COVID-19 and behavioral health: Consequences for companies and employees

In this episode of the McKinsey Podcast, Diane Brady speaks with Erica Hutchins Coe and Kana Enomoto, who colead McKinsey’s Center for Societal Benefit through Healthcare, about the behavioral-health consequences of the COVID-19 crisis and strategies to help leaders and individuals address them. An edited transcript of their conversation follows.

Diane Brady: Hello, and welcome to the McKinsey Podcast. I’m Diane Brady. Many of you listening will be familiar with the struggles that people have faced during this pandemic, from feelings of isolation and anxiety to increased substance-use disorders, grief, and even thoughts of suicide.

Today, we’re going to look at COVID-19’s impact on America’s behavioral-health crisis, with lessons that could apply to any country and any individual. Joining me is Erica Hutchins Coe, a partner in McKinsey’s Atlanta office. Erica, welcome.

Erica Hutchins Coe: Thanks, Diane. It’s a privilege to be here.

Diane Brady: And Kana Enomoto, a senior expert in the Washington, DC, office. Kana, nice to have you here.

Kana Enomoto: Thank you, Diane. Super excited about the conversation today.

Diane Brady: Together, these two have founded and lead McKinsey’s Center for Societal Benefit through Healthcare. So, Erica, let’s start with the problem. I’ve heard so many different reports, from increased depression rates to working dads embracing flexibility and loving the crisis. What is the actual toll of this pandemic on Americans from where you sit?

Erica Hutchins Coe: What we’ve seen happen in the pandemic is not only the impact on the physical side, with some of the increased risk and the significant rate of those contracting COVID-19, but also on the mental side. We’ve seen an exacerbation of existing behavioral-health conditions—both mental and substance-use disorders—for individuals who face a disruption in care with some of the challenges underway, and we’ve also seen a new onset of conditions. There’s been a significant spike in reports of depression, anxiety, and substance use.

This is happening across the board, regardless of socioeconomic status, age, or background composition. It’s creating additional stress for children and adults alike. We’ve been doing some modeling that has shown that we can expect a potential 50 percent increase in the prevalence of these behavioral-health conditions that could lead to $100 billion to $140 billion of additional spend in the US just in the first 12 months post onset.

And I think one important thing to remember is that there are much-longer-term effects of the pandemic. These are going to take a toll for years to come. Sometimes the impact of post-traumatic stress disorder does not even appear right away. And this isn’t just from the pandemic; it’s also from the ensuing financial crisis that’s been happening. People have faced job loss or other economic uncertainty, adding additional pressure and stress.

Lessons from the 2008 financial crisis

Diane Brady: We have seen this in previous crises, haven’t we, Kana? I’m thinking of the last financial crisis in particular. Does that offer any lessons in terms of how this crisis is playing out?

Kana Enomoto: Yes, absolutely. If we look back at the 2008–09 crisis, we saw—both in the United States and globally—increases in suicide rates. So, people are concerned that for every 1 percent increase in the unemployment rate we might see a comparable 1 percent increase in suicide rates if there isn’t any intervention or prevention. That is a call to action for us to put programs in place and to reach out to folks and make sure that they have the support they need so that they don’t see suicide as the only option.

Diane Brady: I’m interested, Erica, in how surprising any of this would be for you since you’ve been doing research in this area for so long. What has struck you as something that perhaps you weren’t expecting or something that’s especially worrying to you right now?

Erica Hutchins Coe: As devastating as the increase in the behavioral needs has been, the silver lining is that people are talking about it. I think what has been unprecedented is the step-change difference in the stigma that has been perpetuating mental and substance-use disorders for years, if we look back to the history of our country.

And I think about how the dialogue has changed almost overnight because everybody is all of a sudden feeling the onset of distress, the onset of worry, the uncertainty, the grief for those who have lost loved ones to COVID-19, and that is making it OK to talk about [these issues].

