7 Mental Health Survey Questions for Employees

You want to make sure that your employees are not feeling anxious? Here's how to do it.

As an HR leader, you feel responsible for creating a healthy work environment.

But this is challenging when you’re managing a fully remote or hybrid workforce.

In the office, managers can check in on employees, have informal conversations, and even sense when someone needs additional support. This isn’t as simple when teams work remotely.

The thing is, our digital tools have done wonders for boosting our work-from-home productivity, but lag behind when it comes to supporting our work-from-home mental health.

As an HR professional, you’re probably aware that there are three categories of prevention in workplace health and safety.

  • Primary prevention: Preventing disease or injury before it happens like when a government body introduces new legislation designed to protect workers.
  • Secondary prevention: Reducing the impact of a potential disease or injury like offering blood pressure screenings at work.
  • Tertiary prevention: Easing the symptoms of an existing condition, for example through rehabilitation programs.

You can apply this framework to managing mental health as well.

Traditionally, companies have focused on managing mental health at the secondary and tertiary prevention levels.

Increasingly, experts recommend that companies focus on primary mental health interventions.

Digital tools can help them do that.

The benefits of distributing anxiety surveys to your virtual workforce

Government agencies and NGOs distribute mental health surveys for educational purposes, but very few businesses distribute them to their own employees.

Companies spend almost a quarter of a billion dollars on employee engagement each year, and annual employee engagement surveys run by third-party human resources consulting firms take up a chunk of that budget.

But while many of these annual survey questions focus on productivity and job satisfaction, very few drill down and ask questions about employees’ mental health.

Oftentimes, the only questions they ask on this topic are about employee health and wellness benefits and programs.

Remember that framework from earlier? Clearly, these questions only focus on secondary and tertiary interventions.

Wouldn’t it be better if your company could assess the mental health of employees in real time and use that information to:

  • Identify and eliminate toxic aspects of workplace culture
  • Understand prevalent stressors in the workplace and put programs in place to help relieve them
  • Fuse a focus on mental health into your company’s employee lifecycle

Anxiety pulse surveys empower you to accomplish these objectives (and more!)

According to the World Health Organization, the primary/secondary/tertiary framework is more effective when dealing with medical disorders that have an easily identifiable cause.

On the other hand, mental illnesses can be due to “the interaction of environmental and genetic factors at specific periods of life”.

This means it’s hard to pinpoint the exact onset of a mental illness and to track when a person shifted from asymptomatic to symptomatic.

This means that anxiety pulse surveys – shorter surveys geared towards assessing employee mental health at a given point of time – can be more helpful for mental health prevention and promotion than a few questions in an annual survey.

So how do you design an effective questionnaire? If you’re not a mental health professional, you may be uncomfortable creating one.

Fortunately, there is a legitimate, self-assessment that employers can use to design their anxiety pulse surveys: GAD-7.

What is GAD-7 and how will it help your organization assess workforce mental health?

GAD-7 stands for Generalized Anxiety Disorder 7.

It’s a self-reported questionnaire, which means that participants read the questions and select responses themselves.

GAD-7 screens and assesses the severity of generalized anxiety disorder, which can cause excessive worrying, difficulty sleeping, irritability, and more.

Although GAD-7 is not meant to replace a diagnosis from a clinician, it’s a helpful tool for companies to use when assessing employee mental health overall.

Why?

Because generalized anxiety disorder has high rates of comorbidity with other depressive disorders and anxiety disorders, including panic disorders.

How Does GAD-7 Work?

GAD-7 is a straightforward questionnaire. It only takes a couple minutes to complete and consists of 7 questions. It works as follows:

  • The participant receives 7 questions.
  • For each question, the participant selects from the following responses:
  • ZERO - Not at all.
  • ONE - Several days
  • TWO - More than half the days
  • THREE - Nearly every day
  • The responses are added up to find the total score from all the questions.
  • A participant receives a GAD-7 score from 0 to 21.

