Making Mental Health Programs Work at Multinational Companies

Employee mental health challenges affect companies worldwide. Due to reduced productivity linked to anxiety and depression, for example, a total of 12 billion working days are lost globally every year. A recent survey with HR professionals across 10 Asian countries found that 82% of employees in this region still have significant mental strain. And across the ocean, UK employers still lose GBP 51 billion annually to poor mental health, with nearly half stemming from presenteeism, where employees are at work but are not fully functioning.

The stakes are particularly high for large multinational companies that operate across different regions. Not only are their organizational structures more complex, but their well-being strategies and programs must cater to a wide cross-section of global workers with different ethnic backgrounds, beliefs, value systems, attitudes about mental health, and more.

Despite real money spent on interventions from wellness apps to counseling services, chief human resources officers, regional heads of people and culture, and well-being leads at several multinationals have told me they’re not seeing enough uptake by their employees. In fact, some workplace mental health initiatives and trainings suffer from such low engagement that companies wind up not expanding or continuing them at all, and initial energy spent on the programs goes down the drain.

What’s stopping these companies’ mental health initiatives from engaging employees and creating real change?

My consulting experience with over 60 global and regional organizations has led me to conclude that the main pitfalls for mental health initiatives across cultures tend to be about three things.

First, many HR officers mistakenly attribute initiative failures to local cultural norms and stigma, assuming that individuals in some locations are simply unwilling to discuss mental health when, in fact, there’s another underlying issue at play. Second, when stigma does come into play, they wrongfully assume that silence and disengagement mean that attitudes of particular groups of employees are unchangeable.

Finally, while the importance of mental health at work is more widely accepted today, many HR leaders fail to thoroughly strategize or plan initiatives that suit the companies’ employees across the world, expecting one-off events to magically change mindsets and behaviors overnight.

Fortunately, I have also observed leaders who have successfully navigated all three traps using the strategies I describe in this article. Their results include enhanced employee engagement, increased awareness of mental health issues at different levels of the organization, and a more effective use of company resources, which contributes to an organizational culture that prioritizes well-being. Most importantly, these efforts go beyond organizational benefits and support employees who may experience mental health challenges in a variety of different ways.

Have an Open Mind and Question Assumptions

The first issue that trips up companies is misreading the underlying reason for a mental health initiative’s failure. This happens because, rightly, multinationals need to be sensitive to local cultures of offices in different countries. Sometimes, however, this well-intentioned mindset can mask the other, more surprising root causes.

For example, a major finance institution’s HR director for the Asia-Pacific region was nervous about hosting a lunchtime talk about mental health. “Asians don’t talk about mental health, because it is a private matter,” she remembered being told by others in the region. Plus, being Asian herself, she had been socialized for a long time to not talk about such “shameful” topics, so was sensitive to the broader context around the stereotype. But she wanted to encourage colleagues to think about mental health as she knew it was important.

Her team did lots of internal communications promoting the session, but only 50 people showed up (they had hoped for 150). During the event, no one said much, and the atmosphere was tense, despite the great food and free coffee.

Her initial assumption was to regard the event as unsuccessful and interpret it as evidence that discussions on mental health were unwelcome in that local culture. In some organizations I have collaborated with, which encountered similar situations, future mental health initiative budgets were reduced, purportedly out of respect for local cultural norms.

However, this HR director decided to dig deeper and discovered that the issue wasn’t cultural at all. In fact, there had been prior breaches of confidentiality around the topic at this office. Although these breaches were unintentional and certain colleagues just wanted to help, it made people feel that their privacy and boundaries were not respected, and they started to doubt whether they could really talk openly to their managers and HR teams about such sensitive issues.

After learning this, the HR director altered her approach to focus on confidentiality training first, highlighting the distinctions between assistance, privacy, and gossip. The director spent a whole year building awareness around respecting others’ private matters. Consequently, employees in her regional office became more willing to talk about mental health with each other and their managers, and the utilization rate of the organization’s counselling hotlines also went up.

In this case, blaming culture for why people avoid discussing mental health at work was an overly simplistic assumption. By fostering strong trust and respect for privacy, mental health didn’t have to be a taboo topic at this workplace.

Engage Different Mindsets with Creativity

Sometimes, of course, cultural stigma around mental health issues does play a role in low uptake. But the trap is in assuming that stereotypes are accurate in all circumstances and giving up prematurely when encountering resistance based on them. Instead, companies can use the knowledge of the stigma as a springboard to try out other methods of engaging with mental health issues.