And people are much more open about how they are feeling and how others are feeling, and I think that that has been a big shift that has happened with the pandemic. And I certainly hope that continues because it’ll be a first step toward treating mental and substance-use disorders like any other physical health condition.

COVID-19’s exponential impact on mental health

Kana Enomoto: What has been surprising to me with COVID-19 is really how we’ve seen synergistic epidemics come together. So we know that COVID-19 leads to social isolation. We see the economic crisis leading to psychological distress from job loss, reduced income, and increasing income inequality. And then you see the frontline healthcare workers who are faced with significant trauma and stress, feelings of helplessness, and frustration. And then you have those individuals who have lost people to COVID-19 or have experienced severe health consequences themselves. You have that whole set of stressors.

But on top of that, we already had an epidemic of opioid-use disorder and opioid overdoses. We already had an epidemic of increasing suicides. Both of these things have been contributing to decreased life expectancy in the United States for the past 15 years.

And then we have the confluence of these three things. And what has surprised me is the exponential impact on the American people, where you see 40 to 46 percent of Americans reporting symptoms of depression and anxiety. That is astounding.

Diane Brady: And the opioid and suicide rates have gotten worse, have they not, during this period?

Kana Enomoto: It’s too early to tell officially. We know that overdose death rates went up in 2019. And we have some leading indicators that the number is going to be even higher in 2020 due to COVID-19.

Diane Brady: We’re living in a time of heightened awareness of social injustice. How does that play into these issues?

Kana Enomoto: You know, ever since the summer, where we had the social unrest and the protests related to George Floyd and other incidences of racism and racial violence, we’ve seen a marked uptick in distress experienced by Black and indigenous communities and people of color in the United States.

We had 46 percent of Latinx and Black Americans as well as an increased proportion of Asian Americans, American Indians, and Alaskan Natives reporting depression and anxiety. And I think that’s really an indicator overall of the stress experienced by these groups not only from the broader social context but also on the everyday level.

And so the impact of COVID-19 and how it intersects with these issues of health equity are really important to attend to. We know that there are also significant rural health disparities. Areas where we face mental-health-professional shortages are much more likely to be rural counties than nonrural counties. When we think of racial disparities, we think of them often as urban challenges. But, in fact, the disparities in access to care for minorities and people of color in rural counties are even more dramatic.

Coping with isolation

Diane Brady: Have you found it easy to cope with the isolation yourself? How has it been going?

Kana Enomoto: It has been interesting for me. Within my own family we struggle with mental-health issues. And so we’ve had to make a rapid shift to telebehavioral health, which has been tremendously effective and a good support throughout this time.

I have a very close family. They’re scattered across the country. And we made concerted efforts to make sure we connected every Sunday for a family game night. And that’s not even something we would have done before the pandemic. So it’s been a nice way to bring people together and get that boost of social interaction when your regular weekdays are so depleted.

Diane Brady: I love that. A family game night. How about you, Erica?

Erica Hutchins Coe: I would say on one front, similar to Kana in that I also have mental-health challenges within the family. So there was an immediate kind of concern and focus on how do we ensure care isn’t interrupted, and how do we make the pivot to telebehavioral healthcare.

Aside from that, there certainly has been a benefit. Coming from [the experience of] being a mother of two very young children who travels for a living, I’ve had the benefit of being home all the time and have, while working significantly, the ability to actually see my family every day. My parents and brother and sister-in-law all live close by. If it hadn’t been for the pandemic, we would not be seeing each other as much as we are now. But we make a concerted effort to spend lots of time together outdoors.

When I think about how the pandemic has impacted me personally, it’s been such a personal call to action. We set up the Center last year before the pandemic hit. Knowing that we are in a position to be able to make a difference on this topic—raising awareness around the urgency to address mental and substance-use disorders as Kana just described—is a strong sense of calling that makes it much easier to get through the days. Even if we’re not able to be with our colleagues physically, it makes everything seem worth it.

Raising awareness about mental health

Diane Brady: Erica, I’m curious. What inspired you to get into this field in the first place?

