Business as Usual: Mental Health in the Workplace

Transcription: 

So good afternoon, everyone. This is Audrey Russo. So happy to be here on another beautiful Friday in Pittsburgh, although it's Friday the 13th. I don't know what, that's a little superstitious. That's okay. It's a great day. It's a beautiful sunny day. And I want people to be safe. And know that our numbers for COVID have increased and we're getting into the holiday season. So please continue to be safe and remember to wear masks and not congregate in mass. So we're thrilled about our guests today. We have a long standing partnership with Highmark. So we're really glad to be able to talk about behavioral health after so many months and COVID. In so many different issues have manifested themselves in terms of, of our people live in terms of their support, etc. We're gonna do a little dive with a leader, a director at the behavioral health as part of Highmark, we'll introduce him in a moment. So I want to say thank you to Huntington bank, please. If you know anyone at Huntington bank, thank them, because they believed in us right from the onset, Jonathan Kersting, Vice President of Marketing and media at the tech councils with us, as always, he's going to make sure that the questions are being attended to. And he is our ultimate Storyteller here at the tech Council. So if you don't know him, and you want your story to be told, reach out to him, and we've muted your chat. You know, we've muted your voice so that we don't hear anything in the background, but we have not muted the chat. This is not an opportunity to sell your wares. This is an opportunity to discuss the matter at hand and the matter today is behavioral health. So I'm going to jump in now and welcome to meet Demetrios Marousis, today's show on business as usual. And as always, I want to jump in and say, How are you to meet this? And who are you and give us a little bit about yourself. And thank you for taking the time with us today. We really appreciate it.

Thank you for the opportunity. And it's, as you mentioned, I'm Demetrius versus and I'm the director of behavioral health at Highmark, I've been doing behavioral health related themes since mid 80s.

What does that mean? What does that mean behavioral health?

Well, so I, you know, as a, as a clinician, I was, you know, in the, in the service provision space for about 20 years, and for about the last 15 years, have been in the managed care space, sort of on the on the sort of the payer side, managing our, our members access to their benefits and promoting access to benefits. You know, behavioral health is, is typically underutilized. People could use it a lot sooner than they do. And our goal is to identify and provide that sort of full access to their benefits through, you know, through our network as well as the right level of care.

So, you know, thank you. So you have actually been a practitioner, and now you're directing the behavioral health services there at Highmark. Right. Am I capturing that correctly?

That is correct. Yes.

So, you know, here we are, I don't know, eight months, seven months into COVID. We've have, you know, interesting things happening, right with, you know, the rise of COVID. Again, we're entering into the winter, although it's been amazing weather here in Pittsburgh. And we as people who lead people, and many of the people who are in our audience today are in the tech, they're in the tech community. And we are working from home, many of us are working remotely, many of us are working hybrid. And the demands and the boundaries of our life have shifted responsibilities around kids changed in terms of school, family members, trying to keep people protected. We're juggling a lot of balls. And what I want to start with you is just to talk at the high level, what are you seeing there any changes over this eight month period? Are you seeing some trends, some things that you'd like to talk about, at the macro level?

