Eat and sleep well: A balanced and healthy diet is essential for physical and mental health and getting in the habit of eating well can dramatically impact one’s wellness. It’s imperative to remember that it takes time to turn a behavior into a habit, sometimes months. It is always a great time to begin eating well.
With all that’s going on in our country, in our economy, in the world, and on social media, it feels like so many of us are under a great deal of stress. We know that chronic stress can be as unhealthy as smoking a quarter of a pack a day. For many of us, our work, our livelihood, is a particular cause of stress. Of course, a bit of stress is just fine, but what are stress management strategies that leaders use to become “Stress-Proof” at work? What are some great tweaks, hacks, and tips that help to reduce or even eliminate stress from work? As a part of this series, I had the distinct pleasure of interviewing Dr. Steven Pratt.
Dr. Steven Pratt, a board-certified psychiatrist, serves as a senior medical director for Magellan Healthcare, Employer Division, where he provides clinical oversight of the behavioral and mental health services provided by the company’s network of more than 110,000 clinicians. Focused on delivering positive patient outcomes, furthering population health and lowering costs, Magellan provides targeted solutions that empower health plans, employers and individuals to successfully address common conditions including anxiety, depression and substance abuse. With extensive experience providing care to patients, overseeing the administration of health services, and supervising doctors and medical directors, Dr. Pratt is well known for creating a positive, inclusive, and engaged culture that empowers employees and creates cohesive, supportive teams.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to know how you got from “there to here.” Inspire us with your backstory!
My backstory, and more precisely what ultimately led me to my role as the senior medical director at Magellan Health — is one shaped in no small degree by a wonderful family and incredibly supportive colleagues and mentors. At Magellan Health, I provide clinical oversight for the behavioral health services we provide to many thousands of employers nationwide. This includes oversight of utilization management, case management and quality management in addition to leading many of the programs we offer to help employers and employees address substance use disorders.
Many different individuals throughout my academic and professional careers provided me with encouragement and counsel. This proved invaluable in my work to address such diverse disciplines within the larger study and practice of behavioral health. There are too many people who helped me along the way to name them all here, but I am grateful for the incredible impact they had on me both as a doctor and as an individual.
My parents also greatly impacted my decision to go to medical school. My father was a department head and interim dean at the College of Biological Sciences at the University of Minnesota and my mother was a librarian. Not surprisingly, the pursuit of academic studies was greatly encouraged in our home with my six siblings. I never doubted that I would earn an advanced degree. Nor should it come as a shock that I attended the University of Minnesota, a state I still happily call home. After earning my Bachelors of Science in Biology, I attended the University of Minnesota Medical School where I earned my Doctor of Medicine.
In the years since, my career presented me with great challenges and equally great opportunities. I have worked in independent practice, for payers and in government agencies. As the executive medical director for behavioral health at the Minnesota Department of Human Services, I provided clinical oversight of a statewide organization that included nine hospitals, nine residential treatment centers and 4,500 employees. I also provided oversight for many of the department’s programs and facilities, including the pre-admissions call center, five dental clinics, pharmacy services and the Forensic Psychiatry Fellowship Training program run by the department and University of Minnesota’s Department of Psychiatry.
Earlier in my career as an associate medical director of one of the world’s largest health insurance companies, I provided care management staff with clinical supervision to ensure not only that counselors offered the most effective guidance possible, but most importantly that individuals received the care and insights required for positive mental and behavioral health outcomes.
Looking back, that is the true gift of and most notable aspect of my back story. I have had the opportunity to influence, improve and create treatment protocols that help people live healthier and happier lives. Because of that, and for that, I am deeply grateful for the countless people who helped me along the way. I am very fortunate that the focus of my life’s work rests on something as fundamentally important and meaningful as mental and behavioral health. Being a psychiatrist is a gift.
What lessons would you share with yourself if you had the opportunity to meet your younger self?
All of us at some point reflect on our experiences and it can be very tempting to second guess decisions we made along the way or wonder what we would have done differently if we could somehow impart to our younger self what we know. Although hindsight is often 20/20, replaying what we could have done or should have done is only a valuable exercise if the lesson learned is equally applicable today. That is why I would counsel my younger self to enjoy the journey. It’s a timeless message that is just as applicable today as it will be tomorrow.
None of us are able to experience success without support along the way. Is there a particular person for whom you are grateful because of the support they gave you to grow you from “there to here?” Can you share that story and why you are grateful for them?
