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John A. Quelch · Carin-Isabel Knoop
Compassionate
Management of
Mental Health in the
Modern Workplace
Compassionate Management of Mental Health
in the Modern Workplace
John A. Quelch • Carin-Isabel Knoop
Compassionate Management
of Mental Health in the
Modern Workplace
John A. Quelch Carin-Isabel Knoop
School of Business Administration Harvard Business School
University of Miami Boston, MA, USA
South Miami, FL, USA
ISBN 978-3-319-71540-7 ISBN 978-3-319-71541-4 (eBook)

https://doi.org/10.1007/978-3-319-71541-4
Library of Congress Control Number: 2018954231
© Springer International Publishing AG, part of Springer Nature 2018

This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
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Printed on acid-free paper
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Endorsements
“Workplace mental health: Wow! A subject that frightens most managers. If they
read this book, they will strengthen their own skills and transform their workplace
and our society.”
—Donna E. Shalala, Trustee Professor of Political Science and Health Policy,
University of Miami; former U.S. Secretary of Health and Human Services
“Mental health is an underappreciated, and oft-misunderstood challenge that is

growing in the modern workplace. This book provides leaders with practical advice
to address mental health challenges in their organization and improve productivity
and well-being. This is a topic that can no longer be ignored by leaders in any field,
and a book that will fundamentally change the way we think about and help improve
mental health in the workplace.”
—Dominic Barton, Managing Partner, McKinsey & Company
“In this provocative and compelling book, Quelch and Knoop prompt new thinking,
break new ground and inspire us all to reconsider the true essence of management.”
—Howard K. Koh, 14th U.S. Assistant Secretary for Health, U.S. Department of
Health and Human Services; Harvey V. Fineberg Professor of the Practice of
Public Health Leadership, Harvard T.H. Chan School of Public Health and
Harvard Kennedy School
“This is a breakthrough book on a topic that is at the root of healthy cultures and
vibrant workforces. Using an absorbing yet practical style, the authors take you on
a fascinating journey of mental health in the workplace. The book is replete with
examples, stories, statistics, and models that helps the reader feel, at the conclusion,
that they truly can positively influence their own mental health as well as others.
Well done!”
—Shane Cragun, CEO, SweetmanCragun Group; author, Reinvention:
Accelerating Results in the Age of Disruption
v
vi Endorsements
“We all have our public life, our private life and…here is the key…our ‘secret’ life.
That is the one we do not want to share with anyone. That is the one that controls
the dysfunctional behavior. The book gave me the reasons to examine the impact of
this secret life on my professional well-being and productivity and those of my
collaborators.”
—Kent Shoemaker, CEO, Lipman Produce
Preface
A state of well-being in which every individual realizes his or her own potential, can cope
with the normal stresses of life, can work productively and fruitfully, and is able to make a
contribution to his or her community.
—The World Health Organization’s definition of mental health
A silent tsunami […] could engulf organizations in myriad productivity and profitability
problems as well as legal liabilities unless mental health is addressed as seriously as are
marketing, compensation and strategic plans.
—Psychology Today on mental health in the workplace1
Work is an essential ingredient in the recipe for human fulfillment and purpose. It
also directly impacts our physical and mental health. This suggests that we have a
professional, moral, and ethical responsibility to do what we can to minimize the
damage our managerial behaviors may inflict (as we plan, staff, and monitor work,
set goals, allocate resources, etc.).
It is widely agreed that we are dealing with a public health crisis and that the
organizations in which many of us spend most of our waking hours are directly
impacted but also have a key role to play.
***
If one-third of the workforce just go through the motions in work and life (or, as
American philosopher Henry David Thoreau wrote, “lead lives of quiet despera-
tion”), then maximizing mental wellness at work must be a central managerial
imperative and responsibility. We need honesty, information, courage, and empathy
to lead ourselves and others in the modern world. This book provides the basic
knowledge and some tools to do so.
Despite sustained public and private sector efforts to improve the way we work,
too many of us suffer from or exhibit behaviors that create toxic, severe stress in
1
“The Silent Tsunami: Mental Health in the Workplace,” Psychology Today, September 26, 2012,
https://www.psychologytoday.com/blog/wired-success/201209/the-silent-tsunami-mental-health-
in-the-workplace, accessed June 2017.
vii
viii Preface
jobs that make us and others unhappy and unhealthy. Many who were historically
productive are sometimes excluded from or drop out of the workforce for mental
health reasons. Stigma and its pernicious cousins, guilt and shame, actively influence
many outcomes. Yet mental illness is nothing to be ashamed of: they are health
conditions involving a change in thinking, emotion or behavior (or a combination of
these)–a medical problem, just like heart disease or diabetes. Some psychiatric dis-
abilities can significantly interfere with daily activities, leading to enduring patterns
of impairment if untreated.
Most of us sit on the sidelines as we watch colleagues, friends, and loved ones
struggle. And there are, were, and will be many more. In the USA alone, about one
in five adults will, at some point, struggle with mental health issues – some of which
will become chronic. About one in ten Americans has a personality disorder,
whereby their feeling, behavior, and thought patterns tend to diverge from the prev-
alent culture. And roughly one in 25 will suffer from a more serious mental illness
such as schizophrenia.2 About one in three adults suffer from an addiction, and one
in four might have a mood disorder (such as depression or bipolar disorder),
doubling their odds of developing another mental health disorder.3 One in seven has
been intoxicated or high at work.
Around the world, media coverage of mental health issues in the workplace has
increased in recent years, highlighting stories of high performers (top executives,
doctors, hedge fund billionaires, elite veterans, among many others) who lost focus,
underperformed, acted out, engaged in destructive behaviors, quit, or died by
suicide. We also know about the silent suffering of those who don’t make the
headlines.
Yet despite increased awareness, we still, on average, wait a decade before g etting
treatment,4 and only about 40% do so5 for fear of stigmatization, prejudice, or dis-
crimination.6 These statistics hold broadly across many industrialized countries.
Mental health disorders impact all professional sectors and socioeconomic classes.
In 2018, managers are more aware than ever before about the impact and extent
of mental health disorders through their own experiences, as well as the experiences
of their children, parents, siblings, friends, colleagues, or subordinates. To a signifi-
cant extent, managers can positively influence how firms attract, retain, and m otivate
2
National Institute of Mental Health, “The Numbers Count: Mental Disorders in America,” http://
www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.
shtml#Intro, accessed July 2014.
3
Liz Szabo, “Cost of Not Caring: Stigma Set in Stone,” USA Today, June 25, 2014, http://www.usa-
today.com/story/news/nation/2014/06/25/stigma-of-mental-illness/9875351/, accessed March 2017.
4
Liz Szabo, “Cost of Not Caring: Stigma Set in Stone,” USA Today, June 25, 2014, http://www.usa-
today.com/story/news/nation/2014/06/25/stigma-of-mental-illness/9875351/, accessed March 2017.
5
National Alliance on Mental Illness (NAMI), Mental Health by the Numbers, NAMI website,
https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers, accessed May 2017.
6
Lynn Jenkins, “Breaking the silence surrounding mental health illness,” The Hill, May 1, 2017,
http://thehill.com/blogs/congress-blog/healthcare/331180-ending-the-stigma-and-breaking-the-
silence-surrounding-mental, accessed May 2017.
Preface ix
employees and organize and reward work in ways that maximize mental well-being.
Sensible strategies can boost productivity, commitment, and enthusiasm.
Several trends make this ideal difficult to implement, despite the best intentions.
The boundaries between home life and work life continue to blur: while at work, we
negotiate sleepovers for our kids, and while attending our kids’ plays, we negotiate
business deals. Many more of us work remotely, in alternative or temporary work
arrangements, and in teams and workplaces of increasing diversity.7 Employment
tenures are shortening, making it more challenging to convince firms to invest in the
short-term and long-term mental health of employees. Finally, as baby boomers
retire, a managerial transition is coinciding with one of the highest levels of reported
stress by younger workers.
However, many take work stress for granted and some even wear it as a badge of
honor. How we experience stress modulates its impact, but we all experience it
differently. Many of us do not understand what this really means for us and the
people whose lives we touch at work and through work.
Consider whether the companies and organizations in which we work, the cities
we inhabit, and the schools we attend have really changed their attention and
approach to mental health and well-being. What about our own, collective
perceptions and attitudes toward mental unwellness?
While we may be more aware of broad categories of mental health disorders –
certainly anxiety disorders, mood disorders, and substance use disorders – and use
these to self-diagnose and analyze others, we are often wrong and unsure how to
proceed with limited and superficial knowledge. Many of us criticize smokers and
alcoholics for their alleged lack of self-discipline, but so many of us keep a handheld
device within arm’s length and compulsively check it every few minutes. Many are
highly functional but mentally unwell and think we do a pretty good job of hiding or
self-managing our own mental health issues.
This book explores the connections between work and mental health, assesses
how some trends reshaping the way we live and work are likely to affect mental
well-being at work, suggests ways to be more aware of ourselves and others in gen-
eral and at particular personal and professional inflection points, describes some
best practice approaches, and provides recommendations about what managers can
do individually and collectively to maximize mental well-being. We are aiming for
“mental health for all by involving all.”8
7
Dan Schwabel, “10 Workplace Trends You’ll See in 2016,” Forbes, November 1, 2015, https://
www.forbes.com/sites/danschawbel/2015/11/01/10-workplace-trends-for-2016/#5aa14a07237f,
accessed March 2017.
8
Professor Vikram Patel describes this approach and his philosophy in his Ted Talk available on https://
www.ted.com/talks/vikram_patel_mental_health_for_all_by_involving_all, accessed June 2017.
x Preface
Our Intentions
This primer’s purpose is to make us better able to recognize our limitations, duties,
and potential as managers of ourselves and others. We hope to impart a greater aware-
ness and understanding of mental health issues in the workplace, offer ideas for useful
interventions, and help you generate key questions or to-do items for your organiza-
tions and for those whose lives you touch. What difference can you make for your
employees and your own well-being when the perceived stressors of the “always-on”
connected modern life seem so great? How will you and your o rganization use this
opportunity? Should organizations keep an eye on their m ental wellness “bottom
line” – to measure and account for the impact of their efforts? Can employee mental
health be linked to increased profitability and greater effectiveness?
We are not clinicians; we study business and health. We do not offer clinical
diagnoses, prescriptions, or responses, and we are not legally or ethically in a
position to offer such input in general, much less in individual cases.
While we may generalize and oversimplify the topics we tackle here, they
nonetheless touch on the essence of what it means to be human and how we organize
societies and teams. Our original research was based in the USA and focused on the
white-collar workplace. That context remains the main focus of the book, but what
we share can transcend borders and cultures with thoughtful adaptation.
Our book is meant for a general, nonacademic audience – managers, human
resources staff, chief medical officers, development heads in professional service
firms, union or employee organization leaders, and investment professionals placing
bets on individuals and teams.
However, we hope our influence will extend more broadly. All of us manage
ourselves and small groups in all aspects of our lives – within nonprofit organiza-
tions, by coaching youth sports teams, or interacting with family members and oth-
ers we choose to invest in, personally and professionally.
We summarize our research on several levels of analysis – the individual (and
family), the team, the organization, the sector, and the broader community – and we
provide ideas for short-, medium-, and long-term actions. Each chapter contains a
reflection or exercise.
Improving our knowledge of mental health and reducing the stigma of mental
illness in the workplace can benefit our communities and society at large. Teaching
employees about mental health encourages them to incorporate it into their constel-
lation of wellness or to seek treatment to get well; in doing so we touch the lives of
countless others for generations to come. This matters to society, managers, and
individuals. Managing for mental health is a collective opportunity. The authors are
deeply grateful to all who contributed to our research and understanding of the
issues covered in this book.
South Miami, FL, USA John A. Quelch