So let's start with, I'll start with the four COVID you know, mental health, um, it was sort of an underrepresented theme. And one of the reasons it's under represented is igma. You know, people who are sort of feeling off, you know, basically that sort of work ethic that most people hold, well, I'm going to shake it off, I'll work through it, I'll tough it out. And the reality is research really suggests that people are symptomatic for good eight plus years before a good diagnosis in many cases. And And so, in essence, you've got somebody struggling with a diagnosable treatable condition for that long. And so I think the power of stigma, the power of not talking about it not having sort of language that we can readily sort of reflect on and share about, you know, and, and, and sort of, you know, find a way of sort of interacting, I think, is significant. Now, that was there before. And before COVID, we, you know, in a given year, about 20, to 24% of the population in the United States would have had a, an experience with a mental health condition. So, that's significant. Now that we have COVID, as you mentioned, you know, it's been a it's been a disrupter. And not only did it, you know, it sort of sort of close things down. But it disrupted our routines, it disrupted our context or social context. It disrupted the context, that we can have conversations, and it's sort of in that context, it's sort of limited, then sort of the sensory sphere. And also, now we're going on more text messaging, more emails, what does it mean when somebody is on a zoom call, and Gosh, they don't have their video on. And I want to go back to that sort of the power of routines. of Okay, I'm waking up, I've got this, and I've got to hit the clock by this time to get my commute otherwise, I'm not going to get through the tunnel, you know, by this time, and I've got this meeting that I've got to be at my seat by this time. And oh, by the way, you know, I really want that coffee from that coffee shop, that's two blocks this direction, I've got a, you know, those are all things we accommodated. And they were all sort of, in many ways, self care things. And so the immediate thing is that sort of all of that shifted, and it shifted dramatically. And it shifted with, you know, some initial optimism, oh, this is going to open up again, in this short order. And things are going to be this way. And it also was sort of in the face of in congruent and conflictual messaging. What is the best way to keep space? What's the best way to keep my business going? What's the best way to keep my employees congruent, and all the chatter and all the different opinions about that, that sort of leaked into everybody's daily conversation, and was somewhat polarizing at times. So all of that, you know, sort of added sort of additional sort of stress, uncertainty. And I think the the other piece of it is sort of the persistence now, you know, here we are, you know, so March 12, for me, was the last day I was in my office. And so here we are, mid November almost. And, you know, and there's sort of a weariness that I think most people can sort of relate to. And I say, weariness is sort of the, you know, sort of mild, some folks are really dragging at this point in time. Now, if you can sort of accumulate all the loss, that individuals have sort of accumulated, you know, the graduations that people didn't get to go to the weddings, funerals, Fourth of July, Memorial Day, different things, parades, you know, kids sort of sports seasons, soccers, baseballs, and how those have all been sort of truncated, modified, you know, adjusted in many ways, and done in many ways unevenly. So if you look around to another community, or here's somebody else, they, you know, may act as if there are no restrictions, whereas your community may have buttoned it down. So I think all of that is sort of what needs to sort of factor into this sort of persistent weariness.

So you mentioned earlier, you mentioned that the onset of what you were just talking about that 21 in four people have experienced, what can you describe,

well, they would have, they would have had something that, you know, a mental health condition. Now, these can be transit, they can pass and, you know, not all require, you know, so if we look at it as sort of a continuum, you know, sort of what is stressful for one person is sort of ground sort of, you know, chattering for others. And so you also then have to look at individual capacity to handle some of these things. And that capacity is really developed early in life. You know, based on sort of our early development and even though You know, there are there are people that are sort of, you know, overcome many, many things. The fact is that early development still locks in some of our capacity to handle this kind of stress. Especially when our sort of agency, and by agency, I mean, our capacity to sort of affect our outcomes our day to day our, you know, our, our pathway through the world, if that agencies affected, then we also then experience that limitation. And not only do we sort of miss out on sort of, sort of that stress reducing stuff, but we also sort of feel poorly, and we, you know, have additional sort of grief and loss associated with it.

Yeah, it's interesting, so has there in terms of the services, and then I want to get back to this whole thing about grieving in terms of the services and the demand for services has that changed over these last eight months?

Well, what we've what we've seen, and what Highmark you know, actively did is sort of recognizing that, you know, the sudden disruption in services is going to be significant. And it's going to be significant, and that we had some, you know, our members, there's a cohort of our members, that were going to be significantly vulnerable. So those that were in existing care, and suddenly that care was disrupted, so turning on capacity for telemedicine, and promoting it, and, you know, working with our providers to pull that off. And what we found is that, you know, we've had sort of, you know, thousandfold increase in the use of telemedicine. And so providers really, you know, up their capacity up their competency, and sort of developing the connectivity to do it. And what we're finding is that it's sort of, you know, if there's a positive about this whole thing, is that sort of COVID sort of provoked, and, and escalated sort of the the maturation of sort of, you know, telemedicine channels of service delivery, not just in sort of medical, you know, medical field, but also behavioral. So that sort of adoption, and the experience with it, and the and the sort of positive sort of, you know, feelings around it, I think are positives for us, and are likely to, you know, increase in the future.

