APA on health insurance and Mental Health Parity Law

The American Psychological Association has put together a brief video (click above) and resource page about the Mental Health Parity Law, which requires coverage for mental health treatment to be at least as comprehensive as treatment for physical conditions. From the APA’s resource page:

Mental health disorders are the leading cause of disability in the United States. . . . Yet, an overwhelming majority of Americans remain unaware that health insurers are required to provide coverage for mental health, behavioral health and substance-use disorders that is comparable to coverage for physical health.

. . . (O)nly four percent of Americans say they are aware of the Mental Health Parity and Addiction Equity Act of 2008, which requires mental and behavioral health coverage to be equal to or better than coverage for physical health, with no annual limits or higher co-pays or deductibles for treatment of mental health disorders or substance-use. The law applies to most employer-provided health plans and to individual plans purchased through the new state and federal health insurance exchanges.

Especially for readers of this blog who are experiencing negative mental health consequences due to their work environments, this information may be helpful.

Study: Nursing school professors face workplace bullying

We know that workplace bullying occurs frequently in health care and in academia. Now, a study published in a recent issue of Nurse Educator brings these two settings together, detailing how faculty at nursing schools are bullied by superiors and peers.

In “Social Bullying in Nursing Academia” (abstract here), nursing school professors Janice Beitz (Rutgers-Camden), Earl Goldberg, Ciara Levine, and Diane Wieland (the latter three from LaSalle University) interviewed 16 mostly non-tenured nursing school professors from around the country who had been targets of workplace bullying. Among the most frequent reported behaviors were defamation, ostracism, threats to physical safety, lying, and unreasonably heavy work demands.

Most commonly, academic administrators bullied junior faculty members, but other instances included peer-to-peer bullying and upward bullying from faculty member to superior administrator.

ScienceDaily carried the Dec. 19 Rutgers news release that provides more details about the study.

You’ll find a lot of related articles on this blog. Here’s a sampler:

UMass Amherst launches campus-wide workplace anti-bullying initiative (2013)

Nurses and workplace bullying (2013)

Keashly and Neuman on workplace bullying in academe (2011)

Workplace bullying in healthcare (2009) (series of 4 articles)

Workplace bullying and mobbing in academe: The hell of heaven? (2009)


Hat tip: David Wexler

Workplace bullying 101 for mental health practitioners: WBI’s invaluable educational DVD


A major challenge faced by many workplace bullying targets is finding a therapist or counselor who can help them. Too many mental health practitioners are unfamiliar with workplace bullying and what it can do to people. Clinicians who lack this understanding may dismiss the client’s experiences, blame the client, offer unwise advice that backfires on the client, and/or misdiagnose the client’s mental health condition.

Help is here

Fortunately, we now have a much-needed and excellent educational primer on workplace bullying for clinicians in the form of An Introduction to Workplace Bullying for Mental Health Practitioners, a DVD produced by the Workplace Bullying Institute (WBI) and featuring Jessi Eden Brown, a licensed mental health counselor and WBI’s professional coach.

I’m one of Jessi’s biggest fans. She has provided counseling and coaching services to hundreds of clients who have experienced workplace bullying. She brings tremendous compassion, insight, and understanding to her work. You can learn more about her background and experience at her private practice website.


The DVD is divided into seven compact, informative chapters:

    • The Phenomenon
    • Why Bullying Happens
    • The Perpetrators
    • Is Your Client a Target?
    • Impact on People
    • Supporting Your Clients
    • Additional Resources

It’s really good

I watched the full DVD over the weekend. It’s a brisk, soup-to-nuts, evidence-based introduction to understanding workplace bullying and working with targets of this form of mistreatment, running just under 40 minutes. There were a few audio glitches early in the program — WBI does not have a fancy production center — but the rest was smooth, like watching a well-organized continuing education presentation. It’s easily the best resource on this subject.

The DVD costs $49.95 and can be ordered directly from WBI.


September 19, 2013 update: WBI sent me an updated DVD with the glitches smoothed out. I’ll reiterate my strong recommendation of this resource for all mental health practitioners.

