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stress-in-the-workplaceStress in the workplace is a public health issue that the World Health Organization called the “health epidemic of the 21st century.”

According to the 2013 Stress in the Workplace national survey by the American Psychological Association, 65% of U.S. adults cited work as a significant source of stress and 35% of working Americans reported that they typically feel stressed during the workday.

As pointed out in the University of Illinois at Chicago (UIC) research study on stress in the workplace, there is a widespread understanding that high amounts of stress are unhealthy and can play a contributory role in or exacerbate mental health conditions, as well as chronic physical conditions like hypertension, cardiovascular disease, diabetes, obesity, asthma, cancer or a weakened immune system.

The costs of employee stress to American businesses are substantial and include healthcare costs nearly 50% greater for workers reporting high levels of stress, diminished productivity, increased risk of occupational injury, absenteeism, employee turnover and workers’ compensation awards.

Were this outbreak an infectious disease that we could vaccinate against with costs and prevalence rates this significant, we would mount an urgent national effort.

In concluding our series on stress in the workplace, let’s look at just what are employers’ obligations to address and proactively manage this issue.

A wide range of workplace laws is in place to protect employees and to ensure fair treatment. Some of those laws employers should consider when employees report being highly stressed or dealing with mental issues include:

  • OSHA: Under OSHA’s General Duty Clause, Section 5(a) (1), employers must maintain a workplace free from recognized hazards that are causing or are likely to cause death or serious physical harm. While stress or mental illnesses are not specifically addressed, OSHA has issued guidelines for establishing programs to minimize workplace violence.
  • Workers’ compensation:  Claims for work-related stress under workers’ compensation benefits may be the first indicator of a workplace issue. The availability for benefits varies from state to state for work-related stress.
  • EEOC guidance on psychiatric disabilities under the ADA: The EEOC has issued guidelines to facilitate the enforcement of the Americans with Disabilities Act (ADA) for individuals alleging discrimination on the basis of psychiatric disability. Whether job-related stress falls within the purview of the ADA has been considered by several courts and, to date, the majority of courts have held that job-related stress is either not a disability or handicap, or that the employee is not entitled to reasonable accommodation.

Because of the complexity of these laws and the risk involved, employers should seek advice from legal counsel and medical health professionals when addressing them.

In addition to the laws mentioned above, the Affordable Care Act (ACA), building on the Mental Health Parity and Addiction Equity Act of 2008, requires coverage of mental health and substance use disorder benefits for Americans in the individual and small group markets who previously lacked those benefits. The ACA also expanded parity requirements to apply to millions of Americans whose coverage did not previously comply with those requirements.

While there are currently no specific laws dealing with stress in the workplace, most businesses recognize a responsibility to treat the wellbeing of their employees as an important business obligation that is important to their success.

What can employers do to address high levels of stress in the workplace? As an initial framework, the UIC study recommends a discussion beginning with three areas: organizational change; screening and outreach; and managing the risk of prescription drugs that impair performance. 

Stress in the workplace is a growing issue and we encourage employers, risk managers, clinicians, public health advocates, ethicists, elected officials and policymakers to engage on how to attack the problem.

Desiree Tolbert, National Technical Compliance Manager

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