Employees are worried about their mental health as they return to the workplace after the COVID-19 pandemic. Stigma can exacerbate their concerns, but employers can thwart its impact.

The COVID-19 pandemic has taken a heavy toll on the global psyche. Today, as the world moves toward the end of the pandemic, almost one billion people have a mental-health or substance-use disorder ¹ —collectively referred to as behavioral-health conditions. As companies prepare for a postpandemic return to the workplace, identifying behavioral-health conditions and offering the necessary support for employees affected by them should be a top C-suite priority.

While most employers report that they are serious about employees’ mental health, many haven’t confronted one critical challenge: stigma. Using data from two recent US surveys conducted by McKinsey’s Center for Societal Benefit through Healthcare, ² this article takes a deep look at stigma in the workplace and its role in exacerbating behavioral-health conditions and driving down an employee’s self-worth and productivity. This is a widespread problem with serious implications. The good news is that employers are in a unique position to address stigma—especially during the short postpandemic window when many organizations are evolving their operations for the new reality of hybrid work.

In behavioral health, “stigma” is defined as a level of shame, prejudice, or discrimination toward people with mental-health or substance-use conditions. Because of stigma, such conditions are often viewed and treated differently from other chronic conditions, despite being largely rooted in genetics and biology. ³ Stigma affects everything from interpersonal interactions to social norms to organizational structures, including access to treatment and reimbursement for costs.

The National Academy of Medicine defines three primary forms of stigma, each of which can have far-reaching and harmful effects: ⁴

• Self-stigma occurs when individuals internalize and accept negative stereotypes. It turns a “whole” person into someone who feels “broken.” As one employee told us, “Depression can be a terrible illness. It makes you feel worthless and without a purpose.”
• Public stigma (which is sometimes referred to as social stigma) is the negative attitude of society toward a particular group of people. In the case of behavioral-health conditions, it creates an environment in which those with such conditions are discredited, feared, and isolated. As an employee explained, “There is such a stigma against mental-health disorders. But if you don’t talk about it, you suffer alone.”
• Structural stigma (including workplace stigma) refers to system-level discrimination—such as cultural norms, institutional practices, and healthcare policies not at parity with other health conditions—that constrains resources and opportunities and therefore impairs well-being. “The number-one challenge I face is finding [healthcare] providers,” one employee told us. “It’s a problem for me, for my wife, and for my kids.”

The impact of stigma can be profound. At a time when people are at their most vulnerable and most in need of help, stigma prevents them from reaching out. This terrible paradox can deepen an illness that is often invisible to others. Evidence-based, effective treatments that allow people with behavioral-health conditions to live productive and fulfilling lives exist. Stigma creates a cloud of shame and uncertainty that obscures what could be a clear path to recovery. ⁵

Our analysis of our two surveys substantiates that impact. For example, many employees with a behavioral-health condition indicated that they would avoid treatment because they didn’t want people finding out about their mental illness (37 percent) or substance-use disorder (52 percent). Stigma was also associated with lower workforce productivity. Close to seven in ten respondents with high self-stigma levels reported missing at least a day of work because of burnout or stress. ⁶

Opportunity for employers to address stigma

There is a pronounced disconnect between employer and employee perspectives on stigma in the workplace. While some 80 percent of the full-time-employed individuals we queried indicated that they believed that an antistigma or awareness campaign would be useful, only 23 percent of employers reported having implemented such a program. Further, when employers were asked to prioritize 11 potential behavioral-health-focused initiatives, they ranked stigma reduction last (Exhibit 1).

Strategies for reducing stigma in the workplace

We understand that stigma can seem like a vague concept and an insurmountable challenge for employers. We also know that attitudes toward stigma can vary by demographics and other factors, making it harder to address effectively without a tailored approach. Nevertheless, those employers that have addressed stigma have modeled approaches that can work across a variety of populations. Blending their experiences and the lessons from our research, here are three overarching strategies that can help dismantle the stigma associated with behavioral-health conditions in the workplace.

Shift the perception of mental illness and addiction

For starters, employers can change the misperception that a behavioral-health condition is a moral failing. These conditions are treatable diseases like other medical conditions. In our survey, a significant percentage of employees with behavioral-health conditions reported feeling “ashamed” or “out of place in the world” because of their conditions. Many respondents expressed worry that people would think they were worthless, or had serious character flaws, if their behavioral-health condition was known (Exhibit 2). As one employee told us, “I had a strong sense of shame, and upper management did not talk to me at all. They acted as if nothing had happened, even though the reason I had to take a leave from work was because of work-driven anxiety.” Many respondents were also concerned that colleagues who knew about their illness would doubt their talents or skills.