Erica Hutchins Coe: I think what inspired me to want to dedicate my career to making a difference in improving our broader behavioral-healthcare system is a very personal experience. When I was in college, my younger brother first started to develop symptoms of a thought disorder.

I think seeing what his experience was—dealing with a mental illness now for the majority of his adult life, seeing the challenges firsthand of actually finding access to high-quality care, some of the challenges of stigma that exist, some of the uncertainties—really fueled me to say, “If we all experience things for a reason in our life, what am I going to actually do about this?”

The fact is that this can truly happen to anyone. This is rooted in a biological disorder, in genetics. It very easily could have been me that was born with a precondition to develop a thought disorder later in life versus my brother. So if I’m actually in this advantaged position, working for a large, reputable firm like McKinsey, how do I use that to drive good?

The opportunity came up to get energy around the Center for Societal Benefit through Healthcare and to raise more awareness about these issues and truly make a difference in the health system on a large but also on a very individual level. Anything I can do to help my brother—and every other individual who might be facing something similar and might not have the confidence to talk about it because of the stigma that exists—is what really drives me to do this day in and day out.

And honestly, that’s what so inspired me about Kana when I met her. If I was ever to fulfill my mission of bringing together my personal passion for driving change in behavioral health with my professional role of being a partner with McKinsey, I knew I needed somebody like Kana at my side to help me make this difference. And it’s been a wonderful experience and partnership so far.

Diane Brady: So, Kana, tell me about your own experience of getting into this field. You were with the Surgeon General’s Office.

Kana Enomoto: I joined the federal government over 20 years ago and dedicated my career to addressing mental-health and substance-use issues at a macro level because, as a child, members of my family struggled with mental illness, with psychosis, with depression, with trauma.

When I was 13 years old, I lost a family member to suicide, which made a marked impact on me because no one ever talked about it. People said she died of a heart attack. She was in her early 20s. She didn’t die of a heart attack.

So I wanted to understand how is it possible that somebody so beautiful, so smart, and so wonderful could not see a path to health, and that the people around her couldn’t get her healthy. In college, I majored in psychology. I did clinical psychology. I worked for the government because I didn’t want to just make a difference at an individual level; I wanted to help create a system where that could never happen again.

And then more recently, in my own family, my daughter has had a number of mental-health challenges. It was almost impossible to get good-quality care. I really had to struggle and fight and call friends and do a lot of investigative work myself and spend the night in the emergency room.

It just shouldn’t have been as hard as it was to get care for somebody. I have all the resources in the world. I can’t imagine how difficult it is for people who know less, know fewer people, and don’t have as good insurance as I do. So I’m super passionate because I know these issues are preventable and they’re treatable, and it’s just a matter of having the political and social will to get it done. We can do it.

Taking a holistic approach to healthcare

Diane Brady: And it’s about having a holistic approach, right? Erica, that’s really what your work is all about: connecting the dots in some ways and creating that ecosystem where change can happen.

Erica Hutchins Coe: Yeah, that’s exactly right, Diane. First, helping everyone to realize that this can happen to everyone. This isn’t someone else’s problem. It’s an issue we all should pay attention to and want to solve together for each other. That approach—to try to improve someone’s health and overall well-being—needs to take behavioral health into account.

We know that one in two individuals, in the course of his or her life, will have some type of mental or substance-use disorder, challenge, or experience. In order to improve the health of our country, to reverse the decline in life expectancy that has been happening, we need to account for the whole person.

Establishing McKinsey’s Center for Societal Benefit through Healthcare

Diane Brady: I’m curious about the Center for Societal Benefit through Healthcare. How did that come about?

Kana Enomoto: Actually, the Center for Societal Benefit through Healthcare is what drew me to McKinsey in the first place. I got a call from Erica. I had met her through other work when I was with the Surgeon General’s Office. And she said, “We’re thinking of starting this center. We’re going to look at mental health. We’re going to look at social determinants. And we think it could be a really exciting way to put McKinsey’s tools and resources to good use. Do you know folks who would be good for this?” And I said, “That sounds so exciting and like something I would love to dedicate my time and energy to.”

