black and white photo of workplace with one group and one female working alone separately

Confidentiality Within the Workplace: The importance of psychological safety for employee assistance programs

The COVID-19 pandemic generated widespread instability and disruptions to the workforce, and the mental health of workers has suffered as a consequence.

  • A survey from 2020 found that 42% of employee respondents reported a decline in their mental health from the start of the pandemic.1
  • Another 2021 survey reported that nearly two thirds of U.S. workers are experiencing mild to severe symptoms of anxiety or depression.2
  • Global trends measuring employee engagement and stress levels paint a similar picture: the mental health of workers is taking a hit—and with it, the bottom line of businesses.3

Stemming the Great Resignation with effective mental healthcare

The pandemic hasn’t only impacted mental health; it’s also shifted employees’ attitudes about mental well-being. A survey conducted by Ginger found that mental health support is an increasingly important consideration for evaluating a new job, with 49% of respondents saying it would be a key factor in their decision — second only to 401k contributions or similar financial aid.4

Providing access to mental health benefits is just as important for keeping current employees around. The so-called “Great Resignation” saw a record number of workers trade up their old jobs for flashy new ones that offer more flexibility and autonomy. The message to employers is clear: mental health isn’t a privilege, it’s a priority.

With the number of job openings in the US near an all-time high5 and workers emboldened to seek new employment opportunities, the incentive for employers to improve the mental health of their employees has never been more important for retaining and attracting top talent. 

Offering employee benefits doesn’t guarantee uptake

Fortunately, many employers (about 40%6) are heeding employees’ demands for increased access to mental health benefits. But employers who provide mental health support through employee benefits programs shouldn’t rest just yet. The problem isn’t so much access to mental health benefits as it is ensuring these benefits are used by employees who need them most.

The utilization rates of industry standard EAPs–many of which offer mental health benefits–are notoriously low at 1.8-6.9%.7 The poor uptake of these programs isn’t just due to a lack of awareness. In a 2016 survey, 40% of respondents said they experienced feelings of depression and anxiety and never sought help.8 Employees dealing with depression have especially low take rates, with only half receiving treatment for it.9  

Closing the utilization gap to increases the cost-effectiveness of benefit programs 

Employers stand to gain from addressing this utilization gap. With an estimated return of $4 for every $1 invested in mental health support,10 employers have an opportunity to enhance the cost effectiveness of their employee benefits programs. In doing so, employers can not only increase profitability but the reputation of their company.

Behavioral Science, Democratized

We make 35,000 decisions each day, often in environments that aren’t conducive to making sound choices. 

At TDL, we work with organizations in the public and private sectors—from new startups, to governments, to established players like the Gates Foundation—to debias decision-making and create better outcomes for everyone.

More about our services
graph on what people care about when accessing online support services

Data retrieved from

Workplaces need a culture of psychological safety

If employees are struggling with mental health, why are they not seeking help? One reason is due to the prevailing stigma associated with mental illness. Employees are worried about facing discrimination from their colleagues and employer, concerns that are not unfounded. A 2008 Canadian survey revealed that 64% of respondents would be concerned about how work would be affected if a colleague had a mental illness, and 46% thought that the term “mental illness” is used as an excuse for bad behavior.11 Although the stigma around mental illness has certainly improved since then, it is no wonder why employees feel uncomfortable accessing mental health support. 

To overcome this barrier, employers need to foster a culture of psychological safety to encourage the uptake of mental health benefits they provide. One way to do this is to assure employee confidentiality by communicating about privacy more effectively. 

The Primacy of Privacy 

Negative emotions can get in the way of seeking help

For individuals struggling with mental health issues, the negative emotions they experience can deter them from seeking help–even when it is in their best interest to do so. Negative emotions not only tax cognitive resources–impairing our ability to make rational decisions–but they generate cognitive distortions that cause us to fixate on the negative outcomes of a course of action over the good. 

This selective filtering of reality through a negative lense can result in inaccurate perceptions of mental health stigma in the workplace. Employees might catastrophize about what would happen if their colleagues or manager knew about their mental struggles. Negative emotions can also distort our self-image, leading people to blame themselves for their perceived ‘weakness’ and evoking feelings of shame for needing support.

Combatting stigma perceptions through privacy protection

It’s important for employers to recognize that cognitive dynamics, though not ‘rational’, can discourage employees from accessing mental health benefits. Employers can combat cognitive distortions, ensuring employees who need help get it, by taking active measures to recalibrate the perceived risks of accessing mental health support.

One key to mitigating these risks is assuring employees that their confidentiality is protected. In our work on digital mental health, TDL found that users’ single greatest concern when accessing mental health resources was protecting their privacy, with 55% of survey participants agreeing that they did not want to risk their data privacy.

Other research demonstrates similar concerns: a 2020 report found that the top reason for accessing company-offered mental health benefits was confidence in confidentiality (tied with ease of access and understanding of care at 38%).4 Given the stigma associated with mental illness, it’s not hard to see why privacy is important to employees. 

graph on people's motivation to take advantage of emotional and mental health benefits offered by their company

Data retrieved from

Seeking mental health support can be an extremely difficult and personal decision. But by protecting employees’ privacy, you directly address their foremost concerns that arise due to cognitive distortions: that their struggles will become company-wide information, resulting in judgement, isolation and discrimination. Not only must privacy be protected - employers must clearly communicate how employees’ privacy is protected.

