Issue 24 of Competitive Advantages

Quick Ask: I began writing this week's newsletter with a note about a report on physician suicide, but as I dove into it, I kept expanding the scope of it. I decided to make it a focal point for this week by writing in a longer form so this issue is a bit of a departure from past ones.

My goal is that you find a deep dive like this more interesting and helpful than just a brief note. I'll include some other links at the bottom, but I'm playing around with a new style here with an in-depth look at an important topic. My ask is that you let me know if you like this change and what you think of it, as I enjoyed writing longer on an important topic to me. I hope it resonates with you in some way.

Notes on Mental Health

Nearly 1 in 4 physicians reported clinical depression in a recent survey & 9 percent admitted to suicidal thoughts. On top of that figure, two-thirds of doctors reported colloquial depression, a high-functioning form of depression.

The suicide crisis among physicians and the population at large is an indictment of our current approach to mental health

Depression has been an issue in the medical community for decades. It's affected me myself - my dad was a surgeon and passed away due to suicide in 2001. Since then, I've volunteered with the American Foundation for Suicide Prevention and spoken on mental health, depression, and suicide awareness.

This stuff sucks.

Full transparency - I myself have been in and out of therapy over the last few years as needed. It's really hard to accept that you need to talk to someone. I get it! But every time I've gone through it, therapy has helped me examine my perspective and outlook on life and enhanced my well-being.

Beyond therapy, I'm exploring more ways of supporting my mental health. Scott Galloway 's recent posts about how important male friendships are to men's health have been on my mind now for a while (see here and here).

Here's a snippet of his recent writings to give you a sense of the issue:

"Too many men lack the emotional skills necessary to form meaningful relationships. This has long been the case, but our digital world, where human-to-human contact is scant, magnifies those inadequacies. Affection is what it means to be a mammal, to be human. In fact, research shows that cultures that practice minimal physical affection experience significantly higher rates of violence. That's just one downside. A strong, healthy man is one who gives, and receives affection."

The quote above is from Professor Galloway's recent post Taking Affection Back on his blog No Mercy / No Malice.

In response to this issue in my own life, I'm making a more concerted effort to stay connected to my male friends, both for myself and for them. We need it.

In fact, Vox has dubbed this period the "Male Friendship Recession." This article summarizes some shocking research:

• The percentage of men with at least 6 close friends fell by half between 1990 and 2021, from above 50 percent to about 25 percent
• One in five single men say they have no close friendships

What issues are at play here with men?

Traditional views on masculinity are a big issue. I'm exploring this topic in more detail right now in For the Love of Men by Liz Plank , which is interesting to visit after taking a course on Toxic Masculinity in college (I could have learned more from it unfortunately).

In general, men are less likely than women to share personal feelings and receive emotional support from friends. This has reduced our feeling of belonging and connection with others, which is detrimental to not just our mental health but our physical health.

Research has found that social isolation weakens our immune system and makes us more likely to suffer from conditions such as Alzheimer's, sleep disruptions, high blood pressure, heart disease, inflammation, diabetes, and cancer.

Some key stats around this issue of male loneliness include:

• 21 percent of men reported receiving emotional support from a friend, versus 41 percent of women
• 30 percent of men shared personal feelings with a friend, compared to 48 percent of women
• And just 25 percent of men told a friend they loved them in the last week, compared to 49 percent of women

Men: We need to ask for more emotional support, we need to share our feelings, and we need to tell people we love and appreciate them

Send a coworker or friend a nice note about how you appreciate them. Let someone know what they mean to you. Ask them how they are doing. And when someone asks you how you are doing, actually answer them. I'm trying to do more of this last one myself, and while it's hard, it's led to some incredibly gratifying conversations with friends that I've rarely experienced in my life.

What's the connection here to work?

We spend a ton of time at work or working, and we can form incredibly close connections with our coworkers. Our mental health is strongly impacted by our relationships and experience at work, so recognize that you can make deeper connections with your coworkers, who often become some of our closest friends and partners (about 1 in 3 couples today met at work).

The bottom line is that our health, and by extension the quality of our life, depends on our ability to form deep and meaningful relationships with the people around us. And the workplace is a great place to remember this and practice it.

Other news and links I want to share with you this week:

The Difference between Captive Insurance and Self-Funding: I wrote an article for our blog this week on how captives differ from traditional self-funding and fully-insured health insurance.

Webinar: Supporting Mental Health in the Workplace: Join Kelly McDevitt and Dr. Candace Nelson of the Integrated Benefits Institute on Thursday, April 13th as they discuss supporting mental health in the workplace. They'll review recent findings on depression and anxiety in the workforce, impacts on DEI, demographic differences in the data, and provide employers tactical guidance to support the needs of their employees and their business. Attendees may receive one SHRM credit for attending this webinar.

MetLife releases their Employee Benefits Trend Study: This report is chock full of insights, but I'll highlight that job satisfaction is the lowest it's been since they started this report and employers are drastically overestimating how healthy employees feel. See the chart below:

The Kids are Not Alright: It's hard to provide a solid resource to groups for pediatric mental health. Mental health is a tough issue to crack as is, and then there are further obstacles in helping children. Consider this:

• 75% of US counties don't have an adolescent psychiatrist. We have deserts with no clinicians and no pediatric-trained therapists in them
• Without innovative care solutions, we can't deliver quality mental health care to the kids of employees
• Half of all severe mental health illnesses manifest before the age of 14, yet have a gap in services and clinicians focused on this cohort
• Mental health care is stuck in a reactive state. We don't practice preventative mental health, partially due to stigma and our culture, but also because we just don't have the billing codes for it. Our system only performs what it can bill for - so let's fix the billing
• Need for quality care navigation - yet purchasers have fatigue with point solutions and can only implement and manage so much
• "We don't have this issue with our population/plan"

Remember that any out-of-network cash pay visits won't show up in your claims data, so you might be totally in the dark on this issue. For more on this topic, check out a recent conversation on the blog Vital Signs with Naomi Allen .

That's it for this week's issue of Competitive Advantages! Subscribe to get future issues delivered directly to your inbox and for future updates. And let's stay in touch:

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