So, in pretty short order, Erica worked her magic, and I was able to join the firm. It’s been an outstanding ride since then, where we’ve been able to do work that is super meaningful and high impact for the field and for the country.

Diane Brady: So, Erica, tell me about the vision. What gap in the marketplace were you seeing that this was meant to address?

Erica Hutchins Coe: As a healthcare practice, we had been doing work across the focus areas of our center for a number of years: client work on mental and substance-use disorders, social determinants of health, rural health, and maternal health. But we really felt that these issues weren’t just impacting the healthcare system, they were impacting the broader society at large. If we were only doing the work one client at a time, we would never make the difference that needed to happen. We knew that the real solution there would be in collaboration.

And how do we really collaborate with other partners and stakeholders to be able to spur the innovation that was needed to make a step-change difference across these issues? Take the topic of behavioral health across mental and substance-use disorders in particular, which is such a cross-cutting topic. That’s going to be driving issues in rural health, driving issues in maternal health, driving issues in some of the unmet social needs. These are issues that matter to our global society. We, as McKinsey, have capabilities to help. So let’s do something totally different. The whole goal is to be able to enable others to replicate things that have been proven effective to try to scale change.

Diane Brady: When you say “partner,” are you partnering with health systems? Are you partnering with employers?

Erica Hutchins Coe: We are still in early days of the Center, but I think the goal would be partnering with anybody. It can be partnering with a foundation that maybe is also trying to move the needle and do important work in certain spaces. It could be partnering with a health system that wants to pilot a specific care-delivery innovation on a population that could better integrate behavioral health into a primary-care setting. It could be partnering with a payer that is really aiming to change value-based payment around behavioral-health conditions. It could be partnering with a community-based nonprofit, with an academic institution, or with employers—given the significant role that employers play in terms of access to benefits for their employees.

So I think that we’re quite open. One of our big partnerships to date has been with Shatterproof, a national nonprofit focused on reversing the negative impact that addiction has across the country by really focusing on how to reduce the stigma that exists.

How the United States is uniquely positioned in behavioral health

Diane Brady: I’m originally from Canada, and I’ve always been intrigued by the US. What is unique about this market with regard to behavioral health?

Kana Enomoto: I think the United States is uniquely positioned in the field of behavioral health. On the one hand, we lead on so many dimensions. Our science is incomparable. In terms of what we’re doing around peer services, community-based services, trauma-informed care, and culturally competent care, the United States really leads the world.

On the other hand, there are some challenges based on how our healthcare system is structured. It’s more of a disease-care system than a health-promoting system. People have access to services through their employer-based insurance.

Where other countries are investing quite a bit in social care—making sure that people have adequate housing, people have employment, people have good transportation and food security—in the United States, those challenges compound people’s experiences of mental illness and substance-use disorder. It makes it that much more challenging for them to achieve recovery.

So I think it is a mixed bag where other countries do better on the prevention, promotion, social-care aspects and helping people achieve and maintain recovery. On the other hand, we really lead in terms of advancing evidence-based models of care and innovation.

Stressed-out parents and an anxious workforce

Diane Brady: Erica, you mentioned employers. I know there have been a lot of investments in wellness programs and such at the private-sector level. But we’re facing some really significant economic constraints and a very different work environment with remote working. What are you hearing from employers?

Erica Hutchins Coe: We’re hearing loud and clear that employers are concerned about the impact that the pandemic is having. We did a recent survey that showed nine out of ten employers felt that COVID-19 has been affecting their workforce’s behavioral health and productivity. They’re seeing increased rates of self-reported depression, anxiety, and alcohol and drug use.