Neglected blog posts seeking more love

At times I will toil away at a blog post that I really think has something to say, only to find that it’s a dud with my readers. The WordPress platform that I use for this blog enables me to check how many “hits” a given article has attracted, and I can see which ones aren’t exactly lighting up the Internet. (In truth, a niche blog like this one rarely “lights up” the online world, but I’m cool with that.)

Anyway, as I close in on 1,000 posts for this blog, here are 10 articles that I believe fall within the “good-but-neglected” category:

Our avocations and hobbies: The third pillar of work-life balance? (2012) — On the importance of finding non-work activities that engage us.

I wish our political leaders would send us to the moon (2012) — A call for public leaders to inspire us, linking two nifty videos of JFK.

Professional schools as incubators for workplace bullying (2012) — Consider the seeds planted by law schools and med schools.

Loyalty, “betrayal,” and workplace bullying: Does insider status matter? (2011) — As a denizen of Boston, loyalty and betrayal are key concepts to me!

Dignity amidst horrific indignity: A job shoveling s**t in the Łódź Ghetto (2011) — A WWII story that helps to illustrate how almost any job has inherent dignity.

What’s the plot line of your life story? (2011) — Is it about overcoming the monster, comedy, rebirth, or something else???

What if we paid less attention to advertising? (2010) — Instead of “them” telling us what to buy…

The moral obscenity of a “jobless recovery” (2010) — Read this and compare to where we are three years later.

On hiring consultants (2010) — I would underscore what I wrote here.

Work and the middle-aged brain (2010) — Some things we do not as well, some things actually better.

Workplace bullying: Human rights, public health, and mental health

Among the many disciplines that need to put workplace bullying more squarely on their respective agendas are human rights, public health, and mental health. Here’s why:

When an academic or professional discipline acknowledges the relevance of a topic and includes it in university courses, scholarly literature, and continuing education programs, generations of new practitioners and graduate students will bring that knowledge to their work.

With workplace bullying, it means that human rights activists will regard it as a profound violation of human dignity. It means that public health advocates will grasp how bullying at work impacts the health of workers and their families. It means that therapists will “get it” when clients share stories of abusive treatment at work.

Human rights

Human rights are often framed in a global context, putting a focus on nations with unstable governments and/or severe poverty. This emphasis is understandable and vitally important. In addition, we need to consider dignity violations at work. On this note, I was so pleased when the blog of the Desmond Tutu Peace Foundation recently published a piece on workplace bullying. Here’s how Rebecca Popham concluded the post:

There are some actions employees who are victims of bullying can pursue.  Depending on the situation and the extent of the bullying, these include coaching, working with a therapist, and seeking legal counsel.  Ultimately, though, workplace bullying needs to be addressed in the same manner that racial and other forms of workplace discrimination were tackled, resulting in legal protections.   The problem of workplace bullying has many causes and won’t be easily solved.  A good starting place, however, is greater awareness of the problem and making sure that its victims are heard.

Public health

Workplace bullying rarely appears in the public health literature, but a hardy few are making the case. For example, in 2010 Drs. Jorge Srabstein and Bennett Leventhal published a paper in the Bulletin of the World Health Organization on the public health implications of bullying across the lifespan, including the workplace:

Bullying is a major public health problem that demands the concerted and coordinated time and attention of health-care providers, policy-makers and families. Evolving awareness about the morbidity and mortality associated with bullying has helped give this psychosocial hazard a modest level of worldwide public health attention. . . . However, it is not enough.

Bullying is a multifaceted form of mistreatment, mostly seen in schools and the workplace. It is characterized by the repeated exposure of one person to physical and/or emotional aggression including teasing, name calling, mockery, threats, harassment, taunting, hazing, social exclusion or rumours. . . . A wide range of bullying prevalence has been documented among students and in labour forces worldwide.

Mental health

While subfields such as industrial/organizational psychology, occupational health psychology, and consulting psychology devote increasing attention to workplace bullying, clinical psychology and counseling continue to fall short. That’s why this March 2013 Counseling Today piece on adult bullying by Lynne Shallcross is most welcomed. It features counselor and coach Jessi Eden Brown, who is associated with the Workplace Bullying Institute and also maintains a private practice:

Unfortunately, graduating from college still doesn’t guarantee an end to bullying. A 2010 survey commissioned by the Workplace Bullying Institute (WBI) found that 35 percent of the U.S. workforce — an estimated 53.5 million Americans — report being bullied at work. An additional 15 percent said they had witnessed co-workers being bullied.