So, yeah, and hopefully, the stigma starts to erode. Through this,

I would, I would hope so, because I think once now, people are more readily able to talk about experiences of stress, and experiences of anxiety, and potentially pursue treat.

Well, one of the things that we're hearing just statements in the chat, it's around grief, if I can cluster it around grief and loss, right, grief and loss, about not being able to attend things, not be able to do things that are incidental, having family that are spread all across the world, or, you know, even all across the United States. So it's really around grief that I'm hearing the reactions to right now, as well as, what can we do? As I mean, obviously, maybe we should learn about, you know, death and dying in terms of the stages of grief. And as leaders, we should, should learn how to embrace that, but what should we be doing? What what are the what's the advice that you're, you know, one of the things that I hear is that people are so productive, people are so productive now that they're working hybrid, they're working remotely? Well, I worry about that. And I've heard that from many leaders, that the blurriness that we had before with tech, it's it's just, you know, grown exponentially.

Yeah. So yeah. So once again, yeah. So, you know, productivity could be a measure of, you know, of whether somebody is struggling or not struggling, or somebody is sort of masking other things by, you know, their over productivity, you know, you know, who's now putting in extra hours, you know, I mean? Because it's easy, you just wander from one room to the other room at your house at this point. And you and you log on, and is sort of the amount of time logged on the best measure, you know, are we truly seeing that productivity shift? Or are we seeing people that are, you know, they're, they're, they're visible, they're available, but we're maybe seeing nuances that there may not be as productive. So, you know, that that may be a that may be a function that we need to look at.

So, what are some signs what are some signs of knowing, you know, as leader, that or even as an individual that we should seek help?

Well, I mean, so once again, so behavior change You know, so are we seeing somebody's productivity shift? We're seeing them less productive, we're seeing deadlines getting missed. We're, you know, we're seeing sort of changes in appearance, and I'm not just talking bad COVID haircuts, you know, you have that kind of thing. You know, so this is my latest COVID haircut. This, it

looks good.

Yeah, yeah, yeah, my son helped me out in the garage. But, you know, so So it's, it's the change, it's also sort of the availability of, you know, you know, who's not on video, and sort of why. And, you know, and, and, and I'm not trying to say compelling people to be on video is necessary. Because this can be a bit much at times, you know, how do you, you know, how do you balance it. And I think sort of the way out of it, is this sort of, you know, almost a necessary curiosity, that sled with empathy, about how people are doing, because we don't get to hear about things that we're not talking about. So as sort of, you know, employers, as you know, leaders, I think we have to ask the question, and it goes beyond How are you doing? Well, we have to, you know, push for the answer. We have to remember, hey, you know, last year, didn't you usually have this sort of big gathering at this time? What are you guys doing instead? And sort of digging into it, how you're handling them? How are you managing that difference? You know, gosh, wasn't your kid lined up to, you know, get some sort of scholarship to college based on his baseball, and you didn't have a season this year? How's that playing out? You know, what are those prospects looking like? Those are all sort of things that, you know, occupy a person's life and not one of them by themself, you know, I think is going to be massively the most meaningful piece. But it's that sort of pursuit of it. And and I think it's, I think the emphasis is on that pursuit of sort of interest in your, in your employee in their well being, because once again, you know, their well being means that they're more likely to be present. And that's not just sort of signed on, but absolutely present, and you're going to get that presenteeism, that sort of absence of all the distractions and diversions that are out there. And you're going to get more productivity. So in 2019, the World Health Organization talked about mental health and the impact on just sort of, you know, lost productivity, and they quantified it to the about a trillion dollars strictly related to mental health issues and concepts of presenteeism, you know, so even though somebody shows up, if they aren't at 100%, you know, you may only be getting 60%, in a given week from them, because of diversions and distractions going on. And some of that stuff is absolutely treatable. And, you know, some of the solutions would be referrals to the APS, call the number on the back of your card, find a provider, talk about what's going on and get linked to the right level of care.

