks forward. And I like sharing power with my staff, giving them more responsibility and letting them run with things so that they can continue to help move an organization forward. And help pull me along on days when I’m feeling a little less productive or feeling I’m making a little less progress.

Paul: So empowering my employees has been very empowering to me as a way to do that and supporting them because I know that they’re going through their own things, but it’s different from what I’m going through. And recognizing that what I’m going through is really, really important to me. And I’ve got to take care of myself. For many other people it’s in the past. It happened, my son died two months ago. That’s a lifetime for many people. My daughter nearly three years ago, a greater lifetime for many people. And so putting myself in their shoes has been really important too, to help me balance both my perspectives and my perceptions of the world around me, but with the perceptions and perspectives of other people who may be in very different emotional places in their life.

Jon: That is excellent advice. From a standpoint of a manager and executive, a leader, what are your thoughts on us using psychologists, therapists, psychiatrists, even business coaches, what are your thoughts and opinions on those professions?

Paul: Well, if people have got the resources to offer those and and can find people, then the more mental health supports we offer to our workforce, the better off in a sense they’ll be. Right now with what we’re seeing with the mental health impacts of the pandemic and just mental health impacts on employees prior to the pandemic, we’re seeing a lot. We’ve been surveying and we released our most recent report just a couple of weeks back. And we’ve just seen a lot of people who are just not feeling as if they’re supported in the workplace. People are actively looking for other jobs. People say they’re taking a lot of the time off that they’re taking to attend to their mental health. People are saying that they’re feeling stressed, they’re feeling unsupported. They take out that stress in other aspects of their life, they’re interacting with family and friends.

Paul: There’s just so many things that employees are reporting. And honestly, even supervisor employees are reporting these same things. It’s not much difference sometimes between the way the CEO is feeling, frankly, and the way the lowest person of the organization, the lowest paid person in the organization or the org chart’s feeling. I just think we need to understand that. We need to acknowledge it. We need to say it. And if the best we can do is just provide informal support, I’ll call it informal peer support, we’re both working for the same place, that gives us something in common to one another, that’s better than doing nothing.

Paul: If we can add on some things to that, if we’re capable of adding on more things like the use of professionals to help our workforce, then there’s no reason not to do that too. And throughout the process though, the most important thing is to continue to get feedback because a lot of employers actually will pay for employee assistance programs, for example, and to provide a benefit to people, but then the employees don’t use them. So you want to keep getting feedback to make sure that what you’re offering is what people are looking for. And to have that dialogue, otherwise to add on additional resources, professional ones in particular can become very expensive, but without a lot of return.

Gene: How do you, Paul, identify amongst an employee, whether there’s a mental health issue or it’s just a bad day or somebody who’s just complaining because that’s the way that they are?

Paul: Yeah. I’m a big advocate of implementing what the U.S. Preventive Services Task Force has been recommending for more than a decade, which is universal mental health screening for everybody over the age of 11. As adults, we should be getting a full mental health screen whenever we’re getting blood pressure screening done or we’re going for our physical. Kids should be getting them as well. And for the most part, we’re not getting those and they’re not hard to administer. The most common depression screening tool is nine questions that people answer, and they respond whether or not they’re having these feelings frequently or infrequently. It’s basically on a scale. So I wouldn’t be shy about, as an employer, and I’m not shy with my staff people to say, well, because we have a website, people go on and take a free mental health screen. And I say, “Go take the depression screen, go take the anxiety screen, and then look at the results you get.”

Paul: And that’s why, how can you distinguish? I’m no expert. I just run an organization. It’s an advocacy organization and people ask me, “How do I know, how can I decide?” I’m like, “Don’t decide and don’t even ask the employee to decide. Tell the employee, go take a free online mental health screening if you’re not getting one from your doctor. And based on the result that you get, you’ll have a better idea what to do.” And that’s where I am. That’s what we should be getting. That’s what’s been recommended and for a long time now, but it’s because we haven’t wanted to talk about mental health, we don’t do this one simple thing and I want to take all the burden off the employer to try to figure out what’s going on with their employee. They shouldn’t have to do that.

