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Buyer beware: Screening out snake oil workplace mental health interventions, experts

In a recent meeting hosted by a large international consulting firm, I talked with leaders who deeply care about workplace mental health. One globally well-respected mental health expert expressed concern about the number of snake oil workplace mental health products, services and programs on the market.

There are many evidence-based programs to choose from, so he often helps employers by being a “bullshit meter” determining what has and does not have efficacy.

Recent Fleming research on workplace mental health raised red flags about the legitimacy of individual-level mental well-being interventions like resilience, stress management, and apps. This researcher concluded there is little evidence that these interventions work, and they could cause harm.

I worry deeply about this. When a product or solution does not consider that marginalized and languishing employees have different experiences, it can cause mental harm to these populations who see no way to engage in or obtain the proposed benefits because of their current life situation.

Fleming’s research did not provide a clear lens on what percentage of the products evaluated were scientifically validated or had defendable program evaluations completed. Self-professed experts promoted their value as snake oil. One sign of snake oil is when a person makes grandiose claims of value and benefit with no defendable evidence and does not address their interventions’ potential harms.

What do workplace mental health snake oil interventions or experts look like?

Screening out snake oil products and experts begins with context on what good looks like. One challenge for many well-intended buyers who care about their employees is a lack of social science knowledge.

Flashy sales PowerPoints, websites, and brochures are fluff; the substance is science and evidence of program impact. Self-professed workplace mental health experts who are masters at selling ideas versus evidence may talk buyers into believing in the value of a product or service without proof. The consequence is that buyers soon discover that the experience and expected outcomes are not aligned.

Psychological and behavioural science is mature and can guide employers in making informed decisions about workplace mental health prevention and support programs, products, and solutions. Credible and qualified experts with industry and academic knowledge can help CEOs and senior leaders make informed decisions to mitigate mental harm and promote mental health.

Because dollars, resources, and time are limited, more employers are hiring chief mental health officers and others with credible training and experience in psychological health and safety, inclusion, adult learning, human behaviour, leadership, and workplace mental health.

For employers lacking a budget for these experts, the following screens may help avoid buying snake oil. On a serious note, mental health and mental illness intersect. This conversation is about people and their well-being. Most would not hire a self-professed brain surgeon, plumber, pilot, mechanic, or IT technician.

Currently, the regulator of what is good must be defined by employers. The hope is one day, there will be credentials for workplace mental health (i.e., psychological health and safety) providers to protect employers and employees from snake oil, or what I often refer to as poor to no science.

Employers should take a system approach that defines the knowledge, skills, behaviours, and habits required to achieve desired outcomes. Too often, they focus on what they are doing with little attention to why and how. Any intervention must be designed through a Plan-Do-Check-Act approach to ensure continuous improvement and program evaluation.

Three screens for avoiding snake oil:

Qualifications

There are no mandatory qualifications for calling oneself an expert in workplace mental health and psychological health and safety. It is up to the buyer to understand what level of competency is acceptable. Employers must be clear on who is behind a product and validate its efficacy. When dealing with trusted brands, they must look beyond the banners and be clear on who is doing the work and their competency.

Screening lens: Ask to see publications, research, or testimonials. Someone claiming an intervention in workplace mental health without expertise in mental health, OHS, inclusiveness, mental illness, or psychological health and safety would be a red flag. Individuals making claims or giving advice who do not know what they don’t know increase their risk of causing harm or raising false expectations. Being a member of a professional college requires a standard of professional ethics and accountability for not over-promising. My concern is workplace mental health is becoming like the Wild West gold rush, with all the mental harm, injury and illness occurring. My best advice is to hire a workplace mental health expert with at least the same degree of rigour you would hire a person to build a house. You probably would not want it to be their first house and would want assurance they have a master carpenter on their team.

Evidence-based

Outcomes in the social sciences can be measured objectively. The minimum objective is not to harm. Examining what research and defendable program evaluation have gone into any commercial product is prudent.

Face validity is the minimal level for a new product, program, or service. Determine if the expert behind it has a proven track history. This typically can be enough to pilot-test and evaluate a product’s efficacy. Conduct research to ensure the product does what it claims. Too often, workplace products focus on activity and sales with little attention to outcomes. Be wary of claims that do not matter. For example, it does not matter how many people took a resiliency course or used a mental health app over three months. Evidence of changes in habits and targeted outcome variables (e.g., engagement score, disability claims, turnover, etc.) — how things are better — are what matters.

Screening lens: Who is behind the product? What is the non-empirical (e.g., literature reviews that support product assertion) and empirical (e.g., data and product study) evidence? The gold standard of scientific claims is positive findings by an independent third party. Program evaluations using credible methodologies like the Phillips model are beneficial. If you do not understand stats, have a trusted expert assess efficacy data. I often fill the role of “Bullshit Metre” for consulting clients, much like the above international expert. Because employers have limited energy, dollars, time, and resources, it is prudent to measure twice and cut once when adopting any product. Screen for red flags like ROI claims over 1.5 and adherence levels over 30%. Too often, outcomes are over-reported to influence buying decisions. Be aware, listen for humility, and ask for data so you or someone else can evaluate merit claims. There is ample evidence to evaluate intervention claims, so ask direct questions about what defines success. Reported participation levels alone do not guarantee change, outcomes, or impact. Look for evidence of habit change and measurable results.

Accessible

All employees are not the same. Thus, not every intervention will help all employees. Understanding what percentage of employees could access and benefit from a product is helpful. Never assume 100% participation. A lead practice is considering accessibility that can include factors like disability (e.g., visual impairment), technology access, reading level, language, culture, and diversity. Pay attention to accessibility claims. For example, a product available only in English would marginalize or oppress francophone team members. Too often, products fail to consider terms and language unfamiliar to minority groups and neurodivergent employees. At a minimum, consider accessibility.

Screening lens: Ask hard questions like, “What population in my workforce today may this product not be accessible to and why?” “What thoughts have gone into making this intervention accessible?” Explore what consideration has been done for the different population interactions and how the intervention will be measured through an intersectional lens. This considers the multifaceted and complex nature of identity, acknowledging that an individual’s experiences are influenced by race, gender, sexuality, and class. Many interventions are developed for a defined outcome without considering the different populations. Buyers must understand what has and has not been done regarding accessibility to help remove barriers.

No expert or intervention can or will be perfect. However, employers can protect their workers and achieve desired outcomes by asking tough questions, looking for evidence, and partnering with experts to focus on results while mitigating harm.

Dr. Bill Howatt is the Ottawa-based president of Howatt HR Consulting.