The National Institute of Mental Health estimates one in five adults experience mental health issues annually. In the workplace, addressing an employee’s mental health can reduce an employer’s long-term health care expenses and improve employee productivity, morale, retention and aid in an employer’s recruitment efforts of qualified employees. With recent studies showing mental health is declining on a national basis, Idaho is taking broad steps toward addressing this issue directly, but also has many complex challenges in front of it.
As of May 2021, Idaho had approximately 150 psychiatrists and 700 psychologists statewide. By 2030, these occupations are expected to increase 20-25% for psychiatrists to around 200 – a national outlook of growth of 10-15% – and decline slightly for psychologists to between 650-675 – national growth outlook up 5-10%, with the most growth in clinical, counseling and school settings.
What is mental health and why does it matter in the workplace?
Mental health is a combination of emotional, psychological and social factors that influence thoughts, feelings and actions. Positive mental health has been shown to increase concentration and memory, reduce anxiety, strengthen personal relationships, result in more rational and clear thinking and improve self-esteem. When a person’s mental health is out of balance or in a state of crisis, the inability to cope with daily stressors can result in depression, anxiety and mood disorders that reduce productivity, engagement, morale and overall well-being in both personal and professional working relationships.
According to a 2016 study by the Centers for Disease Control and Prevention (CDC), 18% of U.S. adults aged 18 and over reported experiencing a mental illness, but only around 40% of them had received mental health services within the previous year. The low percentage of mental health cases seeking professional assistance is likely due to a combination of the historical stigma of showing mental health weakness — especially to employers — lack of information about available local resources and potential out-of-pocket costs for services that are not always covered under a standard insurance policy.
Why is mental health a concern for Idaho’s labor force?
The National Alliance on Mental Illness, Idaho chapter, estimates that one in 20 adults experience serious mental illness each year. The root cause is not generally a single catalyst event, but a web of multiple, linked factors. Mental health illness is likely to reduce the focus and productivity of an employee, even if the initial triggers were not directly related to the work environment.
According to the National Safety Council, employers spend an average of $15,000 per year on employees who experience mental distress. This financial burden is comprised of both direct costs of elevated medical expenses and the indirect value of higher average number of missed workdays and reduced productivity while on the job. However, for every $1 invested by employers in supporting and prioritizing mental health treatments, their organization may experience a return of $4 in a combination of improved health and employee productivity. In a McKinsey and Company survey of employees during 2020, those struggling with anxiety or depression reported missing six times more workdays per year because of their mental health condition. However, depression management as an element of primary medical care can potentially reduce the number of missed days by 30% and result in higher return-to-work rates after mental health-related disability leave.
Through the social isolation and financial hardship many Idaho residents experienced during the chaos of the pandemic, the unique problems presented since 2020 have demonstrated that mental distress risk can occur even without a diagnosed mental illness. The past two years have increased awareness of the gap between a community’s mental health needs and its available resources. In its 2021 Workplace Wellness Report, The Global Wellness Institute said the pandemic highlighted “how much our families, home lives and communities can either benefit or detract from our ability to work effectively.”
“The pandemic highlighted how our families, home lives and communities can either benefit or detract from our ability to work effectively” – Global Wellness Institute
In October 2021, the Idaho Department of Health and Welfare, Division of Behavioral Health surveyed Idahoans to determine the impact of COVID-19 on the mental, physical, and financial health of Idahoans. Some results from the 5,118 responses include:
- 71% of respondents indicated their mental and/or physical health had been disrupted by the COVID-19 pandemic.
- 33% of respondents indicating some level of financial insecurity.
- One of four indicated a level of food insecurity.
- 79% of respondents noticed negative changes to their mental health in the months prior to the survey.
- Two in every 10 respondents reported they sought mental health/counseling services for the first time or resumed mental health/counseling services they participated in before the pandemic.
In a 2021 Limeade survey, burnout was the No. 1 cited reason employees left their jobs. Some employees have gone as far as leaving their positions to seek an employer that would better support their mental health.
Even if burnout does not result in higher turnover directly, an employer is likely to realize the effects of lower morale and less efficiency if the stressors on the organization’s employees are not addressed. For example, almost six in 10 U.S. health care workers reported pandemic-related stress had deteriorated their mental health and three in 10 were considering leaving the profession entirely. If this issue is not resolved and the health care workforce continues to feel overburdened and underappreciated, it is highly possible this occupation will experience significant turnover, and it will be difficult to attract and retain new talent. On the flip side, employers who offer mental health benefits generally experience higher rates of employee engagement and job satisfaction, improving business results and organization retention rates.