Two case studies demonstrate indirect but effective methods to address this issue.

First, consider a global consulting firm’s UK office. The office’s well-being lead realized that majority of its senior management belonged to a generation and gender group that found it challenging to discuss mental health, both in and outside of work. They were taught that mental health and stress were not topics to be discussed with anyone else, and that they simply had to “tough it out.” Yet, in reality, they still needed outlets to open up during hard times, as accessing and articulating emotions is a pivotal way to process experiences, reduce stress, and maintain mental well-being.

Recognizing the importance of encouraging the senior leaders to express themselves and their emotions in a comfortable way, this organization created close-door, small-group activities for these leaders to meet and share, as opposed to open-invitation company-wide events and talks commonly used by many multinationals to save cost. In small groups, the leaders were encouraged to reflect on the challenges managing the organization, using art materials such as plasticine or toy bricks to make a structure that represented their sentiments. They then shared what they had built with each other. Through the practice, these senior leaders were able to “see” their emotional experiences through the object they had built. Feeling less threatened or confronted, they could speak more freely about the anxieties in their roles, and better cope with them without directly talking about burnout or being forced to sit through a lecture of theories on stress.

Similarly, a global bank’s Northern China office found a creative way to engage its local executives in mental health practices. They focused on a common challenge faced by the leaders: parenting. The office organized a series of workshop for leaders on how to speak with their children about emotions as part of the program design. As they practiced with their children, the barriers to expressing themselves lowered. The executives started to check in with their peers and their team members without feeling that doing so would make them any less of a “strong leader.” These conversations built a sense of camaraderie, more open dialogue between leaders and their employees, and allowed HR to tune into vulnerabilities and indistinct calls for help.

The takeaway: It takes creativity to engage groups with different mindsets and attitudes toward mental health. As such, multinationals cannot just do one global roll-out. While they may be able to use something general as a base, like a subscription to well-being apps, HR leaders need to make the program relevant and concrete to the target audience’s demographics and localities to truly change mindsets.

Prioritize Strategic Planning from the Outset

This relates to the most common, and perhaps most detrimental, pitfall I observe in multinational companies: the hasty implementation of mental health initiatives or interventions without thorough strategic planning about how they will be adapted globally. Without understanding the different “end users,” any product or program, however well-designed, will not fit their needs or solve the problems that hinder progress. Worse, this wastes company resources and people’s energy, leading to exasperation and exhaustion.

To avoid a low return on their investment, multinationals must have a comprehensive understanding of employees’ diverse needs and lived experiences related to mental health.

This was the challenge faced by a multinational investment institution that employs over 50 different nationalities. Instead of just copying best practices from other banks, the institution decided to take a customized path for its mental health initiative. It surveyed and interviewed representative employees from a variety of roles, positions, offices, ages, and language spoken to understand the varying levels of awareness and experiences of mental health.

The result was workshops customized to three groups of audiences. For individuals with prior knowledge of mental health information, they could attend focused discussions using case studies created from actual in-house issues to support the goal of changing mindsets and behaviors around mental health. Those with limited awareness of mental health were able to join sessions with more introductory content aimed to shift attitudes first.

Meanwhile, managers received additional training specific to their roles and responsibilities around supporting employee mental health—without needing to become everyone’s therapist. During the training session, facilitators led participants through exercises based on real experiences from interviews with managers and employees. Through targeted questions and debrief sessions, participants gained knowledge and skills on best practices. As a result, managers learned how to support team members struggling to cope and understood where their duty of care began and ended. This training made them more adept (and proactive) at addressing mental health matters at the workplace.

By listening to the different voices of employees, the HR leaders at this institution created increased mental health awareness, from employees and frontline managers to senior management and board-level executives. Such awareness generated demand for an in-house counselor knowledgeable about the specific work environment of the organization, and the institution ended up providing counseling service to families of the employees as well. In a later survey, both employee engagement and employee well-being scores increased. The workshops, enriched with teaching materials and real examples accumulated over the years, also became an essential part of the organization’s onboarding.

. . .

For multinationals, employee differences in mental health awareness and experiences don’t need to hinder the development of successful initiatives. Instead, they can be the catalyst for planning impactful programs with high returns on investment, especially if the programs are relatable to the employees’ direct experiences. Just as multinational companies would approach any new product launch or business implementation, they should invest time in understanding their employees’ well-being needs and experiences, plan tiered mental health programs, and consider incorporating mental health awareness workshops into onboarding processes—because employees are their greatest assets.