Mental health awareness has reached an inflection point. Singers, actors, and athletes are increasingly coming out about their challenges. Michael Phelps has been outspoken about his struggles with depression. Lady Gaga told the press what it’s like to live with PTSD. Prince Harry added his voice to the group when he spoke about his battle with anxiety. Dwayne “The Rock” Johnson, talking about how he copes with depression, said, “One of the most important things you can realize is that you’re not alone.”

While these kinds of stories help to break down stigma, they are, unfortunately, not enough to make people feel safe talking about mental health at work. Despite the fact that over 200 million workdays are lost due to mental health conditions each year ($16.8 billion in employee productivity), mental health remains a taboo subject. In fact, almost 60% of employees have never spoken to anyone at work about their mental health status.

To figure out why, Mind Share Partners, SAP, and Qualtrics conducted a study on the prevalence of mental health challenges and stigma in U.S. workplaces. It looked at the full spectrum, from 100% mentally healthy to chronic and severe impairment. In previous studies, mental health has often been measured through either diagnosable conditions or general stress levels. But these two metrics do not fully capture the breadth of mental health experiences that lie between them, such as undiagnosed conditions, episodic challenges, and symptoms that do not meet a clinical threshold.

We aimed to broaden this perspective by framing our questions in terms of individual symptoms, which are less stigmatized. Instead of asking whether respondents had a specific diagnosis, we asked if they had experienced one or more symptoms from a list of common mental health conditions. (For example, “In the past year, have you ever felt sad, numb, or lost interest or pleasure in most activities for at least two weeks?”) We collected responses from more than 1,500 U.S. adults in the for-profit, nonprofit, and government sectors, with statistically significant representation across race, gender, LGBTQ+ identity, education, and seniority groups — including demographics that have been historically underrepresented and under-researched in this area.

What Did We Find?

Less than half of our respondents felt that mental health was prioritized at their company, and even fewer viewed their company leaders as advocates.

This needs to change. Mental health is becoming the next frontier of diversity and inclusion, and employees want their companies to address it. Eighty-six percent of our respondents thought that a company’s culture should support mental health. This percentage was even higher for Millennials and Gen Zers, who have higher turnover rates and are the largest demographic in the workforce. Half of Millennials and 75% of Gen Zers had left roles in the past for mental health reasons, both voluntarily and involuntarily, compared with 34% of respondents overall — a finding that speaks to a generational shift in awareness. It is not surprising then that providing employees with the support they need improves not only engagement but also recruitment and retention, whereas doing nothing reinforces an outdated and damaging stigma.

Because companies are not doing enough to break down this stigma, many people don’t self-identify as having a diagnosable mental health condition, even though up to 80% of us will manage one in our lifetimes. Low levels of self-identification mean that many workers won’t seek treatment, and it might explain why disclosure rates in companies are low. Our research showed that while nearly 60% of respondents experienced symptoms in the past year — a number much higher than the oft-cited 20% of people who manage a condition in any given year — close to 60% also never talked about their conditions at work. When conversations about mental health did occur, less than half were described as positive. In fact, respondents were the least comfortable talking with their company’s HR and senior leaders, although senior leaders, including CEOs, were just as likely to struggle with mental health symptoms as individual contributors.

While level of seniority had no impact on those who did and did not struggle with mental health, it’s important to note that demographics did. We found that LGBTQ+ people, Millennials, and Gen Zers were more likely to experience mental health symptoms for longer durations and were also more open to diagnosis, treatment, and talking about them at work. In addition, almost half of black and Latinx respondents had left a job at least partly for mental health reasons, compared with 32% of Caucasian respondents.

How Can Companies Do Better?

Companies that want to improve the state of mental health at work — especially for younger, diverse demographic groups — need to adjust their strategies. Mental health is not just an HR issue; it’s also a diversity, equity, and inclusion (DEI) issue and is slowly becoming its own category within DEI given its prevalence across all populations. At the same time, mental health needs to be looked at through an intersectional lens because of how much each person’s experience varies. This means that HR departments or check-the-box solutions like employee assistance programs (EAPs) are not enough to address its nuance or drive change on their own. Nor will mental health policies alone solve the problem.