These statistics are all too familiar to Jessi Eden Brown, who serves as WBI’s administrator and also runs a private counseling practice in the Seattle area. About half of her clients deal with issues related to workplace bullying.

Framing it globally and individually

Together, the human rights, public health, and mental health perspectives help to frame workplace bullying as a fundamental issue of human dignity and as an important health concern. I hope there are enterprising practitioners, advocates, scholars, and graduate students in these disciplines who will help to fill in these gaps.

Nurses and workplace bullying

If asked to identify an occupational group that has been pro-active in addressing workplace bullying and related behaviors, nurses would quickly come to mind.

Over the years I’ve had many interactions with nurses of different certification levels and with organizations that represent their interests, ranging from participation in workshops and conferences to individual exchanges. Here in Massachusetts, for example, I’ve spoken at programs on bullying at work sponsored by the Massachusetts Nurses Association and the Massachusetts Association of Registered Nurses, and the latter has endorsed the anti-bullying Healthy Workplace Bill.

Uniquely situated

Nurses are uniquely situated to address workplace bullying for several reasons:

First, bullying is common in the healthcare workplace, and nurses are on the receiving end of it from doctors and other nurses. This is no small matter to them.

Second, nurses are at the heart of healthcare workplaces. They see a lot and they know a lot, and they are in a position to understand how organizational dots connect.

Third, many nurses are unionized. This provides them with a structure for raising concerns about mistreatment at work through advocacy, member education, and collective bargaining.

Finally, nurses are part of a professional structure that includes health care associations and colleges of nursing. These entities can play a key role in education, prevention, and response.

Lots of blog posts!

I’ve written many posts about nurses, workplace bullying, and related topics on this blog. Here is a good sampling:

Nurse can proceed with age discrimination claim against employer seeking “rising stars,” federal court holds (2013)

Why we need psychologically healthy workplaces in the healthcare sector (2012)

U of Cincinnati conference examines workplace violence, bullying, and incivility in healthcare (2012)

Cheryl Dellasega’s When Nurses Hurt Nurses (2011)

Nurse writes about bullying by doctors, other doctors respond (2011)

Nursing as a Calling: Aspirations and Realities (2010)

Workplace bullying in healthcare IV: Nurses bullied and responding (2009)

Nurse can proceed with age discrimination claim against employer seeking “rising young stars,” federal court holds

Despite signs of increased bias against older workers, age discrimination claims are difficult to win. That’s why a federal district court decision in Tennessee allowing a demoted nurse to proceed with her age claim is welcomed news. According to the BNA Daily Labor Report (no link — subscription required):

A 49-year-old nurse who provided direct evidence that her employer was seeking “young rising stars” to replace older workers is entitled to proceed to trial on her federal and state law claims that she was demoted from a shift leader position due to her age in violation of the Age Discrimination in Employment Act and state law, a federal district court in Tennessee held May 8 . . ..

The case is Woody v. Covenant Health, decided by the federal district court for the Eastern District of Tennessee, docket no. 11-cv-62, dated May 8, 2013. The defendant had moved for summary judgment, a procedural tool that, if granted, would have resulted in the case being dismissed even before going to trial. The court ruled the other way, finding that Nurse Woody is entitled to her day in court.

According to the Daily Labor Report summary of the case, not only did a supervisor express a “stated preference for younger shift supervisors,” but also the supervisor produced a job announcement expressly seeking younger applicants.

Age bias suits face uphill battles

The Age Discrimination in Employment Act and its state law counterparts prohibit employment discrimination against job applicants and workers age 40 or over.

The excellent Next Avenue site recently ran a piece by Penelope Lemov titled “What It Takes to Win an Age Discrimination Suit,” but in reality it’s actually a sobering assessment of the difficulty of prevailing in such a claim.

