Five Ways to Support the Mental Health of Shift Workers

Updated: Aug 9

By Bernie Wong | Senior Manager of Insights and Principal, Mind Share Partners

Photo by Tiger Lily via Pexels

Healthcare, customer service, call centers, food, retail, hospitality, security, and emergency services ⁠— these industries are all fundamentally built upon the labor of shift workers. However, many of these workers face unique and long-unaddressed challenges by virtue of the nature of their roles that directly impact not only their mental health at work but their livelihoods.

The prevailing dialogue around organizational culture and supporting mental health at work often centers on white-collar workers operating during standard daytime hours in an office or remotely. But how do we support the experiences of 16% of the U.S. workforce who work shift schedules outside of that norm?

In this article, we provide a high-level overview of the shift worker experience as it pertains to workplace mental health. We'll talk through five prevalent workplace factors that uniquely apply to shift work, and how these factors impact workplace mental health. We'll then discuss five best practices to support shift employees.

What are the unique challenges to shift workers' mental health?

A growing movement of workers from Amazon, Starbucks, REI, and many more are seeking unionization amidst long-neglected histories of worker exploitation, poor working conditions, unpredictable schedules, poor pay — the list goes on. In fact, union representation petitions have increased 56% between the first three quarters of FY2021 into FY2022.

Employers are increasingly being called upon to take meaningful action in protecting the health and wellbeing of their workers. Understanding the unique challenges shift workforce face is vital to being able to support them adequately.

1. Shift work is associated with poorer mental health outcomes.

This includes higher rates of depressive symptoms and anxiety. In fact, one study found that the risk of depressive symptoms was 33% higher in shift workers than in non–shift workers. And an even broader landscape of research has tied shift work to physical health issues as well, including gastrointestinal, metabolic, cardiovascular, and reproductive conditions.

“Shift work is associated with considerable impacts on sleep, depressed mood and anxiety, substance use, impairments in cognition, lower quality of life, and even suicidal ideation. Pronounced sleep disturbances frequently underlie the mental health consequences of shift work.” - Jessica P. Brown, PhD, et al. (source)

Why is this the case? Shift workers themselves are most certainly not biologically wired any differently. What about shift work itself poses a risk to worker wellbeing?

2. Unpredictable schedules pose challenges to work-life integration.

The inability to build a stable, predictable routine has a detrimental impact on workers’ personal lives and their mental health. Studies show that irregular schedules exacerbate work-family conflict, as workers are forced to make concessions between work and their personal lives. What's more, unpredictable schedules significantly impairs shift workers’ sense of autonomy, flexibility, work-life balance, and overall experience of work.

At face value, many of these factors seem like new workplace perks ⁠— optional elements of the worker experience to optimize, but often secondary to growing profit, reducing bottom-line costs, and streamlining workflows. However, experts and the academic literature alike have identified all of these factors as the core drivers of burnout.

3. Shift employees are on the front lines of dangerous and traumatizing interactions.

Since the pandemic, healthcare staff have observed marked increases in violent interactions with patients, visitors, family members. Shift workers were more than twice as likely to be hospitalized as a result of COVID-19, compared to those with regular work patterns. Content reviewers at Facebook, Tik Tok, and other media platforms have voiced their challenges with PTSD as a result of hours-long shifts reviewing videos flagged for rape, murder, and suicide. And one Amazon delivery driver was even instructed to continue their deliveries despite tornado warnings in the area, which ultimately decimated warehouses just 30 miles away.

Shift work, by definition, are jobs with non-standard working hours. Yet the types of jobs disproportionately represented in shift work⁠—and the level of investment (or lack thereof) in supports and protections of these workers by their employers⁠—pose unique risks to worker wellbeing.

4. Shift work is tied to higher attrition and turnover.

But how much is this based on the nature of shift work itself than the supports surrounding these roles?

In most cases, shift work varies widely in wage equity and access to health insurance, is often deemed lower-skilled, and at many organizations, is among the least likely to be prioritized in broader strategic employee wellbeing efforts around work-life balance, flexibility, and availability of programs by nature of the scope of their roles. In fact, in one study of front-line workers early in the pandemic, only 19% said their employer had made masks available to them.

The issue, then, is less about shift work itself. In fact, Costco⁠—known for their high starting salary and robust benefits structures⁠—maintains an astoundingly low 6% attrition rate after one year of employment. Instead, the compounding impact of low pay, health coverage, and poor working conditions translate into a vicious cycle of turnover and rehiring, which in turn poses unique challenges when it comes to training and meaningful, long-term support for their mental health.

“This lack of respect for shift workers and their value as individual human beings also surfaced through a lack of investment in their career development and trajectories,’ Hollingshead says. She explains that organizations tend to expect high employee turnover in the shift work industry—a stigma that shows up in the way shift workers are treated and contributes to an unfortunate cycle. ‘If you treat workers like they’re not going to be a long-term part of your company, then they won’t be. It’s a self-fulfilling prophecy in a way.” - Beth Elwood (source)

5. The negative effects of shift work disproportionately impact low-income workers, women, and people of color.

This furthers inequities in life, career, advancement, and overall wellbeing for disenfranchised communities.

"Minority workers, particularly women of color, are 'exposed to the most unstable and unpredictable work scheduling practices,' according to a report published Wednesday by sociologists at The Shift Project at the University of California. 'This is not desirable schedule flexibility, but rather unpredictability and instability imposed by employers'... Minority workers in the retail and food service industries are 10% to 20% more likely than white workers to report canceled shifts, on-call shifts and 'clopenings.'

Workplace mental health and diversity, equity, and inclusion are intrinsically tied together. Without dedicated and intentional efforts to support these workers, these disproportionate challenges to marginalized groups run the risk of exacerbating broader social, cultural, economic, and health disparities.

Photo by Pema Lama on Unsplash

How to support shift employees’ mental health at work

We've just covered some of the core challenges shift employees face when it comes to mental health at work. Now let's talk about how to create meaningful change to support this vital and vast segment of the workforce.

1. Create shifts that are minimally damaging to workers’ wellbeing.

Consider what is within the realm of possibility based on your unique industry, region, and business model. One source offers the following guidance:

  • Limit night work as much as possible, and avoid a large number of consecutive night shifts.

  • Rotate night shifts more quickly (every 1-3 days) over slowly rotating (i.e. weekly or longer) or permanent night work.

  • Set adequate rest days between shifts, particularly after night shifts.

  • Keep the shift system as regular as possible.

  • Allow flexible working time arrangements according to workers' needs and preferences.

Still, the nature of shifts and schedules will vary by role, industry, and company. The intent here is to be intentional around crafting these schedules in sustainable and minimally disruptive ways, ideally with input from your shift workers themselves.

2. Find ways to cultivate autonomy and flexibility.

Intuitively, this could simply be the ability to adjust hours slightly or pick specific shifts. But flexibility and autonomy can mean much more. This can include details like if, how, and when workers take breaks, how they communicate with each other, and how they get work done. This cultivation of a sense of control has been linked to a variety of positive health outcomes for shift workers. From one study:

“Health, work–life balance, and organizational effectiveness were positively enhanced in all three of the studies that examined the introduction of self-scheduling among shift workers. Self-scheduling necessarily entails increased employee control at work, something that has been strongly associated in the epidemiologic literature and other reviews of work-reorganization interventions with improved health and well-being.” - Clare L. Bambra, PhD, et al. (source)

3. Provide consistent clarity and transparency in communications.