THRIVE Manager Toolkit by CernerCorporation

Healthe Minds A manager toolkit

Your guide to supporting your associates

At Cerner, we want associates to be happy, healthy and productive and understand that emotional health plays an important role. This toolkit will supply you, our Cerner managers, with tools, resources and practical guidance on how to support an associate who may be experiencing emotional distress or mental concerns. This toolkit is intended to guide you to appropriate resources for these scenarios. It is our not our expectation that managers address associate matters alone. In fact, making assumptions about an associate’s health can put the manager, the associate and Cerner at risk.* Disclaimer *Only a qualified medical professional should diagnose mental illness and you, as a manager, should not make assumptions or draw conclusions concerning an associate’s health. Many countries in which we operate have specific laws which provide definitions and contain certain obligations applicable to individuals with disabilities in the workplace. In the United States, the Americans with Disabilities Act (ADA) does consider some mental health conditions to be disabilities as defined under the law. It is the policy and practice of Cerner Corporation to comply with all federal, state and local laws applicable to all associates – U.S. based and global - concerning the employment of persons with disabilities and Cerner will act in accordance with all regulations. If an associate makes you aware that he or she may have a disability (mental health or otherwise) or, if an associate requests an accommodation, please contact your Associate Relations Partner or AssociateRelations@cerner.com for assistance and to ensure Cerner is meeting all of our obligations under applicable law.

Objectives for managers • To distinguish a difference between normal stresses of life and what might be related to a mental health concern • To know the associate resources available to help • To provide direction and support for your associates

Intended outcomes for your associates • To feel supported by their manager and/or fellow associates • To engage in tools and resources provided by Cerner • To seek professional support as appropriate

• To be proactive and have a positive influence • To have the confidence to take action when appropriate

Table of contents The impact of mental health 6 6 7 7 8

Defining mental well-being across the continuum Who is impacted by mental illness? Mental health in the workplace The cost of mental health Performance & productivity

Work-life integration for Healthe Minds 10 11 12

Create a positive team culture Set healthy boundaries Support stress management

Show your associate support 14 15 16 17 18 19

Recognize signs and symptoms Questions to ask yourself when you see sudden change Express concern: Dos and Don’ts Conversation starters: Dos and Don’ts Support: Dos and Don’ts My associate has a mental health concern

Empower and support your associate 21 22

General resources U.S.-specific resources

THE IMPACT OF MENTAL HEALTH

Defining mental well-being across the continuum Mental health Mental health is a state of well-being in which an individual realizes their own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to their community. 1

Mental health concerns

Mental illness

Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function. 2

Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. 3

Who is impacted by mental illness?

1 4 in every

people in the world will be affected by mental or neurological disorders at some point in their lives. About 450 million people currently are affected by such conditions, placing mental disorders among the leading causes of Nearly ill-health and disability worldwide. 1

2 /3

1 2 3

World Health Organization (WHO) http://www.who.int/whr/2001/media_centre/press_release/en/ Mayo Clinic

of people with a known mental disorder never seek help from a health professional. 2

The facts: Impact of mental health 300 million people worldwide suffer from depression, making it the leading cause of disability.

Approximately

800,000 people die from suicide globally each year, averaging one death every 40 seconds.

Depression is the leading cause of disability worldwide and is a major contributor to the global impact of disease. (Source: World Health Organization)

Employees experiencing unresolved depression lose 35% of productivity each week

35%

(Source: National Alliance on Mental Illness)

Mental illnesses cause more days of work loss and work impairment than any other chronic health condition, including arthritis, asthma, back pain, diabetes, hypertension and heart disease

(Source: American Psychiatric Associate Foundation)

80B

Mental illness and substance abuse annually cost employers in indirect costs an estimated $80 - $100 billion (Source: Partnership for Workplace Mental Health)

Performance & productivity

When unaddressed mental illness or emotional distress can affect performance and productivity. Distress symptoms Sleep problems Lack of concentration

Signs Lower quality work, lateness to work Procrastination, more frequent mistakes

Slowed thoughts

Indecision or trouble making decisions

Aches and pains

Doctor’s visits, time away from work

Self-medication

Missed deadlines, absenteeism

Irritability Low motivation

Poor relationships & toxic environment Presenteeism

Reduced sick days and turnover

When depression and other forms of mental illness are addressed, companies experience...

Improved productivity 8

WORK-LIFE INTEGRATION FOR HEALTHE MINDS As technology continues to advance, associates become increasingly interconnected. To integrate work and life in a healthy manner, it’s important to align habits and behaviors with personal values. Your own work-life integration will set the tone for expectations on your team.

Create a positive team culture A manager can be an important part of cultivating an environment for healthy, happy and productive associates. Creating a positive team culture allows associates to form relationships at work, which can help promote: • • • •

Open and honest dialogue Increased trust Increased focus Willingness to ask for help

Showing you care for your associates’ well-being also establishes bonds of support outside of working time.

