What ambient societal fear is doing to your workforce — and your health plan

Gallup's February poll just documented what many of us have been sensing for a while: American optimism has hit a record low. Research published last year in Social Science & Medicine confirms that political stress correlates directly with elevated anxiety, depression, and overall stress burden — not as metaphor, but as measured, replicable outcome. Nearly 40% of Americans reported being stressed by politics as far back as 2017.

Employees don’t leave such at the workplace door – and might it be even more acute for the virtual workforce?

We are in genuine polycrisis conditions — multiple destabilizing systems failing simultaneously — and the emotional weight that generates is reshaping workforce behavior in ways that don't show up cleanly in behavorial health utilization reports or culture surveys. The cultural dimension has too often been a burr under the saddle for employees. And the health plan and benefit program dimensions are concentric circle challenges emanating from the cultural core.

The upstream problem: emotional health
Thirty years ago, Fast Company profiled organizational psychologists Peter Naylor and Claire Crittenden, who spent careers mapping what they called the "Red Box" — the primal fight-or-flight brain state activated by fear, anger, and insecurity. Their finding: most management systems run on red-zone fuel, and the result is deferred, slow-motion decline masquerading as actual performance.

In 2026, the Red Box has more potent activators than just bad management: it's ambient, scrollable, and unrelenting.

This matters enormously for how we design — and honestly evaluate — behavioral health programs. Fear and anger are pre-cognitive. They arrive before rational evaluation, not after. Shame and guilt follow the mental gyrations that come later. Most behavioral health programs operate squarely in the cognitive domain: CBT modules, therapist matching, meditation apps, digital companions. These have real value. But it’s a legitimate question to ask how well they’re addressing the deeper drivers.

Emotional health — the felt, somatic, pre-narrative dimension of being human — is the upstream driver. Mental health challenges are frequently its downstream expression. I applaud vendors in this space who are making serious efforts to address emotional health. But the broader architecture of most programs struggles actually to do so.

The vendor revenue model challenge
The rise of behavioral health-specific programs emerged from the broader wellness and well-being industry. Virtually the entire behavioral health vendor landscape — Lyra, Headspace, Calm, Woebot, Kyan, and the rest — operates on a PEPM (per-employee-per-month) model.

This is EAP economics with a modern interface. And as Lyra itself has publicly acknowledged, flat-fee PEPM means low utilization is more profitable. This is the same basic challenge that all wellness and well-being programs faced from the get-go. And the per-participant / per-enrollee point-solution market exists because their niche percentage of identified employees cannot support a PE/PM model. No company will pay fees for 100% of its employees to be “covered” when only 10% are actually diabetic.

For digital-only platforms, the marginal cost for “more engagement” is negligible, so the economics differ — but the pressure doesn't disappear. Low engagement means thin renewal conversations and weak upsell narratives. The response, predictably, is engagement metrics that may measure app logins in lieu of behavior change.

I co-founded a full-service wellness company in 2005. We grew to over 1mm employees having access to our platform. But as for engagement? We never solved that problem – and I daresay it remains an oblique failure for the entire industry, to this day. I don’t mean to be malicious – I deeply believe in well-being programs. But the engagement challenge is structural. And it’s the exact same challenge for behavioral health as it was for broad-based wellness. So employers buying behavioral health solutions in a polycrisis environment should ask the hard questions about what "engagement" actually means — and what it conspicuously doesn't.

The health plan cost impacts
When employees don't meaningfully engage with behavioral health resources, the costs migrate — eventually — into medical claims. Depression and anxiety independently drive higher medical service utilization, worse chronic disease management, and when inpatient admissions do happen, they tend to be longer lengths of stay. Chronic stress and fear accelerate cardiovascular risk and suppress immune response. The physical and the emotional are not separate systems; they are the same system observed from different angles.

I’ve never seen a stop-loss report that measured the employees who were – and are - running silently in the red zone. But it’s not even that simple. Deferred diagnoses, undertreated chronic conditions, disability claims rooted in stress-driven physical deterioration — these are the downstream artifacts of upstream emotional dysregulation at scale.

There's also something harder to quantify but equally real: a workforce operating in ambient fight-or-flight doesn't take ownership of their health. Activation, self-care, and preventive behavior require a nervous system with enough felt safety to plan ahead. Polycrisis conditions erode exactly that.

The culture signal
Companies that fail to achieve meaningful engagement in their behavioral health programs (like broader-well-being programs) send a message — whether they intend to or not: this is a checkbox, not a commitment. That perception compounds the disengagement it's meant to address. The benefit exists. Too few use it. Trend accelerates.

The whole-being human — physical, emotional, mental, relational — brings all of it to work. In 2026, that includes a considerable weight of ambient dread. Programs designed for episodic, discrete mental health needs will systematically underperform when the stressor is the cultural atmosphere itself.

What "better" actually requires
I want to resist ending here, because diagnosis without direction is just complaint. So let me be honest about what better looks like, and not dismiss how hard a challenge we face.

The thirty-year-old Fast Company piece is, yes, a cautionary tale. But might we consider it as something of a design manual hiding in plain sight? Naylor and Crittenden's core insight was that you can't think your way out of an emotional system. You have to change the conditions that generate the emotions. For employers, that points toward a few things that are genuinely within reach:

• Manager capability is the first line of behavioral health
  Most managers are inadvertent Red Box activators — not out of malice, but because the systems they operate in reward it. Training that addresses emotional recognition, not just communication skills, is upstream intervention that no vendor can replicate. It's also where psychological safety — measurable, accountable, tied to leadership behavior — becomes structural rather than aspirational.

  

• Demand outcomes, not activity metrics
  Some vendors, Spring Health most vocally, are pushing outcomes-based and fee-for-service contracting as an alternative to flat PEPM. Employers willing to negotiate that structure change the vendor's incentive in their favor. It requires more sophistication at the buying table, but the leverage is real.

• Peer support deserves a harder look
  Remember wellness program team challenges? That human-to-human connection reaches people in ways that apps and therapist-matching platforms don't. And nothing’s stopping companies from enlisting their vendors in training behavioral health champions, not unlike peer wellness leaders. It’s a low-cost, high-value approach. For a workforce navigating ambient fear, being heard by someone who's been there may be the active ingredient that digital CBT can't synthesize.

The last word
None of this solves the polycrisis. It doesn't make the world less frightening or the news cycle less relentless. What it does is build organizational tissue that's more resilient when conditions are hard — which, by all available evidence, they will continue to be.

None of us needs blind optimism. But we can likely use some targeted program engineering.

~ Mark Head
© 2026. All Rights Reserved.

Aspirations

“When we are no longer able to change a situation, we are challenged to change ourselves.”

~ Viktor E. Frankl, Man’s Search for Meaning

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