Generally speaking, the cut off points are:

  • 5 - For mild anxiety
  • 10 - For moderate anxiety
  • 15 - For severe anxiety

What questions does GAD-7 ask and why are they important?

There are 7 questions on the GAD-7 survey. They want to know, “Over the last two weeks, how often have you been bothered by the following problems…?”

Feeling nervous, anxious, or on edge?

In a survey conducted by the Mental Health Commission of Canada and Morneau Shepell, 34% of respondents pointed to workplace stress as the primary cause of their mental health challenges.

Anxiety was one of the top reported mental health problems.

What does it mean to feel nervous, anxious, or on edge?

The first thing to note is that we’re not referring to a professional diagnosis of clinical anxiety disorder here, but simply the feeling of nervousness and anxiety.

Nervousness is the body’s response to a stressful situation. Likewise, anxiety is the body’s way of warning us and preparing us for danger or discomfort.

In the workplace, that could be a good thing (e.g. landing a meeting with a huge client) or a bad thing (e.g. messing up a project for that big client you just won).

The purpose of this response is to help us manage the situation at hand.

In the workplace, instances of nervousness should be limited to the situations mentioned above.

Nervousness helps you take that big meeting seriously and thoroughly prepare.

Likewise, if you care about your job you should be a little nervous before discussing how a project went horribly wrong.

But remember the key thing about nervousness: It’s temporary. It’s meant to pass along with the stressor.

But if your workplace has created an environment where nervousness is a constant, that’s a problem.

In a remote work environment, this could be caused by technology that routinely fails. If your team’s working on a project, but they can’t log into the system, they’re in a constant state of stress that they won’t be able to complete tasks on time or that work won’t save properly.

On an individual level, constant nervousness and anxiety can have a detrimental impact on employees’ health.

This chronic anxiety can manifest itself in symptoms like headaches, irritability, panic attacks, extreme fatigue, and a pounding heart.

Plus, anxiety leads to detrimental effects at the organizational level including:

  • Absenteeism
  • Difficulty participating in meetings which reduces the effectiveness of brainstorming sessions or problem solving
  • Trouble meeting deadlines
  • Hesitancy taking on new projects

There are also reports that work from home tools can amplify worker anxiety. Experts say that the inherent delays in videoconferencing tools can increase feelings of anxiety and isolation.

Think about it: We rely on body language and non-verbal cues to pick up on how people feel and make an interaction agreeable. Any delay – even slight – leaves us feeling anxious and eager to fill in the gaps which creates an exhausting experience.

If your GAD-7 WFH survey identifies high levels of nervousness and anxiety, you can explore further and write more targeted questions for your routine pulse surveys.

This way you can find out why employees feel this way and what they need to feel supported.

Not being able to stop or control worrying?

What’s the difference between “worry” and “anxiety”?

It’s helpful to think of worry as a symptom of anxiety.

There are three main pillars of anxiety as Harvard Health explains:

  • Emotional: You feel fear before a big client meeting.
  • Physiological: You feel nausea or heart palpitations at the thought of presenting your pitch.
  • Cognitive: You think, “I’m not qualified enough to do this. I’ll mess it all up.” in the days leading up to your presentation.

Worry falls under the cognitive category. In small doses, worry can be productive. It helps us plan ahead and prepare for situations. But left unchecked, it’s unhelpful and damaging.

If an effective, high performing employee experiences thoughts of self-doubt despite being fully prepared in every practical sense, this can prevent them from:

  • Accepting a promotion
  • Taking the lead on a big project
  • Pitching to a client (even though they are fully qualified)

A company that sense high levels of worry can take steps like:

  • Designing programs to help excellent individual contributors become effective managers and leaders
  • Offering professional development workshops that focus on public speaking, delivering presentations, or managing clients
  • Provide the tools and resources employees need to do their work to the best of their abilities

Worrying too much about different things?

The modern workplace needs employees to wear multiple hats. Employees will need to be flexible, adaptive, and creative to succeed in the competitive and rapidly changing economy.