Jonathan asked a question, Jonathan, why don't you ask yours? And then I see Lisa, and there might be a couple of others died. Demetrius

definitely. So is there a real mental connection with zoom fatigue, we find out that after being on seven, eight zoom meetings, it's more tiring than actually being in real life meetings. Is there something to that?

Well, I think there is because once again, you know, it requires, you know, sort of a level of attentiveness. And you're without sort of some of your sensory experience. You know, so the zoom meeting, you know, you're not walking from, you know, the same corner of the floor to the conference room, and on the way, you know, you're touching base with your colleague, you know, zoom meeting right now is you're appearing. And, and you're, you know, you're right into the agenda. And, you know, you're done at noon, you know, and then 1201, you've got your next meeting, and it's just a few clicks away. And so even that sort of stroll from one meeting to the other when you had in person, you know, and even you may have had those days, revert back to back regardless, you know, if like, that wasn't every day.

Exactly. And, you know, because it's like, you log on to the zooming the next one, it's just like, you're all it used to be just three cylinders down.

And some folks had sort of travel that sort of broke things up, you know, they were out of the office, they were on the road to the other side of the spade or somewhere else. You know, for a face to face conversation elsewhere. And once again, that the stimulation of all That is significant. So even though we may be able to accomplish many things in one, shift the difference in it, you don't get that sort of respite. You don't get that sort of collegial lunch out. Hey, what are you doing for lunch today? Oh, no, I've got a break. Let's go, I can go for here here. What do you want to eat? And, oh, there's this new place. You know, all of that is sort of, you know, I think sort of gets into that sort of last pile and not the sort of

maybe it's like, it's dehumanizing. For just like these Natanz, like, just, that's right.

Yeah. Yeah, what do you see now, as some of the folks are, you know, now getting more sort of competent with zoom, and, and they're getting creative with backgrounds, you know, or, you know, there's that day when, you know, the most critical day of any meeting you had, and somebody took out a poll in your neighborhood and your connectivities down, and you're challenged, and the only thing you've got is, you know, your your telephone Connect, and in and, you know, and how do you put on your best professional sort of presentation with that. And then you've got a call somebody who's going to get creative. And then today, they're going to use teams, and Gosh, never use teams before. Now I've got to go accumulate, download this, that, and I didn't think I had to look for that. And, you know, now I'm scrambling and, you know, not only late, but I'm sort of, you know, feeling less competence, or somebody is using Skype or somebody is using, you know, WebEx or, you know, whatever those things are, that catches people off guard and, and, you know, they feel like disruptions to your sort of flow to your momentum of that of that day and moment.

Make sense?

So what about kids? What about what's, what is some advice for? For parents?

