Companies can play a role in helping to reduce employee stigmas around seeking healthcare.
Do you know the real reason why some employees avoid seeking healthcare? According to McKinsey & Company, a global management consulting firm, 40% of full-time employees surveyed report bypassing essential mental or physical health services out of fear of shame and embarrassment. This leads to a higher risk of missed detection of preventable or treatable illness, later-stage diagnoses and even mortality.
About half of respondents noted a stigma around taking time off to address physical health needs, and 61% reported the same regarding mental health. Destigmatizing healthcare helps to provide a more equitable benefits experience for employee populations.
Dr. Terry Layman, SVP Corporate Medical Director at Marathon Health, says reasons people don’t engage with healthcare include fear, previous bad experiences or not seeing the need to visit a doctor.
The McKinsey & Company survey showed that people who miss work days due to their own or their dependents’ health conditions report higher levels of stigma, creating a cycle of burnout and more sick days.
Family Nurse Practitioner and Marathon Health Regional Clinic Leader Silvia Madrigal definitely see a mental health stigma in the rural population she serves.
“I think the main stigma comes around behavioral health,” she says. “There’s still that stigma of, ‘If I say I’m depressed, I’ll be labeled with a handicap or as someone who can’t cope with life.’ So we do find there’s less disclosure of that.”
Employees also fear their medical details won’t be kept private, Madrigal adds.
“We definitely run into the fear of, ‘Would you share my information with my employer?’ Because they associate our health centers with their employer’s benefit,” she says. “So one of the things we do, especially as we start getting connected with our clientele and start building that patient-provider relationship, is just reinforce that we follow the same privacy laws as any other health center. Unless they give us permission, we will not disclose any of their health information with anyone.”
Offering healthcare benefits doesn’t go far enough to break down healthcare disparities; employers must create and promote policy that actively addresses health equity and considers social determinants of health. Consider the following tips for reducing the stigmas around seeking healthcare:
Bring Healthcare to Employees
Onsite or near-site health centers break down barriers to receiving care and also normalize the practice of using healthcare benefits. Allowing employees to access care during work hours provides flexibility for those who need it while eliminating the stigma associated with requesting time off work to tend to healthcare.
Bringing healthcare directly to job sites takes it a step further. For example, ConocoPhillips sends providers to site locations across the country to conduct biometric screenings.
“We provide U.S. employees with incentives toward their medical plan premiums if they complete their basic blood pressure, cholesterol, height, weight and BMI checkup,” says Frank Alexander, Manager of Health & Welfare Benefits for ConocoPhillips. “Our focus is to create awareness. I have anecdotes from people across the company who tells us, ‘I haven’t been to the doctor for years; a nurse came to our office and turns out I had really bad blood pressure problems. I went and saw a doctor and got it taken care of.’”
Within Marathon Health healthcare centers, providers use motivational interviewing to get to the root of a patient’s issue.
“Some people will come in with recurring headaches or recurring stomach problems, and that’s where the providers really do a great job with the history taking,” Madrigal says. “That’s when you start asking, ‘What are your triggers for a headache? What are your triggers for this abdominal pain?’ Then you can identify that it is a physical symptom, but it’s coming from maybe some anxiety, depression, or maybe it’s a recent life change.”
Madrigal says Marathon Health providers focus on their messaging to address behavioral health stigmas. Instead of saying “Visit the health center if you’re dealing with anxiety or depression,” they use language like, “If you’re dealing with a major life event or if you’re having difficulty at work, come talk to us.”
“Sometimes people don’t want to label themselves,” Madrigal adds. “Once they’re in the visit, we can say, ‘Well, it sounds like this might be an underlying anxiety issue or maybe some depression. Would you want to consider some of these treatment options that have worked well for other people?’”
Madrigal notes the Marathon Health model (providers working outside of fee-for-service) makes these conversations possible.
“Typically, providers have very limited time,” she says. “If you have a 10-minute appointment with a patient, you’re just going to keep treating the acute issue. So, having the time is key to being able to really take care of that individual comprehensively.”
Survey your employees on why they do or don’t access healthcare services to uncover existing stigmas and learn how to address them. To promote engagement, Health Clinic Director and Nurse Practitioner Cindy Hayes polls her employee population on what types of programming or incentives they’d like to see from the health center.
From polling data, Hayes learned the staff wanted programming that supported holistic wellness for their mind, body and spirit. Her team devised a Monopoly-type game that brings employees into the wellness center.
“They roll the dice, go around the board and land on different spaces,” Hayes says. “For every space, there are challenges they can pick from.”
- Lay outside with your family to stargaze
- Host a family movie night
- Climb to the top of a tower in town
Employees then show a picture of them completing the task to earn property cards and safety bucks they can spend in the safety store, which includes employee-branded swag.
“We have people coming back multiple times, and they’re rolling the dice and having a blast with it,” Hayes says. “It also brings in new people we’ve never seen before.”
The ingenuity doesn’t stop there. They’ve hosted challenges where employees explore tourist spots across the state and cook nutritious recipes from around the world.
“It’s about being approachable, personable and creative,” Hayes says. “Our goal is to get people in the door. We know if we can get them in the door, and they can meet us and learn about the services that we have, they’re going to engage.”
This article is the third in a four-part series on how employers can deliver an equitable healthcare experience for all employees. Explore the other articles to learn more about the value of health equity, how health risk assessments and employee surveys can uncover health barriers and strategies to make employee healthcare more equitable and accessible for all.