Rethinking employer strategies for mental health remission

The COVID-19 pandemic blindsided businesses, triggering an urgent scramble among employers to address a rapidly escalating mental health crisis. Now, four years later, mental health issues still loom large, prompting a critical question: Have these solutions truly made a difference?

With depression and anxiety set to cost the global economy $16 trillion per year in lost production by 2030, HR and benefit professionals are beginning to reevaluate workplace mental health solutions to determine if they have a meaningful impact and identify areas for improvement. There is an opportunity to reimagine the employer's role in mental health remission, simultaneously improving employee well-being and reducing costs linked to lost productivity.

From August 2020 to February 2021, adults with recent symptoms of anxiety or depression increased to 41.5% from 36.4%, according to the Centers for Disease Control and Prevention. Since then, mental health has remained a significant concern in the U.S. In February 2021, 39% of adults reported symptoms of depression and anxiety. By 2023, that percentage had only dropped to 32%. 

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Elevated rates of substance use coincided with pandemic-related mental health issues. The use of opioids alone increased 57% during the first year of the pandemic, while opioid-related deaths rose to 81,806 in 2022 from 49,860 in 2019, a staggering 64% increase. 

To address rising mental health concerns related to the pandemic, a number of employers turned to traditional employee assistance programs (EAPs), which are generally comprised of short-term counseling and psychiatric services. However, many of these solutions fell short of their goals and are now under review – highlighting a gap between intention and outcome.

One reason EAPs are typically ineffective is that they focus on reactive rather than proactive measures. The solution only comes after employees have reached a crisis point. Historically, EAPs have also been underutilized, with only 5 out of every 100 employees using them for personal counseling in a year.

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Although EAP services can be beneficial, their one-size-fits-all approach often only addresses symptoms of depression, anxiety and substance use rather than root causes that are unique to the individual.

This calls for a more personalized, holistic approach that has the power to not only treat but also prevent the broad reasons for mental health challenges. The concept of "whole" health at work transcends traditional mental health services to encompass physical, emotional and social well-being. Studies have supported this approach's effectiveness in reducing depression, anxiety and stress. 

By reimagining mental health as holistic health, employers can create with the help of their benefit advisers a healthy and high-performing workforce. Here are several practical and proven strategies that organizations can implement to support their employees in achieving sustained improvements in mental health:

1. Promote a holistic mind-body approach.
Although the use of therapy is on the rise in the U.S., the nation's mental health continues to decline, suggesting that therapy alone is not a full-stop treatment. This is why a holistic, whole-person approach in the workplace and beyond is crucial to address mental health concerns. Practices such as mindfulness and breathwork have been shown to improve mood and reduce anxiety. Additionally, proper sleep, physical exercise and nutrition can combat symptoms of mental health disorders. Employers can help employees build these habits by practicing themselves, encouraging healthy work-life balance and embracing a flexible work environment.

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2. Create a supportive environment.
According to the National Alliance on Mental Health, 74% of full-time employees in the U.S. say it is appropriate to discuss mental health concerns at work, but only 58% feel comfortable sharing, citing stigma, lack of communication and retaliation as key reasons.

To overcome these barriers, organizations must foster psychologically safe workplaces. Promoting mental health benefits and investing in ongoing mental health and well-being training for senior-level employees can be effective places to start fostering a positive culture.

3. Provide comprehensive access to care.
Employers need to ensure that mental health services are easily accessible. This includes offering clinically validated digital mental health solutions, which have proven effective in providing convenient, high-quality care.

A study by Meru Health, Harvard University and several other institutes found that therapist-supported holistic digital mental health interventions reduced depression and anxiety symptoms for up to 24 months after treatment.

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4. Make care more affordable.
In 2021, a Kaiser Family Foundation study revealed that 39% of employers adjusted their health plans due to the pandemic. However, only a few of them made changes that lowered employee mental health expenses. 

Lowering costs is vital for improving access to mental health services at work. Employers can achieve this by expanding provider networks, increasing out-of-network coverage and waiving or reducing cost-sharing for mental health services.

5. Ensure anonymity and confidentiality.
Studies point to mental health stigma as a contributing factor to the underutilization of mental health care at work. So, while employees may have access to support, they may fear that their identities and concerns will not remain confidential.

Providing employees anonymous access to strictly confidential in-person and digital mental health services is essential to getting everyone the treatment they need.

6. Regularly review and adapt.
It's important to regularly review and adjust mental health strategies to meet employees' changing needs. Creating a mental health task force can help gather feedback and update initiatives. This continuous approach ensures that programs stay relevant and effective. Companies can gauge the effectiveness of their mental health programs in terms of return on investment using validated scales such as the Work Productivity and Activity Impairment Scale.

Employers will continue to play a crucial role in addressing the ongoing mental health crisis. By recalibrating the mental health strategies they offer, they can create a supportive and effective workplace environment. 

Furthermore, evidence-based, holistic approaches can improve employee well-being in the long term, reduce costs associated with lost productivity, and even serve as a competitive edge in recruiting and retaining talent.