Suggested activities

Consider establishing platforms where associates learn more about one another to foster collaboration and understanding on a personal and professional level. The more you can connect with an associate as a human being, the better you can relate to them and handle a concern.

Ways to support a positive team culture

• Schedule regular team meetings and spend five minutes getting to know each other • Facilitate team learning and development opportunities to foster interpersonal connection and gain insight into how your team members work • Work with your associates to set expectations when returning from a leave and assess each situation as appropriate

Set healthy boundaries While working on a positive team culture, it is also important to set and understand personal and professional boundaries. Boundaries will look different to each person and will ebb and flow throughout different stages of someone’s life.

Defining healthy boundaries

How to set healthy boundaries

When feasible, allow associates to make adjustments to business demands to meet the needs of their personal and family goals.

Encourage team members to care about one another, but also to respect the boundaries between personal lives and work lives.

Set the tone by also modeling healthy work-life behaviors, such as not sending non-urgent emails or communications after hours or on weekends.

Encourage associates to take time for themselves.

Manage expectations with the wide variety of demands your associates face, referring back to the positive team culture and what you know about your team. Work with your associate to set expectations when returning from a leave and assess each situation as appropriate. Practice appropriate flexibility. Create a healthy atmosphere to ensure associates feel supported in the professional environment.

Remind associates that appropriate boundaries also apply to our clients. Help new associates foster the creation of boundaries that align with their values (i.e. learn your limits and how you define your boundaries). See values worksheet. Respect the confidentiality of your associates. Treat associates’ personal information as if it is protected health information. Recognize when boundaries are crossed and coach team members as appropriate.

Support stress management Stress has many impacts on our health, both physically and emotionally. Stress isn’t always negative and can’t be avoided. It’s often a motivator to foster growth and development. Healthy methods of coping with stress - including exercise, mindfulness, reading and spending time with family and friends - can help mitigate the negative effects of stress in our lives. Basic stress management techniques: • Consider ways to optimize an associate’s time away from work. For example, establish efficient backfills and cross-training to facilitate coverage. • Managers should set expectations with associates about role responsibilities and how their work fits into the big picture. • Encourage short brain breaks to foster a stress-free activity. • Encourage associates to find volunteer opportunities to further develop and connect to a different purpose. • Encourage proper self-care, such as eating healthier, getting enough sleep and leading an active lifestyle. • Make efforts to provide an associate with regular check-ins, such as one-on-one meetings, to support them in proper stress management. From the recommendations above, it’s important to keep in mind that all roles and workforces operate differently. Our expectation is that managers use appropriate discretion when determining which actions to implement.

Know your resources

See pages 21-22 to view resources

Types of stress EUSTRESS

Eustress are positive, often chosen, stressors that people experience in life.

DISTRESS

Distress are generally unavoidable or unpredictable stressors that we often see as negative.

Lead by example It's important to set an example of positive self-care for your team. Your actions and behaviors will set the precedent for what’s expected on your team. For example, it’s important to take regular breaks, brainstorm healthy celebration ideas as a team, encourage competitions in steps or movement, be open about making sleep a priority, and demonstrate and promote proper hygiene.

SHOW YOUR ASSOCIATE SUPPORT

Signs & symptoms of mental health concerns

Show your associate support

When looking for signs and symptoms of mental health concerns, it is important to pay attention to sudden changes in thoughts or behaviors.

Withdrawal

Recent social withdrawal & loss of interest in others

Problems thinking

Lack of concentration or difficulty remembering

Change in self-care

Decline in personal care or hygiene

Apathy

Nervousness

Mood change

Increased sensitivity

Illogical thinking

Reduction in productivity

Loss of initiative or desire to participate in an activity

Heightened sensitivity to sights, sounds, smells or touch

Fear or suspicion of others

Unusual or exaggerated beliefs

Rapid or dramatic shifts in feelings

Increased absenteeism

Change in sleep/appetite

Dramatic changes in eating or sleeping habits

Show your associate support

When you’ve recognized a sudden change, ask yourself...

? ?

Has my associate made me aware of… • • • • • • • •

Recent family or workplace conflict Recent marriage, divorce or separation Recent birth or adoption Caring for elderly parents Recent death of a friend, family member or colleague Involvement in a serious incident or accident Financial difficulty Other significant life events (i.e. a move, sending a child to college, etc.)

Is my associate suddenly… • • • • • • • • • •

Making a lot of errors Distorting conversations or situations More frequently breaking down or crying Appearing agitated; quick to get angry Having difficulty concentrating on tasks or recalling activity Complaining regularly of headaches or other pains Taking more sick days or constantly late to work Having more frequent conflict with colleagues Demonstrating obsessive, repetitive or controlling behavior Having more difficulty communicating

Has my associate…

• Had a dramatic shift in personal care (untidy, unpleasant odor, unwashed hair, etc.) • Suddenly gained/lost weight, been binging or had a lack of appetite • Cited feeling particularly fatigued or tired on a regular basis 15

Show your associate support

Express Concern: Dos & don’ts

DON’T

Talk to your associate about job-related performance issues if they exist

Initiate a conversation about a potential medical issue

You CAN talk about performance issues if it’s affecting their job. If the associate says a medical condition is the cause for performance issues, then you should contact Associate Relations (AR).

Initiating the conversation about a potential medical condition could be seen as making an assumption.

WHY?

Listen compassionately If an associate talks to you about their situation, it’s okay to LISTEN, but don’t probe for details. Let them know that there are resources available to them. Direct the associate to available resources, including: • My Life Resources (EAP): US & Non-US • Offer to connect them with AR: AssociateRelations@Cerner.com If an associate confides in your about a medical condition; you MUST contact your Associate Relations Partner.

• Many countries in which we operate have specific laws which provide definitions and contain certain obligations applicable to individuals with disabilities in the workplace. In the United States, the American with Disabilities Act prohibits discrimination based on the “perception” of a disability. • It is the policy and practice of Cerner Corporation to comply with all federal, state and local laws applicable to all associates – U.S. based and global - concerning the employment of persons with disabilities and Cerner will act in accordance with all regulations. • Making assumptions about an associate’s medical condition can put the manager, the associate and Cerner at risk.

Effective listening Be present

When listening to your associates, be present in the moment. Refrain from distractions, such as using technology.

Be open

When listening to your associates, be open. Pay a ttention to body language and make appropriate eye contact.

Be engaged

When listening to your associates, be engaged. Actively listen, absorb what they’re saying, don’t use reflective listening.

Conversation starters: Dos and Don’ts

Show your associate support

Below are examples of how you can start a conversation with an associate should you observe any of the signs previously mentioned.

DON’T

• “How are things going?”

• Say nothing.

• “Is there anything specific you would like to discuss today?”

• “I understand you have had several doctor’s appointments recently, is there anything you want to tell me about?”

• “I have received feedback that you seem to be struggling with [insert area of concern] and I am concerned because that is not consistent with previous feedback I have received. Is everything okay?” • “Is there anything I can do for you?” • “Do you have any concerns that we haven’t already discussed that you would like to?” • “You haven’t been as upbeat as you normally are. Are you okay?”

• “I have received feedback that you seem to be struggling with [insert area of concern] and I am concerned because that is not consistent with previous feedback I have received. Are you having any personal issues or medical issues that are effecting your performance?” • “You haven’t been as upbeat lately as you normally are. Do you think you may be suffering from depression?”* *The initial statement is fine, it’s the follow up question that we have concerns about.

Only a qualified medical professional is able to diagnose a mental illness. This toolkit is intended to guide managers to help associates through a difficult situation. When in doubt, contact your Associate Relations partner. If there is an immediate medical emergency, call the appropriate emergency help line.

Support: Dos & don’ts Show your associate support

Engage the experts & employ your resources

DO Consult the experts & know your resources. Contact your Associate Relations (AR) partner if: • You believe the mental health concern (or any medical condition) is affecting an associate’s performance • If the associate is asking for something from Cerner (i.e. an accommodation due to a medical condition) • If you are concerned about the safety of your associate

DON’T Think you are alone.

Cerner has a variety of available resources and benefits to help. Ask the associate if they are willing to speak with an AR partner. If something is affecting their performance, or if they need an accomodation to perform their job, contact AR.

Show your associate support

If your associate tells you about their own mental health concern or mental illness, Cerner has some guidelines to help you navigate the conversation.

DO Listen. The associate is telling you this information because they trust you. Understand the spectrum of mental illness and remember a diagnosis is not an indication of an associate’s ability to complete their work. Educate yourself about mental health diagnoses and broaden your understanding around medical leave policies. If the associate is asking for support to do their job or for a medical leave, engage with Associate Relations.

DON’T Ask probing questions. Try and find out more about their mental health concern or illness than they are willing to share. Agree to any long-term or significant accommodation without engaging your associate relations partner (ARP) (i.e. schedule changes or work modifications). Always engage your ARP if the associate mentions the condition is impacting their ability to do their job.

Be flexible for their medical needs and set clear expectations. Ask what you can do to support the associate. Provide resources such as My Life Resources and THRIVE toolkits. 19

EMPOWER AND SUPPORT YOUR ASSOCIATE Cerner provides a variety of resources and benefits to associates to help them live well across the continuum of health and care. As managers, please be aware of the below resources that may be available to support your associates.

Empower and support your associate

My Life Resources (EAP)

Provides confidential, professional counseling and consultation by local providers for Cerner associates and their families at no cost. It is there to help associates resolve personal concerns which may affect his or her health, personal well-being, or job performance. My Life Resources is committed to helping with a wide range of concerns including, but not limited to: stress, depression and anxiety, grief and loss, marital or relationship concerns, legal and finance referrals, child and elder care consultations, anger management, domestic violence, and substance abuse. Contact My Life Resources (EAP): US Associates & Families or Non-US Associates & Families

THRIVE

Associates have access to a variety of mental well-being resources through our THRIVE SharePoint site. There are toolkits on mindfulness, sleep, positivity and resiliency, as well as on-demand Wellness Classes and Mindful Minutes sessions. Visit the THRIVE SharePoint site.

Total Brain exercises

A resilient brain will help to handle the challenges that life brings. Total Brain helps individuals gain resilience by assessing and strengthening cognitive and emotional capacities with engaging games and exercises. Access Total Brain here.

Physical well-being and fitness benefits Healthe Fitness Center

Healthe Fitness Centers help members stay on track with their fitness goals. The Centers offer a variety of group exercise classes, equipment, programs (virtual and in-person) and a knowledgeable staff. Visit the Healthe Fitness Center SharePoint site to learn more.

On-demand fitness

Cerner associates and spouses/partners around the world have access to a robust library of on-demand fitness classes through the Technogym MyWellness App. Classes are taught by both Technogym’s training team and Cerner’s Healthe Fitness Center Specialists. Search the app for classes based on format, length, instructor, level, or language. Learn more here.

Motion Health and Build Better Joints

Motion Health is a comprehensive program with on-site and virtual offerings designed to help you manage your musculoskeletal health. One virtual program offering, Build Better Joints, will guide you through eight weeks of mobility exercises and educational content complete with weekly support from Cerner’s Certified Athletic Trainers. Learn more here.

Health Club Reimbursement Policy for International

View information on reimbursements for Health Club (Gym) memberships by country (non-U.S.). Visit the Human Resources Cerner Wiki Knowledge Base.

Interested in mental well-being team builders and activities? Click here!

Additional resources for U.S. health benefits members

Empower and support your associate

Therapy • All health plan members have access through Cerner Health Benefits for substance abuse and mental health services. To identify a behavioral therapist or service provider, visit Cerner HealthPlan Services by logging into HealtheAtCerner.com to find a provider. • Healthe Clinic members can schedule an appointment with a Healthe Clinic behavioral therapist by calling (816) 201-CARE.

Health coach

A health coach can guide a member in making lifestyle changes (i.e. weight loss, stress management, learning healthy coping skills, healthy sleep habits, etc). Appointments can be made by logging into HealtheAtCerner.com.

Pharmacy Advocacy program

Tria Health and Healthe Clinic pharmacists will help members to manage medications; making sure they are safe, effective and affordable. The program is voluntary, confidential and available to Cerner Health Benefits primary subscribers and their covered dependents at no cost. Learn more about the Pharmacy Advocacy program here.

Your Medical Ally

Your Medical Ally helps members navigate and get the best out of the healthcare system. Members can work with a physician-led team and receive personalized treatment decision information to make more educated decisions about health and care. Information kits are available on a variety of topics, including: • Depression • Friends and Family of Adults with Mental Illnesses • Parents and Caregivers of Children with Mental Illness • Stress Management • Understanding Grief and Loss Access Your Medical Ally here.

Morgan Stanley Financial Wellness Program

In collaboration with Morgan Stanley, Cerner offers a Financial Wellness Program to help address the unique financial needs of its associates and strengthen the financial health of the workforce. Benefits of the Financial Wellness Program include a financial wellness digital portal, customized solutions and education, and financial advice and guidance. This benefit is available at no cost to U.S. associates. Learn more about the Morgan Stanley Financial Wellness Program here.

REMINDER *Only a qualified medical professional should diagnose mental illness and you, as a manager, should not make assumptions or draw conclusions concerning an associate’s health. Many countries in which we operate have specific laws which provide definitions and contain certain obligations applicable to individuals with disabilities in the workplace. In the United States, the Americans with Disabilities Act (ADA) does consider some mental health conditions to be disabilities as defined under the law. It is the policy and practice of Cerner Corporation to comply with all federal, state and local laws applicable to all associates – U.S. based and global - concerning the employment of persons with disabilities and Cerner will act in accordance with all regulations. If an associate makes you aware that he or she may have a disability (mental health or otherwise) or, if an associate requests an accommodation, please contact your Associate Relations Partner or AssociateRelations@cerner.com for assistance and to ensure Cerner is meeting all of our obligations under applicable law.