Cambridge, MA, USA Carin-Isabel Knoop
Framework
Our central argument is that wide-ranging effects flow from how managers choose
to educate themselves about mental health issues and use and promote the spread of
best practices. It follows that making changes, even if initially at a small and local
level, can have much broader impact.
We therefore build our analysis around a set of concentric circles – at the center is
the manager’s behavior and attitude, which ripples outward, first to his or her closest
collaborators (an employee who might need attention, help, and accommodation)
and family, the team (which could be better managed), and then potentially across the
organization and the broader community (which could be doing more collectively to
hold itself and me responsible for my impact on the mental health of others).
At the same time, the manager and his or her ecosystem are impacted by changes
in the outside circles (such as technology, social developments, and political
upheavals) (see Fig. 1).
Fig. 1 The ripples we

make (Source: Authors) Community/Sector
Organization
Team
Employee
Me
xi
Book Organization
Chapter 1 provides a broad review of our current understanding of the connection

between work and mental health and the impact of mental illness on workplace
productivity and well-being.
Chapter 2 describes recent changes that have improved mental health and
engagement at work and presents some best practices among selected companies.
Chapter 3 suggests that despite changes for the better, the workplace has become
even more challenging to our mental equilibrium in part because we are constantly
bombarded with information from our professional, personal, and media worlds.
We feel both more connected and stimulated yet also more lonely and lost.
Starting with Chapter 4, we describe how our actions in the area of mental health
can have a ripple effect – they start with us and impact our employees, teams,
organizations, and broader communities.
Chapter 4 then continues by focusing on you, on who you are or the person you
present at work, what impact you might be having, and how you can make i mmediate
changes to promote mental wellness for yourself and others.
Chapter 5 challenges you to “dare to care.” It allows you to consider a past or
current situation involving an individual who might be struggling with a mental
health issue and provides some suggestions about how to proceed in the short term.
How would you start the conversation? What should you say? And how? What are
the key professional inflection points?
Chapter 6 describes known personal and professional stressors, inflection points
that warrant close managerial attention.
We then move to the team as unit of analysis in Chapter 7 and provide some
building blocks for mental health: to recruit, deploy, and manage employees to
minimize the contribution that your own style, history, workplace, and team make
to known stressors.
Ultimately, however, we cannot be effective ourselves and with our immediate
teams if our organizations and communities do not change how they think about
mental health. We have a larger opportunity: to change the way the world of work
thinks about mental health. These subjects are the focus of Chapter 8.
xiii
xiv Book Organization
We close with the need to think of Mental Health for All and by All. We are
h opeful that the new generation, with its greater exposure to mental health issues
and willingness to be open about them, will be a catalyst toward holding organiza-
tions more accountable for the damage (and good) they are doing in this arena. The
quick reference guide at the end brings together the chapter reflections.
Appendix 1 describes the major categories of mental illnesses in the US
Diagnostic and Statistical Manual of Mental Disorders.
Appendix 2 describes mental health issues in the legal and financial services
sector.
Appendix 3 focuses on the challenges in startups and small businesses.
Contents
1 Mental Health and Work�� 1

An “Epidemic of Disengagement”: Sleepwalking
through Life and Work�� 3
Greater Understanding of the Essential Elements of Well-Being�� 6
Why Work Matters to Our (Mental) Health�� 7
The Opportunity Cost of Unwellness in the Workplace and Beyond�� 11
Substance Abuse and Gambling�� 14
Beyond the Individual�� 16
Illustration: The Wells Fargo Scandal�� 17
Unfortunately, We Are Wired for Stress�� 18
What If the Affected Employee Is You?�� 23
Reflection: What Do You Think You Know about Mental Health
and Its Impact in the Workplace?�� 24
2 Efforts to Foster Mental Health at Work�� 27
Better Norms and Regulations �� 29
Companies Have Been Investing in Mental Wellness�� 31
Mindfulness and Stress Reduction�� 36
Creating a Policy�� 38
Mental Well-Being as Competitive Advantage�� 39
Reflection: What Does Your Organization Do to Promote
Mental Health? What Has Changed for the Better?�� 42
3 The Challenges of the Modern Workplace: A Brave New Connected
World�� 43
The Tethered Life�� 45
The Impact of Speed, Volatility, and Complexity�� 47
Doing More of Everything, Except Sleeping�� 48
Connected but Alone�� 51
Economic/Technological Pressures �� 55
The Three “Outs”: Burning Out, Boring Out, and Sensing Out�� 58
Reflection: What Is the Cost of the Always-On Workplace
for You and Your Colleagues?�� 64
xv
xvi Contents
4 Mind the Mind: How Am I Doing and How Can I Do Better?�� 65
Manager, Know Thyself! (Ego, Body, and Soul)�� 66
Do You Recognize Yourself in the Vignette Below?�� 68
Monitor Emotions�� 69
Develop Emotional Agility�� 70
Don’t Be a Superhero�� 72
Beware of Busyness as Status Symbol�� 74
Be as Honest as Possible�� 77
Set the Tone�� 78
Observe and Ask�� 81
Learn from Other Sectors Such as Sports�� 82
Develop Alternative Ways to Manage�� 83
Reflection: How Am I Doing? �� 85
5 Dare to Care: How Are Others Doing, and How Might I Help? �� 87
Recognize an Employee at Risk�� 87
React to What You Observe �� 91
Understanding the Legal Context�� 92
Starting the Conversation�� 93
Tailor Your Approach: Generational Conversational Styles�� 96
Supporting Employees in Recovery/During Reentry�� 97
Ask Employees: Those Who Go and Those Who Stay�� 103
Reflection: What Kind of Mental Health Manager Are You?�� 104
6 Stress About Stressors: What Are Key Inflection Points?�� 109
Professional Transitions �� 109
Personal Inflection Points�� 114
Generational Inflection Points�� 121
Emotional Impact of World Events�� 125
Get to Know Direct Reports/Important Colleagues�� 128
Reflection: Stressors in Your Workplace�� 128
7 Building Blocks for Mental Health: How Do I Best
Manage My Team?�� 131
Recruit for Fit�� 131
Testing for Wellness and Fit�� 133
Encourage Uniqueness�� 135
Facilitate Integration, Not Just Assimilation�� 137
Build Teams for Mental Wellness�� 141
Workplace Personalities�� 143
Think About How and Where Your Team Works�� 143
Don’t Eat “Al Desko”�� 150
Sustain and Help Others Sustain Ties to the Community�� 152
Make (and Create) Time to Talk�� 154
Reflection: The Questions Below Can Help You Surface
Information About Your Team’s Culture and Mental Wellness�� 156
Contents xvii
8 Changing My Organization and Beyond: How Can I Have

a Greater Impact?�� 157
Understand Your Organization in Order to Change Its View
of Mental Health at Work�� 158
Reduce Stigma through Education�� 159
Make It Easier to Get Treatment�� 163
Harness the Power of Technology and Data Analysis �� 166
Embrace Neurodiversity�� 170
Broaden Your Impact �� 174
Reflection: Where Does Your Company Rank on the Stress/Support
Dimensions? Where Would You Like It to Be?�� 176
9 Conclusion: Toward Mental Health for All and by All�� 177
Enroll Your Organization �� 178
Looking Ahead: Welcome and Support for the Generational
Transition�� 179
Design Your Own Human Sustainability Index �� 181
Managing for the Whole Person, Including You�� 182
Quick Reference Guide: Chapter Reflections�� 184
Appendix 1: Most Common Mental Disorders in the USA, 2015�� 189
Appendix 2: Legal Field, Tournament Systems, and Financial
Services Overview�� 193
Appendix 3: Startups and Small Businesses�� 201
Index�� 209
About the Authors
John A. Quelch Since 2017, Professor John A. Quelch

has served as Vice Provost of the University of Miami
and Dean of Miami Business School.
He was formerly the Charles Edward Wilson
Professor of Business Administration at Harvard
Business School and Professor of Health Policy and
Management at the Harvard T.H. Chan School of
Public Health.
Professor Quelch is the first person to be Dean of
three leading business schools on three continents. He
served as Dean of the China Europe International
Business School (CEIBS) in Shanghai and Beijing, as
Dean of London Business School in the United
Kingdom, and as Senior Associate Dean of Harvard
Business School. At CEIBS, he raised the school’s MBA Financial Times ranking
to number 15 in the world. At London Business School, he raised the global ranking
to number 8.
Professor Quelch is the author of 25 books on strategic marketing, global
branding, and consumer-centric healthcare. He has been a director of ten publicly
quoted companies including Reebok, Pepsi Bottling Group, Aramark, and WPP, the
world’s largest marketing services company. He has given speeches and seminars in
more than 50 countries and has consulted to many multinationals including Sinopec
and Tencent. He is senior strategy advisor to JD.com.
Professor Quelch earned his degrees from Oxford University, the Wharton
School of the University of Pennsylvania, Harvard Business School, and Harvard
School of Public Health.
xix
xx About the Authors
Carin-Isabel Knoop Exposed as a child to the

s ometimes fatal consequences of a toxic workplace on
mental health, Carin-Isabel Knoop attended Harvard
Business School to learn how to build better
organizations. As the head of the Harvard Business
School Case Research and Writing Group for the past
two decades, she and her team have supported the
development of over 1,200 case studies. In addition to
working on cases and research projects related to
healthcare and well-being, leadership, and o rganizational
design, she has developed and refined a set of
management tools focused on maximizing mental

health and professional well-being. The book builds on
her research, personal, and managerial experience to
help others understand their responsibility and opportunity to build well-performing
human ecosystems.
Mrs. Knoop, formerly a consultant in Europe, earned her MBA from Harvard
Business School and her BA from the University of Texas at Austin.
Chapter 1
Mental Health and Work
The border separating general ennui from clinical mental-health problems is especially
challenging to managers in 21st century workplaces, seeing as it requires them to ask per-
sonal questions on matters that they are largely unqualified to deal with.1
In early 2017, a Financial Times columnist asked, “Why are we unhappy [at
work] when we have gyms and free foods?”2 If one types “my job is…” into a
search engine, she wrote, it tries to complete the search request with “so boring,”
“making me suicidal,” or “making me miserable.” “My boss is” yields “lazy,” “bul-
lying me,” or “a cow.”3 She also suggested that “people with university degrees tend
to dislike their jobs more than people without them. Hence, as more people have
degrees, unhappiness rises.”4
Because most adults spend at least one quarter of their time working, their
mental health is directly impacted by and consequential to work and their work-
place. The connections between mental health, physical health, and business pro-
ductivity, innovation, and profitability have been (for centuries) and continue to
be the focus of research. In the context of the workplace, and for the purpose
of this book, we define poor mental health as a person’s significantly com-
promised mental well-being that affects their capacity to do their job to
their fullest capabilities – which in turns affects their lives and connections
outside of work.
1
William Davies, “All the Happy Workers,” The Atlantic, June 6, 2015, https://www.theatlantic.
com/business/archive/2015/06/all-the-happy-workers/394907/, accessed February 2017.
2
Lucy Kellaway, “Why are we unhappy when we have gyms and free fruit?”, The Financial Times,
January 23, 2017.
3
January 23, 2017.
4
January 23, 2017.
© Springer International Publishing AG, part of Springer Nature 2018 1