Improving communication can cut employees’ concerns about privacy in half 

When it comes to privacy, how you communicate matters. In our partnership with Wellness Together Canada, a platform for mental health and substance use resources funded by the Government of Canada, TDL was able to reduce user privacy concerns by 50% through simple behavioral design changes.

What’s crucial to note here is that the privacy policy itself didn’t change, only the way it was communicated to users. 

Step-by-step: Cutting privacy concerns by 50%

The first step is to ensure that privacy information is communicated in a timely manner. On Wellness Together Canada, at any touchpoint where users were asked to provide personal information, they were provided with a simple explanation of how their privacy was being protected and what value was added to them by sharing this information.

We also made sure to minimize the amount of personal information required for signing up and provided options to users who felt uncomfortable doing so. Employers should not leave it to their employees to sift through a cumbersome privacy policy if and when they happen to seek out support. Instead, employers need to explicitly mention how the confidentiality of their employees is protected prior to their accessing these benefits.

Negative emotions can distort an individual’s default assumptions about how well their privacy is protected, or whether their privacy is protected at all. Unless told otherwise, they may hold the inaccurate belief that accessing benefits presents too great a risk to their privacy and never seek help because of it. 

illustration of an accordion and a privacy policy

Clarity counts!

Another way you can improve communication about privacy is to deliver this information in a clear and progressive manner. No one enjoys reading through a barrage of privacy policy details, especially when they are in the midst of dealing with mental health concerns.

To address this on Wellness Together Canada, we presented the user with simplified, easy-to-understand privacy “takeaways,” which included:

a.) why the user’s data is being collected

b.) how their data is being handled, and

c.) what control they have over their data (for example, users were able to choose what data was tracked in the form of cookies)

Each of these privacy implications provided links to a more detailed privacy policy should the user want to learn more. Negative emotions are cognitively taxing, so making privacy policies clear and salient instills a greater sense of comfort when accessing mental health resources. 

By implementing these strategies for effectively communicating privacy concerns, employers not only improve the well-being of employees but can earn their trust and confidence in the process.

Learn more about TDL’s work in digital mental health 

Although employers have recognized the importance of providing mental health benefits for their employees, the pervasive stigma around mental illness discourages many employees from accessing this support. By assuaging employees’ concerns about privacy, employers can increase the uptake of their employee benefits programs, boosting the well-being and performance of their employees. 

The Decision Lab is an evidence-based consultancy that uses behavioral science to promote social good. In the midst of a global health crisis, we’re committed to building digital mental health solutions that deliver empathetic, personalized support at scale.  If you'd like to work together to revolutionize health and wellness services, contact us.


  1. Greenwood, K., & Krol , N. (2021, August 31). 8 ways managers can support employees' mental health. Harvard Business Review. Retrieved February 22, 2022, from 
  2. Leonhardt, M. (2021, September 20). U.S. workers are not okay-and employers are the last to know. Fortune. Retrieved February 22, 2022, from 
  3. Gallup. (2021). State of the Global Workspace 2021 Report.
  4. Ginger. (2020). Workforce Attitudes toward Mental Health Report 2020.
  5. Picchi, A. (2021, December 8). Job openings near record high, with 11 million vacancies. CBS News. Retrieved February 22, 2022, from 
  6. KFF. (2021). 2021 Employer Health Benefits Survey.
  7. Chestnut Global Partners. (2016). EAP Trends Report 2016.
  8. Boak et al., (2016). The mental health and well-being of Ontario students, 1991-2015: Detailed OSDUHS findings. CAMH Research Document Series no. 43. Toronto: Centre for Addiction and Mental Health.
  9. Minor, M. (2021, January 20). Mental health in the workplace: The high cost of depression. Forbes. Retrieved February 22, 2022, from 
  10. World Health Organization. Mental health in the workplace. Retrieved February 22, 2002 from  
  11. Canadian Medical Association (2008). 8th annual National Report Card on Health Care. Retrieved from

About the Authors

Ryan McPhedrain

Ryan McPhedrain

Ryan is currently pursing his PhD in neuroscience at McGill University, focusing on the molecular and cellular mechanisms of neural plasticity in the developing brain. His main interest is in applying behavioural frameworks to guide interventions that enhance mental health and wellbeing. A staunch advocate for data-driven solutions, he seeks to leverage data science and machine learning tools to improve behavioural outcomes in digital health and finance. He has also participated in McGill-affiliated science outreach campaigns, giving presentations on neuroscience topics for high school students and answering publicly-sourced neuroscience questions. In his spare time, Ryan can be found enjoying a good book, playing various sports like hockey, volleyball and tennis, or simply getting lost in nature.

Marielle Montenegro's portrait

Marielle Montenegro

Marielle Montenegro has a background in behavioural neuroscience from McGill University. Her prior experience ranges from projects in behavioural finance to health, where she was responsible for designing programs that unlocked barriers to medication adherence, curating behaviourally guided content for financial planners and informing policy to improve access to and perceptions of mental health services in University. Prior to working at The Decision Lab, she was based in Johannesburg working as a Behavioural Policy Analyst, where she designed impact measurement framework to assess the effectiveness of telecommunication policies on access to communications in rural communicates.

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