Lemov notes that age bias claims have been on the rise since the economic meltdown in 2008:

Age-related charges make up a growing number of complaints filed at the Equal Employment Opportunity Commission, the federal agency that handles such matters. Between 1997 and 2007, there were generally between 16,000 and 19,000 annual filings. But since 2008, the number of complaints has soared to 23,000 to 25,000 a year. Federal law says it’s illegal for an employer with 20 or more employees to discriminate against employees 40 or older based on their age.

Nevertheless, she aptly points out that “it has gotten harder and harder to win an age discrimination suit,” thanks to a combination of narrow interpretations of the law by federal courts and employers who are good at covering their tracks.

Obviously, in Woody v. Covenant Health, the employer was not very good at hiding its bias. Hopefully it will lead to a good result for this nurse.

Working Notes: A busy Friday discussing workers and workplaces

L to R: DY, Rep. Kay Khan, Rep. Ellen Story

L to R: DY, Rep. Kay Khan, Rep. Ellen Story

Yesterday served as a welcomed reminder that healthy dialogue can play an important role toward advancing the interests of workers and workplaces. I was fortunate to participate in two excellent events, and I’d like to share a bit about each.

MARN Legislative Forum

I spent the morning at the Massachusetts Association of Registered Nurses 2013 Health Policy Legislative Forum, held in the Great Hall of the State House. There I joined Representatives Ellen Story (a lead sponsor of the HWB, House Bill No. 1766) and Kay Khan (a HWB co-sponsor and psychiatric nurse) for presentations and Q&A about workplace bullying in healthcare and the importance of supporting anti-bullying legislation. MARN is one of the organizational endorsers of the HWB.

The discussion was both practical and policy oriented. We talked about the challenges of dealing with bullying behaviors in the healthcare workplace, as well as the role that associations like MARN can play in advancing the Healthy Workplace Bill.

It’s an honor to present with two elected officials who truly “get it” when it comes to how public policy can promote human dignity in the workplace. The three of us were pleased to be there, as the photo above (grabbed shamelessly from Rep. Story’s Facebook page) indicates!

Northeastern University Conference, “Employed or Just Working?”

For the afternoon, I hopped on the subway to a conference sponsored by the Northeastern University Law Journal, Employed or Just Working? Rethinking Employment Relationships in the Global Economy, which focused on the changing definitions of employee status and their impact on workers and organizations.

I gave a talk on the “intern economy” and detailed the emerging legal and social movement against the widespread practice of unpaid interns, explaining how this practice excludes individuals who cannot afford to work for free and likely violates minimum wage laws. I will be submitting an article on this topic to the journal later this year, updating my 2002 Connecticut Law Review article on the legal rights of interns. (You may download the 2002 piece without charge, here.)

Several panels focused on the common practice of employers misclassifying workers as independent contractors that, in turn, allow them to avoid paying wages, overtime, and benefits. Some of these practices are egregious, as lawyers who litigate these claims explained to us. We also heard from attorneys representing employers, and they provided an important perspective on the challenges of engaging in good-faith compliance efforts with laws that define “employee” in significantly different ways.

A compelling panel featured advocates and scholars who are examining the difficulties confronting domestic workers such as home health care attendants who are trying to obtain decent wages and benefits. These issues aren’t going away as our population ages and the demand for affordable in-home care increases.

Thanks and kudos

Thank you to both MARN and Northeastern for these opportunities to share information and ideas and to engage in discussions with people who care about the quality of our work lives, and congratulations for putting on very successful events involving multiple speakers. I hope that others who attended and participated benefited as much as I did.

Working Notes: Upcoming speaking appearances, Spring 2013

I’ll be heading out of the office on several occasions during the coming months for speaking engagements, mostly on workplace bullying and related issues of labor relations. For programs accepting registrations, I’ve provided links.

Massachusetts Association of Registered Nurses, State House legislative forum, Boston, MA (March 22, 2013) — I’ll be discussing the Healthy Workplace Bill, the anti-bullying legislation I’ve authored, filed in the current session of the MA legislature, House Bill No. 1766, with Representatives Ellen Story (HWB lead sponsor) and Kay Khan (HWB co-sponsor). MARN is among the organizational endorsers of the HWB.

