Mental health is the ultimate “open secret” in the office. We all have it, but few of us talk about it. Karishma Patel Buford, Chief People Officer at Spring Health, is on a mission to change that. She believes that when leadership gets real about their own struggles, it doesn’t just make the workplace kinder—it makes it more productive.
In this week’s HR Query, Patel discusses the “taboo” of therapy, the gap between “acceptance” and “comfort,” and why psychological safety is actually a business superpower.
Here’s what she had to say.
We hear a lot about wellness these days, but actually admitting you go to therapy still feels like a brave act in most offices. Do you think the “taboo” is finally fading, or are we just getting better at pretending it is?
KPB: Unfortunately, going to therapy is still a bit of a taboo subject in many circles, but the positive side is, we are making progress. We’re just not there yet. Studies from 2024 have shown that people are discussing mental health at work in general, but there’s an important caveat. About ¾ of employees think talking about mental health at work is “acceptable” yet only 58% said they would feel comfortable talking about their own mental health with coworkers. This signifies that there’s work to be done.
If the data shows people are still hesitant, where does the responsibility fall? Is this an employee-led shift, or does it have to come from the top?
KPB: That’s where HR comes in. It’s the role of HR and leadership to steer the ship and make sure that openness, transparency, and acceptance are part of the company’s brand DNA. And as part of this, the prioritization of mental health is key. Psychological safety is not only important for making sure a workplace feels comfortable and inviting for employees, but it’s also a factor in employees’ overall wellbeing and–ultimately–workplace performance.
Do you think that mental healthcare is an important part of an employee benefit package? How can HR teams prove that ROI to their CFO and C-Suite?
KPB: Mental healthcare is a critical component of every company’s benefits offerings, and this is true regardless of a company’s headcount. Looking at this through a purely business lens, companies need their employees to be mentally healthy to operate at peak performance. The WHO found that “globally, an estimated 12 billion working days are lost every year to depression and anxiety at a cost of US$ 1 trillion per year in lost productivity.
But beyond that, with the right mental health partner, companies can save money and achieve measurable ROI. In fact, ROI can be calculated through a few steps:
- Hard Cost Savings: For example, HR teams can compare health plan claims for employees with a diagnosed mental health condition who have care with those who do not.
- Soft Cost Savings: Tracking absenteeism and turnover with employees engaging in mental health care can demonstrate its effectiveness.
- Calculate the Actual Costs: With the right tracking, you can look at the savings by comparing the program cost to your health plan savings and productivity gains to show the Net ROI.
To choose the right mental health plan, HR leaders should look for a partner that has (1) a diverse high high-quality provider network and fast access to care, (2) precision matching between patient and provider for faster outcomes, and (3) transparent, third-party validated guarantees of net ROI. Every employee is different, so having a program that can fit diverse needs of a broad team is critical for success.
Can you provide guidance for HR leaders and executives who are trying to make mental health conversations more open? Is there anything you’ve done over the course of your career that’s worked? Has anything you’ve tried failed or backfired?
KPB: Transparency should be practiced across the entire executive leadership team, not just from HR. If you have C-suite leaders who are comfortable speaking about their own mental health journeys and what they have personally done to take care of themselves, encourage it. It’s so important for employees to see that their senior leaders are facing similar situations and that they are not alone.
Some other actionable ways to make conversations about mental health more open across the company are by encouraging time during the day for breaks for therapy and/or mindfulness. A slack status of “Therapy” can be created, and people can use that when they are taking this designated time. If that status is on, I recommend managers and other employees to not ping those who are stepping away.
How can HR leaders spot signs of burnout across teams? What are the best first steps they should take to solve that?
KPB: Employee burnout has become an ongoing crisis in workplaces, globally. In fact, 65% of employees are as stressed or more stressed as they were five years ago and 52% said they felt burned out in the past year due to their job. Some distinctive signs of burnout include employees calling out sick, dips in productivity, a change in attitude towards tasks or going into the office, and withdrawal from social workplace activities like happy hours, holiday events, etc.
Recent research has linked workplace stress to up to $190 billion in healthcare costs each year. As burnout continues to impact every corner of the workplace–from HR teams to managers to mid-level employees and beyond–investing in prevention and early intervention will get companies back on track. When evaluating mental health solutions, organizations should look to see that they will be provided:
- Clinically validated assessments to identify burnout risk early
- Personalized care plans that meet each employee where they are–whether they need mindfulness tools, coaching, therapy, or high-acuity care
- Manager support and training to equip leaders with the tools to recognize and respond to burnout within their teams
- Care navigation for seamless, human-guided access to the right care
- Ongoing support through life’s biggest challenges, not just one-time responses
What do you think is the biggest threat to employee wellbeing in 2026?
KPB: One of the biggest threats to employee wellbeing is not engaging in proactive care as it relates to burnout. This is especially critical for highly engaged employees who can be both engaged and burned out at the same time. Being proactive allows people to participate in actions (e.g. setting boundaries, seeking feedback and asking supervisors for support, engaging in tasks that interest them versus drain, etc.) that prevent burnout before it occurs, rather than reactive self-care we have seen the US workforce fallen into after the stress has already impacted them.