As I watched that story unfold, I was reminded of the comparison between the support offered to people with behavioral health conditions versus physical health conditions. Good behavioral healthcare costs money, takes time, and deserves the same level of coverage and attention that physical health issues garner. Yet, it seems to be repeatedly relegated to the back burner or treated as an optional “nice to have” benefit. Perhaps the increased awareness of these challenges during the pandemic offers us an opportunity to shine some light on this important issue and make real progress.
A Continuing Challenge
As I discussed in my previous blog on this topic, even before the COVID-19 pandemic, mental health was an escalating challenge in this country. And I’m not just referring to the often discussed (and very serious) issue of the increasing homelessness and imprisonment of individuals battling serious mental health and substance abuse disorders. I’m referring to the daily challenges facing those around us – our families, colleagues, and friends.
Recent data from Springbuk and many other sources point to an escalating trend in mental health diagnoses over the past several years among the commercially insured - some of which has grown even more significantly since the onset of COVID-19. For example, in our data, as reported in our recent Employer Health Trends report, we saw a steeper increase in anxiety disorders being reported since mid-2020, especially among younger adult women. Prescription antidepressant use has increased in these same cohorts.
As anxiety disorder continues to be recognized as a related but separate condition from depression (actually re-recognized - Anxiety disorders were far more often identified and diagnosed than depression in the 1950s and ’60s, for a myriad of reasons - its prevalence continues to grow.
The Cultural Roadblock
The stigma of struggling with mental health and substance abuse conditions is real. And it’s pervasive. And no matter how much discussion occurs about being transparent and accepting of people’s struggles with mental health, it remains a challenge for employees to feel safe and supported when acknowledging their struggles with these conditions.
A recent survey by Ginger, an on-demand mental health company, revealed that 96% of CEOs think they are doing enough for employee mental health, yet only 69% of employees agree. And while 70% of CEOs say they’re accepting of emotional and mental health issues in the workplace, only about a third of employees believe this is true in their workplace.
This discrepancy was also reflected in a November 2020 study by PwC, which reported that just under a third of employees strongly agree that their company has successfully addressed employee wellbeing during the pandemic, including mental health and morale, although 84% of CFOs believe that they are successfully addressing these items.
It Starts at the Top
In a recent company-wide meeting here at Springbuk, our President and COO reminded us of the extended EAP mental health benefits being offered in 2021, including a limited number of free counseling sessions. After reminding everyone that these were available, she concluded with the comment, “I hope you take advantage of these benefits for you and your families - I certainly am.” The last three words were unusual to hear spoken publicly, especially by an executive. Unfortunately, this kind of openness and acknowledgment happens far too infrequently.
In 2019, the Harvard Business Review published an article on the topic of openness in the workplace around behavioral health challenges. The article reported that almost 60% of employees have never spoken about their mental health status to anyone at work. Fewer than half of respondents felt that mental health was prioritized at their company, even though 86% thought that a company’s culture should support mental health. This percentage was even higher for the youngest generations of working adults. The most commonly desired workplace changes to support mental health are a more open and accepting culture, training, and clearer information about where to go or who to ask for support.
Corporate leadership is in a unique position to set an example and model such cultural change. Yet, it happens infrequently. The Ginger survey identified key concerns of CEOs regarding talking about their own mental health and wellbeing. When asked what might motivate them to discuss their own mental health, over half indicated that it would help make them a better leader. However, 30% indicated that they only discussed it because it “comes up sometimes, so I participate.”
When asked further questions about why they might hold back from such discussions, 58% cited concerns that it would impact their credibility as a leader, while 44% feared their employees would lose confidence in them. Simultaneously, almost 90% of employees indicated they would appreciate hearing their leadership discuss their emotional and mental health. This discordance in how CEOs believe they may be viewed vs. how employees would actually view them is a key disconnect that continues to inhibit behavior that might have a significant positive influence.
Reasons for Hope
A recent article by McKinsey & Company suggests change is happening, driven by a combination of employee demands and recognition of the impact of mental health and substance abuse on cost and productivity of employees. The article identifies three main reasons to expect improvement:
As more younger people enter the workforce, they are driving a shift toward more openness and willingness to seek treatment for behavioral health issues.
Companies are becoming more aware of the productivity impacts associated with not addressing employees’ mental health issues.
The impact of behavioral health on other aspects of healthcare costs is becoming more evident. Increasing evidence shows links between behavioral health conditions and serious—and expensive—medical conditions such as diabetes, cancer, and coronary artery disease.
The article summarizes its findings as follows: “What has effectively been a “don’t ask, don’t tell” approach to mental health in the workplace is becoming instead “do ask, do tell, let’s talk.” There is a coming revolution in how companies (and public-policy makers) think about, talk about, and cope with all forms of mental health issues.”
How Employers Can Affect Change
As employers, we have an opportunity to make strides in the right direction. Offering benefits and programs are a clear first step, and an easy one compared to changing the underlying company culture. However, as the Harvard Business Review article stated, “Regardless of how robust a company’s benefits are, it is culture that ultimately reduces stigma and empowers employees to actually use those benefits without fear of retribution.”
If you don’t think that issues around mental health pose a challenge in your population, I encourage you to look beyond what might be openly discussed or diagnosed, and investigate its links to workforce productivity and physical health conditions. Combining healthcare data and productivity data might provide new insights on the role mental health conditions play in your population. The pandemic has further highlighted the need for better mental health care. Let’s not squander the opportunity to improve something so essential to our employees’ wellbeing.
For more insight into Telehealth utilization trends, download the 2021 Employee Health Trends Report.
Or, read the posts in this series on trends: