Rethinking Mental Health in the Workplace

Taiwan firms, known for their long work hours and lack of separation between work and personal life, are gradually beginning to prioritize employees’ mental health.

Taiwan routinely finds itself near the top of global rankings for the length of working hours. A 2020 survey of 40 countries by Taiwan’s Ministry of Labor (MOL) put Taiwan fourth, while statistics from the Penn World Table the same year placed Taiwan 16th among 66 locations. Whatever the exact position, it is clear that Taiwan has some of the longest working hours among developed nations.  

Of course, working hours are not an exclusive metric for gauging workplace stress, but when combined with deep-seated cultural norms dictating employee responsibilities, a somewhat bleak picture of mental wellbeing among Taiwan’s workers emerges. And while Taiwan did not experience the same pandemic-induced wholesale disruption to workplaces as some other countries, healthcare experts say that the insecurity COVID-19 created likely increased stress levels among employees and management.    

“COVID has been a big stress to many people in different ways,” says Julie Tsai, managing director of the Taiwan office of Human Dynamic, which offers coaching and consultancy services to employees and management under the rubric “Leadership and Change.” 

“It doesn’t just impact whether people need to work from home,” she says. “Some people don’t have that option – that’s the stress. For others, it’s worrying about getting sick, the greater economy, or their own future.” 

A recurrent theme faced by clients of mental health workers, consultants, and government agencies is the feeling of uncertainty and associated anxiety, an issue that has been exacerbated by the COVID-19 pandemic.    

“Because of COVID and the macroeconomic situation, some companies need organizational change,” says Tsai. “This creates stress on management and employees because organizational change might mean they won’t have a job anymore. They are unsure what’s next and ask themselves, ‘Will I be impacted? If not this month, then maybe next month.’” 

Pan Chih-hong, a senior researcher with MOL’s Institute of Labor, Occupational Safety and Health (ILOSH), agrees with this view. “When people are worried about their jobs, it affects many other things,” he says. “If employees are without a good job, without a salary, this is another kind of job stress.”   

Some of the anxiety over job security was fueled by scaremongering, according to Jonathan Gropper, founder of the American Taiwanese Mental Institute, a clinical practice catering primarily to English-speaking professionals in Taiwan.    

“There was an increased level of anxiety due to media and social media,” he says. “Taiwanese went from one crisis to another, fixating on numbers scrolling on the TV, and a lot of it was politicized, which also did not help individual stress levels.” Gropper admits that it can be difficult to disengage from “the talking heads on TV and regurgitation on social media” but that this would be “one of the healthiest things to do.”   

For all the added stress it caused, COVID may have had an indirect positive impact on some employees. Noting a dramatic uptick in the number of calls to Human Dynamic’s 24-hour coaching service since the onset of the pandemic, Tsai says many people have been forced “to rethink their work.” The Great Resignation in the United States and other countries demonstrates this phenomenon, she says. 

“Psychological safety became even more important after COVID because people were thinking about the value and meaning of work,” says Tsai. “They needed to find a place where they feel safe, where their voice is valued.” This “awakening,” as Tsai calls it, is observable from the type of calls made to the consultancy. “Many were about bullying,” she says. “People started to realize, ‘I have worth. I should be valued. I should not be bullied.’”  

Managers and executives are also beginning to understand that psychological safety enhances team performance. “When people feel safe, they are more willing to contribute, and their energy is in the right place rather than wasted worrying and feeling anxious,” says Tsai.  

While the pandemic may have compounded the problem, much of the work-related stress employees face in Taiwan has long lurked beneath the surface. Chung I-hang, a psychiatrist at Chang Gung Memorial Hospital in Taoyuan, says that based on his experience with patients, the long workdays endured by most Taiwanese likely negatively affect daily stress. Chung cites “complex cultural aspects in traditional industries” and “overwhelming bureaucracy” as important factors that hinder efficiency and create excess hours.  

Local phenomena 

Several healthcare professionals highlight other aspects that, while not necessarily unique to Taiwanese society, appear ingrained in the culture.   

“There are some special phenomena in Taiwan,” says Lee Er-chiao, an occupational physician (a specialist in workplace health issues) at Taipei Municipal Hospital. “Some workplaces create a ‘double schedule’ – having workers punch out of work, then go finish their jobs. This creates two versions of work schedules – the real one and another for inspection.” 

Lee also cites the prevalence of small and medium-sized enterprises (SMEs) as affecting office norms. As SMEs have their own idiosyncratic working cultures, employees are often at the “mercy of the owner,” she says. “This is one of the main causes of overwork in Taiwan. Since workers view themselves as partners with the boss, working overtime is not only necessary but honorable.” 

Counseling psychologist Chloe Wu says more companies are interested in Employee Assistance Programs (EAPs), which help troubleshoot organizational effectiveness and personal issues that affect employee performance.

Aside from being forced to work overtime – often with no compensation – employees are pressured to take work home and be on-call almost 24/7, making it nearly impossible to maintain a proper work-life balance.   

“I think many Taiwanese do not have strong boundaries,” says Chloe Wu, a counseling psychologist who runs a clinic in Taipei. “There’s a limit where we can identify ‘that is my personal life,’ but even then, when we work overtime, we think it’s our duty.” Wu extends this analysis to emotional boundaries, noting that many employees can’t separate their own emotions from their manager’s feelings. They feel “if my boss is upset, that is my fault,” says Wu. “This is another part of the culture.”  