Yeah, so I mean, once again, I mean, I think kids are going to, in many ways, sort of mirror, you know, how the adults in their world are, you know, and I'm talking younger kids, for right now, you know, how the adults in their world are managing this, how they're managing the stress, how they're articulating it, you know, how they're, you know, I mean, so you can have parents that are beside themselves, and they're angry at the world, they're angry at sort of, you know, what's going on around them and in our society now, and, you know, have public expressions of all that, then you have others that are sort of recognize, and they're talking about it in a way that sort of a kid can sort of competently resonate with. So the uncertainty is, is manageable. The uncertainty? Yes. You know, you can't go to the Joey's birthday party. Yeah, we can't have your birthday party. Yeah. You know, I know that, you know, we thought Chuckie cheese would be a good place. But, you know, so how do you talk virus to kids? You know, how do you know, you know, how do you talk, you're, you know, you've got all these new classmates that you may have never met. Things like that. And then older kids, you know, who are, you know, once again, they're old enough, these, they're digesting their own sort of social media pieces, they're out there. They're, they are developing their own opinions and their own expressions of that. And, you know, just even sort of, you know, mask yes, no, what's the proper mask? What's the best way of wearing one, and they're casting their judgments and aspersions willingly to anyone who's still around them, you know, some talking about your sort of typical surly adolescent you know, let alone sort of adult children who've, you know, had this sort of regroup at home, given changes, given changes in sort of employment status, and things like that, and, and everybody is around them around each other. So I think it's all sort of, you know, managing that. And then I think, you know, you mentioned when you started off that many people are in caregiver roles, whether those are people they're caring for in their house, or whether they're in a primary caregiver who's for somebody who's living independently, and trying to sustain that independence, and how do you do that? And how do you, you know, um, you know, make that work, and how do you sort of make that work by not creating risks?

So what services are available? So we sort of talked about all the different things that we're all dealing with what services are available through Highmark?

Well, I mean, through through Highmark, I mean, once again, you know, sort of at the at the lowest end of sort of the continuum of care would be outpatient treatment, you know, outpatients therapy. Easy enough, you know, no authorization. You can identify a clinician through the network directory. And talk. Now some some of our, you know, some of our clients, you know, also have access to some digital modes of care. And there's some phenomenally evidence based practice models around behavioral health that are science based and use computer based technology, some applications of AI. those are those are also quite effective and quite useful. In terms of

find that information, maybe we can put that out and share it.

Well, once again, some of that is some of that is sort of client dependent. So you know, so a particular employer may opt to, you know, have those available resources, whereas others don't, they're also they're also, you know, apps available, you know, around anxiety or sort of mindfulness, people have continued sort of the practice of things like meditation yoga, have found alternatives to sort of, you know, practices or their spiritual life, church license and sort of alternative ways and, you know, those are all positive aspects that get back to sort of normalizing and also provide some of that, that sort of stress relief that many people need.

So to access that through Highmark, they would apset would they reach out if they are using Highmark, they would reach out to where?

Well, they would, I would suggest calling the number on the back of the card, sort of reviewing their their particular benefits. Okay, talking talking to Member Services. And, you know, from there being linked to the resources that are available with, you know, how their benefits are structured.

Okay. And have you seen an influx in terms of requests for services? During COVID? We mentioned earlier? Yeah.

You have Okay, though, absolutely. I mean, we did see sort of a downswing and some of the more restrictive levels of care early on in COVID, which makes sense, you know, in terms of some of the group living kind of environments in the residential and inpatient space, because of the risk of transmission. But what we've seen is that's picked up those, you know, the providers are once again, getting more competent in managing the risks associated with that, you know, my biggest concern are the things that we don't know, you know, so if, you know, by looking at just sort of, you know, you know, emfs utilization patterns, you know, so we're seeing more, you know, sort of opiate overdoses, and the risks associated with that are people using in greater isolation than they had before. We're hearing stories of, you know, people who are now trapped with others, and they're trapped with, you know, abusers, you know, they're trapped with people who are incredibly unpleasant. They're victimizers, they're, you know, so you know, so we're seeing some risks, we're hearing anecdotally of increased risk around, you know, suicide, suicide attempts, suicide completion, and sort of we're, you know, waiting for some data on a lot of that, in our primary tool, until, you know, we get sort of sort of clarity, and there's so certainly a lag in some of this data. But, you know, getting messages like this out there, that stigma is a factor that stress and anxiety are absolutely real, and asking for help. Putting your hand up, is, is sort of the best strategy. And then that each of us, you know, who knows others sort of reaching around? And are you okay, you know, I'm noticing this difference, or, you know, can we talk, can I help you connect to services? Because I think, you know, I think you're a little, you know, beyond where you usually are when you're having a bad day.

