Authors: Emily Brainerd, John Jurik, Michael Moussea


Americans have shown a remarkable aptitude to ride out and rebound from the adverse mental health effects of the pandemic. Yet the latest shift in the unsteady course of COVID-19 has challenged that stamina again.

Signs that the pandemic continues to strain mental health and emotional wellbeing appear in everyday life, and so do signs of resilience. So what does research say about the state of America's state of mind under the influence of COVID-19?

According to an ongoing U.S. household survey, feelings of anxiety peaked in late November through December 2020, with about 37% of people reporting symptoms. Fortunately, this timing coincided with the start of vaccine rollouts that influenced a steady decline from spring through early summer. The rate fell below 25% in late June, but as the Delta variant of COVID took hold shortly thereafter, reports of anxiety edged back up in early August to 27%.1

What may be less apparent than persistent stress linked to the pandemic are the multiple sources that contribute to anxiety and depression. Among the more prevalent influences, a clear connection exists between financial worries and decreased mental health. During the pandemic, factors such as lower income, savings of less than $5,000 and exposure to more COVID-related stressors have been shown to increase the risk of experiencing symptoms associated with depression.2

Prolonged stress that affects one aspect of employee wellbeing tends to affect the others. Financial and physical wellbeing challenges often test mental health and emotional wellbeing, potentially manifesting in the work environment as increased presenteeism and lower productivity. Most employers are aware that external pressures, from personal to societal, can hinder the emotional wellbeing of their employees, but many are at a loss to help them cope effectively.

How stress impairs mental health and decision-making

The complexities of life outside the office can't be set aside when the workday begins. Because employees bring their whole selves to work, employers realize the importance of supporting every aspect of wellbeing — especially emotional wellbeing and its relationship to mental health.

Stress ebbs and flows, but at some level, it's a regular experience for most people. How they manage and respond to pressure tends to make one of the biggest differences in their wellbeing, especially when helpful practices become habits.

When managing stress becomes difficult, a commitment to self-care often diminishes. Left unchecked, the risks of this behavioral pattern may extend beyond emotional and physical wellbeing to include financial and career aspects, too.

Under constant stress it becomes easier to make unhealthy decisions. Employees often struggle to perform at their best, and in some cases, poor judgment may lead to safety issues. Even worse, when stress goes unaddressed, the risk increases for serious mental health challenges.

Responding to the business case for strengthening emotional wellbeing support

Fluctuating labor markets may be weak or strong, but sufficient support for mental health and emotional wellbeing will always help lower the risk of losing good people.

In the current environment, employers often feel pressure to fill gaps in their programs and services while making a good investment. Yet it's important to resist the urge to make decisions too quickly, without due diligence, or to slow the process too much, over indecision about the best choices.

For all employers, a practical starting point is to take stock of the resources they already have, including any untapped services available through their health plans or other vendors. After determining how to make the most of existing options, the next step is to add complementary resources as needed.

The strong link between easy access and higher utilization

Creating easier access to the right mental health support services at the right time may be more difficult than procuring them, but it's the crux of utilization. Mental and emotional stress saps energy, often making employees less inclined to seek help on their own.

So it's incumbent on employers to come up with an effective communication strategy. Connecting employees to well-matched resources when needs arise requires well-timed messages.

Strategies used to deliver wellbeing support differ among employers. Helping employees establish and reinforce healthy habits through targeted outreach focuses on advance communication that builds awareness of support services, preparing them to connect with known resources as needed. In contrast, an on-demand approach increases utilization, emphasizing ready access for employees in the moment. Some employers see value in combining the two.

The intentional pacing of targeted outreach is designed to deliver communications at intervals, so messages can register and resonate in employees' minds. Embedding that awareness helps to counteract the paradox of choice — if employees don't know what to do or where to turn when they need wellbeing assistance, indecision can lead to inaction. But over time, through microlearning, a succession of small tips becomes a reliable repository of valuable information.

However, some potential drawbacks apply to targeted outreach strategies. Carefully assembled information about mental health and emotional support resources could be underutilized. And if navigation is confusing for employees, they may give up their search. That's why some employers are shifting to an on-demand approach. When employees need help, they often prefer to connect with someone by phone or through email in the moment of need who can direct them to the right place.

Reducing barriers to services and programs that support mental health and emotional wellbeing is key to increasing access, including activating the proper involvement of managers. When an employee alerts a manager to challenges they're facing, the goal for that manager is to suggest services that may be helpful and offer guidance on where to find them. Managers usually require training to address these situations with their workforces and to learn how to appropriately express empathy in their responses. Directing the employee to HR or an employee assistance program misses an opportunity to link that person to a full selection of resources, which may offer ongoing support for wellbeing.

Preparing managers to properly refer employees to mental health and emotional wellbeing services is a work in progress for many employers. While 33% agree their managers are well-equipped to carry out this responsibility, 42% are neutral and 25% disagree.3 For those employers with ill-equipped managers, arming them with the skills needed to support the organization's mental health philosophy should be a top priority.

A steady demand for mental health support services

Not all stress is created equal. Even exciting developments like getting married, buying a new a home or welcoming a child into the family can strain mental and emotional health. There can be good and bad stressors, but when stress becomes chronic and unavoidable, the brain experiences physiological changes.

History has positioned employers to engage their employees in benefits that often met with some resistance in less tumultuous times. By sheer coincidence, the pandemic has escalated mental health and emotional wellbeing from a growing concern to a crucial need, making stigma a lesser deterrent. In fact, employers now see support resources as a competitive necessity when considering what programs and services to offer.

As long as stress is part of the human condition, employers will gain by actively managing it. When they develop, evaluate and refine their strategy for emotional wellbeing, it's important to look for new ways to round out mental health support programs and services to meet current needs. This ongoing commitment to the workforce is also an ongoing commitment to the organization, helping ensure a positive employee experience that boosts retention — in boom times and lean times.

This article is part of the 2021 Q4 Gallagher Better WorksSM Insights Report: Building a Better Employee Experience that explores longer-term strategies centered on paid time off, mental health resources and hybrid work environments, as well as trending approaches for more immediate challenges like vaccination mandates and incentives.

Access the full report


1 Centers for Disease Control and Prevention, "Anxiety and Depression: Household Pulse Survey," accessed August 2021

2 JAMA Network, "Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic," September 2020

3Gallagher, "Workforce Trends Pulse Survey #3," October 2021

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