J. A. Quelch, C.-I. Knoop, Compassionate Management of Mental Health in the
Modern Workplace, https://doi.org/10.1007/978-3-319-71541-4_1
2 1 Mental Health and Work
Mental health-related issues in the workplace continue to make more and more
headlines5 and spike around tragedies. In early 2016, mental health received renewed
attention after a 27-year-old pilot deliberately crashed a passenger airplane, causing
150 deaths. Subsequent media coverage highlighted the fact that the pilot had been
referred to a psychiatric hospital two weeks earlier, and his employer had not been
made aware of his declining mental state.6 He also had been treated for severe
depression while in school.
In 2010, 51% of Americans with a mild mental illness had full-time employment
in the previous year (compared with 62% of people without mental illness); corre-
sponding figures were 47% of moderately mentally ill people and 38% of those with
severe mental illness.7
Cognitive impairment from mental illness is particularly damaging in a knowl-
edge economy that relies more on our minds than our hands and puts us in constant
contact with others, either physically or virtually. More cognitively demanding jobs
make it more difficult for people distracted or disabled by mental health challenges.8
Knowledge workers, however, whose output can be harder to measure than, say, that
of factory workers, can also more easily hide underperformance at work.
The most common mental health disorders in the USA are substance use disor-
ders, anxiety disorders, personality disorders, major depression, and bipolar dis-
order. In 2017, the most common mental disorder among white-collar workers
was depression.
Though awareness of mental illness has grown over time, many experts contend
that the overall prevalence of these disorders has remained steady for several
decades.9 Instead, mental disorders are being studied, diagnosed, and treated at
higher rates. For example, while prescriptions for antidepressant drugs have
increased significantly in OECD countries, most respondents cite a reduction in
stigma (an attitude that marginalizes someone because of a mental health problem
and denies that person’s abilities and competence) and growing faith in the useful-
5
Nicholas Kristof, “First Up, Mental Illness. Next Topic Is Up to You,” The New York Times, http://
www.nytimes.com/2014/01/05/opinion/sunday/kristof-first-up-mental-illness-next-topic-is-up-to-
you.html?_r=0, accessed February 2014.
6
David Kroll, “Germanwings Pilot Referred to Psychiatric Hospital Two Weeks Before Deliberate
Crash, Airline Unaware,” Forbes, March 13, 2016, https://www.forbes.com/sites/davidk-
roll/2016/03/13/germanwings-pilot-took-5-drugs-ordered-to-psychiatric-hospital-2-weeks-
before-murder-suicide-crash/#707362b01556, accessed May 2017.
7
Alison Luciano and Ellen Meara, “Employment Status of People with Mental Illness: National
Survey Data from 2009 and 2010,” Psychiatric Services, October 1, 2014, http://ps.psychiatryon-
line.org/doi/abs/10.1176/appi.ps.201300335, accessed February 2017.
8
Organisation for Economic Co-operation and Development, “Sick on the Job? Myths and
Realities about Mental Health and Work,” pp. 199–210, 2011, https://www.oecd.org/els/
emp/49227343.pdf, accessed February 2017.
9
Organisation for Economic Co-operation and Development, “Sick on the Job? Myths and
Realities about Mental Health and Work,” pp. 199–210, 2011, https://www.oecd.org/els/
emp/49227343.pdf, accessed February 2017.
An “Epidemic of Disengagement”: Sleepwalking through Life and Work 3
ness of these treatments, rather than an overall increase in depressive symptoms.10

Some may view this as a positive, suggesting that efforts to destigmatize11 mental
illness worked, access to care improved, and the mental health of individuals
improved.
However, others argue that there has been an increase in the prevalence of mental
illness and that the increase is in part due to heightened stressors in the workplace.
Furthermore, stress is associated with weakened immune systems. Stress therefore
shows up not singularly in mental unwellness but also in physical illness.
Despite growing mental health literacy and a trend toward lower stigma, mental
health problems seem to be impacting employment more than ever. More and more
people are asking for disability assistance because their mental health issues make
it hard for them to work. By many accounts, work is more stressful and intrudes
more on the daily lives of workers.
n “Epidemic of Disengagement”: Sleepwalking through Life

A
and Work
Thomas Chamorro-Premuzic, Professor of Business Psychology at University College

London and Columbia University, sees an “epidemic of disengagement.”12 Employee
engagement has been defined as “the degree to which an employee works with pas-
sion and feels a profound connection to the company”13 and “an emotional and psy-
chological bond between workers and workplaces.”14 What of it? Well, various studies
have linked employee engagement with better mental health outcomes.15 Yet scholars
10
OECD iLibrary, “Health at a Glance: 4.10. Pharmaceutical Consumption,” 2013, http://www.
oecd-ilibrary.org/sites/health_glance-2013-en/04/10/index.html?itemId=/content/chapter/health_
glance-2013-41-en, accessed February 2017.
11
Researchers have identified four main beliefs that contribute to the social stigma of mental ill-
ness, especially at work: (1) that those who have mental health issues are incompetent, (2) that they
pose a risk to others, (3) that employment will harm their mental health further, and (4) that hiring
them is charitable. Source: Mental Health Misconceptions, http://www.psychguides.com/interact/
mental-health-misconceptions-analyzing-americas-awareness-of-common-conditions/, accessed
March 2017.
12
Lucy Kellaway, “Why are we unhappy when we have gyms and free fruit?”, The Financial
Times, January 23, 2017.
13
Jennifer Falkoski, “Burnout, Employee Engagement, and Coping in High-Risk Occupations,”
Journal of Psychological Issues in Organizational Culture, January 2012, via ResearchGate,
14
Jennifer Robinson, “Disengagement Can Be Really Depressing,” Gallup, April 2, 2010, http://
www.gallup.com/businessjournal/127100/disengagement%ADreally%ADdepressing.
aspx?version=print, accessed March 2017.
15
Fenna Leijten et al., “Associations of Work-Related Factors and Work Engagement with Mental
and Physical Health: A 1-Year Follow-up Study,” Springer, June 14, 2014, https://link.springer.
com/article/10.1007/s10926-014-9525-6, accessed March 2017.
Table 1.1 Gallup employee engagement index results, 2011–2017

Year Engaged (%) Not engaged (%) Actively disengaged (%)
2011 29 52 19
2012 30 52 18
2013 30 52 19
2014 31 51 17
2015 32 51 17
2016 33 51 16
2017 34 52 14
Note: “Engaged employees” are usually very positive and enthusiastic about their work and
actively and positively bring forward colleagues and the organization. The “actively disengaged”
are not only unproductive and unhappy but are also actively spreading their unhappiness to others.
They can have a very negative impact on their immediate surroundings, suppliers, and customers.
The “not engaged” are somewhere in between.
Source: Gallup Employee Engagement Index
have generally been unable to determine whether engagement at work leads to mental
wellness, or whether those with fewer mental health problems or more psychological
hardiness are likely to be more engaged at work, a phenomenon known as reverse
causation.16 According to famed psychologist Hagop S. Akiskal, some chronic depres-
sives do not withdraw from work, but rather put everything into their work.17
Gallup studies on the subject found that employees who reported that they felt
engaged at work were less likely to be diagnosed with anxiety and depression within
eight months.18 “Engaged people feel less stress and the stress they do feel is offset
by a lot more happiness and enjoyment and interest,” said a Gallup researcher.19
An Employee Engagement Index published in 2006 by the Gallup Management
Journal revealed that only 29% of respondents demonstrated active engagement
with their job and were described as “passionate” or as feeling a profound connec-
tion to the company. Conversely, the 54% of employees who were described as
“mentally checked-out” or as “sleepwalking through their workday and putting
time – but not passion – into their work” were classified as not engaged.20 Since
16
Fenna Leijten et al., “Associations of Work-Related Factors and Work Engagement with Mental
and Physical Health: A 1-Year Follow-up Study,” Springer, June 14, 2014, https://link.springer.
com/article/10.1007/s10926-014-9525-6, accessed March 2017.
17
Hagop S. Akiskal, “Overview of Chronic Depressions and Their Clinical Management,” in
Hagop Akiskal and Giovanni B. Casson, eds., Dysthymia and the Spectrum of Chronic Depression
(New York: Guilford Press, 1997), p. 24.
18
19
20
Dan Crim and Gerard Seijts, “What Engages Employees the Most or, the Ten C’s of Employee
Engagement,” Ivey Business Journal, March/April 2006, http://iveybusinessjournal.com/topics/
the-workplace/what-engages-employees-the-most-or-the-ten-cs-of-employee-engagement#.Uu_
EGRAzTAI, accessed January 2014.
An “Epidemic of Disengagement”: Sleepwalking through Life and Work 5
2011 things have improved somewhat, as shown in Table 1.1. While more people
are engaged with their work, those who remain unengaged are just as numerous.
Gallup studies on employee engagement show that 87% of workers worldwide
are not properly engaged and that one in five workers in North America and Europe
is “actively disengaged.”21 Another 2016 study showed that roughly 34% of all
American workers feel engaged at work,22 with fewer millennials (people born after
1980 and before 2000) – 29% – feeling engaged.23
One could take this positively too – that people are honest and better in tune with
what they need at work to be engaged, and that companies are asking about engage-
ment and acting on results. On average, actively disengaged workers are sick more
often, show up to work less often, and exhibit more presenteeism – the reduced
productivity and engagement of an employee resulting from mental illness.24 This
type of behavior is estimated to cost $550 billion annually in the USA.25
Beyond the mental health impacts, these low levels of employee engagement have
important economic implications; studies have shown that organizations with lower
employee engagement have lower profitability, productivity, and share price.26 There
are many possible paths – disengagement leads to stress and then to illness; illness
causes stress that expresses itself as disengagement; disengagement causes illness
leading to stress; and stress and unhappiness lead to disengagement and then illness.
Disengaged employees are twice as likely to look for other jobs, according to Gallup.
A major factor affecting job satisfaction is the content and caliber of the job
assignment itself; jobs that are complex, challenging, and interesting are correlated
with higher degrees of happiness at work.27 However, to provide happiness, jobs
should also be well-suited to the individual worker. Of course some responsibility lies
with the employee to recognize when he is ill-suited for his position, and when an
individual, or his manager, recognizes that he is unhappy in his job, the manager needs
to proactively work to either expand his employees’ role(s) or seek better-suited
opportunities. Finally, high levels of stress are inherent in sectors such as financial
services and startups (Appendices B and C provide more background on these).
21
22
“Gallup Daily: U.S. Employee Engagement,” Gallup, February 1, 2016, http://www.gallup.com/
poll/180404/gallup-daily-employee-engagement.aspx, accessed February 2016.
23
Brandon Rigoni and Bailey Nelson, “Few Millennials Are Engaged at Work,” Gallup, August 30,
2016, http://www.gallup.com/businessjournal/195209/few-millennials-engaged-work.aspx,
accessed February 2017.
24
25
26
Emma Seppala and Kim Cameron, “Proof That Positive Work Cultures Are More Productive,”
Harvard Business Review, December 1, 2015, https://hbr.org/2015/12/proof-that-positive-work-
cultures-are-more-productive, accessed February 2017.
27
Cynthia D. Fisher, “Happiness at Work,” Bond Business School Publications, December 1, 2010,
via International Journal of Management Reviews, 12 (4), p. 27, http://epublications.bond.edu.au/
business_pubs/304/, accessed January 2017.
reater Understanding of the Essential Elements