So, I know, we're coming to an end, and I just want to wrap it up, and Matt Verlander actually made a statement here. That's sort of a question, you know, like, how do we balance the health impacts of COVID? You know, for those compromised health conditions, with the imminent some physical, you know, shutdowns, you know, so can we like the social interaction, you know, you've got Thanksgiving you've got, yeah, holidays behind that.

I would say that the risks that COVID presents, wins, you know, so that has to be the first priority. We then accommodate everything else around that by managing and mitigating that risk. And I think it's critical and you know, some of the some of the stuff that we see more recently is, is coming to a consistent message, coming to a consistent message, that it's not just sort of the status telling me I have to do this, but then even as an employer, I am aligning with the standards of how to manage COVID. So it's not just something that's being imposed on me from outside. But as an employer, I'm training my employees, because my business model is dependent on the health and welfare and productivity of my folks. And I need them to do a, b and c. So, you know, I think that's critical. So I think that COVID messaging is first, because it takes away some of that ambiguity in that sort of what if, and that it's others doing this to me, you know, as well as, you know, the in congruence of people, how they carry themselves in the workplace, you know, espousing broad, non science based opinions around COVID, for instance,

well, we are very committed at the tech Council in supporting our member companies and their leaders, in talking and supporting and making sure that the resources are available, we will do whatever we can to make sure that we talk about things to eradicate stigma, since it's so prevalent, and it's prevalent, even outside of COVID. And I think that's important. When you focus on productivity very often, it's hard to remember that, that there's a whole piece of the human that, that matters, that just matters, and that the empathy is something that we can all learn. I know I have to work on it each and every day. And it's not necessarily easy. So I really appreciate to meet trust for you joining us today, I really hope that if people use Highmark that reach out to the resources that Lexi on our team Collins put out, and, you know, reach out on the back of your card, if you tie mark, and, you know, make sure that you're leveraging the resources, there's nothing, you know, err on the side of caution, always err on the side of caution would be my advice that, you know, don't think you can always just shake things off. And I like the way that you set the stage Dimitris and talked about, it's those little things even during the course of a day of getting up going to work, seeing a barista, talking to someone on the street for a second having accidental conversations that we're not having now. And that is part of the socialization and human need. That is not embedded into many of our lives. And then on the other end, people who are absolutely, you know, consumed with lots of people to be responsible for and to care about. So I don't want to end a Friday on a Friday, the 13th and November, it's a beautiful day out, I know that we're headed into winter, we're gonna continue to try to weave into the conversations that we have on business as usual around the matters of mental health. And in try to eradicate that stigma and make sure that we are doing what we can to be helpful to the community. So if anyone is listening has ideas, and wants us to talk about this more, you can reach out to Jonathan kersting reach out to myself, and we will do whatever we can to make sure that the resources and the conversations continue. So thank you Highmark, for for the work they do in behavioral health. This is just one small piece of their work. But really appreciate appreciate Demetrius joining us. So I'm asking everyone wear a mask, stay safe, be practical, be considerate of others, and have just a really great weekend trying to unplug. So thank you all. Sounds great. We have on Monday, Jonathan. Monday, we

have motional stopping by one of Pittsburgh's newest, automated driving companies really fun.

Wow. Okay. Great.

I should also say we should have Demetrius or someone else behind Marc stop by every six weeks or so just to kind of keep us on the straight narrow because there's been some great tape. I think our crowd really appreciate

that idea.

Yeah. Well, I have I have more of my team that have other messages as well. So we certainly,

yeah, that's great. So thank you so much to me to stay safe.

Thank you. Okay, have a great weekend. Thanks.

You too.

Transcribed by https://otter.ai