Employers must take bold action to address the current mental health crisis

The mounting mental health crisis

Prior to the COVID-19 pandemic, most employers (66%) identified mental health as the top clinical priority to address by 2021, according to the Willis Towers Watson 24th Annual Best Practices in Health Care Employer Survey.

This level of employer focus was driven by the rising prevalence of mental health conditions prior to the pandemic — with around three in 10 employees suffering from severe stress, anxiety or depression, according to the 2019/2020 Global Benefits Attitudes Survey.

As expected, our research collected during the pandemic indicates a worsening state of mental health among workers — over nine in 10 employees (92%) now report some level of anxiety, with 55% indicating a moderate or high degree of anxiety. Employee anxiety and stress from the pandemic is also having a significant negative impact on productivity with seven in 10 workers (70%) conveying at least some distraction from work due to COVID-19 concerns and only one-third (32%) saying they can balance working from home and other responsibilities.

These statistics no longer highlight a problem, they indicate a crisis.

As organizations gradually reopen the workplace, 47% say enhancing mental health services is a top priority over the next six months, according to Reopening the Workplace: Health, Safety and Wellbeing Employer Survey. Importantly, 66% of employers recognize accessing high-quality mental health solutions in their health care program is a top priority according to our 2020 COVID-19 Benefits Survey, with companies most focused on expanding mindfulness programs, training for managers and high-touch navigation.

It’s time for employers to “hit reset” on their approach to mental health and this article proposes actions they can take to make a positive impact for their workforce.

Taking bold action

Four actions employers can take to hit reset on their approach to mental health

1. 01

   Understand the complex emotional wellbeing needs of your employees

   Taking bold action to address the mental health crisis begins with understanding the complex needs of your employees and putting your employees at the center:

   • Our research on employee wellbeing strongly links poor mental health to other physical health and financial issues. Many employees are living paycheck-to-paycheck, and most have at least one member of their household living with a chronic condition.
   • For most employers, the top presenting conditions for employee assistance programs (EAP) are stress, domestic relationships, anxiety, depression and financial issues.
   • There is a strong association between chronic conditions and mental health conditions — specifically depressive disorders, according to the Centers for Disease Control.
   • Our research from the Global Benefits Attitudes Survey indicates that organizations with a high culture of health and wellbeing also tend to have fewer employees reporting average or high levels of stress.

   Undoubtedly, the COVID-19 pandemic has exacerbated this medley of financial, physical health and social issues impacting mental health. Therefore, as outlined above, employers should evaluate the specific emotional wellbeing needs of their workforces across key indicators such as lifestyle risk, disease prevalence and barriers to care. This initial assessment is most likely to reveal a spectrum of employee mental health needs ranging from healthy, mild disruption, moderate disruption and severe disruption. Understanding the baseline mental health needs of your workforce is critical to developing a long-term and sustainable approach.

   Understanding the baseline mental health needs of your workforce is critical to developing a long-term and sustainable approach.

1. 02

   Design for impact — ensure your benefits design and vendor partners deliver an enhanced employee experience

   In response to the increased need for mental health support during this pandemic, many employers have wisely focused on communicating existing mental health resources and some have expanded access to virtual mental health solutions. However, to ensure these changes make a sustainable impact, there are additional actions employers should consider:

   • What is the role of your EAP? Most employers in the U.S. offer an EAP. Too often, EAPs are not effectively promoted and are sometimes positioned as a crisis-assistance resource rather than an integral piece of the employer’s overall benefits or wellbeing ecosystem. For employees who contact the EAP, the likelihood of successful issue resolution is often dependent on the employee’s ability to independently navigate the list of providers or referrals obtained from the EAP.
     Employers should re-evaluate the role of their EAP by focusing on these key areas — improve the member experience, enhance support hours for trainings and critical incidents, supplement telephonic and face-to-face visits by providing access to virtual therapy/psychiatry, leverage digital, cognitive- based therapy resources, and rebrand the EAP to highlight the full spectrum of its services, including high-value work/life resources.
   • Out-of-network mental health utilization continues to be a significant concern. For a myriad of reasons — including the need for faster access, continuity of care and a preference for higher quality providers — some employees and their covered dependents obtain mental health care with out-of-network providers. Patients who seek care with out-of-network providers are more likely to have higher out-of-pocket expenses for consultation fees and other charges. To address affordability, employers should re-evaluate the benefit differentials between out-of-network and in-network mental health services. To address quality and wait time concerns, employers should consider emerging network solutions that prioritize faster access to high-performing, evidence-based behavioral health providers.
   • Have you mapped the employee’s mental health journey? Almost half of employees with mental health issues have sought support from their employers (social network at work, manager support or employer provided services/benefits), according to our Global Benefits Attitudes Survey. As employees navigate your benefits ecosystem, a set of shared experiences emerge, and perspectives are formed — whether negative or positive. Employers should understand their employees’ journeys as they navigate resources to support their mental health needs.

   Therefore, employers should consider role, process and vendor changes to enhance the employee’s overall employee experience, including improvements in member navigation, especially for complex care.

   Employers should consider role, process and vendor changes to enhance the employee’s overall employee experience.

2. 03

   Elevate your workplace culture to align with your company’s values

   Many organizations have well-established core beliefs and values such as caring for their employees, promoting health and safety, and fostering an inclusive and diverse workplace. Such organizations now have the unique opportunity to re-commit to their values as part of a broader cultural emphasis on employee mental health during these times.

   Vocal, visible, and intentional commitment from leaders and managers to address mental health issues in the workplace goes a long way to end stigma and create a workplace culture where employees feel comfortable to seek support. In addition to executive sponsorship, here are examples of other specific actions HR and benefits leaders can take (with supporting data from our 2020 COVID-19 Benefits Survey) to enhance their culture around mental health issues as a result of the pandemic:

   • Manager training: More than half of employers (51%) provide or are planning to provide manager training to recognize signs of anxiety and depression, and how to refer to resources such as EAPs.
   • Increased workplace flexibility: To address anxiety and loneliness, 85% of employers have increased video conferencing for work and non-work purposes, and 73% offer flexible work hours allowing employees to manage work and home challenges.
   • Caregiver benefits: 26% of employers will enhance their caregiving benefits (childcare, eldercare, etc.) to address the increased pressure on employee work/life responsibilities during the pandemic.
   • Emphasize social connections: Organizations with existing infrastructure around affinity groups or employee resource groups should promote these social networks and connections. With existing shelter-in-place orders and/or guidance on social-distancing, employee loneliness and a lack of social connections is contributing to heightened levels of stress and anxiety. As a result, 55% of organizations already have or plan to promote employee resource groups (or affinity groups) to encourage employee discussions among those with common interests/situation, while 11% have measured employee loneliness/social connection.
   • Change management and communications: Understandably, 67% of employers will communicate benefits or programs that are important to employees during this time — including mental health resources. Employer communications have leveraged traditional and non-traditional methods to engage a broad spectrum of employees. Given the unique needs of workforce segments during this time, it’s critically important for employers to consider an evolved change and communication strategy that incorporates (and is informed by) employee sensing gathered through virtual focus groups or pulse surveys.

   Vocal, visible, and intentional commitment from leaders and managers to address mental health issues in the workplace goes a long way.

3. 04

   Measure and improve tactics

   Taking bold action to address the current mental health crisis also requires a measurement approach that is designed to proactively inform, assess and improve the employer’s approach. Employers should develop a measurement framework or module for mental health that tracks both leading indicators (registration rates, utilization rates, etc.) and lagging indicators (financial and health-related program outcomes, business outcomes e.g. productivity, safety, etc.).

   In closing, employee mental health has worsened as a result of the pandemic and employers must take bold and deliberate action to address the multiple facets of this crisis in a cohesive manner — understanding workforce mental health needs, redesigning the current employee experience, elevating the workplace culture, and developing a measurement approach that ensures the effectiveness of actions taken to address the mental health crisis.

Author

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Abinue Fortingo

Director, Health Management, Health and Benefits

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