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Dr. Talia Varley holds a Master of Public Health from Harvard University and MD from McMaster University. Dr. Seema Parmar holds a PhD in International Public Health from the Johns Hopkins Bloomberg School of Public Health. They are leaders in Advisory Services at Cleveland Clinic Canada, a medical centre where physicians, wellness experts and management consultants help organizations improve employee health and manage organizational risk.

Since the beginning of the pandemic, we’ve seen the best of Canadians – strong support for essential workers, hybrid work innovations, a quickly expanding social safety net and significant engagement in new policies to keep us safe. Unfortunately, we’ve also seen the worst, and frontline workers including retail staff, customer service representatives, first responders and clinicians have borne the brunt.

Many have been yelled at, insulted, suffered racial slurs and even faced physical aggression. Individual “microtraumas” do not require post-trauma treatment so they are easily missed. However, these smaller scale insults and negative experiences build up over time and can lead to devastating personal health issues including low self-esteem, anxiety, depression and chronic stress. And the effects of these microtraumas manifest in the workplace, lowering productivity and engagement, increasing absenteeism and straining relationships with colleagues.

The healthcare industry has been familiar with microtraumas for years. Intoxicated patients, profanity, slurs and boorish behaviour are common in the nation’s clinics and emergency rooms. With many of today’s workplaces stressed, short-staffed and challenged to deliver services at a time when the pandemic has fuelled caustic behaviour, microtraumas now plague the frontlines of countless sectors. Making matters worse, many frontline employees receiving public insults lack the training, messaging or company support to effectively deal with these difficult situations.

Given microtraumas are difficult to label, stats are few. However, as physicians and business advisers we are seeing more companies seeking help to support and retain frontline staff suffering from mental-health issues that can lead to disability or resignation. Meanwhile, during exit interviews, frontline workers are revealing that continuing microtraumas have contributed to their poor mental health.

Fortunately, there are effective ways to equip staff to manage and cope before they quit, with many of the tactics used and proven in the healthcare industry. They include both reactive and proactive supports:

Reactive supports

  • Train managers to identify signs of distress and coach employees through difficult situations.
  • Create a “safe room” for customer-facing employees feeling distressed.
  • Offer employees breaks to step away and reset.
  • Hold regular meetings with staff to discuss challenges, concerns and potential solutions.
  • Recruit mental health champions and peer supporters willing to share their experiences, provide support for co-workers and promote mental health resources.
  • Offer help in settings outside the workplace, in confidence and without judgment, for those who are uncomfortable sharing concerns with co-workers.
  • Monitor absences, tardiness, declining performance and resignations to identify employees or teams who are struggling.

Proactive supports

  • Add physical signs and customer policies that explicitly state behaviours that will not be tolerated and follow through with consequences when those boundaries are crossed.
  • Redesign the physical space to create an environment that supports mental health (for example, bright lights, plants, clutter-free).
  • Offer user-friendly mental health and wellness resources accessible through multiple mediums such as employee portals, phone apps and printed material in lunchrooms.
  • Provide tips and guidance on stress management and self-care.
  • Instill a culture of kindness where good news is celebrated and shared, and managers are encouraged to check in with and show appreciation for employees.

Training is key

Verbal de-escalation techniques and simulation training sessions that replicate customer interactions are critical. Verbal de-escalation techniques have three core components – behaviour, physical stance and discussion – all aimed at trying to calmly defuse the intensity of the customer’s anger. Simulation training sessions replicate customer interactions to provide employees with the proper knowledge, tools and mindset to effectively deal with micro-aggressions. Such sessions allow employees to practice company-approved responses, techniques and messaging in a safe environment until they become confident and comfortable. In addition, these sessions reinforce an organization’s commitment to and support of frontline staff.

We work with multiple companies across industries including retail and call centres whose employees are subject to microtraumas stemming from customer anger, threats and aggressive behaviour. A new urgency to retain frontline staff given current staff shortages has encouraged these companies to invest in new and innovative supports including mental health training, expanded mental health benefits with 24/7 mental health support, peer support programs and easily accessible clinician-crafted educational material available on websites, videos or podcasts.

Importantly, we all have a positive role to play. The next time you are checking out at the grocery store or talking to a call centre attendant, think about the ‘”microkindnesses” you can offer. These small acts of kindness are known to increase serotonin, which improves mood and health; decrease cortisol, our stress hormone; and benefit everyone involved, even those who witness it.

This column is part of Globe Careers’ Leadership Lab series, where executives and experts share their views and advice about the world of work. Find all Leadership Lab stories at and guidelines for how to contribute to the column here.