Regardless of how robust a company’s benefits are, it is culture that ultimately reduces stigma and empowers employees to actually use those benefits without fear of retribution. Our study shows that the most commonly desired workplace resources for mental health are a more open and accepting culture, training, and clearer information about where to go or who to ask for support. The ways to achieve these, and other critical components, are multifaceted.

Start at the top. Changing the culture is a top-down process. It starts with transforming leaders into allies. Encourage executive teams, managers, and senior employees to share their experiences (or those of close family members or friends) at all-staff meetings or in other interactions with their teams. Modeling disclosure and vulnerability as strengths, not weaknesses, goes a long way toward reducing the stigma and setting the tone for transparency.

The CEO also has an important role to play here. Currently, many departments within a company have touchpoints with mental health, from HR to DEI to Learning & Development. However, there is rarely a single owner of corporate initiatives around it to ensure accountability. Given its prevalence, as well as employees’ desire for their companies to address mental health, CEOs can no longer afford to ignore it. Instead, they should serve as the normalizers-in-chief of mental health challenges, with support from their CHROs, to help build a culture of acceptance that permeates their organizations. “When SAP CEO Bill McDermott goes out of his way to champion wellness and mindfulness,” says Nick Tzitzon, executive vice president of marketing and communications at SAP, “it sends an unmistakable signal to 100,000 colleagues that we’re serious about building a culture of psychological safety.”

Invest in education. Trainings are imperative for all employees — and especially managers — to learn how to name, normalize, and navigate mental health at work. We’re not advocating for managers to become therapists. However, they should have baseline knowledge of tools they can use during difficult conversations and actions they can take to reduce the stigma, in addition to an understanding of mental health conditions, their prevalence and impact at work, and ways to recognize and respond to employees who may be struggling. In short, managers need to be taught to treat each individual with respect and realize that there is no one-size-fits-all solution.

Tzitzon believes that mental health is the next wave of inclusion, but that it won’t be accomplished until all employees feel comfortable being honest and open about their mental health conditions without fear of consequences. “The leaders who help people open up about whatever is holding them back at work,” he says, “will be the most effective and admired.”

Provide support. At a minimum, companies need solid mental health benefits, and those that do have them must learn how to communicate them clearly — as well as their confidential nature. Many employees are either unaware of the mental health resources offered at their organizations, or they are afraid to use them. In our study, Millennials were 63% more likely than Baby Boomers to know the proper procedure for seeking company mental health support.

One way to ensure every worker is aware of these benefits is to talk about them, and any policies that support them, during employee orientations, as well as periodically each year. Stand-alone anonymous surveys or mental health-specific questions within existing employee engagement surveys are effective ways to measure attitudes toward mental health and keep organizations accountable. (After all, what gets measured, gets done.)

Some companies, like Verizon Media, Johnson & Johnson, and RetailMeNot, are taking their efforts a step further and implementing employee resource groups as a part of their DEI strategies. Such groups help raise mental health awareness throughout companies and create a forum for individuals with a condition, caregivers, and allies to support one another. Including mental health in DEI strategies is a critical component of enabling people to bring their full selves to work.

The ability to support employees with mental health conditions — and that includes most employees at one time or another — is becoming a defining issue in the next-generation workplace. While progress is being made, much more needs to be done to destigmatize conversations and treatment. So far, the lack of organizational ownership and a reactive approach have failed to create work cultures in which employees feel safe speaking up.

The good news is that change is possible. It starts with acknowledging the equal prevalence of mental health conditions from the C-suite to the front lines, changing organizational culture, introducing proper training and support, and addressing mental health as a standalone DEI issue. CEOs must lead by example as both the priority and culture setters of their companies. That said, every employee has a role to play as well. Culture change of any kind requires top-down and bottom-up support. Mental health is no different.

Editor’s note: We have updated the original article due to a wording error in one of the study’s findings. Fifty percent of Millennials and 75% of Gen Zers had left roles in the past for mental health reasons, both voluntarily and involuntarily (not just voluntarily). This changes the comparison percentage to 34% of respondents overall that had left roles both voluntarily and involuntarily (20% of respondents overall left roles voluntarily as originally stated).