People and Strategy

Cara McNulty on Helping Employees Be the Healthiest They Can Be

Episode Summary

In this episode of People and Strategy, Cara McNulty speaks with host Tony Lee on topics that include the importance of prioritizing mental health awareness among the workforce, training managers to help employees dealing with mental health challenges and the connection between mental health and employee disengagement.

Episode Notes

Cara McNulty followed a career in population health science, always driven by awareness that everything people do, including work, is tied to their health. Now, as president of behavioral health and mental well-being at CVS Health, she spearheads the development of CVS Health and Aetna's mental health programs, products and capabilities. In this episode of People and Strategy, host Tony Lee speaks with McNulty on topics that include the importance of prioritizing mental health awareness among the workforce, training managers to help employees dealing with mental health challenges and the connection between mental health and employee disengagement.

Episode transcript

Episode Transcription

Speaker 1: Business success requires thinking beyond today. That's why ADP uses data-driven insights to design HR solutions to help your business have more success tomorrow. ADP. Always designing for HR, talent, time, benefits, payroll, and people.

Tony Lee: Welcome to today's People and Strategy podcast. I'm Tony Lee, vice president of content for the Society for Human Resource Management and the SHRM Executive Network, which is the premier network of executives and thought leaders in the field of human resources.

I'm excited to speak today with Cara McNulty, president of Behavioral Health and Mental Wellbeing at CVS Health, the healthcare company that operates CVS pharmacies, CVS Caremark, a pharmacy benefits manager, and Aetna, the health insurance provider, among many other businesses.

Based outside Minneapolis, Cara oversees a national team that spearheads the development of CVS Health and Aetna's mental health programs, products and capabilities. Cara, welcome to the People and Strategy podcast.

Cara McNulty: Hi, Tony. Thank you. It's great to be here.

Tony Lee: Well, thanks for joining us. So you've held a range of senior leadership roles in your career at a wide variety of organizations, starting with the Minnesota Department of Health, followed by Blue Cross Blue Shield, Target, Willis Towers Watson, and now CVS. And all along the way, your focus seemed to be on employee health and well-being. What attracted you to that area?

Cara McNulty: Well, I've been very fortunate to work for great employers and have an exceptional opportunity to help advance the health and well-being of employees across the country. And what attracted me to population health and population health science is the fact that everything we do is impacted by our health. How we live, how we work, how we are in community, how we are with our family or if we're able to have family.

I learned this at a young age and have been really fortunate to be able to dive into what gets in the way of total health and well-being, what improves total health and well-being. And then, what can we do as employers, as leaders, as communities, as parents to help people be the healthiest they can be?

Tony Lee: Well, I think you're in the right place at the right time, right? I mean, HR is facing a lot of critical challenges right now, but I would think pretty high on that list is employee mental health. Do you think HR leaders are doing enough to prioritize mental health awareness among the workforce, among people managers, among the C-Suite?

Cara McNulty: Well, first and foremost, let's call a spade a spade. HR is the hardest area in any company and often is given the least amount of credit. And I will say, in general, no one is doing enough around mental health and mental well-being. So it's not just HR. But if I ask specifically about HR, I believe that people are trying. But we have to take different and broader tactics around the topic of mental health and its interconnection to workforce.

And by doing that, that is the only way we're going to change the systemic view of what mental health is and what it isn't. And when I say that, I mean for a long time. If you just think about social media and how we talk about mental health or mental illness, we clump it all together, and we make it as though if you have a mental health issue or a mental illness, that you're broken.

And the reality is everyone will have some type of mental health disruption. That doesn't mean it's going to be a mental illness. But all of us, over the pandemic... I bet there's very few people who could say, "Oh, no, didn't have any additional stress or fear or anxiety or maybe depression or the blues." Pretty limited in that department. So we need to, as a society and community and within HR, look at mental health differently and address it differently.

Tony Lee: It's interesting. We've heard from a fair number of CHROs and others in the C-Suite saying basically what you're saying, that employee mental health is not just widespread, it's accepted. It's being more accepted. It's not something that can be pushed aside like maybe it used to be.

But I think the question that HR keeps coming back is, how do we train the managers, the people who are helping employees who are dealing with a mental health challenge, how do we train them to work with those employees more effectively? How do we put mental health in their toolkit of skills?

Cara McNulty: Sure. It's such a great question. Well, first, let's start with this stat that 35%, only 35% of the general workforce feels like they can talk about their own mental health or the mental health of a family member in the work setting. Now, that that number is better, 35%, but that's very few people.