G
of Well-Being
Assuming that basic needs are met, work can affect all of the five Gallup-defined
essential elements of well-being – social, financial, physical, communal, as well as
career well-being (see Box 1.1) – and managers should keep these dimensions in
mind when they run their teams and design their organizations. The Well-Being 5
assessment, the result of a Gallup research project to find what helps people thrive
in life,28 takes 12–13 min and assigns people a well-being score across the five
areas.29
According to its creators, the Well-Being 5 can be used to “track and compare
well-being over time and across groups” and even assess the effectiveness of work-
place health interventions.30 High marks in all five areas (achieved by approximately
7% of the population) predict individual well-being.31 Questions range widely,
Box 1.1 The Five Essential Elements of Well-Being32
Career People tend to undervalue how much their career impacts their well-being
People who do well in career well-being have a belief in living
meaningfully and doing what they love
Well-being in other areas decreases if career well-being is low
Well-being can rebound faster after the death of a spouse than it can from
a period of unemployment
Social Amount of time spent on social interaction drastically impacts life quality
A few close, strong relationships help people become healthy and find
happiness
Financial Having money is not a guarantee of happiness, although there is a general
correlation between higher GDP and improved well-being
To improve well-being with money, spend on experiences rather than
material possessions
Physical Physical fitness, diet, and sleep are all important to overall well-being
Consistent exercise is far more important than strenuous or long-lasting
workouts (though they don’t hurt)
Community Safety and security are central to community well-being
Parks and scenic outdoor atmospheres improve overall well-being
Involvement in the community, through volunteer organizations or
otherwise, improves well-being
28
Tom Rath and Jim Harter, Well-being: The Five Essential Elements, (New York: Gallup Press,
2010).
29
2010).
30
2010).
31
2010).
32
2010).
Why Work Matters to Our (Mental) Health 7
including, for example, “How much alcohol did you consume in the last week?” and
“How hard is it to get out of bed in the morning?”
Why Work Matters to Our (Mental) Health
Most of us need to work to be happy, productive adults. Psychologists identify

major mental health benefits of working:
1. Being in a “social contract” “forces us” to interact with others on a regular basis.
2. Having a structure and a set schedule shapes the day and helps us organize the
rest of our daily tasks (vs. a retiree who takes the entire day to mail a letter).
3. Providing a sense of community and belonging, a reason for being beyond fam-
ily and friends, and the sentiment that we are part of a “collective effort.”
4. Having a “social identity,” as a contributing member of society and an answer to
the perennial question “What do you do?” – important for social placement, find-
ing mates, and a sense of self-worth.
Employed people spend a great deal of their time at work or thinking about work.
The average US worker spends 8.8 h working each day, and 34% do some work on
the weekends.33
Because we spend so much time at work, how we behave and what we experience
there greatly impact us (and those we touch). Since the 1920s or earlier, scholars have
been investigating the link between worker well-being and workplace conditions and
the ability to find meaning there. In the late 1920s and early 1930s, sociologist Elton
Mayo studied the impact of workplace interventions at Western Electric’s Hawthorne
Works factory outside Chicago, Illinois.34 Mayo and his team conducted experiments,
interviews, and long-term observations in the workplace as they made changes to fac-
tory lighting, break times, and workday length.35 In 21,000 free-ranging interviews
with factory workers,36 the team found that positive attitudes about work, strong
friendships with their coworkers, and good management motivated employees.37
33
Bureau of Labor Statistics, “Charts from the American Time Use Survey,” December 20, 2016,
https://www.bls.gov/tus/charts/#work, accessed February 2017.
34
“The Hawthorne Effect,” The Economist, November 3, 2008, http://www.economist.com/
node/12510632, accessed February 2017.
35
“The Hawthorne Effect,” The Economist, November 3, 2008, http://www.economist.com/
node/12510632, accessed February 2017.
36
“The Human Relations Movement: The Interview Process,” Harvard Business School Historical
Collections, https://www.library.hbs.edu/hc/hawthorne/07.html#seven, accessed February 2017.
37
“The Human Relations Movement: The Women in the Relay Assembly Test Room,” Harvard
Business School Historical Collections, https://www.library.hbs.edu/hc/hawthorne/06.html#fnl6,
accessed February 2017.
Mayo’s work suggested that “by including all of their personal concerns and
mental well-being, work might provide the laborer with their deepest source of
meaning, and offset the risk of industrial upheaval once and for all.”38 Though
Mayo’s original findings regarding productivity were challenged due to what is now
called the “Hawthorne effect” (the theory that empirical data can be compromised
if subjects know they are being observed),39 recent studies have found that happy
workers are more productive – on average 12% more productive than their peers,
according to one study.40 “It really boils down to this question: do we value produc-
tivity over people or people over productivity? Show me an organization that puts
people first and in most cases you will see an organization that is far more produc-
tive. It just does not always sit well in the strategic planning process,” Lipman CEO
Kent Shoemaker believed. People are one of his firm’s five strategic pillars.
The success of the Parnassus Endeavor Fund, a mutual fund which invests exclu-
sively in 30 major companies with supportive workplaces,41 suggests that promoting
a hospitable workplace brings real financial benefits. Between 2005 and 2015, the
fund achieved an 11.57% average annual return, four percentage points above the
Standard & Poor’s 500 Index.42 “Treating people well and authentically respecting
them does lead to far better business performance,” said Jerome Dodson, the fund’s
founder. “We proved it works.”43
Similarly, the stock of public companies included on the Best Companies to
Work for list compiled by Fortune and the Great Place to Work Institute has repeat-
edly achieved higher returns than the S&P 500 stock index.44
In 2016, the World Health Organization (WHO) reported “increasing evidence
that both the content and context of work can play a role in the development of
38
39
Hilda Bastian, “The Hawthorne Effect: An Old Scientists’ Tale Lingering ‘In The Gunsmoke Of
Academic Snipers’,” Scientific American, July 26, 2013, https://blogs.scientificamerican.com/
absolutely-maybe/the-hawthorne-effect-an-old-scientistse28099-tale-lingering-e2809cin-the-gun-
smoke-of-academic-sniperse2809d/, accessed February 2017.
40
Jonha Revesencio, “Why Happy Employees are 12% More Productive,” Fast Company, July 22,
2015, https://www.fastcompany.com/3048751/the-future-of-work/happy-employees-are-12-more-
productive-at-work, accessed February 2017.
41
Parnassus, “Parnassus Endeavor Fund,” https://www.parnassus.com/parnassus-mutual-funds/
endeavor/investor-shares/, accessed January 2017.
42
Paul Katzeff, “Do-Gooder Stocks Do Well for These Mutual Funds,” Investor’s Business Daily,
July 8, 2016, http://www.investors.com/etfs-and-funds/mutual-funds/parnassus-dodson-wins-
with-hot-tech-stocks-that-pass-esg-screens/, accessed February 2017.
43
Mark C. Crowley, “The Proof Is in the Profits: America’s Happiest Companies Make More
Money,” Fast Company, February 22, 2013, https://www.fastcompany.com/3006150/proof-prof-
its-americas-happiest-companies-also-fare-best-financially, accessed January 2017.
44
Andrew Chamberlain, “Beating the Market Again: Updated Stock Returns for Best Places to
Work Companies,” The Huffington Post, December 9, 2016, http://www.huffingtonpost.com/dr-
andrew-chamberlain/beating-the-market-again-_b_8755512.html, accessed February 2017.
Why Work Matters to Our (Mental) Health 9
mental health problems in the workplace.”45 Job stress can be defined as “the harm-
ful physical and emotional response that occurs when the requirements of the job do
not match the capabilities, resources or needs of the worker.”46
“Some of the effects of stress include numerous physical ailments as well as
mental health problems such as depression and increased risk of suicide.”47 The
management occupational group had the tenth highest rate of suicide, but accounted
for the second largest percentage of suicide deaths overall.48 An estimated 90% of
people who die by suicide had mental illness.49 In 2014, the US Centers for Disease
Control and Prevention (CDC) reported more deaths by suicide (42,733 deaths)
than by road accidents (35,398 deaths).50 It listed “self-harm” as growing public
health concern.51 Suicide was the 10th leading cause of death among US adults.52
Overall, “[e]vidence linking work organizations with depression and other men-
tal health problems, and with increased productivity losses, is beginning to accumu-
late. A number of studies of a diverse group of occupations have identified several
job stressors (e.g., high job demands, low job control, and lack of social support in
the workplace) that may be associated with depression.”53
A 2015 American Psychiatric Association survey found that 29% of working
Americans experienced chronic work stress, while only 37% reported that their
organizations provided sufficient support to manage stress.54 Occasional stress can
be productive, but sustained stress is corrosive, impacting health, mood, behavior,
45
World Health Organization, “Mental Health Policies and Programmes in the Workplace,” 2005,
p. 2, http://www.who.int/mental_health/policy/workplace_policy_programmes.pdf, accessed
January 2014.
46
The National Institute for Occupational Safety and Health, “STRESS…At Work,” https://www.
cdc.gov/niosh/docs/99-101/pdfs/99-101.pdf, accessed February 2017.
47
UK Trades Union Congress (TUC), Stressing the Law, 2000, ILO document.
48
Wendy LiKamWa McIntosh et al., “Suicide Rates by Occupational Group – 17 States, 2012,”
Centers for Disease Control and Prevention, July 1, 2016, https://www.cdc.gov/mmwr/volumes/65/
wr/mm6525a1.htm?s_cid=mm6525a1_w#T2_down, accessed February 2017.
49
“Mental Health Reporting,” Washington School of Social Work, http://depts.washington.edu/
mhreport/facts_suicide.php, accessed March 2017.
50
Centers for Disease Control and Prevention, National Vital Statistics Report, “Deaths: Final Data
for 2014,” Table 11, p. 49, https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf, accessed
January 2017.
51
Tony Dokoupil, “Why Suicide Has Become an Epidemic – and What We Can Do to Help,”
Newsweek, May 23, 2013, http://www.newsweek.com/2013/05/22/why-suicide-has-become-epi-
demic-and-what-we-can-do-help-237434.html, accessed August 2014.
52
Wendy LiKamWa McIntosh et al., “Suicide Rates by Occupational Group – 17 States, 2012,”
Centers for Disease Control and Prevention, July 1, 2016, https://www.cdc.gov/mmwr/volumes/65/
wr/mm6525a1.htm?s_cid=mm6525a1_w#T2_down, accessed February 2017.
53
Centers for Disease Control and Prevention, “Workplace Health Promotion,” March 1, 2016,
https://www.cdc.gov/workplacehealthpromotion/health-strategies/depression/index.html,
accessed January 2017.
54
American Psychological Association, “2015 Work and Well-Being Survey,” http://www.apaex-
cellence.org/assets/general/2015-work-and-well-being-survey-results.pdf, pp. 21, 24, accessed
January 2017.
and well-being, and those who experience chronic, unmanaged stress and anxiety
are at risk for developing depression and dementia.55,56
In 2015, Harvard Business School and Stanford University researchers conducted
a meta-analysis of 200 studies that sought to understand the effects of stress in the
workplace. “They found that worrying about losing your job makes you 50% more
likely to experience poor health and that having an overly demanding job makes you
35% more likely to have a physician-diagnosed illness.”57 Job insecurity and unat-
tainable expectations had health impacts similar to those of individuals exposed to
“significant amounts of second-hand smoke.”58 Being in a job in which one has “low-
job satisfaction on key job attributes has an even greater detrimental effect on reported
happiness with one’s life than being in unemployment,” according to a study.59
Work also matters for those who are not working. Unemployment reduces hap-
piness and life satisfaction, possibly due to low social capital, lack of job security,
stigma, psychological effects, lack of structure, and loss of utility.60 Those who lose
employment have “a much higher chance of increased depressive symptoms and a
diagnosis of clinical depression than those who remained unemployed.”61 Therefore,
it is in society’s best interest to keep people employed and rehabilitate those who
have left the workforce for mental health reasons. These individuals account for
nearly half of long-term absences.62
Research shows that returning to work, even when the individual does not feel
100% well, is often better than prolonging the absence. In most cases, the benefits
55
Daniel K. Hall-Flavin, “Can Chronic Stress Cause Depression?” MayoClinic.org, November 25,
2014, http://www.mayoclinic.org/healthy-lifestyle/stress-management/expert-answers/stress/faq-
20058233, accessed March 2017.
56
Sally Guyoncourt, “Chronic Stress Could Lead to Depression and Dementia, Scientists Warn,”
The Independent, January 25, 2016, http://www.independent.co.uk/life-style/health-and-families/
health-news/chronic-stress-could-lead-to-depression-and-dementia-scientists-warn-a6831786.
html, accessed March 2017.
57
For more, please see Travis Bradberry, “Four Signs Your Boss Is Worse Than Cigarettes,”
October 11, 2015, available via https://www.linkedin.com/pulse/your-boss-worse-than-cigarettes-
dr-travis-bradberry, accessed March 2017.
58
For more, please see Travis Bradberry, “Four Signs Your Boss Is Worse Than Cigarettes,”
October 11, 2015, available via https://www.linkedin.com/pulse/your-boss-worse-than-cigarettes-
dr-travis-bradberry, accessed March 2017.
59
Alfred Michael Dockery, “The Happiness of Young Australians: Empirical Evidence on the Role
of Labour Market Experience,” The Economic Record, December 2005, p. 331, onlinelibrary.
wiley.com.ezp-prod1.hul.harvard.edu/doi/10.1111/j1475-4932.2005.00272.x/epdf, accessed
January 2017.
60
Jianbo Luo, “Unemployment and Unhappiness: The Role of Pecuniary Factors,” Social Science
Research Network, June 11, 2016, https://doi.org/10.2139/ssrn.2813844, accessed January 2017.
61
Gaston Harnois and Phyllis Gabriel, “Mental Health and Work: Impact, Issues and Good
Practices,” World Health Organization and International Labour Organisation, 2002, http://www.
who.int/mental_health/media/en/712.pdf, p. 12, accessed February 2017.
62
United Kingdom National Health Service (NHS), “Returning to Work After Mental Health
Issues,” http://www.nhs.uk/Livewell/mentalhealth/Pages/returning-to-work-mental-health.aspx,
The Opportunity Cost of Unwellness in the Workplace and Beyond 11
of resuming work – e.g., a sense of purpose, positive social interactions, greater

