How employers (should) handle mental health

Late in my career as a practicing physician I came across a statistic that blew me away and changed the way I think about patient care: somewhere around 20% of prescriptions never get filled. It took me a minute to let that sink in. As a doctor, I was comfortable with my routine: I consulted with my patients, determined with them the best course of care and then used “the power of the pen” to write prescriptions to address what was ailing them.

Yet, time after time, studies have shown a large percentage of those scripts just never get picked up. “What determines that?” I wondered. I started thinking more and more about what might be causing this level of noncompliance: a lack of trust in the physician who wrote the script? Issues related to lifestyle or access to services? Cost? Or was some of this noncompliance symptomatic of broader mental health issues present in the population served?

In the early days of my career, I heard colleagues say “but the patient has been non-compliant” as if that absolved them of all responsibility. Yet when the medical industry moved more towards value and outcome-based care, there was suddenly the recognition of the clinical, social and economic consequences of noncompliance.

As I took on more administrative responsibilities as CEO of Hartford Medical Group, I became more focused on creating a culture that supported greater understanding of the underlying issues around patient care.

When I became a consultant, I joined Mindyra Health Corporation to continue this work. Mindyra provides digital assessment tools and customized resources to help employees deal with issues of mental health. We give their employers an efficient and effective way of capturing high-quality yet anonymous data on mental health of the workforce. We use technology and automation to gather and analyze that data to help employers figure out what programs can best help their employees with their mental health and wellness.

For those of us who came of age in the 60s and 70s, this is a sea change. It’s not that people from my generation weren’t interested in mental health. It’s just that, generally speaking, us Baby Boomers would never look to our employer for solutions. If you were dealing with a mental health issue, it was private. The last place you would think of seeking assistance is the workplace.

Well, times certainly do change. A recent McKinsey study found almost 60% of Gen Z respondents considered mental health resources while selecting and deciding to stay with an employer. Those from my generation? Only about one-third.

But generational change can lead to social good. More Millennials and Gen-Z’ers are sensitive to issues of mental health and looking for their employer to be a part of the solution.

For corporations and employer groups, much like for the health care industry, real change is driven by the old axiom: “follow the money.” Physicians started caring much more that people weren’t picking up their prescriptions when it began impacting their costs. The same is true of employers. They want the best for their employees, but they care a lot more about employee mental health once you show them how much it’s impacting their bottom line, either through burnout, absenteeism, lack of productivity or simply turnover.

Current labor shortages have led smart companies to understand that providing mental health tools to employees is good for business and for the bottom line. Employers recognize that if people come to work but are constantly distracted or dealing with issues that negatively impact their productivity, they are not maximizing their ability to compete as a company in a global marketplace.

When I was treating patients, I always used to say that with some disorders (like diabetes or asthma), the patient needs to know almost as much as the doctor, because of the need to vary their disease treatments in response to their symptoms.

We have to take the same approach to mental health. It’s not as simple as saying, “Go find a therapist” or “take this pill.” Through accurate testing and honing in on a patient’s specific circumstances and symptoms, we can provide people with the tools they need to find the solutions that make sense for them. Maybe it is a therapist, but maybe it’s just some psycho-education, a mobile app, participating in peer-to-peer support groups or other simpler steps instead.

In population health, we often talk about the “rising risk” group. They are not really sick yet, but they have illnesses that lead to more severe symptoms (and costs) if left unattended. Many American workers are in a similar situation with regard to their mental health. Without the right mental health support, some will continue to struggle and some will see their mental health go into serious decline. By intervening early and successfully, we can save enormous cost and significantly improve lives.

Dr. Kent Stahl is chief medical officer at Mindyra Health Corporation. He has spent more than 30 years leading physician organizations and is the former CEO of Hartford HealthCare Medical Group.