And addressing mental health in the workforce doesn't mean that we have an employee assistance program. It doesn't mean that we do a campaign once a year to talk about it being okay to have mental health issues. It really has to be a core systemic part of a company's value proposition.

And when we think about the value prop and how it's changed between employee and employer... It's changed dramatically. And it has been changing. But Covid just catapulted that change. And so, not only do those managers and supervisors need support and resources and guides and tools around mental health, but everyone in a company does so that we can build inclusive, culturally diverse, and accepting workplaces that support people wherever they're at on their mental, physical and emotional well-being journey.

Tony Lee: Well, it sounds like a great goal. We'll see how well companies do trying to achieve it. One motivation, though, may be as a way to address employee engagement. We all have know and have heard that employee engagement has declined pretty significantly, which includes both a higher number of resignations, whether people are leaving for more money or they're just taking greater control of their life, their work-life balance and seeking that, or quiet quitting. They're still on the job, but they're just not doing their job.

Do you think that mental health is playing a role in that disengagement, or is there something else that companies need to be focusing on?

Cara McNulty: Absolutely think that our mental health and mental well-being is playing a role in whether it's the quiet quitting or disconnecting or leaving the workforce. Absolutely. And if we don't address mental health and well-being and normalize it as a part of not just addressing our physical health but our mental health, we won't have the workforce we need to advance our economies, to drive innovation, to explore and expand cultural diversity, which we know we need in order to improve our economic outcomes.

And so, when we think about this concept of people leaving the workforce, what we hear over and over is that people don't just want to have their company every once in a while address mental health. It has to be a part of the fabric. And that means that we're allowing people to bring their full self to work, their full inclusion, diverse and physical, mental, emotional self to work. And when we do, we get the best out of our employees.

Now, as you said, we'll see how this all pans out, but we know that when employers are doing this, when they are offering policies that really support their employees and their employees' mental well-being, when they offer a culture that is inclusive and talking about the importance of taking care of not only your physical health but your mental health, and when they are leading with actions, that's where they see the best results. And those actions, they come in a whole host of different ways.

I mean, that employee-employer value prop, as I said, has changed. And so you might hear employees say, "I want and need more flexibility. I just need it because I have so many things that I'm trying to manage." Well, what employees are really saying is, "I can't have my workday be so long that it goes into my evening, and there is no start and end to my day."

Are employees willing to have parameters or go back into an office? Yes, but they need guidance from HR and their companies on, "Hey, how can we put some guardrails around what a new value prop is going to be for me as the employee and you as the employer?" And so, it's really taking a look at our policies, our programs, our culture to ensure that they're meeting not only the mental well-being but also, how do we improve resiliency, reduce stress, so people can be their best.

Tony Lee: But there's a real rub there. If you have a smaller workforce because you are losing employees because there's a huge talent shortage and you're not necessarily filling the positions, then burnout is inevitable because people are working harder trying to get their work done. And yet, if they have childcare, if they have elder care, if they have school, whatever it might be, how do you address that?

It could have an impact on the company's bottom line if a company lets someone have greater flexibility and name their own hours when they don't have backfill, when they don't have positions that are getting filled. From a C-suite perspective, how do you balance all that?

Cara McNulty: Well, that's totally it, Tony. It is a balance. It's not a one-size-fits-all. And so, as workforce has been shrinking, companies have had to get really creative. And that doesn't mean maybe the work hour or work days are shorter, but they're more flexible.

What we hear from employees is that they're willing to go back into the work location if that's required, but they might need more time commuting because now they have different childcare needs or caregiving needs because maybe their parents now live with them. And they need an end to their day when going into an office that stays consistent.

One of the things we've lost in the pandemic is more of that regular routine. Maybe you got into work by 8:30, and you left by 5:00. Well, for those who no longer went into an office setting, those guardrails just went by the wayside. And you hear people say all the time, "I have way more meetings. I have less free time in my workday to even think. And now I'm supposed to commute?" So we really have to look at, what is the best way to be accommodating without sacrificing your bottom line?

And that means providing flexibility. It also means having open discussions with employees and looking at what are the services and programs the company is providing. One of the things we've learned over the pandemic is almost everyone has some kind of caregiving responsibility, whether that's your own family, whether that's for your parents, or even an animal. Look at all the people who chose to get a pandemic puppy or a cat, or a gerbil. People are caregiving. And employees want the ability and flexibility to do that caregiving without the sacrifice of they're not meeting their employer's needs.