financial security, a return to routine, and additional physical activity – outweigh
the risks.63
Yet most managers need to be aware that when an employee returns to work after
an absence, he or she often struggles with the transition. Such employees may fear
that they have not fully recovered, or that returning to the workplace will trigger a
resurgence of past symptoms. They may fear facing stigma or coping with col-
leagues who may be poorly informed regarding mental health conditions.64
For most employees, work is an economic requirement. For those who depend
on their jobs for healthcare benefits, work is also a health imperative. (In 2015, the
average annual premiums for employer-sponsored health insurance in the USA
were $6,251 and $17,545 for single coverage and family coverage, respectively.)65
As healthcare costs continue to rise, Americans may be more apt to remain in a
mentally unhealthy position because their physical health depends on it from a
financial perspective. However, by doing so they run the risk of exposure to stress-
ors, which, as we know, can then have negative consequences not only on one’s
mental well-being but on their physical health as well.
Due to dramatic inconsistencies in insurance premiums in the years following
the passage of the Affordable Care Act (ACA), many Americans have remarked on
the stressful nature of healthcare enrollment and the annual re-enrollment process
necessary to maintain the best coverage options.66 As countries struggle to pay for
increasing health expenses, healthcare provision remain in flux in many countries,
especially in the USA.
he Opportunity Cost of Unwellness in the Workplace

