What Managers Need Now: 3 Overlooked Ideas Inspired By The Kaiser Permanente Strike

Today marks six weeks since Kaiser Permanente employees began striking for what may be the most prescient of reasons. The company is putting undue burdens on therapists who work for them and managing patient crises and care, has become untenable, according to a press release put out by the The National Union of Healthcare Workers. Their message, on signs and picks lines, is that Kaiser is putting corporate wealth ahead of patient health. Research backs them up, showing 50% of behavioral health workers are burning out.

The Kaiser nurses strike—and the company’s response— deserves national attention from business leaders. This is an opportunity for businesses to assess how their own stewards of mental and physical health—millions of managers—are coping. They are responsible for insuring the psychological and physical safety of employees. Their lives depend on managerial decisions.

To be clear, managers are not mental health workers nor should they be called upon to do the work of highly trained professionals. But it feels like a parallel universe to me. Managers are juggling mental health-related concerns daily. These include burnout, quiet-quitting, anxiety and concern about pandemic safety measures for people with disabilities.

There are two levels of problems going on. One is the garden-variety, I want to be seen and heard and feel like my job has purpose. This is what managers have done throughout history. A deeper issue is one that’s gained attention thanks to the pandemic. This is the issue of managers limited understanding of two key words: disability and accommodations. It helps to know that 80% of disabled people have non-apparent disabilities. People who can ask for accommodations (not special treatment, simply changes to a work environment or schedule) include everyone from workers who are autistic or ADHD to workers diagnosed with cancer or long Covid. There are 1.4 billion disabled people globally. There is also a huge shortage of professional help available, as the Kaiser Permanente strike spotlights.


“You can’t un-hear a request for accommodations. The pandemic has changed everything about the workplace,” says Yvonne Cowser Yancy, chief administrative officer and head of workplace at Understood.org.


· Unmanageable stress in the workplace leads to 120,000 deaths annually. The health care cost stress is estimated to be the U.S. $190 billion.

· One survey showed that the most effective help employees got was not from managers trained in mental health at work but from their peers.

· Although public awareness of mental health issues has grown, at work only 1 in 4 would speak about mental health personally, according to one study.

· Organizational leaders who act with humility themselves help set a positive tone, creating a work environment where coworkers feel empowered, engaged, and satisfied with their jobs.

Here is a look at solutions that should be more widely recognized.

Empower Managers With Actionable Advice

The most basic conversations can get heated fast. What’s a manager to do? Ground the issue in facts to provide everyone with a safe, neutral place to start a discussion. Depression, anxiety, PTSD, a learning disability, ADHD/ADD, and other serious mental illness (SMI) are protected disabilities. An invisible disability or illness is a chronic condition with debilitating pain and symptoms that cannot be recognized just by looking at a colleague, according to the Invisible Disabilities Association.

Best practices include checking in daily on how people are feeling, asking how you can help without judgement, being flexible on hours, especially around health care appointments and caregiving duties, and knowing your own biases and trying to keep an open mind. That’s a lot to ask—and as I recently reported, the implicit bias issue in particular can take years to uncover and eradicate.

Being a self-aware manager who has had some mental health training does not impart immunity. Many are likely to experience burnout if they aren’t well trained and supported. Mental health has become a catchall phrase, as others have recently begun to point out, and it does the whole issue of treating serious mental illness and disability a disservice. You can find links to learning resources with details and evidence-backed medical advice in a list at the end of this article.

Pay For Employee Resource Group (ERG) Leaders

Second, what managers need, in my opinion, is an army of truth-tellers and people with lived experience. Research shows people who have experienced disability work very effectively in partnership with professionals and patients to help navigate complex health and disability issues. But this can’t just be a passion project. That’s where leaders miss the mark. This is paid work.