But there’s a difference between being dynamic and being overextended.

Employees have countless tasks to worry about at work.

If work were their entire world this may be manageable. But work is not an employee’s entire world.

They also have to think about their health, their families, their friends, the health of their friends and family, and their sources of personal fulfillment.

Can an employee ensure employees are happy in all areas of their lives? No. And it’s not their job to do so. What they can do, however, is ensure work doesn’t have a detrimental impact on those other areas of their lives.

The sad thing is: It often does. Research shows that work can undermine family life and jeopardize personal health. On the flip side, healthy employees show up more often and work more effectively.

So let’s see how this insight can play out starting from distributing an anxiety survey all the way to implementing a solution.

  1. You distribute the anxiety survey and discover employees recorded high scores for “worrying too much about different things”.
  2. You distribute a pulse survey that specifically asks questions about sources of worry for employees.
  3. You learn that your employees are worried about things like:
    1. Managing their families while working from home
    2. Paying medical bills
    3. Finding time for physical activity and stress management
  4. You may choose to address this by:
    1. Offering a stipend for home office improvements
    2. Undergoing a revamp of your employee benefits
    3. Offering a stipend for purchasing a gym membership or exercise equipment

Difficulty relaxing?

Shutting off completely takes a lot of willpower in today’s hyperconnected world.

It’s even more challenging for remote workers whose living space is now their workplace.

This is bad news for workers. Proper downtime is important for mental and physical health, but workers struggle to get this much needed R&R. Even if they’re ready to rest, they can’t seem to relax.

One study found that only 53% of workers return feeling rested after a holiday.

There’s even something called “leisure sickness”, the anecdotal phenomenon where employees fall ill in their off time.

Insufficient downtime also diminishes productivity.

For many, not working leads to stress, because they can’t stop thinking about all the stuff they need to do. But it turns out that working through the evenings and weekends doesn’t lead to a much stronger outcome.

According to one study out of Stanford University, productivity per hour starts declining after 50 hours a week of work.

Push that past 55 hours, and the decline is so precipitous it makes working any longer futile.

Moreover, those who work more than 70 hours per week accomplish the same amount as those who work 55.

On the other hand, rest allows us to work smarter and more effectively.

In sum, if your workforce struggles to relax, your company’s overall productivity could go down.

Your GAD-7 survey can help identify whether this is a problem. If it is, your HR team can turn its attention to programs around stress management, time management techniques, and other wellness programs.

You can also increase the number of resources you distribute to your employees.

If they’ve never worked remotely before, they may not know there are strategies for adjusting to a work-from-home job.

Some strategies include writing a to-do list at the end of the day (as well as the beginning) and setting your device to a timed night mode so there’s a visual cue that the work day is over.

Being so restless that it’s hard to sit still?

Restlessness is a symptom of anxiety. A worker dealing with restlessness struggles to sit still or relax.

This symptom is linked to the “fight or flight” component of anxiety.

The worker receives a surge of adrenaline and winds up a bundle of anxious energy.

This can lead to agitation and irritability and impact an employee’s ability to do their job well. They may have trouble sleeping or struggle to concentrate.

This isn’t a good thing for even one employee. So imagine if it’s prevalent across several employees. This can lead to higher absenteeism, a toxic work culture, reduced employee engagement, and eventually, increased turnover.

Becoming easily annoyed or irritable?

A positive company culture is critical to any organization’s employee engagement and retention strategy.

But here’s the thing: While company culture is really valuable, it’s also really easy to pollute.

Irritability is one of those emotions that have the power to infect other people quickly. When someone acts irritably, they can cause a number of negative outcomes including:

  • Making colleagues or direct reports uncomfortable: An irritable manager increases the anxiety of direct reports who feel uncomfortable asking questions or bringing a problem to a manager’s attention.
  • Causing confrontations: While some employees deal with a grumpy employee by avoiding them, others do so by reacting in kind. This leads to a situation where everyone’s tolerance for each other decreases, minor issues are blown out of proportion, and the work environment is further polluted.