My decision to become a psychiatrist was inspired by Dr. Chris Sigurdson. Now retired after an inspiring career as a clinical psychiatrist, Dr. Sigurdson had a great impact on my decision to go to medical school. I met her while working in a genetics lab in college where she was a postdoctoral fellow, and had already decided to become a doctor. Her infectious positive attitude, and insistence on a career that would help others, convinced me to become a doctor as well. I still stay in touch and will be forever grateful for the guidance she provided.
Are you working on any exciting new projects now? How do you think it might help people?
I am very excited about a program we recently unveiled called Magellan eMbrace that reimagines a robust employee assistance program by combining its capabilities with a personalized approach that is made possible by our proprietary Gallup® Wellbeing Index™. The survey enables us to create a highly personalized wellbeing plan that directly addresses the issues and stressors employees encounter in their specific workplace while simultaneously impacting the larger elements of wellbeing: emotional, career, social, financial, physical and community.
In this way the program is not only more effective, but it’s also more applicable. For example, employees in a hospital setting may experience very different stressors and challenges than those in a manufacturing operation. Traditional employee assistance programs approach every employee in the same way regardless of where they work.
Magellan eMbrace instead takes a much more targeted approach. It also provides employees with a mix of services, from in-person and virtual counseling, to digital cognitive behavioral therapy programs, digital tools that help manage stress and improve sleep and moods, and an intuitive and highly dynamic website that guides them at every step of the journey. Just as importantly, it provides employers with the support and information they need to effectively institutionalize eMbrace and the focus on employee well-being it delivers.
I’m very excited about the program because I believe it will help people in two very important ways. First, it will provide employees with a strong and effective resource they can use to attain the mental and behavioral health services they need, when they need them. Secondly, it will demonstrate to employers how investing in employees’ well being ultimately results not only in happier employees, but also employees who are more effective. I believe those benefits will help many people.
Ok, thank you for sharing your inspired life. Let’s now talk about stress. How would you define stress?
Stress of course has many definitions. The clinical definition of the word stems originally from its use not in medicine, but in physics where it was synonymous with the force produced by strain. That is of course applicable to physical health and treatments that address it. For example, you might injure your back by lifting something too heavy or damage a knee while twisting to catch a ball in a team sport.
As it applies to the workplace, stress can of course manifest itself in the form of physical stress or mental stress. Physical stress, and the injuries that all too often result, remain a significant challenge in many industries. These environments are often marked by mental and emotional stressors as well. For example, the modern office environment, while on the surface is seemingly safe physically, is often rife with emotional and mental stressors.
Strain is the key differentiator. Stress is what we feel when we experience things that strain us. In manageable amounts, this strain can be helpful, but when unmanageable, it is damaging. This is true regardless of whether you are discussing physical or mental stress.
Athletic training for example is physical stress we subject ourselves to in a manageable framework. It makes us stronger. Likewise, mental stress when manageable can be motivational and inspire us to do our best work or to go above and beyond. The right amount of performance anxiety can help people perform better. It is when it is no longer manageable that stress causes harm.
So, if we are talking about stress in the workplace, I would define it like this: Workplace stress is a strain employees cannot manage on their own or that leads to mental health issues, lower workplace performance and unhappiness if not addressed.
In the Western world, humans typically have their shelter, food, and survival needs met. So what has led to this chronic stress? Why are so many of us always stressed out?
Unfortunately, I don’t agree that we can assume that Americans’ most basic shelter, food and survival needs are being met. On a single night in 2022, the U.S. Department of Housing and Urban Development estimated that 582,500 people were homeless and in 2021 the U.S. Department of Agriculture estimated that 10.2% of American households were food insecure.
Those findings reflect the fact that in many communities, survival needs are a chronic source of stress. They also can be exacerbated by, or contribute to, other environmental factors such as substance abuse and higher crime rates.
It is also worth noting that social determinants of health — poverty, lack of transportation, food insecurity, homelessness and other issues — are widely acknowledged to have a far greater impact on physical health than clinical care. Physical health of course impacts mental health and vice versa and employees are not immune to this reality or the stress that can result. Just because an individual is gainfully employed does not mean that they are not impacted by SDOH.
If we are talking about stress in its most generic form though, we live in a very fast-paced time. It can be very difficult to juggle all of the demands on our time from family, friends and of course work.
If, on the other hand, we are talking about work-created stressors, there are numerous reasons. Some include the demand for constant connectivity in today’s always-on corporate culture, long hours, mandatory overtime, tight deadlines, increasing demands, fear over being laid off and the feeling among many employees that they lack control over their work and how they do it.