One survey by The Rise Company shows paying ERG or affinity group coordinators and leaders is on its way to becoming a best practice and that the number of paid positions is increasing. Still, there’s a debate over how much to offer and what kind of compensation is best. LinkedIn paid their 20 ERG co-chairs $10,000 for each year of service, according to the blog Culture Amp publishes, which reported that they pay ERG Chairs $6,000 and compensate four leads as well. 1

Designing, leading, and creating the space for groups to gather to talk about disability, caregiving, mental health, and other personal issues takes a lot of work. Traditionally it was volunteer work. An employee passionate about supporting an issue, for example, parents of children who are autistic, diversity and equity for Black, Indigenous, and People of Color (BIPOC), or elderly caregiver support, spent time managing these networks.

For an alternative take on why ERG leaders are compensated, read the JustWorks blog.2 The ERG Leadership Alliance holds conferences and offers resources to help put transformative policies in place.

ERG leaders and managers should ground the issue in facts to provide everyone with a safe, neutral place to start a discussion. Depression, anxiety, PTSD, a learning disability, ADHD/ADD, and other serious mental illness (SMI) are protected disabilities. An invisible disability or illness is a chronic condition with debilitating pain and symptoms that cannot be recognized just by looking at someone, according to the Invisible Disabilities Association.

In companies big and small, managers are being asked to check in more often, open mental health conversations, remain flexible, and be approachable. Even the most self-aware managers are likely to experience burnout if they aren’t well trained and supported. Americans are exceedingly aware of the idea of mental health, but as many others have pointed out, the words have become almost euphemistic and are beginning to lose their meaning. What exactly are managers managing when they manage mental health? What managers need is…clarity. Stress can put you in a lot of situations you never dreamed you’d be in. Spilling your heart out to your manager isn’t one of them. In a Workplace Initiative study, 64% of participants said when it comes to stress and anxiety, they’d choose a robot to talk to over their manager. The survey of 12,000 employees at all levels across 11 countries indicates the limited role employees give bosses when it comes to discussing personal mental health. For more information and an upcoming conference on the topic, check out The ERG Leadership Allliance;

Ask Leaders To Be More Open About Invisible Disabilities

Today, disability advocates are talking about their experiences and their talents, and their challenges as neurodivergent job seekers, gig workers, and employees. But there’s one glaring gap: People in leadership positions rarely come out and talk about their disability. It’s the elephant in the office. Without these role models, many coming up the ranks will not see people like themselves and imagine a future in which they don’t have to mask certain traits, such as sensitivity to noise, inability to focus or difficulty with working memory issues that assistive technology could alleviate.

I am not suggesting that every leader post a video about their latest therapy session or their struggle with a learning disability or ADHD. In that regard, leadership has already failed us. Too few leaders at the top of their game are willing to raise their hand to say they were recently diagnosed with ADD or dyslexia or that they are autistic.

Happily, younger generations are much more comfortable talking about their disability. The day will come where it is not uncommon to be ‘out’ about being neurodivergent, but Americans are not there yet.

What would help is if leaders who are open about mistakes can create a feeling of psychological safety for employees—meaning, allowing people to show up as they are and to admit to mistakes without fear of punishment. Workplaces that encourage mistake-sharing are more innovative, and productive than those that don’t.

For some, this may seem counterintuitive. Won’t admitting to mistakes just make people lose confidence in leaders? No. Overestimating how much you are trusted is one of the biggest mistakes.

The bottom line: Being obsessed with a perfection is a sign of insecurity, say therapists. Know thyself, know your resources and admit that you are human.


  • For a list of mental health disabilities, visit The Recovery Village or learn about the Americans with Disabilities Act and its amendments. For resources, including finding a mental health facility near you or details on calling or texting The National Helpline 988, visit SAMSHA.gov.
  • Use these occupational health standards for safety that protect workers are available
  • Behavior health guidelines for workers in crisis due to substance use and mental illness
  • Disabilities including invisible ones such as serious mental illness and learning disabilities are protected under the Americans with Disabilities Act and its amendments.
  • Guidelines for healthy minds at work from Canada offer concrete advice that can help American companies.

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What Managers Need Now: 3 Overlooked Ideas Inspired By The Kaiser Permanente Strike

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