T
and Beyond
Mental unwellness has a cost to society, the organization, and the individual.
According to one estimate, mental health issues – depression, schizophrenia, bipo-
lar disorder, etc. – cost the US economy about a half-trillion dollars per year,67
63
United Kingdom National Health Service (NHS), “Returning to Work After Mental Health
Issues,” http://www.nhs.uk/Livewell/mentalhealth/Pages/returning-to-work-mental-health.aspx,
64
Clare Whitmell, “Returning to Work After Mental Health Issues: Tips for the Transition,” The
Guardian, January 27, 2014, https://www.theguardian.com/careers/careers-blog/returning-to-
work-after-mental-health-issues, accessed March 2017.
65
Kaiser Family Foundation,“2015 Employer Health Benefits Survey,” Sep 22, 2015, http://www.
kff.org/report-section/ehbs-2015-summary-of-findings/, accessed September 2017.
66
Abby Goodnough, “Shopping for Health Insurance Is New Seasonal Stress for Many,” The
New York Times, November 18, 2015, https://www.nytimes.com/2015/11/19/us/shopping-for-
health-insurance-is-new-seasonal-stress-for-many.html?_r=0, accessed April 2017.
67
Catherine Rampell, “The Half-Trillion-Dollar Depression,” The New York Times, July 2, 2013,
http://www.nytimes.com/2013/07/02/magazine/the-half-trillion-dollar-depression.html?mcubz=3,
accessed September 2017.
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on the mainland, near Littleton Island. The figures proved to be
Eskimos; and through the agency of Eskimo Joe, who was on board
the Tigress, it was soon ascertained that Captain Buddington had
deserted the Polaris on the day after her separation from the floe;
that he and his companions had erected a house on the mainland,
and wintered therein; had fitted it up with sleeping-berths for fourteen
men, the full number, and furnished it with stove, table, chairs, and
other articles removed from the abandoned ship; that during the
winter the party had built and equipped a couple of sailing-boats; and
that “about the time when the ducks begin to hatch” they had
departed for the south.
SAVED!
The Eskimo chief, or leader, added that Captain Buddington had
made him a present of the Polaris; but that the gift proved of no
effect, for in a violent gale she broke loose from the ice, drifted out
into the channel, and foundered.
Further search brought the crew of the Tigress to the winter-
camp of the Polaris crew. It was situated in lat. 78° 23’ N., and long.
73° 46’ W. Some manuscripts were found there, with the log-book,
the medical stores, and remains of instruments; and these, with
whatever else that seemed of intrinsic value, having been removed
on board the Tigress, the expedition bore away to the southward,
and on the 16th of October reached St. John’s, Newfoundland,
where they received the welcome intelligence of the rescue of the
Polaris party under the circumstances we shall now relate.
We return to the eventful night of the 15th of October 1872.
During the tremendous gale that then raged along the Arctic coast,
the bow-hawser of the Polaris snapped like a “pack-thread,” the
anchors slipped, and the ship drifted away into the darkness. The
wind forced her in a north-easterly direction; and next morning those
on board found her “a little north of Littleton Island, in Smith Sound,
having been exactly abreast of Sutherland Island during a portion of
the night.”
As she was leaking rapidly the pumps were set to work; and the
fires with much difficulty being lighted, the ship was got to obey her
helm. It was then found that the following officers and men remained
on board:—Captain Buddington; Mr. Chester, chief mate; William
Merton, second mate; Emil Schuman, chief engineer; Odell,
assistant-engineer; Campbell and Booth, firemen; Coffin, carpenter;
Sieman, Hobby, Hays, and Manch, seamen; Dr. Emil Bessel,
meteorologist; and Mr. Bryan, astronomer and chaplain.
A look-out was kept, it is said, for the nineteen who were missing,
but no signs of them being discovered, Captain Buddington came to
the comfortable conclusion that they had saved themselves in the
boats. Doubting the feasibility of carrying the Polaris to the
southward, he determined to abandon her, and winter on shore. With
this view she was run in as near land as possible, and finally
grounded in Kane’s Life-boat Cove, lat. 78° 23’ 30″ N., and long. 73°
21’ W. Here, on the 17th of October, Captain Buddington prepared to
establish a winter-camp; and the next few days were occupied in
removing from the stranded vessel all the food and fuel, and such
articles as could conduce to the comfort and sustenance of the party
through the ensuing winter.
With spars, bulk-heads, and canvas brought from the Polaris a
commodious house was erected, measuring twenty-two feet in
length, and fourteen feet in width. It was thoroughly water-tight;
warmed inside by a stove; and banked outside with masses of
compact snow. In the interior the sides were lined with fourteen
sleeping-berths. A table and chairs and lamps added to the general
comfort; so that our explorers were prepared to brave a Polar winter
under more favourable conditions than those experienced by most
Arctic navigators.
In the course of a few days a party of native Eskimos, with five
sledges, made their appearance, and their friendly labours were
found of no little value. They considered themselves amply repaid by
a few presents of knives, needles, and the like, and after a short stay
returned to their settlement at Etah. However, others soon took their
place; and eventually two or three families built their igloes in the
neighbourhood of the American camp. The Eskimo women made
themselves very useful by making and repairing clothing, and
rendering other feminine courtesies; while the men, when game
became plentiful, supplied the little settlement with a welcome
abundance of fresh meat. Nor was this the only advantage derived
from the presence of the Eskimos; on the contrary, it had an
excellent effect on the morale of the men, who did not feel that utter
isolation, that sense of being cut off from human companionship, and
separated from the rest of the world, which is one of the severest
trials of wintering in the Arctic regions. The heavy pressure of the
long, dark Polar night was wonderfully lightened by the kindly
attentions and mirthful society of the Eskimos.
It is probable that some of the Polaris crew never spent a happier
winter. There was no want of food, no suffering from cold; their
quarters were warm, cheerful, and well-lighted. Time did not hang
heavily on their hands; for when the house-work was done, when the
fires were replenished, the lamps trimmed, and the day’s provisions
cooked, they amused themselves with reading or writing, or played
at chess, draughts, and cards. It is true they had no communication
with the world without, and no intelligence could reach them from
friends or kinsmen; but, surgit amari aliquid—in the cup of human
happiness a bitter drop is always found!
When the worst of the winter was past, they began, under the
direction of the carpenter, to construct a couple of boats, with the
view of returning homeward as soon as the ice broke up. Each was
twenty-five feet long, square fore and aft, and five feet beam;
capable, that is, of carrying seven men, with provisions for about two
months, in which time they might reasonably calculate on reaching
the civilized settlements. It was the end of May before the condition
of the ice enabled them to set out. Then they broke up their camp,
rewarded their Eskimo friends, carried on board stores and
provisions; and, finally, early on the morning of the 1st of June they
bade farewell to their winter-home, and sailed out into the waters of
Smith Sound.
Their voyage was unmarked by any disastrous incident, and
presents a strange contrast to the dangerous experiences of Tyson
and his companions. Wherever they landed, they obtained an
abundant supply of aquatic birds, seal, and other game. They were
all in good health, well-fed, well-clothed. Their boats were sound and
strong. The winter had long passed away, and the glorious summer
sun poured its full radiance on the calm surface of the Arctic sea.
Sailing pleasantly along, they touched at Hakluyt Island, and
subsequently landed on the west shore of Northumberland Island.
The pack-ice detained them there until the 10th. They then entered a
water-way toward Cape Parry, but were subsequently forced back by
the ice to the place whence they had started. On the 12th the
channel was clearer. They set sail again; crossed the southern part
of Murchison Sound; doubled Cape Parry; and halted for rest and
refreshment on Blackwood Point, near Fitz Clarence Rock. Thence
they made, in due succession, for Wolstenholme Island, and Cape
York,—names which recall the adventures of the earlier explorers.
Their course now assumed a more difficult character, as they had
come face to face with the ice of Melville Bay,—that great expanse of
Arctic waters which is surrounded by glacier-loaded shores, and has
always been a favourite “whaling-ground.” Here they encountered
some difficulty with the “pack;” the “leads,” or water-ways, curiously
intersecting one another, and striking far into the ice, and so closing
up that it was often necessary to haul their boats across a kind of
promontory, or tongue, from one lead to another. Their troubles,
however, were of brief duration. On the twentieth day after leaving
Life-boat Cove, they sighted a steamer, beset in the ice, at a
distance of thirty or thirty-five miles from Cape York. She could not
come to them, it was true, but they could go to her; and this they
prepared to do. They had not traversed half the distance, however,
before they met a body of eighteen men from the ship; for they too
had been seen, and recognized as white men, and relief immediately
despatched. The friendly vessel proved to be the Ravenscraig of
Dundee, Captain Allen, lying in lat. 75° 38’ N., and long. 65° 35’ W.
It was now found, according to the narrative of the expedition,
that the relief did not come much too soon, for the boats had been
considerably injured by contact with the rough hummocky ice. And
the fatigue of hauling them over such a surface may be inferred from
the fact that it took the Polaris crew, with their eighteen relief-men
from the Ravenscraig, six hours to reach the latter vessel. The
difficulty was increased by a deep slushy snow, which lay thick upon
the ice, and which was not only heavy and disagreeable to the
wayfarer, but exceedingly dangerous, as more than one found by
sinking into the pitfalls it treacherously concealed.
But they reached the Ravenscraig at midnight, and received a
hearty welcome from Captain Allen, who was able also to
communicate the grateful intelligence that their comrades, the little
company sent adrift on the ice-raft, were all in safety.
It has been well said that the Polaris expedition proved curiously
prolific of startling and exciting incidents. From the time when
Captain Bartlett of the Tigress rescued the “exhausted waifs” of the
ice-floe, until the last scene in this romantic drama was enacted, the
public mind had been kept in a condition of continual expectancy by
the progress of events connected with the story of these Arctic
explorers. The lamentable death of Captain Hall,—the long voyage
on the ice-floe through the gloom of the Polar night,—the return of
the nineteen castaways after so many hairbreadth escapes and
wonderful adventures,—the departure of the Tigress,—the discovery
of Buddington’s winter-camp,—and now the rescue of him and his
crew by the Dundee whaler, formed a series of surprising and
exciting events, which, if not of epical interest, would certainly seem
to furnish matter for a poet’s song. Even the early annals of Arctic
exploration, with their narratives of the achievements and sufferings
of Hudson, Davis, Barentz, present no incidents of a more
remarkable character. As men dwelt upon them, they came to
acknowledge that the “age of romance” was not ended yet.
On the 18th of September 1873, the Arctic whaling-steamer
arrived at Dundee with eleven of the Polaris survivors, who had been
transferred to her from the Ravenscraig, as the latter was not
homeward bound. Three others reached America in the Intrepid; and
thus the expedition of the Polaris terminated without any loss of life,
if we except the unfortunate death of her enthusiastic commander,
Captain Hall.
It added nothing, it is true, to our geographical knowledge of the
Arctic World; and yet it was not without some useful results. The
Polaris, at all events, approached nearer to the North Pole than any
one of her predecessors; and men of science were thenceforth
justified in asserting that the hope of complete success was no
longer chimerical. The distance to the pole from the point reached by
the Polaris was comparatively so trivial, as to afford good reason for
believing that it would not long baffle human resolution and
enterprise. Then, again, it was established as a fact beyond doubt
that Europeans could securely winter in a latitude of 81° 38’; that a
ship well built and well equipped might push northward as far as 82°
16’; and that no insuperable obstacles to its further advance could
then be detected. It was also shown that the temperature, even in
lat. 82°, was not of a nature to overcome the energy and enthusiasm
of men accustomed to life and adventure in the Arctic World. These
data, so conclusively established by experience, constituted a
source of great encouragement to future navigators, and permit the
conclusion that the Polaris expedition, with all its disasters and
mismanagement, helped forward the great work of discovering the
North Pole.
“We now know,” says Mr. Markham, “that the American vessel
commanded by Captain Hall passed up the strait, in one working
season, for a direct distance of two hundred and fifty miles, without a
check of any kind, reaching lat. 82° 16’ N.; and that at her furthest
point the sea was still navigable, with a water-sky to the northward.”
The Polaris, however, was nothing better than a river-steamer of
small power, ill adapted for encountering the perils of Arctic
navigation,—with a crew, all told, of thirty men, women, and children,
including eight Eskimos. If she could accomplish such a voyage
without difficulty, and could attain so high a latitude, it was
reasonable to anticipate that a properly equipped English expedition,
under equally favourable circumstances, would do, not only as
much, but much more, and carry the British flag into the waters of
the circumpolar sea, if such existed. With this view, the Admiralty
fitted out the Alert and the Discovery, under Captains Nares and
Stephenson. Every precaution that science could suggest was
adopted to ensure the completeness of their equipment; and the two
ships, accompanied as far as Disco by H.M.S. Valorous as a tender,
left England on the 29th May 1875.
The British Expedition, consisting of the Alert and the Discovery,

did not succeed in all it was intended to accomplish; and yet it can
hardly be spoken of as a failure. It did not reach that conventional
point of geographers, the North Pole, but it penetrated within four
hundred miles of it; and it ascertained the exact nature of the
obstacles which render access impossible, except under conditions
not at present in existence. We agree with a thoughtful writer in the
Spectator that this was a most important service rendered both to
Science and the State. We now know that by the Smith Sound route
a ship may attain to within 450 miles of the Pole; and that,
afterwards, a journey about as long as from London to Edinburgh
must be undertaken, in a rigorous climate, with the thermometer 50°
below zero, over ice packed up into hillocks and hummocks which
render sledge-travelling almost impracticable, or practicable only by
hewing out a path with the pickaxe at the rate of a mile and a half a
day. And further: the work would have to be begun and completed in
four months, or, from lack of light and warmth, it could not be done at
all. These are serious difficulties, and whether it is worth while for
men to encounter them, where the gain would be problematical, we
need not here inquire. Before any attempt can be made, some
provision must be discovered for protecting those who make it
against the excessive cold, and for a surer and swifter mode of
conveyance than the sledge affords. The journalist to whom we have
referred speculates that science may furnish future expeditions with
undreamt-of resources,—with portable light and heat, for instance,
from the newly-discovered mines at Disco; preventives against
scurvy; electric lights; supplies of dynamite for blowing up the ice;
and a traction-engine to traverse the road thus constructed; but, in
the meantime, these appliances are not at our command. We must
be content with the measure of success achieved by Captain Nares
and his gallant followers.
And these well deserve the gratitude of all who think the fame
and honour of a nation are precious possessions. They have shown
clearly that the “race” has not degenerated; that Englishmen can do
and suffer now as they did and suffered in the old time. They
displayed a courage and a fortitude of truly heroic proportions. And
the experiences of Arctic voyaging are always of a nature to require
the highest courage and the sternest fortitude. The long Arctic night
is in itself as severe a test of true manhood as can well be devised.
The miner works under conditions for less laborious than those to
which the Arctic explorer submits, for he enjoys an alternation of light
and darkness; his underground toil lasts but for a few hours at a
time. Yet we know that it tries a man’s manly qualities sorely! What,
then, must it be to keep brave and cheerful and true throughout a
prolonged night of one hundred and forty-two days—that apparently
endless darkness, almost the darkness of a sunless world?
We know, too, that continuous work, without relaxation, for month
after month, will break down the nerves and shatter the intellect of
the strongest. Yet we read that the men of the Alert toiled like slaves,
on one occasion, for seventy-two days, in cold so extreme that the
reader can form no conception of its severity, and with the dread
constantly hanging over them of that terrible and most depressing
disease, scurvy. Owing to their inability to procure any fresh game,
as most former expeditions had done, each of the extended sledge-
parties, when at their farthest distance from any help, was attacked
by it. The return-journeys were, therefore, a prolonged homeward
struggle of men who grew weaker at every step, the available force
to draw the sledge continually decreasing, and the weight to be
dragged as steadily increasing, as, one after another, the men
stricken down had to be carried by their enfeebled comrades.
It has been well said that in such exploits as these there is a
sustained heroism which we cannot fully appreciate, because we
cannot fully realize the terrible character of the sacrifices involved.
But it is comparatively easy for us to understand, and therefore to
admire, the courage of Lieutenant Parr, when he started alone on a
journey of thirty-five miles, with no other guide for his adventurous
steps than the fresh track of a wandering wolf over the ice and snow,
in order to carry help and comfort to his failing comrades. It is easy
to understand, and therefore to admire, the devotion of Mr. Egerton
and Lieutenant Rawson, when, at the imminent risk of their own
lives, they nursed Petersen, the interpreter, while travelling from the
Alert to the Discovery, with the temperature 40° below zero.
Petersen, who had accompanied them with the dog-sledge, fell ill;
and with a noble unselfishness they succeeded in retaining heat in
the poor fellow’s body by alternately lying one at a time alongside of
him, while the other by exercise was recovering his own vital
warmth. We can also acknowledge and admire the constancy of
Captain Nares, who, in that horrible climate, lived thirty-six days in
the “crow’s-nest,” while his ship laboured among the grinding,
shivering, crushing ice, until exhaustion overcame him. And we can
acknowledge and admire the bravery and faithfulness of the men of
the sledge-parties who, for days and weeks, drew the sledges and
their comrades, with gloom above and around them, ice and snow
everywhere bounding the prospect, and in a temperature which
seemed to freeze the blood and benumb the heart.
What a tale, says a writer in the Times, what a tale of unrequited
suffering it is! Surely not “unrequited;” for those who suffered,
suffered at the call of duty, and have been rewarded by the approval
of their countrymen, and by the consciousness of having done
something great, of not having lived in vain. “How lightly do all talk of
glory; how little do they know what it means! The little army had to
cut its way through the ice-barriers, dragging heavily-laden sledges,
and going to and fro, the whole force being often required for each
sledge, content to make a mile and a quarter a day, in pursuit of an
object still four hundred miles off, through increasing difficulties, and
with barely five months, or one hundred and fifty days, wherein to go
and return. The labour is a dreadful reality; the scheme itself a
nightmare, the phantasy of a disordered brain. Even the smaller and
subsidiary expedition for planting a depôt last autumn cost three
amputations. The cold was beyond all former experience for intensity
and length, and the physical effect of a long winter spent in the ships
under such conditions is particularized as one reason why the men
were less able to endure cold, labour, and the want of proper food.
Every one of the expeditions, whatever the direction, came back in
the saddest plight,—some dragging the rest, and in one case only
reaching the ship through the heroism of an officer pushing on many
miles alone to announce his returning comrades, and to procure the
aid by which alone they were saved from destruction. These are
episodes, but they are the matter which redeems the story and
makes its truest value. They tell us what Englishmen will do on
occasions beyond our feeble home apprehensions, when once they
have accepted a call, and are in duty bound.”
At the time we write no elaborate record of the expedition has

been published, and the materials of the following sketch are
collected therefore from various narratives which have appeared in
the daily journals. We shall begin by endeavouring to place before
the reader, with the assistance of Mr. Clements R. Markham, a rapid
summary of what the expedition accomplished. And then we shall
describe its more interesting incidents.
The object of Captain Nares and his followers was to discover
and explore as considerable a portion of the unknown area in the
Polar Regions as was possible with reference to the means at their
disposal, and to the positions the vessels succeeded in reaching as
starting-points. The theories about open Polar basins and navigable
waters which once obtained have long been discarded by practical
Arctic geographers. A coast-line, however, is needful as a means of
progress to “the threshold of work;” and it is needful, too, in order to
secure the desired results of Arctic discovery in the various
departments of scientific inquiry.
The expedition, then, in the first place, had to force its way
through the ice-encumbered channel which connects Baffin Bay with
the Polar Ocean; a channel which successively bears the names of
Smith Sound, Kane Basin, Kennedy Channel, Hall Basin, and
Robeson Strait. Smith Sound opens out of Baffin Bay between
Capes Alexander and Isabella. The Alert and the Discovery passed
these famous headlands and entered the Sound on July 29, 1875;
and from that date until September 1, when the Alert crossed the
Threshold of the Unknown Region, they fought one continuous battle
with the ice. The Polaris, it is true, had made a rapid passage on the
occasion of its memorable voyage; but the circumstances were
exceptional. Generally the Sound is blocked up by heavy floes, with
winding waters caused by the action of wind and tide. With great
difficulty our two ships forced the barrier; but their success was due
in no small measure to the skill and vigilance of Captain Nares, who
allowed himself no rest until they were out of danger. At length, after
many hairbreadth escapes, and many laborious nights and days,
and much energy and devotion on the part of the officers, and equal
courage and industry on the part of the men, the expedition reached
the north shore of Lady Franklin Inlet, and found a safe, commodious
harbour in lat. 81° 44’ N. Here the Discovery took up her winter
quarters, as had previously been arranged; and the Alert, after a
brief interval of repose, continued her northward progress.
This she was enabled to do through the opportune opening up of
a water-lane between the shore and the ice. Bravely she dashed
ahead, rounded Cape Union, so named by the men of the Polaris
expedition, and entered the open Polar Ocean. Then, in lat. 82° 20’
N., the white ensign was hoisted on board a British man-of-war in a
latitude further north than the ship of any nation had reached before.
Soon afterwards the solid masses of the Polar pack-ice began to
close around the adventurous vessel; and on the 3rd of September
1875, the Alert was fast fixed in her winter quarters, on the ice-bound
shore of the inhospitable Polar Sea in lat. 82° 27’ N.
This, says Mr. Markham,[11] was the first grand success; and it
assured the eventual completion of the work. For, owing to the
admirable seamanship of Captain Nares, and to the zeal and
devotion of the officers and crew, the Alert had been carried across
the Threshold, and was within the Unknown Region. A point of
departure was thus obtained, which rendered certain the
achievement of complete success; inasmuch as in whatever
direction the sledge-parties travelled, valuable discoveries could not
fail to be the result.
The autumnal excursions, during which depôts of provisions were
established for use in the work of the coming spring, were not
performed without a very considerable amount of suffering.
Lieutenant May and two seamen were so severely frost-bitten, that,
to save their lives, amputation was found necessary.
As will be seen from the latitude given, the ships wintered further
north than any ships had ever previously wintered. The cold
exceeded anything previously registered, and darkness extended
over a dreary period. The winter, however, was not spent idly:
observatories were erected, and a mass of valuable scientific data
industriously accumulated.
“But the crowning glories of this ever-memorable campaign
were,” as Mr. Markham exclaims, “achieved during the spring.” Three
main sledge-expeditions were organized: one, under Commander
Markham and Lieutenant Parr, instructed to keep due north, as far as
possible, into the newly-discovered Polar Ocean; another, under
Lieutenant Aldrich, to explore the American coast, westward; and the
third, under Lieutenant Beaumont of the Discovery, to survey the
north coast of Greenland, facing eastward. Each party consisted of
two sledges; and the six, with their gallant crews, set out on the 3rd
of April 1876, determined to vindicate and maintain the reputation of
British seamen. They separated at Cape Joseph Henry; and before
they again met, this was what they achieved:—
Commander Markham and Lieutenant Parr pushed northward as
far as lat. 83° 20’ 26″ N.; being the most northerly point which any
explorers have attained. They may therefore be fairly and justly
regarded as “the Champions” of Arctic Discovery, until some
successors, more fortunate than they, shall surpass their glorious
feat.
Lieutenant Aldrich struck westward; rounded Cape Colombia in
lat. 83° 7’ N.; and explored 220 miles of the American coast-line,
previously not laid down on any map.
Lieutenant Beaumont crossed Robeson Strait, and surveyed the
northern coast of Greenland for about seventy miles.
“In order,” it is said, “that these three main parties might do their
work successfully, every soul in the two ships was actively
employed. The depôt and relieving parties did most arduous work,
and the officers vied with each other in promoting the objects of the
expedition, while the most perfect harmony and unanimity prevailed.
Captain Feilden and Mr. Hart were especially active in making
natural history collections; and Lieutenants Giffard, Archer, Rawson,
Egerton, and Conybeare did admirable work in exploring and
keeping open communications.” When the sledge-parties returned to
the ships, Captain Nares found that they had suffered terribly; but he
also found that their success had been complete. They had solved a
geographical problem; no open sea surrounded the Pole, as so
many sanguine spirits had anticipated. The way northward was over
a waste of ice—of ice broken up into hummocks and ponderous
masses. And with the appliances they possessed further progress
was impossible; the expedition had reached its ne plus ultra.
The work was done, and Captain Nares perceived that nothing
more could be gained, while valuable lives might be lost by
remaining longer in the Polar Ocean. He decided upon returning to
England, with the following rich results to show as the reward of an
heroic enterprise:—
First, the expedition had discovered a great Polar Ocean, a
knowledge of which cannot fail to prove of exceeding value to the
hydrographer. Next, the shores of this ocean had been explored
along fifty degrees of longitude, and important collections formed of
specimens of the Arctic fauna, flora, and geology. The channel
connecting the Polar Ocean with Smith Sound had also been
carefully surveyed, and an accurate delineation effected of either
shore. Geological discoveries of high value had also been made; as,
for example, that of the former existence of an evergreen forest in
lat. 82° 44’ N.,—a fact significant of vast climatic changes. And,
lastly, interesting observations in meteorology, magnetism, tidal and
electric phenomena, and spectrum analysis had been carefully
recorded. The expedition of 1875–76 must, therefore, in view of
these results, be classed among the most successful which ever
adventured into Arctic waters; though it failed, like its predecessors,
to gain the North Pole.
The Alert and the Discovery left the shores of England in May
1875. After a voyage of five weeks’ duration they arrived at Lievely,
the port of Disco Island, on the west coast of Greenland. This small
settlement numbers about ninety-six inhabitants, Danes and
Eskimos,—generally speaking, a mixed race. The Danish Inspector
of North Greenland resides here, and he received the expedition with
a salute from three brass cannon planted in front of his house. There
is a well-conducted school, attended by about sixteen children; and a
small church, where the schoolmaster reads the Lutheran service on
Sundays,—the priest coming over from Upernavik occasionally, to
perform marriages, christenings, and other religious services.
The Alert having taken on board thirty Eskimo dogs and a driver,
the expedition left Disco at one o’clock on July 16th, and next
morning reached Kiltenbunto, about thirty miles further north.
Kiltenbunto is a little island in the Strait of Weigattet, between
Disco and the mainland. Here the Discovery took on board thirty
dogs; and shooting-parties from both ships made a descent on a
“loomery,” or “bird-bazaar,” frequented by guillemots, kittiwakes, and
other ocean-birds. Two or three days later the expedition arrived at a
settlement named Proven, where it was joined by the Eskimo dog-
driver, Hans Christian, the attendant of Kane, Hayes, and Hall, in
their several expeditions. At Proven the adventurers received and
answered their last letters from “home.”
Striking northward through Baffin Bay, they reached Cape York
on the 25th of July, and met with a company of the misnamed Arctic
Highlanders, who traversed the ice-floes in their dog-sledges, and
soon fraternized with the seamen. A narwhal having been
harpooned, a quantity of the skin and blubber was given to these
Eskimos. Mr. Hodson, the chaplain of the Discovery, describes them
as exceedingly greedy and barbarous, eating whatever fell in their
way, but living chiefly upon seals. They were not so far advanced in
civilization as to be able to construct kayacks, and apparently they
had never before seen Europeans. They wore trousers of bear-skin,
and an upper garment of seal-skin.
Proceeding northward by Dr. Kane’s Crimson Cliffs, they soon
reached that brave explorer’s celebrated winter quarters, Port
Foulke, and took advantage of a day’s delay to visit the Brother John
Glacier. They found Dr. Kane’s journal, but no relics; shot a reindeer,
and a large number of birds.
Between Melville Bay and the entrance to Smith Sound no ice
was met with; but on the 30th of July the “pack” was sighted, off
Cape Sabine, in lat. 78° 41´ N. Here, at Port Payer, the ships were
fast held by the ice for several days. An attempt to proceed further
northward was made to the west of the islands in Hayes Sound; but
the water-way not leading in the right direction, the ships returned.
On the 6th of August they made a fresh start, and thenceforward
maintained an uninterrupted struggle with the ice. The Alert led the
way, with Captain Nares in her “crow’s-nest,” anxiously looking out
for practicable channels. At Cape Frazer the huge solid mass again
delayed them. Then they succeeded in crossing Kennedy Channel to
the east side, and taking shelter in Petermann Fiord—so named
after the great German geographer. After a few days they again
pushed northward; and on the 25th of August, after many narrow
escapes from being crushed in the ice, a well-sheltered harbour
received them, on the west side of Hall Basin, north of Lady Franklin
Sound, in lat. 81° 44´ N. This was at once selected as the winter
quarters of the Discovery. Her sister-ship, continuing her course,
rounded the north-east point of Grant Land; but instead of falling in
with a continuous coast-line, stretching one hundred miles further
towards the north, as all had anticipated, found herself on the border
of what was evidently a very extensive sea, with impenetrable ice on
every side. As no harbour could be found, the ship was secured as
far north as possible, inside a kind of embankment of grounded ice
close to the land. There she passed the winter; and during the
eleven months of her detention no navigable water-way, through
which she could move further to the north, presented itself.
Far from meeting with the “great Polar Sea” dreamed of by Kane
and Hayes, our adventurers discovered that the ice-barrier before
them was unusually thick and solid. It looked as if composed of
floating icebergs which had gradually been jammed and welded
together. Henceforth it will be known on our maps as the
Palæocrystic Sea, or Sea of Ancient Ice; and a stranded mass of ice
disrupted from an ice-floe is to be termed a floeberg.
Ordinary ice does not exceed ten feet in thickness; but in the
Polar Sea, generation after generation, layer has been
superimposed on layer, until the whole mass measures from eighty
feet to one hundred and twenty feet; it floats with its surface nowhere
less than fifteen feet above the water-line. It was this wonderful
thickness which prevented the Alert from driving ashore. Owing to its
great depth of flotation, sixty feet to one hundred feet, the mass
grounded on coming into shallow water, and formed a breakwater
within which the ship was comparatively secure. “When two pieces
of ordinary ice are driven one against the other, and the edges
broken up, the crushed pieces are raised by the pressure into a high,
long, wall-like hedge of ice. When two of the ancient floes of the
Polar Sea meet, the intermediate lighter broken-up ice which may
happen to be floating about between them alone suffers; it is
pressed up between the two closing masses to a great height,
producing a chaotic wilderness of angular blocks of all shapes and
sizes, varying in height up to fifty feet above water, and frequently
covering an area upwards of a mile in diameter.”
We must now return to the Discovery. As soon as she had taken