What are some of the physical manifestations of being under a lot of stress? How does the human body react to stress?
Physical, mental and behavioral health are intertwined, with each influencing the other. Some of the physical manifestations of being under a lot of stress are behavioral like not exercising enough, not sleeping enough and not eating well. All of these can lead to or contribute to physical symptoms as well as feelings of irritability and anxiety. If left unaddressed they can bring about major depressive disorders which must be addressed.
Physical symptoms include aches and pains, obesity, hyper-tension and the many comorbidities associated with them. Also, while researchers are still deciphering how stress impacts diseases such as cancer, we do know it impacts the growth of some tumors. The important thing to remember is that stress if not addressed or dealt with effectively, it absolutely impacts the human body and the human mind.
Is stress necessarily a bad thing? Can stress ever be good for us?
As I noted above, there are absolutely times when stress can be a good thing. An element of performance anxiety helps us perform at a higher level and, on the most basic level, stress can be the motivator for us to do our best work. Left unchecked though, it can have the opposite effect. Long-term, sustained stress hinders performance.
Is there a difference between being in a short term stressful situation versus an ongoing stress? Are there long-term ramifications to living in a constant state of stress?
The duration of stress is absolutely an important factor. Experiencing a high-stress situation, like delivering an important presentation at work, does not impact your health in the same way that long-term, ongoing stress does. Stress is particularly harmful when it is ongoing and unrelenting.
Is it even possible to eliminate stress?
There will always be some level of stress to contend with in our personal and professional lives. The goal should never be to eliminate all forms of stress, it is simply not possible. Instead, try to embrace tools and techniques that enable us to address it effectively and to maintain our physical, mental and behavioral health.
In your opinion, is this something that we should be raising more awareness about, or is it a relatively small issue? Please explain what you mean.
I think there is a lot of awareness about stress, but awareness alone is not sufficient to ensure physical, mental and behavioral health. As with any challenge, just knowing a problem exists is not a solution. What is more important is that as a society we value and impart the tools and techniques we have at our disposal to effectively address it. That means knowing not only to effectively manage it, but also when assistance is needed. And of course, we must address the bigger issues such as poverty that cause and exacerbate stress.
Let’s talk about stress at work. Numerous studies show that job stress is the major source of stress for American adults and that it has escalated progressively over the past few decades. For you personally, if you are feeling that overall, work is going well, do you feel calm and peaceful, or is there always an underlying feeling of stress? Can you explain what you mean?
It is absolutely true that workplace stress is a key source of stress for adults in America and has gotten worse over the past few decades. And the problem isn’t confined to the United States. Gallup’s State of the Global Workplace 2022 Report found that employees were more stressed than ever in 2021, that 60% of people are emotionally drained at work and that 19% are miserable. Clearly, all is not well in the workplace globally!
While the United States and Canada were found to have the highest number of engaged employees, and the second highest percentage of employees that are thriving, we also saw what came to be known as the Great Resignation, with 47.8 million Americans quitting their jobs in 2021. All of this is to say that workplace stress is a very real and serious issue.
For me personally, when work is going well, I feel calm and peaceful, I also accept that there will always be an element of stress that helps me perform well, but I am also quick to act when I see my stress level increasing to a level that is either problematic or unhealthy. In my own life, and in the lives of others, I believe it is important to effectively manage it and prevent it from becoming something that impacts overall health and wellbeing.
Okay, fantastic. Here is the main question of our interview: Can you share with our readers your “5 stress management strategies that busy leaders can use to become “Stress-Proof” at Work?” Please share a story or example for each.
First, I think it’s important to highlight that no one can become “stress-proof. As human beings we will never be immune from the negative impacts of stress. While some individuals manage their stress and mental health more effectively than others, no one is immune from the physical ramifications of stress or the anxiety and depressive disorders that can result if long-term, overt stress is not addressed.
That is why it is imperative not only to practice stress management strategies, but to know when you need help, which ties into my first recommendation busy leaders can use to reduce stress in the workplace. I would also add that because we are talking about leaders, these strategies should be shared with employees and institutionalized whenever possible to help reduce stress for the organization as a whole:
- Be mindful of your mental health: Although significant gains are being made, such as the introduction of the 988 Suicide and Crisis Lifeline that provides callers with help 24/7/365, there remains a stigma around mental health. This is particularly true in the workplace, where many feel pressure to simply “soldier on.” Long-term, soldiering on rarely benefits anyone and when left unaddressed, severe workplace stress can manifest itself in numerous ways. This includes feeling like you are on an emotional rollercoaster at work, feeling panic about deadlines, loss of interest in work, trouble concentrating, social withdrawal and feeling depressed or apathetic.
As I’ve alluded to, stress can also contribute to the genesis of numerous mental health conditions. This includes a variety of depressive disorders that demand immediate attention. Do not delay getting treatment if you suspect that you need help. The same proactive approach should be taken on behalf of those you work with. If you suspect that a colleague is having difficulty with workplace stress, do not delay. Ask them how they are doing and take action to connect them with professionals who can help when needed. - Identify the sources of your workplace stress and take steps to reduce it: There are likely things in your workplace that cause stress that you cannot control such as tight deadlines. But there are steps you can take to mitigate them. For example, for tight deadlines, being organized and taking steps to avoid procrastination may offer relief.
One such example I personally experienced was in a position that involved a troublesome commute. I was often delayed by traffic, and by the time I arrived at the office I was often either irritated or at times late — either of which was a horrible way to start the workday. To reduce this stress I decided to arrive at the office at 7 a.m., a full hour before many of my coworkers. Not only did I enjoy an hour of uninterrupted work, but I was in a great mood when my colleagues arrived. Ultimately, I was more productive and was able to leave earlier to get a jump on the evening commute as well. - Proactively discuss workplace stress with your supervisor and colleagues: If you are feeling workplace stress, the time to discuss it with your supervisor is before it impacts your job performance, not after. This isn’t always easy, and some supervisors are not as open to taking steps to address workplace stress. If in doubt, ask a colleague how they think the supervisor in question will react.It is also important to come to the conversation with solutions. For example, if mandatory overtime is causing stress because you are not given enough time to plan for childcare, one approach might be to work with your supervisor to determine which days you can secure childcare, and prioritize your help on those days.
- Make time to exercise during the workday: Exercise helps reduce stress and short exercise breaks or a walk during your lunch break is a great way to blow off steam, lighten your mood and improve your overall conditioning. I have seen the impact of this in my own career and find that my focus improves after a short exercise break.
Each day I plan to walk for a half hour or 45 minutes and put a placeholder on my calendar that is color coded in purple. I might have to move it, but I never delete it. This is my “me time” during the workday and I have found that it greatly increases my overall productivity. I always return to the office with more energy and often with new insights. - Eat and sleep well: A balanced and healthy diet is essential for physical and mental health and getting in the habit of eating well can dramatically impact one’s wellness. It’s imperative to remember that it takes time to turn a behavior into a habit, sometimes months. It is always a great time to begin eating well.
Not getting enough sleep can also dramatically impact one’s physical and mental health, as well as our ability to effectively manage and deal with stress. It’s worth exploring whether you are getting enough sleep. When fitness trackers first came out, I bought one and was surprised to find that I averaged less than six and a half hours of sleep. I adjusted my schedule to get seven and a half hours of sleep. As a result, I feel better and have more energy.
Notably, all of these strategies will help improve your experience at work and at home. This is particularly true today, when the lines between work and home are increasingly blurry for many. This point itself is worthy of reflection: If you work from home, be sure to create a boundary between your personal time and work by setting specific hours for your personal life and your professional life.
Do you have any favorite books, podcasts, or resources that have inspired you to live with more joy in life?
I first encountered Thich Nhat Hanh’s book “The Miracle of Mindfulness” in 1992. I always have a copy at my work desk as well as several other copies spread around my home. It is a wonderful and very accessible introduction to mindfulness meditation. I also regularly listen to the podcast “Hidden Brain.” A lot of the information about stress management techniques above has come from episodes of that podcast.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
I would make the business case for increased investment in social services. Earlier in this interview I mentioned the social determinants of health that dramatically impact physical, mental and behavioral health. Unfortunately, so many of the very programs that address those determinants — poverty, lack of transportation, food insecurity and other issues — are viewed not for their impact, but for their cost.
The problem with this view is that it takes time for programs that address big issues and big challenges to deliver their return on investment. For that reason, they are often the first to be cut when budgets are tight. For example, many programs that are designed to address poverty, such as education and job training programs, are viewed as luxuries even though these same programs help to reduce crime and spending on everything from incarceration to welfare programs. When it comes to health and society, we absolutely must take a long-term view.
What is the best way for our readers to continue to follow your work online?
The best way to follow my work online is to visit https://www.magellanhealthinsights.com/
This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.