One of the big challenges of this large-scale shift to remote work is that you don’t see each other personally on a day-to-day basis. It becomes that much harder to really be able to detect if somebody needs help and if they’re facing a challenge, or to just check in.

In addition to employees themselves feeling increased distress, parents who are working full time and have children in a remote-schooling situation have the added challenge of concerns about their children’s mental health.

That is another draw on productivity. So employers are also trying to take a more holistic approach and asking, “How can we help our employees in terms of their total life?” We’re hearing employers show and express interest but often not knowing what tools to use.

So how do employers know where they currently stand in terms of their offerings? Are they at parity with what they’re offering for behavioral-health care versus physical-health care? What are things they can be doing to increase the dialogue and reduce stigma around issues, especially in a remote environment?

Diane Brady: It’s very easy to have the whole conversation revolve around mental health and substance abuse, but there are other areas of focus that you take, Kana, in the Center. Can you tell us a little bit more about that and the impact COVID-19 is having, say, on the societal determinants of behavioral health?

Kana Enomoto: People who have challenges on various dimensions of social determinants are going to be at higher risk for COVID-19. For example, those who have to take public transportation are at increased risk, as are people who have insecure housing, who are homeless, who are living in overcrowded conditions. These are tremendous risk factors that we are seeing result in higher rates of positivity and health risk. And then if you combine that with the already-existing challenges of poverty, economic deprivation, or income inequality, that compounds those inequities.

Then you have the challenges of kids going to schools and the education loss. Kids from lower-income families are going to suffer more educational loss than kids who go to excellent-quality schools. As they have moved to distance learning, you hear of some schools that have high rates of free and reduced lunch also having very high rates of kids not signing into the virtual-learning environment. We are going to have years to deal with the impact of COVID-19 on the social dimensions that we were just talking about.

Overcoming the stigma of behavioral-health disorders

Diane Brady: What are some of the things that can spark change? Let’s start with healthcare leaders. What could they be doing right now to avert or at least mitigate some of the worst impacts of COVID-19?

Erica Hutchins Coe: We’ve known for decades that there are high rates of co-occurring disorders between behavioral-health and physical-health conditions. So what’s really going to spark change now? I think it comes down to two things. One is knowing that there’s a solution, knowing that substance-use disorders and mental-health disorders are treatable, addressable conditions, and people can recover from them or they can be prevented.

A second part of that is the business case. This isn’t just the right thing to do to help people, but there’s value there. Then, I think the third piece is the social-norm aspect of it. The more that dialogue continues about the awareness that behavioral-health conditions can happen to anybody—they’re not something that is a moral failing because of how you were raised; they really, truly cut across class, economic background, age, et cetera—the more there is an obligation to say it’s time to do something about this.

In our work with Shatterproof, we did a whole set of research on analogous change movements. What is it that changed behavior when there was a deeply rooted stigma and lack of treatment and change? Take the example of HIV/AIDS. One of the biggest pieces that drove action was when all of a sudden focus was on Ryan White, Magic Johnson, or others where a light bulb went off—“oh, this could really happen to anybody.” That starts to make a difference.

How other countries approach behavioral health

Diane Brady: It does. And certainly you’re seeing a lot of people talk about mental health. When we look at other countries and the approach that they take, how is it different from the US?

Kana Enomoto: In developed Western countries, we see that emphasis on social care and prevention and on embracing behavioral health. In some low- or middle-income countries you see the exact opposite, where there really is no behavioral-health or mental-health system to speak of, where there is very low health literacy around mental illnesses and substance-use disorders, and you lack much of an infrastructure to address these issues.

One of the great researchers in this area, Vikram Patel, says there’s virtually less than 1 percent penetration of psychological therapies in some low- and middle-income countries. It’s impossible to get care because it’s just not something that’s talked about. One anecdote that I heard is that in all the 22 [scheduled] languages spoken in India there isn’t a word for “mental health.” So it just shows that we have a ways to go.

There are interventions that are innovative and that have worked in lower-resourced economies. There is a greater reliance on social supports and social networks that can be very supportive, healing, and curative, helping people achieve and attain recovery. But there are also some surmountable factors in terms of getting people access to evidence-based therapies as well as the modern-generation psychiatric medications. So lots of challenges and lots of opportunities.

Erica Hutchins Coe: I think one big difference is that often other countries are making a much more deliberate investment in social care and social needs—the broader social services that surround someone—which directly plays into that concept of whole health.

So it isn’t just about your physical health and your behavioral health, it’s about how are your broader social needs met? Do you have a roof over your head at night? Do you have access to healthy food? Do you have social support? Are you isolated?

There often is a higher amount of investment into the surrounding social services than here [in the US], which is some of what exacerbates the challenges that then fall on our existing behavioral-health care system because it is more separated from the broader social supports that an individual needs to truly thrive.

Creating a culture of support in the workplace

Diane Brady: As an employer or healthcare leader, what are some of the tactics right now that you could be doing to perhaps encourage people to address some of these issues?

Kana Enomoto: That’s a great question, Diane. I think there are a few things that we’re recommending that employers can do to help their workforce address the stress and the mental-health and substance-use consequences of COVID-19. First of all, let’s take a deep look at the benefits that they’re offering to make sure that they have sufficient healthcare benefits, that they have access within their EAPs [employee-assistance programs] to tools and programs that can help people manage their stress and access help should they need it.

Then the employer needs to make sure they’re communicating what those resources are to their workforce and sending the message that this is the expectation, that it’s OK to not be OK, and that we see this as a fundamental part of your overall health. Because we value you as an employee, as a workforce, as a person, we want you to be healthy. And part of that means that you are mentally healthy, that you’re addiction free, and that you have access to the treatment services and supports that you need.

And then it’s creating a culture within the work environment where it’s OK to talk about these things, where people who are in treatment are respected and cared for, and where people who are in recovery are also celebrated and supported for having overcome a health condition just like any other.

If you or somebody you know is struggling with one of these issues—depression, anxiety, problems with drinking too much or turning to prescription drugs—it’s important that people take the brave step to ask for help, whether that’s from a friend, from a clergy member, from a primary-care doctor, or from a mental-health or substance-use specialist. Asking for help is not easy to do, but it can be life changing.

If you’re a person who isn’t struggling but has the resources to help others, reach out and take the brave step to offer help to someone who you might see struggling. That can be so important and pivotal in a relationship where it’s hard to break past exchanges such as, “How are you doing? I’m doing fine.”

For people who are part of an organization where they have influence—whether that’s as a CEO or as a frontline employee—look around and ask the question of whether or not we are supporting these issues. Are we supporting people who struggle with these issues? Demand that we treat mental illnesses and substance-use disorders with the same care, urgency, skill, and knowledge that we do any other condition. If we all do that, it can really make a difference.

Diane Brady: Kana, I’m curious about the role that policy plays in this area.

Kana Enomoto: That’s a great question because in the last 12 or so years, we’ve seen incredible momentum come from the policy side—where you have mental-health parity and addiction equity, where payers are no longer allowed to discriminate and put unfair limitations on treatment for mental and substance-use disorders in ways that they don’t put limitations on treatment for physical-health conditions.

For example, people used to be limited to, say, 12 outpatient therapy sessions a year. Well, if you have a condition like schizophrenia, there’s just no way to manage that. So it was an unfair burden on families and individuals to try to manage mental-health and substance-use challenges.

For many people, substance-use care was not covered at all. In the last dozen or so years, together with the Affordable Care Act, you’ve seen tremendous progress in this space because of those policies. And then more recently, in the SUPPORT Act and the 21st Century Cures Act, we’ve seen more and more momentum growing on the federal side as well as in states, which are moving quickly to make sure these issues are getting addressed.

The business case for addressing mental-health and substance-use disorders

Diane Brady: Erica, in terms of the return on investment—as a society, as individuals, as employers—what thoughts would you want to leave with people to make this top of mind?

Erica Hutchins Coe: The return on investment is the fact that you have increased productivity and retention. If you’ve hired somebody and invested significantly in them and then they leave because of some type of challenge with a mental-health or substance-use disorder and the right supports weren’t there to keep them there, you have to hire somebody brand new. That’s lost investment.

From a healthcare-system side, there’s been ample research that shows that those with behavioral-health conditions that are unmanaged are driving a spike in physical-health costs. The incremental dollars it will take to provide more therapy or the right medication are nothing compared to the savings on the physical-health side.

Imagine somebody who is suffering from depression who also has diabetes. Well, if their depression isn’t well managed, they are unlikely to be checking their blood-glucose levels on a regular basis, unlikely to be taking medicine, to be checking in with their physician, to be keeping to the right diet and exercise.

This isn’t an insurmountable problem. We actually know what works. There are evidence-based interventions that exist. They just aren’t scaled.

Take, for example, first-episode psychosis. Only about 5 percent of adolescents who experience psychosis for the first time actually get the evidence-based care that we know works today. And there’s significant access issues, too. So it’s not that we don’t know what works. We just need to apply it, which in a sense is a much better position to be in than if we had no idea where to even begin.

Diane Brady: You talked about silver linings. I imagine that some of what we’re learning about remote work, for example, could be applied to areas like rural health, which I know is another area of focus for you.

Erica Hutchins Coe: Certainly. I think that there has been tremendous benefit from some of the flexibilities that have been introduced in telebehavioral health. Once a number of providers got up and running and were able to be tele-enabled, there has been a significant benefit in addressing some of the access challenges that existed. It’s something that we certainly hope will persist beyond the pandemic as a benefit and an opportunity that has come out of the situation.

Why self-care and human connection are more important than ever

Diane Brady: The game night, Kana, sounds intriguing to me [as an example of staying socially and mentally healthy during the pandemic]. What would you say to the individual listener right now that could make a real difference? Any advice?

Kana Enomoto: I think there are basic precautions that people need to take to make sure they’re eating, they’re sleeping, they’re exercising adequately. And that can be hard when there’s a blurring of lines between your workday and every other day—or every other time and every other space in your life. It all blends together, and so it can be hard to take the time out to do that self-care.

I think it’s also important to monitor yourself and ask, “How is my mood doing? Am I drinking more alcohol than normally, or am I using illicit substances in a way that is worrisome to me or to others?” And then to make sure that you’re willing to ask for help and you know where to get that help because we want to address these issues before things get too far away from us.

Diane Brady: Erica, any advice for individuals or even individual leaders?

Erica Hutchins Coe: Never underestimate the impact that human connection can have. You need to deliberately build it into your day. You’re not going to be passing someone in the hall. You might not be seeing extended family members as often.

Ask someone how they’re doing. To Kana’s point earlier, go beyond the cursory “How are you? I’m fine, thanks,” and move on to the next thing. And try to stay a little bit even more in tune [than usual], really keeping that radar up to anything that seems off, and ask the next question.

I think it makes a significant difference to individuals who are suffering to know that somebody is reaching out and that it’s okay to talk about it. So I think that’s something that we can all apply in our personal and professional lives—keeping an eye out for our colleagues just as we would with our family members or close friends and taking that extra effort to ask somebody how they are really doing today.

Diane Brady: Great. Erica and Kana, thank you very much for your time.

Erica Hutchins Coe: Thank you, Diane.

Kana Enomoto: Thank you for having us.

Diane Brady: That was Erica Hutchins Coe and Kana Enomoto. Together, they lead McKinsey’s Center for Societal Benefit through Healthcare. If you’d like more information about the Center, and also to see some of the articles and data that they’ve produced on this topic, go to the Center’s webpage. Thank you for listening. And also thank you to Elizabeth Newman and Belinda Yu in McKinsey Publishing for their contributions to this podcast. I’m Diane Brady.