Northeastern University School of Law, Symposium on Worker Misclassification, Boston, MA (March 22, 2013) — Sponsored by the Northeastern Law Journal, this is shaping into a very good program on the widespread problem of misclassifying workers as independent contractors and other non-employees to avoid paying wages and benefits. I’ll be speaking on the legal status of unpaid interns.

City University of New York Law School, Faculty Forum, Queens, NY (April 10, 2013) — CUNY Law is dedicated to educating future public interest lawyers. I’ll be speaking on “Law Professors as Intellectual Activists.”

New York State Psychological Association, Workshop on bullying & violence at work, New York, NY (April 28, 2013) — This workshop is sponsored by the NYSPA’s Division of Organizational, Consulting, and Work Psychology and will be held at John Jay College of Criminal Justice. I’ll join Dr. Gary Namie of the Workplace Bullying Institute to talk about various aspects of workplace bullying.

Work, Stress and Health Conference 2013, Los Angeles, CA (May 16-19, 2013)  — Co-sponsored by the American Psychological Association, National Institute for Occupational Safety & Health, and Society for Occupational Health Psychology, this multidisciplinary, biennial conference is one of my favorites. I’ll be on panels discussing low-cost approaches to helping targets of workplace bullying (May 18) and the use of social media to promote healthy workplaces (May 18).

Professional schools as incubators for workplace bullying

It has long been my belief that the seeds of workplace bullying are planted in professional schools that prepare people to enter occupations such as law and medicine.

You start with ambitious young people who (1) are used to being heralded as academic stars; (2) do not have a lot of life experience; and (3) tend to be driven, Type A achievers. You then put them in high-pressured educational environments that emphasize technical knowledge and skills and a lot of “left-brain” logical thinking. These degree programs don’t place a lot of emphasis on interpersonal skills and the development of emotional intelligence.

You then unleash them unto the world of work. Uh oh.

Med school

Dr. Pauline Chen, in a New York Times blog piece that already has attracted hundreds of comments (link here), writes about a resident doctor who terrified the medical students with his explosive behavior:

Powerfully built and with the face of a boxer, he cast a bone-chilling shadow wherever he went in the hospital.

At least that is what my medical school classmates and I thought whenever we passed by a certain resident, or doctor-in-training, just a few years older than we were.

With the wisdom of hindsight, I now see that the young man was a brilliant and promising young doctor who took his patients’ conditions to heart but who also possessed a temper so explosive that medical students dreaded working with him. He had called various classmates “stupid” and “useless” and could erupt with little warning in the middle of hospital halls. Like frightened little mice, we endured the treatment as an inevitable part of medical training, fearful that doing otherwise could result in a career-destroying evaluation or grade.

Chen goes on to discuss studies documenting high levels of abuse directed at medical students, as well as efforts that have been undertaken by some medical schools to change their educational environments — often with disappointing results.

Law school

Lest I be accused of tossing bricks from my glass house, let me quickly acknowledge that law schools are no better at educating their students to be socially intelligent practitioners. Even in the face of pressures being exerted by accreditors and leaders of the Bar to do a better job of preparing students for actual practice, law schools overwhelmingly emphasize the study of judicial decisions, statutes, and regulations.

To the extent that lawyering skills become a part of the law school curriculum through simulation courses, clinical programs, and externships, much of the focus remains on advocacy as the dominant interpersonal skill. Client counseling and personal communications are considered “soft” skills, and they rarely get a lot of attention.

Consequently, a lot of lawyers who possess the intelligence to earn a law degree and pass a bar exam come up short on interpersonal skills. It shouldn’t surprise anyone that the legal profession is home to a lot of workplace bullying. Too many lawyers are wired to act aggressively in any interpersonal situation, including dealing with colleagues and clients. Some cross the line and are downright abusive.

Start early

The cues for what constitutes appropriate behavior often are communicated initially in these professional schools. Doctors and lawyers in training may have no idea how to conduct themselves as practitioners, other than being influenced by a lot of unfortunate “role models” on television. If we want to prevent workplace bullying, the training schools for these professions are the first and perhaps best places to start.


Hat tip to Dr. Loraleigh Keashly (Wayne State U.) for the New York Times article.


Get every new post delivered to your Inbox.

Join 956 other followers

%d bloggers like this: