U.S. workers face major obstacles that are likely to create greater mental stress and anguish, including long and irregular hours and no guarantees when it comes to paid sick days, vacation and paid family leave, Slate reports.

Health spending per capita in the country has ballooned nearly 29-fold in the last 40 years. And while companies and their HR departments have introduced wellness programs, such as lunchtime yoga, meditation, anti-smoking or obesity prevention, these efforts are doing little good, says Jeffrey Pfeffer, a professor of organizational behavior at Stanford Graduate School of Business.

In Pfeffer's recent book, Dying for a Paycheck, he argues that all the wellness programs fail to deal with the real reasons that leave workers so frazzled. These include excessive work hours, unpredictable schedules, toxic managers and after-work emails.

Pfeffer and his colleagues reviewed 10 workplaces and how they impacted health. He stressed the title of the book is not hyperbole and that "we are literally killing people."

"We found that [workplace environments] account for about 120,000 excess deaths a year in the United States, which would make the workplace the fifth leading cause of death and costs about $190 billion dollars in excess health costs a year," Pfeffer says. "So many of these workplace practices, like work-family conflict and long work hours, are as harmful to health as secondhand smoke, a known and regulated carcinogen."

Companies and HR staff may embrace efforts that, on the surface, seem to create greater work efficiencies, but in actuality are creating greater stress for their workers, Pfeffer notes. One such effort--"just in time" scheduling software--helps managers avoid adding extra staff as a way to cut labor costs.

"But that kind of scheduling is quite stressful for workers, because you don't know what your work hours [are] and therefore what your income is going to be from one week to the next," Pfeffer says. "You don't know very far in advance when you're going to be working, so that makes it hard to plan for your other family obligations."

Employees also are forgoing vacation and going to work sick. Pfeffer acknowledges improvements over the decades, such as child labor laws, that have greatly increased physical safety in the workplace. "But we have not cleaned up the psychosocial aspects of work," he notes.

Workers also need to understand that HR may not have their back when it comes to their mental health, he said. "For the last 40 years, human resources departments in their policy manuals say you are responsible for your own health," Pfeffer says. "So you have to take responsibility for your own well-being."

Some employers have turned to so-called "mental health first aid" training that started in Australia and came to the U.S. in 2008 via the National Council for Behavioral Health, The Seattle Times reports. Through the program, 6,000 workers will receive company-sponsored training this year.

"There's a growing recognition that mental health and addiction problems are having an impact in many ways, driving up health-care costs and absenteeism," says Betsy Schwartz, vice president of public education and strategic initiatives at NCBH. "Companies know that's true."

Emma Mcllroy, CEO and co-founder of online women's apparel company, Wildfang, shared some insights about the mental stress that she and other entrepreneurs encountered in launching their startups, Forbes reports. "It would be so much easier for me to stand up and not be vulnerable--to just say, 'It's all great. I'm a big deal CEO,'" Mcllroy says. "But that doesn't help the people coming behind you who are going through the same difficulties or those who want to become entrepreneurs."

One way Mcllroy tries to create a healthy workplace is by having her employees talk about one thing they are proud of and one thing they are grateful for every Monday. The goal is "to create a culture where personal and professional lives are expressed and celebrated and there's room for both."

Mcllroy strives to "be a very human leader" by sharing "a bit more of myself with my team than I ordinarily would."

"The point is that if my team sees me going through something and can understand what I'm going through, not only does it create a human connection, but they know its okay for them to go through the same thing," she says.