Expanding access to mental health care: How employers can (and should) take the lead

We are watching a mental health crisis unfold in this country. The Covid-19 pandemic turned many employees into essential workers overnight while others became remote, indefinitely. Schools went virtual, family members were separated, there was a barrage of negative news every day, and life as we knew it was canceled. Many Americans spent the better part of a year in some form of isolation, and it has taken its toll on our collective mental health. A recent survey by the Kaiser Family Foundation found that 41% of adults reported symptoms of anxiety and depressive disorders. Prior to the pandemic that number was 1 in 10.

Related: Stress, anxiety and chronic back pain: 3 ways employers can help

Employees are facing a new set of challenges as they navigate back to “normalcy” while managing the fallout of the past year. Employees who are struggling with feelings of depression and anxiety are more likely to feel stress, have higher rates of absenteeism and lower rates of productivity. According to the American Psychiatric Association, employees with unresolved depression experience a 35% reduction in productivity, contributing to a loss of $210.5 billion a year in absenteeism, reduced productivity, and higher medical costs. Adding to the challenge, we also face a shortage of mental health providers nationwide, making it difficult to find care.

There is some light at the end of the tunnel though, in the form of engaged employers. American businesses can help mitigate the growing mental health crisis for their employees by addressing three key barriers: access to mental care, the costs associated with it, and the stigma attached to it.

Increasing access

When companies provide access to health care services to their employees – including mental health care – their employees enjoy better health outcomes which in turn help improve productivity and reduce medical claims. Employers who provide onsite preventive health care are able to offer their employees exclusive access to a health center where they will not need to compete with the general public for appointments. This is particularly critical for mental health care but is beneficial for all forms of preventive care.

By providing better access, virtually no wait times and personalized, unhurried appointments to their employee population, employers reap the benefits of a healthier workforce. Employers see an average annual savings of about $2000 per employee per year in health care costs when they provide access to an onsite preventive health care clinic. This is in addition to the financial benefits of having happier, healthier and more productive employees.

Managing the cost

There is a two-fold barrier that employers need to manage — there’s the cost to the employee (often out-of-pocket) and the cost to the employer (often out of control). 156 million Americans receive health insurance through their employer, but many times mental health care services are not fully covered. This is often because those employers are self-insured, meaning they are paying employee health care claims themselves.

Many mental health providers do not take insurance, meaning patients must pay out-of-pocket, which can cost anywhere from $75-$200 per session. For some, these costs are an insurmountable barrier to seeking out mental health care. One solution is for businesses to work with a workplace health care partner to mitigate those costs by converting their health care spending to a fee-based expenditure.

Unlike the established health care industry that encourages volume (doctors get paid for each patient visit/interaction), an employer-based health care provider can work with companies to establish primary care services with a fee-based structure. Because the health partner isn’t paid for each and every appointment, they can instead focus on patient health outcomes – working with patients to manage chronic issues like high blood pressure and diabetes and providing key services like mental health care. This helps produce healthier employees while also providing a significant cost savings on overall health care spending – even with mental health in the mix.

Removing the stigma

Unfortunately, there are still those who attach a stigma to seeking mental health support, but there are a number of ways employers can help break down these barriers:

• Open a dialogue — Providing access to mental health benefits is only one piece of the equation. Getting employees to use those benefits is another issue. Company leadership can help here. When managers and leadership openly talk about the importance of mental health, especially their own experiences, it helps to remove the stigma in place. Leaders should have these conversations in a variety of outlets and formats – one-on-one, group settings, etc. – so that it becomes part of the natural discourse (not something to be feared) and give employees space to take care of themselves.
• Tie mental health to professional development – Mental health professionals can provide employees with a number of skills needed to help in their professional development – from conflict resolution to stress relief or improving communication skills. These skills not only help with professional development but also give employees the tools they need to navigate their own social and emotional lives, helping them to strengthen their personal mental health. Once employees have been introduced to the mental health providers through professional development, it removes barriers for those same employees to seek support for mental health care if and when needed.
• Provide ongoing education — Some employers are utilizing monthly webinars on mental health topics to educate employees about access to care and to encourage participation. These webinars can be recorded so employees can participate live or view later, at a time more convenient for them. Mental health professionals can discuss topics ranging from managing stress to grief and bereavement to parenting – and provide practical tools that will employees manage these situations.
• Create peer-to-peer opportunities — Employee support groups (organized and supported by a mental health professional) can provide a safe place for employees to discuss issues and talk about the benefits of mental health care. Many people are hesitant to seek mental health treatment but are willing to join a club or peer group to discuss issues and test the water. Many employee support groups can be in the form of things like book clubs, where the topics of the books being read directly relate to issues employees are wrestling with today – like navigating aging parents/eldercare and the toll it takes on the caregiver or parenting a teenager and the stress resulting from that.

While many are calling for a “return to normal,” it’s clear that “normal” is not going to look the same as it did pre-COVID. Many companies are shifting to hybrid work environments, people are moving and changing not just jobs but entire careers, and many of the stresses that resulted from the past year are not going away easily.

What is certain is that companies that support the mental health of their employees will be better equipped to navigate whatever comes next. Employers nationwide have the opportunity to take a leadership role in managing the current mental health crisis – and those who step up to the plate will be all the better for it – with healthier employees and healthier bottom line.

Jeff Wells, MD, is the CEO & co-founder of Marathon Health, an employer-based health care provider with onsite and near site clinics in more than 40 states nationwide, serving both large and small employers by providing preventive health care to their employees and family members.