There are not enough licensed mental health providers within Idaho to meet the service needs of all its citizens. With only about half of Idaho residents with mental health conditions receiving the treatment they need, every county in Idaho is designated as a mental health professional shortage area by the U.S. Health Resources and Services Administration. Mental health professional occupations include psychiatrists, psychologists, counselors, clinicians, home health workers and other community support providers. While Idaho currently has fewer psychiatrists and psychologists per population than the national average, a mental wellness focus by employers can significantly fill in the gaps and result in a more satisfied organizational culture. Through open communication, reducing mental health stigma, providing co-worker and supervisor training to spot the signs of mental health illness, while working to make resources easily accessible when needed, a focus on mental health within the workplace itself could result in improved employee engagement, higher retention rates and a more productive workforce overall.
How is Idaho addressing mental health/wellness in both local communities and in the workplace?
Mental health is a kaleidoscope of many moving parts on both its cause and solutions. From working to provide more local mental health crisis services to increasing residency opportunities for psychiatrists and creating incentives for them to continue practicing within the state, Idaho is taking significant steps forward to increase the visibility of its mental health resources and access to care:
- The Idaho Department of Health and Welfare has begun implementing a statewide, comprehensive strategic plan for Idaho’s behavioral health care system to have services available when they are needed. As part of the Idaho Crisis System of Care, a Behavioral Health Community Crisis Center has been established in each of Idaho’s seven health region districts (Boise, Caldwell, Coeur d’Alene, Idaho Falls, Lewiston, Pocatello, Twin Falls) to reduce emergency room visits and high-stress law enforcement responses for short-term care while providing a mental health professional at the critical time it is needed most.
- The Idaho Behavioral Health Council published a strategic action plan in the summer of 2021 to improve access to Idaho’s behavioral health resources, recommending nine priority areas over the next three years to address the growing issues faced by Idahoans with mental illness or addiction.
- Free and reduced rate mental health resources may be available through programs administered by the Idaho Department of Health and Welfare and the State of Idaho’s Employee Assistance Program (EAP) available to benefit eligible state employees.
- In 2016, Idaho started the Suicide Prevention Program to combat the state’s high suicide rates and educate people about mental health. Idaho Department of Health and Welfare (DHW) has trained more than 25,000 Idahoans to identify the signs of suicide so they can refer people to suicide care. Suicide awareness and prevention training is available to all DHW staff. In 2020, Idaho’s age-adjusted suicide rate of 23.2 per 100,000 population was the fifth highest rate in the nation (70% above the national rate of 13.5 suicides per 100,000). Suicide was the No. 9 leading cause of death for Idaho residents in 2020, compared with No. 12 nationally.
- “988” – This new national three-digit behavioral health crisis line was launched on July 16, 2022, linking callers to a network of 180 local- and state-funded crisis call centers that make up the National Suicide Prevention Lifeline. 988 will replace the current 10-digit National Suicide Prevention Lifeline number.
What are challenges in the future of Idaho’s mental health resources?
Although the need for more mental health workers is apparent, it will take time and additional statewide training opportunities to significantly increase the supply of Idaho’s psychiatrists, psychologists and counselors. With a minimum of a master’s degree (psychiatrists require a doctorate degree and a four-year residency program) required for many mental health professionals, pursuing a mental health occupation requires significant time and expense and has very limited program openings per year. As with most occupations in demand, Idaho’s struggles to increase employment for mental health occupations reflect that of the U.S. In 2018, the Health Resources and Services Administration (HRSA) found that 77% of U.S. counties reported severe shortages of psychiatrists in 2017 with 55% of counties were not home to any psychiatrists at all. HRSA estimated that national demand for psychiatrists will exceed supply by 25%, or 15,000 professionals, in 2025.
Lisa.Grigg@labor.idaho.gov, regional economist
Idaho Department of Labor
(208) 799-5000 ext. 3849
 “Mapping Supply of the U.S. Psychiatric Workforce,” University of Michigan School of Public Health Behavioral Health Workforce Resource Center, October 2018.
This Idaho Department of Labor project is 100% funded by USDOL as part of an Employment and Training Administration award totaling $1,039,383.