In a remote environment, irritability can cause even further damage.

Remote teams succeed based on their ability to effectively communicate with each other, particularly through text.

Even a polite email can sound cold or brusque without the right wording or punctuation. So an irritable email can be downright rude.

This can jeopardize the quality of communication among virtual team members who may stop reaching out with questions, sharing information, or flagging issues.

Feeling afraid as if something awful might happen?

The dictionary defines dread as feeling fear or apprehension about an upcoming event.

Some might call this a rare feeling.

Others may report feeling it every Sunday evening about going to work the next day.

For most people, dread is a sign that it’s time to change jobs. Great news for their personal happiness. Bad news for your bottom line, because employee turnover is expensive.

What tends to cause employee dread? Stuff like:

  • Feeling like they have no control over their success and project outcomes because of lack of support or resources
  • Feeling overwhelmed by tasks and deadlines
  • Feeling intimidated or belittled by toxic colleagues or superiors
  • Dealing with discrimination and microaggressions in the workplace

If your employees report high rates of dread, it’s definitely a bad sign.

Think about it. If a loved one told you they were dreading going in to work on Monday, you’d likely tell them it’s just a bad work week and to stick it out.

If they told you they felt this way every Monday, you’d advise them to update their LinkedIn profile and start looking for a new role.

If there are high levels of workplace dread, it’s worth investigating, so you can eliminate the root causes. And it’ll be worth it. Eliminating sources of dread can help other negative feelings like stress, restlessness, and fatigue to hopefully reduce workplace anxiety overall.

How to promote employee mental health

A workplace anxiety survey helps you assess the overall mental health of your organization.

If you think back to the prevention framework we discussed earlier, you might have one nagging concern: This doesn’t help me with primary prevention. This is more like secondary prevention stuff.

Well, yes and no.

Sure, the survey identifies mental health challenges after they occur. But it also helps you put strategies in place to prevent future occurrences, both in current and future employees.

Your survey may lead you to implement new policies to reduce workplace harassment or discrimination. These new policies would be an instance of primary prevention informed by your anxiety survey.

Beyond prevention, workplaces can also actively promote mental health and wellness. There are several ways companies can do so.

Leading by example with regards to work/life balance

It’s one thing to say, “work/life balance is a good thing”.

It’s another thing to show that work-life balance is an acceptable thing.

If a worker hears that they should avoid working after hours, but regularly receives emails from their manager at 7pm, it sends a mixed message.

Managers can model healthy behavior by leaving and arriving at reasonable hours, only sending emails during business hours, and explicitly telling employees not to work during their vacations.

Openly discussing mental health in the workplace

Healthy workplaces increase awareness about mental health and wellbeing by discussing them through workshops, events, and corporate communications.

These workplaces also educate managers on how to properly support their teams and how to recognize signs that an employee is struggling.

Offer anonymous screening tools to employees

Oftentimes, people dismiss warning signs and tell themselves to “stick it out” because of feelings of shame or lack of education around mental health.

If employees have access to anonymous screening tools, they can privately conduct a self-assessment. If they identify symptoms related to mental health challenges, they can seek out professional assistance.

Provide information about mental health resources

Do employees know what to do or who to speak with if they’re struggling with mental health?

If you offer online mental health treatment resources, be sure to actively promote them. If not, share external resources that employees can access.

Incentivize behavior related to maintaining health and wellness

Expand your employee health and wellness benefits to include funding for gym memberships, yoga classes, or therapy. In addition, your company can also provide on-site classes and workshops for employees’ benefit.

Looking out for your workforce’s mental health is both the right thing to do, both as a human and as a business leader.

But remember that identifying and eliminating sources of stress and anxiety takes a thoughtful, strategic approach.

Using an anxiety pulse survey to gauge the mental health of your workforce is a smart start.

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