Read the Full Report



We began the year with a renewed hope of recovery and a path forward with increased vaccination availability, reopenings, and for some, a return to the office. This year, we have primarily focused on the process of recovery in the wake of last year’s unprecedented challenges. Reflecting on last year and the progress we’ve made since, while remarkable, has revealed a new set of challenges as we adjust to a new sense of normalcy. 

Last March, the onset of COVID-19 changed the way we operated as business leaders and as people. Few of us felt prepared to lead the charge through what became a year of unimaginable circumstances. Yet, as new restrictions, policies, and information came into play, we adapted quickly and remained flexible in our decision-making. It was a year of profound loss demanding steadfast resilience, both from our people and ourselves.

Within one crisis arose many, with political and social issues reshaping our perspectives and the landscape of American culture. We became better critical thinkers and more empathetic toward one another, as each of us found ourselves uniquely challenged by the circumstances of 2020. Last year’s hardships, in hindsight, showcase the resilience shown by each of us as we continue to emerge from a once-in-a-lifetime crisis.  

As business leaders, it is our responsibility to lead our recovery efforts for our people and our organizations. The first six months of this year required us to be flexible as we emerged from a challenging year and found hope in opportunities to support those we lead.

Between September 2020 and May 2021, we surveyed 2200+ employees from various industries and businesses across the U.S., including finance, advertising, marketing, I.T., accounting, facilities management, and education. Our survey results revealed that a majority of American workers are still grappling with the impact of last year’s events. As such, the response to last year’s hardships has not been acute or limited and persists at significant rates across all verticals.

We’re presenting the following data and insights for other business leaders to get a glimpse of the current state of mental health among American workers. In this year’s report, we hope to illuminate the persistent struggles of employees regarding their mental health at work and offer insights into how we as leaders can better support our people. 

The top employee mental health concerns from the past year:



Four Leading Factors of Poor Employee Mental Health: Stress, Anxiety, Fatigue, and Burnout


Among the employee concerns reported, our findings revealed striking and persistent stress, fatigue, anxiety, and burnout among employees surveyed. These four factors are closely related and often contribute to one another in a workplace setting. The initial numbers reported by employees in December 2020 were alarming but expected during the second pandemic wave. However, the initial escalation in employee reports of stress, fatigue, anxiety, and burnout remained consistent throughout our survey. Thus, despite improvements in disease prevention and vaccination rates, employees reported the same level of stress, fatigue, anxiety, and burnout that they did at the height of the pandemic.

For employers, this means that the psychological effects of the pandemic will persist long beyond the cessation of infection. These persistent levels of stress, fatigue, anxiety, and burnout will ultimately hurt employee productivity, engagement, morale, and retention. Moreover, our findings revealed little to no change in the occurrence of these mental health concerns, which means employers should prepare for the long-term prevalence of employee stress, fatigue, anxiety, and burnout.

Burnout was the number one concern for employees over the past year.


Over 30% of employees showed a high level of concern for their stress and anxiety levels.



The Workplace Impact of Poor Employee Mental Health


Understanding how stress, anxiety, fatigue, and burnout present themselves within the workplace context is fundamental to a complete picture of employee wellness. The incidents of increased stress, anxiety, fatigue, and burnout result in adverse outcomes in the workplace, specifically around performance.

Measuring the impact of employee mental health concerns on job performance is evidenced through productivity, managing conflicts at work, and building trust in the workplace. Sleep disruptions like fatigue and insomnia inhibit decision-making and focus, leading to significant performance issues over time.

The sustained levels of sleep disturbances recorded among employees in our study indicate that employees are likely experiencing performance issues as a result. With employees reporting high levels of stress, anxiety, and burnout, incidents of communication issues, work conflict, misconduct, or mistrust are likely to materialize at a higher rate.

To capture the impact of the four critical mental health issues employees reported, we collected data regarding their productivity, ability to manage conflicts, and building trust in the workplace. Unsurprisingly, employees reported elevated levels of concern across all three categories, with a slight dip from 2020 to 2021.

The small decline is likely due to the economic and financial gains that have led to a more promising job market, less concern over layoffs, and improvements to job security. Despite the progress from last year, the occurrence rates remain high. More than 60% of all employees surveyed reported concern over productivity, managing conflicts, and building trust at work in 2021. 

Almost 75% of employees showed concerns about building trust at work in Q2 2021, a 13% increase from Q3 2020.


70% of employees showed concern with managing work conflicts in Q2 2021.



How Employees’ Personal Lives Impact Work


The multifaceted nature of COVID-19’s impact was pervasive in employees’ work and personal lives, causing unique effects that stem from multiple contributing stressors. The far-reaching consequences of the pandemic influenced personal relationships, family relations, living situations, finances, resources, and health. Ultimately, employees bring their personal circumstances to work, and those external factors influence their productivity and interactions with others.

The transition to remote work eroded routines related to work-life balance, where there became little delineation between the office and the home. Parents and caregivers were impacted substantially by school closures and inaccessible care brought on by the pandemic.

Struggling with personal relationships, isolation, feelings of loneliness, boredom, anxiety, and depression were common complaints last year. These factors led to new incidents of substance use disorders and caused relapses among those working toward sobriety. In addition, recreational activities that once served as means of self-care and wellness were largely unavailable during the pandemic, such as gyms and places of worship. As a result, healthy coping mechanisms and activities that were once readily available were no longer in place to curtail the emotional and mental health toll of COVID-19.  The reduction in healthy outlets and increased external stressors ultimately impacted the workplace: how well employees work and how well they work with others. 

Personal stress and a poor work-life balance come at the cost of employers. Presenteeism refers to the lost productivity when present employees are not fully functioning because of stressful life events, illness, or injury. Employees’ increased concern with work-life balance, managing stressful life events, managing depression, and preventing substance misuse often leads to presenteeism. The estimated cost of presenteeism amounts to $180 billion annually for U.S. companies, 34% more than absenteeism.

Work-life balance was the third-highest concern among employees in 2021.


Employees showed a high level of concern with depression in Q4 of 2020, with over 70% showing some level of concern.



The Onset & Ongoing Effect of COVID-19 on Employee Mental Health


Reflecting on COVID-19 and analyzing employee reports provides perspective on recovery efforts and supporting employees in a post-pandemic work environment. The changes to work and everyday life were profound and introduced many challenges and stressors that employees are still coping with today. However, data collected from our employee survey reveals positive trends in pandemic-related categories, providing insights into employee resilience and adaptability throughout the pandemic and initial recovery.

While adapting to remote work was challenging for most, 2021 reporting illustrates marked improvements in employees’ comfort with working remotely. Additionally, employees had lower levels of financial stress in the first and second quarters of 2021, reflecting the improved economic conditions in recent months.

While these trends are encouraging, supporting employees after COVID-19 depends on addressing the issues they struggled with the most. 20% of employee respondents reported they were coping poorly with the effects of the pandemic in 2020. Inadequate coping mechanisms and unhealthy habits developed throughout the pandemic will not immediately disappear upon infection rate improvements.  Learning to work remotely successfully was only half the battle— 10% of employees reported being very concerned with isolation and loneliness throughout the pandemic.

Challenges of social isolation will undoubtedly have a lasting impact on employees, regardless of whether they stay remote or return to the office. Following a year of isolation, social interactions are likely to cause anxiety among adults. Vaccinated adults have not returned to pre-pandemic levels of socialization, which indicates long-term implications due to prolonged isolation. Employees will likely have to grapple with the behavioral and mental health implications of COVID-19 for years to come. Employers will be responsible for creating a post-pandemic work environment that addresses the events of 2020 by taking a stance on employee wellness that considers the long-term impacts of the pandemic.

Over 1 out of 5 employees were poorly coping with the effects of the COVID-19 pandemic in 2020, with those concerns continuing into 2021.


Only 18% of employees successfully managed remote work in Q3 2020, with over 50% successfully working remotely in Q2 2021.


Concerns with financial stress from the pandemic were much larger in 2020 compared to 2021.



Racism and Social Injustice Concerns


COVID-19 was not the only pandemic that disrupted everyday life in 2020. By June, a second pandemic permeated the lives of Americans— institutionalized racism and social injustice. The murders of George Floyd, Breonna Taylor, and others sparked public outrage and nationwide protests, bringing attention to the pervasive issue of racism in America.

While the issue of police violence against Black Americans was central to the protests, the conversation about racism in America included the disproportionate impact COVID-19 had on minority populations and raised historically buried sentiment about systemic racism. Thus, the dual pandemics proved to be a multifaceted issue, highlighting the intersection of social issues, public health, and racial inequality in the U.S. 

While the conversation about racism and social injustice in America was long overdue, it compounded existing mental health challenges, especially for people of color. Racial trauma has psychological and physical consequences, including intense anxiety, depression, distress, distractibility, and avoidance related to the stressor, and increased occurrences of cardiovascular disease and hypertension.

Healthcare access inequities among ethnic minorities exacerbated the impact of racism and social injustice issues in 2020. The effect of these issues proved to be more challenging for employees of color, who reported higher incidents of workplace stress, anxiety, and exhaustion following the events of June 2020

Employees across all ethnic and racial identities expressed mental health concerns due to the social injustices of 2020. Most employees reported racism and social injustice as a top concern in 2020, a trend that has continued into 2021. The following metrics highlight employee perspectives on the social and racial injustices of 2020, noting the continued level of concern in recent months.  

Almost 30% of employees were poorly coping with racism and social injustice during 2020, with some of those concerns continuing into 2021.




Overall, the data collected in 2021, compared to 2020, indicates recovery trends and improvements in employee mental health. Our employee well-being metrics reflect the strength and determination of our team members and their need for additional support. While the impact of COVID-19 variants on employee mental health remains to be seen, positive employee well-being trends may plateau due to prolonged pandemic conditions. Nevertheless, the data paints a picture of what our employees need now and how we, as employers, can prepare to support our team members should the pandemic persist.

We remain encouraged by the data’s implications. Namely, the resilience employees have exhibited over the past two years. Recognizing employees’ demonstrations of flexibility, tenacity, and strength in the face of unprecedented challenges will be paramount to our collective recovery efforts. 

The positive trends captured by our survey are encouraging, and we will continue to collect employee data to assess how developments in the COVID-19 pandemic influence workplace mental health. One thing is certain when looking at our data: addressing mental health has become imperative in the workplace, and employers should prepare to support employee mental health for the foreseeable future.

After reviewing survey responses, it’s clear that we can do more for our employees’ well-being regardless of what the future holds, whether it’s stress management, mental health resources, or conversations that reduce stigma around mental illness. In the long term, our efforts to help employees become mentally healthy now will help them cope in the future, should we endure further uncertainty due to the pandemic or struggle to grapple with its impact as we recover. Unfortunately, the limited information about long-term effects and delayed onset of mental health concerns point to a slow recovery. As a result, employees will need ongoing mental health support for years to come. 

While our report included data from a wide range of participants and across several industries, mental health data about COVID-19’s impact is still generally limited. It will take experts years to collect data and report their findings of how the pandemic impacted our emotional well-being. Understanding the full scope of the pandemic’s impact on our mental health will also be delayed by the emergence of new COVID-19 variants. In the meantime, employers can focus on what we do know.

While employees have improved their ability to manage negative emotions, most employees would benefit from additional mental health support. To recruit talent, increase retention, and cultivate a healthy company culture, business leaders should prioritize mental health and well-being initiatives that address employees' future and existing needs.  While we grapple with more uncertainty and prolonged pandemic conditions, our employees will depend on our support to cope effectively.

A productive and well-rounded workforce depends on leaderships’ ability to respond thoughtfully to the current state of employee mental health. 

About the Authors


Patti van Eys, Ph.D.
Vice President of Product

Patti van Eys, Ph.D., is a licensed clinical psychologist and Vice President of Product for Pathways at Work, concentrating on Mental Health and Wellness for employees of various organizations. Dr. van Eys is also a consultant for van Eys Mental Health regarding complex mental health issues. She is a published author and has trained extensively at the local, regional, and national levels on trauma-informed care and mental health issues. The joy of her life is playing with her two young granddaughters.


Dustin Keller, Ph.D.
Vice President of Clinical Strategy

Dustin Keller, Ph.D. is a Licensed Professional Counselor-Mental Health Service Provider and National Certified Counselor who serves as Vice President of Clinical Strategy for the Pathways at Work program. He regularly conducts training workshops on various issues, including leadership development, employee and personal motivation, mental health, children and youth, and suicide prevention. He received his Ph.D. in Psychology from Northcentral University and currently lives with his wife and six-year-old son in Nashville, TN.

No one has all the answers.

Together, we can help you and your company get through these difficult times and help develop an even stronger, healthier workforce.

If you are interested in learning more about our workplace mental health training workshops, tools, and interactive discussion groups led by mental health professionals, please schedule an introductory call with one of our Behavioral Wellness Consultants today.

Additional Resources


Workplace Mental Health Calculator

What is the estimated price you pay each year for not addressing your employees’ mental health issues?


How Mental Health Training in the Workplace Supports Your Ongoing HR Efforts

80% of employees say they’d leave their current job for a company that focused more on mental health. Learn more about how HR teams can provide this necessary benefit to their employees.



Customized Workplace Mental Health Programs That Help Your Employees Thrive

Give your employees the support they need to be highly engaged at work with a mental health program tailor-made for your workplace.

Download the full report on the current state of employee mental health in 2021.

  • Read quotes from employees on how their work, culture, and leadership affect their mental well-being.
  • Get additional insight into how each aspect of the employee experience has influenced employee mental health over the past year.
  • View more statistics and data about employee mental health concerns.