Paul: Just offer a mental health screen, free, anonymously online, if they want to do it through Mental Health America, or either doctors or whatever. And then just figure out when you get the result what the next steps are, because there’s plenty of information and advice that will flow from getting an actual answer instead of just making a guess.

Gene: Okay. So two quick follow ups on that point that you raise. First of all, does Mental Health America, your organization, provide a free screening that employees can use?

Paul: Yeah.

Gene: It does.

Paul: Yeah. And People can just go to or go to our website and there’s free anonymous, 10 free anonymous evidence-based mental health screening tools that anybody could use.

Gene: What about privacy concerns though? I’m assuming that if an employee is going to participate in that, are you basically telling the employee that if any problems arise, please let us know. And then trusting the employees to act on their own, or is that something that an employer can get involved in?

Paul: Yeah. We have some partners with screening where the employer partners that offer screening. And in that instance, they may want to get involved. Again, they don’t necessarily want to know about the individual employee at that point, but they want to develop enough tools and programs within the workspace to try to support employees in general. So people can go all the way in that direction. But the other side of that and again related to privacy is the reason why the screening tools on our website are both free and anonymous. People do not have to provide any identifying information. It’s because that alone gives the person enough information that they can decide what their next step is. It may be that they just want to get more information. It may still be they don’t want to disclose to their employer. They might want to use peer support. They might want to go get a clinical support or just some do-it-yourself tools.

Paul: But the important thing for them to know is that when you are ready to disclose a serious mental health condition, you’re covered under the Americans With Disabilities Act if you’re otherwise qualified to do your job. So a lot of people don’t understand that either and think, well, if I do this and I tell my employer, then what if they fire me? And that’s a legitimate worry that people have, but it’s actually highly unlikely to happen because you have ADA protections and most employers I know understand that they have to offer ADA protection.

Gene: Got it.

Gene: Okay. We only have a couple of minutes left so I did want to just ask you these final, specific actionable questions, Paul, because this information you’re giving us is really fantastic. Number one is again, as a business owner, can you give me some just specific things I should be looking for in my employees to determine if there is a potential mental health issue? That’s question number one. And then my final question is, if I do identify a potential mental health issue, what do I do as an employer? What should be my steps to take that you would recommend?

Paul: So just the first few things is their productivity going down? Have you noticed changes in what they’re describing in terms of eating habits or sleeping habits? What they’re disclosing about that. Have their complaints gone up? Is their absenteeism going up? These are the demonstrable things that aren’t the earliest stages, but could be more moderate stage of a mental illness that’s come on if they’re not otherwise describing any physical reasons behind some of these things happening.

Paul: And then what can you do? I just honestly think that talking first, setting a culture where you talk about it and other people can talk about mental health, as much as they’re talking about overall health or physical health. I like to talk about going out for a run in which I do at work from time to time. I also can talk about having done cognitive behavioral therapy. It’s no big deal. Both of them are taking care of my own overall health. And recognizing that if you can give your employee an opportunity to feel comfortable and supported by telling them that, and by talking about things yourself. That’s what you can do. And that you can do for everybody. And then other people also help move that person along who may be having a more serious effect into something that is appropriate for them for services or treatment.

Gene: Paul Gionfriddo is the President and CEO of Mental Health America. It’s Paul great advice and great information. I appreciate the time that you’re spending and we would love to have you back and continue to talk about these issues as they will continue to be a big priority among smart business owners that want to take care of their employees.

Gene: My name is Gene Marks. I’ve been joined by Jon Adikonis, my partner here on the Hartford Small Biz Ahead podcast. If you’d like more advice and information on running your business, please join us at or Plenty of information. And you can also find prior episodes of our podcast. Again, Paul, thank you so much.

Gene: Jon, great having you on board with me as well. And we will see all next time.

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