Despite a focus on workforce mental health programs, employees aren’t necessarily feeling better, according to Calm’s Voice of the Workplace Report.

Overall, 69% of employees said their mental health has stayed the same or worsened during the past year, and 81% said they’ve struggled with nervousness, anxiousness and stress recently.

In addition, 61% said they’ve felt down, depressed or hopeless during the past month, and 68% said they’ve had trouble falling asleep during the past month.

“In the past few years, HR leaders around the world have made huge strides in supporting the mental health of employees and their families,” according to the report. “In short, you’ve done the critical work of laying a strong foundation for employee mental health [...] Now it’s time to build on that foundation to accelerate positive change and results.”

In a survey of 4,000 employees and 150 HR and benefits leaders, nearly 60% of global workers agree they’re always connected or available for work. For more than 40%, this constant pressure to be always available contributes to their mental health decline. In addition, over half are worried about the rapid pace of technology developments in their workplace, and a third think AI tools will contribute negatively to employee well-being.

Managers can contribute to both the problem and the solution, the Calm report showed. About 65% of employees said managers significantly influence their mental health, whether positively or negatively. Only 38% said their manager fosters a low-stress work environment, and 54% said their manager has a negative or neutral impact on their mental health.

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