So having those open discussions, having the discussions around, "What's a workday going to look like when I'm coming into the office? What's a workday going to look like when I'm at home?" Or vice versa, is really, really important. And then, what are the benefits that people really care about that align to the changing value proposition that we talked about earlier?

Tony Lee: Yeah, it's so critical. And you're in a unique position, Cara, in that CVS Health and Aetna, you have tens of thousands of employees sitting in offices, but you also have, through CVS pharmacies, tens of thousands of frontline employees who are interacting with customers every day. They have to be there. You can't do that from home. How does a company balance that when they have folks who are in both types of positions?

Cara McNulty: It's such a good question, Tony, because there isn't one way to balance it. And it's not as if we set it in stone and then we don't have to come back and revisit. So what we at CVS Health have done is looked at, what do our frontline colleagues, who are working in stores or in pharmacies, need? And how can we help and support them along that journey? Which might and usually is very different than what an employee who has been working at home, is within headquarters, and doesn't have the accountability to be in a store or in a pharmacy. The needs are different. And so we treat those needs and those offerings differently.

We also look at, how do you help to build the capacity, the space, and the resiliency of all employees with our policies, with our programs, with our offerings so that they feel heard, that they feel listened to, and that we are doing everything we can to advance the reason and for our employees to see the reasons why being a CVS employee is really beneficial not only to the company but to them as an individual. So we don't treat everyone the same. We look at where you're at, what you're handling, what you need, and we adjust our policies, and our systems, and our programs to advance and meet the needs of that population.

Tony Lee: Well, it makes perfect sense. I'm almost hesitant to go there, but I think, given the topic, we should. It's a very difficult topic to address, but suicide among employees is a real issue. And whether it's in relation to the employee directly or someone within the employee's family, is there something HR should be doing from a suicide prevention standpoint that maybe they're not doing now that you would suggest?

Cara McNulty: The answer is yes, yes, and yes. I'm so glad you asked this question, Tony because if we don't normalize the topic of suicide and the importance of meeting people wherever they're at on their mental and physical health journey, we're going to continue to make it taboo to talk about. We're going to make it feel as if, "Ooh, that's something we shouldn't discuss."

Suicide, we believe as a company, is preventable. And one of the ways you prevent suicide is by ensuring you're building a culture that people are empathetic, but they also understand the signs, symptoms, and what to do if and when somebody might be displaying characteristics of being suicidal or self-harming. That doesn't mean everybody needs to be an expert. It means that we train our frontline colleagues, employees, managers, supervisors, to understand the signs and symptoms of when someone might be experiencing a self-harming behavior.

It's easy for companies to do to spread this knowledge. We use and partner with the American Foundation of Suicide Prevention. They have a training called Talk Saves Lives. And it really helps people understand what are the important things to know, to ask, and to do when you think someone is having a mental health issue or is displaying self-harming behaviors.

So we normalize it. We ask and teach our employees to ask the hard questions, "How are you? How are you really? You don't seem okay. Is there anything I can do? Is there anything we can help you with?" And even asking the question of, "Have you thought about self-harm?" When we do that, when we have these open and honest discussions, the person who's asking doesn't have to be an expert. All they have to do is ask the tough question and then know what to do if the person says yes.

So yes, we need to be focused on this as HR, but also broader as individuals who are working in a group of other humans, really listening, watching, and supporting one another. And then, when we think about our own workforce and the work we're doing at CVS Health... As I shared, we believe that suicide is preventable. And so, we have made a goal to reduce suicide attempts 20% by 2025, not only for our own team but for anyone we serve via Aetna Health Insurance.

And by making this statement and deploying very simple policies, clinical interventions, and assessments, we've reduced overall suicide attempts in a little over one year by 17.5%. In one year, Tony. And this isn't something that only we could do. This is something any company can do. So it's possible, but we have to remove the barriers and the myths that we shouldn't talk about mental health or suicide, or self-harming behaviors.

Tony Lee: Well, Cara, thank you so much for sharing your perspective on that. A difficult topic. And all of employee mental health can be difficult for some, but you've given some very terrific advice today, very practical advice that, hopefully, our listeners will take to heart. Thank you again. You can follow the People and Strategy podcast wherever you listen to your podcasts, and you can learn more about the SHRM Executive Network at

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Speaker 1: Business success requires thinking beyond today. That's why ADP uses data-driven insights to design HR solutions to help your business have more success tomorrow. ADP. Always designing for HR, talent, time benefits, payroll, and people.