up her winter quarters, her crew began to unload her, landing the
boats, stores, and spare spars, and otherwise preparing for the
winter. The first day ashore they shot a herd of eleven musk-oxen. A
few days afterwards the sea was frozen all round the ship, so that
they could freely move to and fro about the ice. A week later they
saw a large number of musk-oxen, and shot about forty—thus laying
in a considerable supply of provisions.
Their winter port, which was surrounded by snow-clad hills, about
two thousand feet high, they christened Discovery Harbour.
As soon as the sea was completely frozen over, the sledging-
parties were organized and duly despatched; but as the autumn was
rapidly passing, very little could be done in this direction. The usual
preparations on the part of Arctic explorers were then made for
“hybernating.” Houses were built; also a magnetic observatory and a
theatre of ice—recalling the glittering edifice constructed by
Catherine II. of Russia on the Neva, and celebrated by Cowper in the
well-known lines,—
“No forest fell
When thou wouldst build, no quarry sent its stores
To enrich thy walls; but thou didst hew the floods,
And make thy marble of the glassy wave.”
A smithy was erected on the 11th of November, being the first the
Arctic ice had ever borne. Its roof was made of coal-bags, cemented
with ice. The ship’s stoker reigned supreme in it as blacksmith; and
when we consider the accessories,—the ice, the snow, the darkness,
—we must admit that his blazing forge must have made a curious
picture. The chaplain tells us, humorously, that the smith adorned the
interior wall with a good many holes, as each time that his iron
wanted cooling he simply thrust it into the ice!
As for the theatre, which, as we know, has always been a
favourite source of amusement with Arctic explorers when winter-
bound, it was sixty feet long and twenty-seven feet broad; and, in
honour of the Princess of Wales, was named “The Alexandra.” Her
birthday was selected as the day of opening—December 1st; and
the opening piece was a popular farce—“My Turn Next.” As sailors
are generally adepts at dramatic personations, we may conceive that
the piece “went well,” and that the different actors received the
applause they merited. It is recorded that foremost among them was
the engineer, Mr. Miller, who appears to have been, emphatically, the
Polar Star. Several of the men sung songs; and recitations, old and
new, were occasionally introduced; the result of the whole being to
divert the minds and keep up the spirits of the ship’s company during
the long, long Arctic night.
The Fifth of November and its time-honoured associations were
not forgotten. A huge bonfire blazed on the ice; a “Guy Fawkes” was
manufactured and dressed in the most approved fashion; and the
silence of the frozen solitudes was broken by the sounds of a grand
display of fireworks and the cheering of the spectators.
A fine level promenade had been constructed on the ice, about a
mile in length, by sweeping away the snow; and this served as a
daily exercise ground. A skating-rink was also constructed. A free
hole in the ice, for the sake of better ventilation, was carefully kept
up. Whenever it closed, through a process of gradual congelation,
the ice-saws were set in motion to open it up again, or it was blasted
with gunpowder. The dogs lived on the ice-floe all the winter. It must
not be thought that the cold was uniform day after day. Probably it is
not the low temperature so much as the variable temperature that
makes an Arctic winter so very trying to the European. In a few hours
the change would be no less than 60°. The cold reached its height—
or depth—in winter, when the thermometer marked 70½° below zero;
the greatest cold ever experienced by any Polar expedition. It is
difficult for the human frame to bear up against this excess of rigour,
even with the help of good fires, good food, and good clothing. Not
only the physical but the mental faculties are debilitated and
depressed.
Our ice-bound seamen, however, managed to keep Christmas
merrily. Early on the day so dear to Christian memories “the waits”
went their usual rounds,—a sergeant of marines, the chief
boatswain’s mates, and three other volunteers,—singing Christmas
carols, and making “a special stay outside the captain’s cabin.” In the
forenoon prayers were said on the lower deck; after which the
captain and officers visited the men’s mess, tasting the Christmas
pudding, and examining the tasteful decorations which had been
improvised. Then the gifts which, in anticipation of the day, had been
sent out by kindly English hearts, were distributed by the captain,—
to each gift the name of the recipient having been previously
attached. This was an affecting scene; and hearty, though not
without a touch of pathos in them, were the cheers given as the
distribution took place; a distribution recalling so many “old familiar
faces,” and all the sweet associations and gentle thoughts of home!
Cheers were also raised for the captain and men of the far-away
Alert. Next, a choir was formed, and echo resounded with the strains
of “O the Roast Beef of Old England!” of which, no doubt, many of
the singers entertained a very affectionate remembrance. The men
dined at twelve and the officers at five, and the day seems in every
respect to have been most successful as a festival.
A few particulars of the “situation” may here be given in the
chaplain’s own words:—“We had brought fish, beef, and mutton from
England,” he says, “all of which we hung up on one of the masts,
and it was soon as hard as a brick, and perfectly preserved. We had
also brought some sheep from England with us, and they were killed
from time to time. When we arrived in Discovery Bay, as we called it,
six of them were alive; but on being landed they were worried by the
dogs, and had to be slaughtered. During the winter the men had to
fetch ice from a berg about half a mile distant from the ship, in order
to melt it for fresh water.”

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Compassionate Management of Mental

Health in the Modern Workplace John

Consumers corporations and public health a case based

Mental Health in the Athlete Modern Perspectives and

Taking Ethics Seriously: Why Ethics Is an Essential

Structural Competency in Mental Health and Medicine A

The Biological Basis of Mental Health William T. Blows

The Design, Implementation, and Audit of Occupational

Perinatal Mental Health : a Sourcebook for Health

Handbook of evidence-based mental health practice with

ISBN 978-3-319-71540-7 ISBN 978-3-319-71541-4 (eBook)

Library of Congress Control Number: 2018954231

© Springer International Publishing AG, part of Springer Nature 2018

Printed on acid-free paper

“Mental health is an underappreciated, and oft-misunderstood challenge that is

South Miami, FL, USA John A. Quelch

Fig. 1 The ripples we

Chapter 1 provides a broad review of our current understanding of the connection

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8 Changing My Organization and Beyond: How Can I Have

John A. Quelch Since 2017, Professor John A. Quelch

Carin-Isabel Knoop Exposed as a child to the

© Springer International Publishing AG, part of Springer Nature 2018 1

ness of these treatments, rather than an overall increase in depressive symptoms.10

 n “Epidemic of Disengagement”: Sleepwalking through Life

Thomas Chamorro-Premuzic, Professor of Business Psychology at University College

Table 1.1 Gallup employee engagement index results, 2011–2017

 reater Understanding of the Essential Elements

Box 1.1 The Five Essential Elements of Well-Being32

Why Work Matters to Our (Mental) Health

Most of us need to work to be happy, productive adults. Psychologists identify

of resuming work – e.g., a sense of purpose, positive social interactions, greater

 he Opportunity Cost of Unwellness in the Workplace

The British Expedition, consisting of the Alert and the Discovery,

At the time we write no elaborate record of the expedition has

We must now return to the Discovery. As soon as she had taken

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