A longstanding obstacle to more progressive views on mental health in the workplace has been the social stigma surrounding the issue. While this factor continues to exert a pernicious influence, most experts are cautiously optimistic that change is afoot.  

“It’s still a problem in our society, but in recent years it’s getting better,” says Chung. He points to the use of “politically incorrect jokes” among colleagues as a way of broaching the issue, demonstrating that Taiwanese are becoming more comfortable expressing their feelings on the subject. 

This attitude is particularly prevalent among younger employees, notes Lee. “People in their 40s might see depression as special and exceptional, but 30-something workers accept each other taking mental sick leave,” she says. “It’s normal to cope with emotional problems from time to time.”  

This trend is even more pronounced among employees in their 20s, who increasingly see the accumulation of wealth and reputation as less important than wellbeing, according to Lee. “They go to therapy as part of everyday life,” she says.  

Wu pinpoints the change as being led by the post-1990s generations. Prior to that, workers were an “obedient generation.” Being born into larger families where they vied for attention meant many people used work as a way to “get more recognition,” Wu says, whereas people born in from the 1990s onward have a stronger tendency to prioritize personal fulfilment.  

Lee also emphasizes the increasing prioritization of satisfaction over traditional concepts of worker diligence. “People in their 20s don’t work overtime because they believe there is no future for them [without their health],” she says. Furthermore, the emergence among younger employees of a “slash worker” mentality (a preference for working multiple jobs instead of being tied to just one) signifies a fundamental shift in attitudes toward career choices, where flexibility and freedom are deemed more important. 

This change has inevitably sparked intergenerational conflict in the workplace, as traditional expectations and management styles are resisted by a younger generation that is, in turn, viewed as entitled and “very difficult to manage” by their elders. Gropper agrees that younger people are more aware of their mental health but worries that they experience symptoms “without always understanding the underlying issues.” The “headwind and pressures” they face come from many directions, including “family, work, society, and self.”  

For employees who seek assistance, the options remain frustratingly limited. ILOSH’s services, for example, are confined to research and advice for companies about potential health issues for their employees. These mostly relate to physical conditions such as high BMI and obesity, with simple exercise programs recommended.  

“We can help with a job stress assessment scale and methods to prevent job stress,” says ILOSH’s Pan. “This can help companies prevent occupational hazards or occupational diseases from job stress, but because we’re just doing research, these companies then have to ask for assistance from hospitals.”  

OSHA legislation 

Lee also notes that the role of occupational physicians is largely restricted to workers’ physical health and safety, lung disease due to asbestos exposure being one example. “Some of the work we do regarding long working hours is related to the Occupational Safety and Health Act (OSHA), which says employers need to arrange health check-ups for everybody,” says Lee.  

Lee explains that OSHA provides guidelines on abnormal workloads to help evaluate the risk of karoshi – the Japanese term for death through overwork. Two categories that nurses and occupational physicians consider during evaluations are working hours and subjective work stress – an individual’s perceived stress levels as measured through questionnaires.  

The Act also seeks to protect employees from discrimination due to their mental health conditions. “If you are diagnosed with PTSD, depression, or anxiety, or there is bullying, sexual assault, or super-long work hours, we can help you get compensation,” says Lee. “But in my opinion, this does little to help workers under stress.” 

As for private-sector services that address mental wellness in the workplace, Taiwanese employees generally have few options. Most private services target foreign nationals, multinational firms, or English-speaking Taiwanese. Human Dynamic, which offers a range of one-on-one and group coaching services, works almost exclusively with international companies. 

Coachworkslive’s Lina Lo says managers should continously work to find their blind spots and improve their management skills.

“Sometimes local companies ask us to do training, but not with an annual contract – just a one-day or two-day workshop,” says Tsai. “For our work-life coaching, it’s a yearly program, and Taiwanese companies might not offer this to employees. They need to understand how employees’ wellbeing impacts company performance and might not have that knowledge yet.” 

Still, as companies wise up, there are signs of growing interest in Employee Assistance Programs (EAPs), says Wu. Rather than fixating on workloads, these programs emphasize the importance of factors that are seldom considered to affect performance.  

“Maybe employees can’t face that workload because they are facing a life crisis,” says Wu. “They might be moving, wanting to get divorced, suffering from the pandemic or a family loss – EAP addresses things like that.”     

Pitching its work-life programs as even more comprehensive, Human Dynamic also offers courses on stress mitigation, resilience building, diversity and inclusion, and transition management, Tsai says. Programs targeting leadership include Executive Wellness Coaching, which aims to help managers address their weaknesses. “Though [managers] had great success in the past, they may have some blind spots,” says Tsai. “When they’re not aware of these, the people who work with them suffer.” 

This viewpoint resonates with other coaches in Taiwan. “Think of a good athlete going at it alone,” says Lina Lo, who runs Coachworkslive, a service based on the positive intelligence philosophy of super coach Shirzad Chamine. “All the top athletes have coaches partnering with them to identify blind spots they don’t even see.” 

In the end, a root and branch change to old modes of thinking might be required. “One often encounters [an attitude of] ‘this is just how we do it because it’s how we have always done it,’” says Gropper. “This can be quite aggravating and difficult to deal with.” He believes that not enough value is currently placed on the individual as well as interpersonal relationships, which has led to distorted priorities.  

“Work is not life,” he says. “Money is not success. Time does not come back. Until people understand their value is not measured by the car they drive or the number on their bank account receipt, they will be exposed to an odious amount of stress and stuck in a cycle consisting of stressors, angst, pressure valves, and diminishing health.”