Flexibility, training and support: Steps practices can take for staff mental health

For the employees who greet patients at the front desk, room them for visits and field calls from frustrated families, the job has grown harder as the public has grown angrier.

That is a central concern for Paula Allen, global leader of research and insights at TELUS Health, as the company's latest TELUS Health Mental Health Index finds health care workers' mental health trailing the rest of the U.S. workforce.

"My biggest concern for any worker in health care is the increased cynicism and the lack of civility that we have in the general population," Allen said in an interview.

The health care and social assistance sector scored 69.0 out of 100 as of June 2026, the most recent index. That is slightly below the national score of 70.1 and down from 69.2 in February, even as the overall U.S. workforce improved. That's not the worst showing among business sectors, but Allen said it isn't good enough given the demands of the work.

"If you put that into the context of what health care workers do, I would say we shouldn't feel comfortable with slightly below average, or close to average," she said.

TELUS Health, which provides health and well-being services to employers in more than 180 countries, surveyed 5,000 U.S. workers for the index. Scores from 50 to 79 fall in its "strained" range.

What the index found

Among U.S. workers overall, the index found:

• 21% say their mental health is hurting their productivity at work.
• 49% would feel comfortable telling their manager about a mental health issue, and those who wouldn't scored nearly 12 points lower than those who would.
• Workers who believe their employer cares more about productivity than their well-being scored 60.1, compared with 75.0 for those who believe it cares about both.
• Workers ages 20-29 scored 60.5, the lowest of any age group, compared with 75.4 for those ages 60-69.
• Women scored 68.6, compared with 71.7 for men.

Small employers fared well. Workers at organizations with two to 50 employees had the highest score by employer size, 71.3, while the self-employed and sole proprietors had the lowest, 68.1.

Allen said younger employees' openness about mental health doesn't mean they will speak up at work. "If you have a highly stigmatized environment, I don't care whether you're 20 or 40 or 60, you're probably not going to be open," she said.

Track incivility and train for it

Allen said practices should track incidents of incivility, not only violence, and look for patterns that a change in systems or procedures might help de-escalate.

Patients and families are often not at their best when they arrive. "When people are in a situation of pain and fear, you're generally not going to see the best of them," Allen said.

Staff also need training, repeated over time, on how to calm a hostile patient, protect themselves, step away when needed and find support.

"It's quite difficult to go through a very rattling incident and then serve another patient immediately without some process change," she said.

An employee assistance program is a good first stop for that training and for crisis support after an incident, Allen said. Independent practices without one may find similar help through professional associations, many of which offer member assistance programs that are "exactly the same as what I'm describing as employee assistance programs," she said.

The manager's response matters

How a supervisor reacts after a confrontation can determine whether an employee recovers or is "retraumatized," Allen said. A supervisor who questions what the employee did wrong, or warns that it had better not happen again, can do harm. One who first asks how the employee is doing, what support they need and what they did well to de-escalate builds that person's strength.

"You're going to have two very different outcomes as a result of that supervisor's behavior," Allen said. "So it is really important that leaders of teams understand that part of their job is to do no harm and to make things better in difficult situations."

Flexibility beyond working from home

Women make up most of the health care workforce. Allen said employers' support for women's health often focuses on menopause, but a broader view is needed. "Women are more than menopause, premenopause and postmenopause," she said.

Caregiving for children and aging parents falls disproportionately on women, she said. The index found workers who care for or financially support aging parents scored 63.0.

"Flexibility comes up as a screaming ask," Allen said. Remote work is out of the question for most health care workers, she said, but managers can offer more controlled approaches to shift scheduling, plus backup and emergency coverage options.

"There are things that will come to you if you ask your population to help you problem-solve on flexibility that is realistic in a health care environment," she said.

Without that support, Allen said, employers will see the consequences "in employees dropping out of the workforce, moving to part time, going on disability leave because of the strain, and reduced productivity."

"What is happening in your life impacts your work, and what happens at work impacts your life," she said.