Mental health in the workplace: Shifting from stigma to solutions is key for employers

A recent all-day seminar on mental health in the workplace looked closely at mental health strategies, the role of the employer, and the challenges of regulation in the form of mental health parity rules.

Entitled “Workforce Mental Health: New Times, New Approaches, New Treatments,” the event was hosted by the Midwest Business Group on Health (MBGH), and featured more than a dozen speakers on benefits, HR management, compliance, mental health treatment, and pharmaceuticals.

Cheryl Larson, president and CEO of MBGH, outlined the results of a survey that found that the No. #1 mental health benefit strategy of member companies was manager training. She noted that this term wasn’t even on the survey a few years ago but has become the top goal for employers. “We’ve come a long way, and we all recognize the importance of manager training,” she said. She also noted that employee engagement, chronic condition management, and high-cost medical claims were top health benefit priorities in the survey. Mental health/substance abuse benefits were also a top category of employer priorities.

Mental health experts weigh in on stress and stigma

A panel of three mental health experts discussed some recent developments regarding mental health in the workplace. They agreed that this is a time of significant change: employees are much more interested in discussing mental health and finding help with their issues, but stigma is still a problem, and there are issues with proper diagnoses and simply finding providers in a time of high demand.

Megan Delp, director of workplace mental health at the National Alliance on Mental Illness, noted that a recent survey of medium and large-size employers found that although many employees are open to talking about mental health issues, barriers remain. “We found 74% of the American workforce wants to talk about mental health at work,” she said. “So three out of four people want this to be a conversation. But only 58% actually feel comfortable doing so. So, there is a gap there.”

Of those who said they were not comfortable, respondents cited stigma, fear of retaliation, and lack of communication about these issues at work as main reasons for their discomfort. “That fear, that stigma around mental health really is persistent” she said.

The survey also found that 52% of respondents said they experienced burnout in the last year. “We know that the American workforce is feeling very, very stressed—feeling overworked; feeling like they can’t catch a break,” Delp said.

The panel also discussed a new development in mental and behavioral health treatment, the use of ketamine. Marcus Capone, founder and CEO of Tara Mind, is a former Navy Seal who had personal experience with the trauma experienced by service members. He said that many of the treatments and medication that traumatized employees turn to are not effective for their types of depressions and anxiety. His company is building on research that showed that ketamine-assisted therapy can be helpful to treatment-resistant individuals. He stressed that the new treatments were clinical and therapist-guided and had been supported by recent research in the New England Journal of Medicine.

“There is this huge gap that I experienced… I was considered treatment resistant. I and millions of others have not responded to old technology. How are we helping these individuals?” he asked. “This is important because it’s affecting a portion of the workforce and also … costing the employers—there’s a significant cost here.”

The panel also looked at advances in technology. Tarolyn Carlton, PharmD, director of global medical strategy, digital medicine and therapeutics at Otsuka Pharmaceutical Companies, discussed some new developments in digital therapeutics, saying that this area opens new opportunities for employees. She noted that that access is a major benefit of a more digital approach. “Think about it, if you’ve got digital therapy, the patient no longer has to wait to get seen,” she said. Carlton mentioned that wait times for therapists can be six months in some cases. “Just imagine suffering for six months waiting to get better treatment,” she added. The ability to cut down on wait times, and get more timely help— “That’s huge,” she said.

Employer perspectives—showing leadership is key

An afternoon session covered new strategies for improving mental health in the workplace for employers. One topic covered was the state of Employee Assistance Programs (EAPs), the long-standing entity for helping employees with issues such as mental health.

Tara Sherman, mental health and wellbeing strategy leader for The Boeing Company, said that EAPs are evolving. “We are in the process of moving from a traditional EAP to one of the more innovative EAPs out there,” she noted. “The concept is that all the (EAP) providers are in our health plan as well,” she said, adding that the new arrangement gives coverage to more sessions for employees. “That continuation of care is something that is really important to us,” Sherman said.

The panel also addressed the change of attitude in the workforce toward talking about mental health. Wendy McLaurin, deputy director of human resources for the City of Gary, Ind., said that younger workers were sometimes leading the way on reducing stigma among the city workers.

“One of the things that we’ve noticed is that is that our employees are now younger; we’re finding out the millennials are not concerned about being labeled, not concerned about reaching out for help,” she said. “They’re very open and honest about the need to have help. So, the stigmas we see in our older workforce… part of the work is through our younger workforce, [older workers] are looking at them and saying, ‘maybe it’s ok to reach out and get help.’”

Sherman noted how important it is for leadership to provide the same kind of example to workers. “We had a middle-aged, white male executive who said, ‘I’d like to share my story,’” she recalled. “When he shared that, we had several other employees start to come forward. Providing these journeys, providing these stories, gives people someone they can relate to… it helps people feel like they’re not alone.”

Employers prepare for new mental health parity rules

Margaret Faso, executive director of the American Health Policy Institute and senior director of public policy for the HR Policy Association, also spoke at the conference, outlining the challenges of a new mental health parity rule.

Faso noted that regulations can be dense and difficult to dig through but added that the new mental health parity rule could have a significant effect on employers. The new rule came out last year and will be finalized in 2024. It will likely impose new mental health parity obligations on employer health plans, with impacts on reimbursement rates and administrative/compliance costs, Faso said.

Related: Breaking the mental health stigma: A ‘spicy’ conversation

“We’re hoping that we see an increase in reimbursement rates,” as a result of the changes, she said. “This will bring providers into networks, but at the same time we’re likely to see an increase in administrative and compliance costs.”

Faso said employer groups have worked with the Department of Labor to find more clarity on rules around mental health parity, and although the new rule is expected to be detailed and provide guidance, it still is likely to impose new burdens on employer-sponsored health plans. This will require employers to work closely with third party-administrators and other partners to make sure everyone is on the same page and in compliance, she said. When asked to be more specific about cost increases, Faso said it was hard to predict for sure, but the best guess is that administrative costs could increase from 2% to 7%.