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May 23, 2017

13 Reasons Why You Need a Mental Health Benefits Strategy

Jami Longlais
Senior Director of Analytics
Artemis Health

The Netflix series “13 Reasons Why” explores the topic of teen mental health, and it has attracted some criticism and controversy. Mental health professionals are concerned that the show glorifies the main character’s suicide as a means of revenge.

On the other hand, some are praising the show’s willingness to openly discuss an issue that is too often seen as taboo. Mental health is a hot topic for employers now, and many are struggling to find the right means to help employees struggling to access quality care. Since May is Mental Health Month, let’s explore 13 reasons why employers should make this a priority in their benefits strategy.

Reason 1: We can’t pretend it doesn’t exist anymore.

Employees suffering from depression, anxiety, or other mental illnesses are still expected to show up to work, perform at high levels, and act professionally - all while hiding their illness. Mental health is rarely (if ever) discussed at work, so even if an employee is lucky enough to have an outlet or “safe space” for open discussion at home, it’s taken away everyday from 9-5. For the best outcomes, patients need encouragement and acceptance in all parts of their lives. A robust mental health strategy lets employees know that you support them in their healing and will offer resources as needed.

Reason 2: You can address opioid addiction and substance abuse in your population.

In 2015, an estimated 20,101 overdose deaths were due to prescription painkiller abuse. Artemis Health hears from employers regularly with questions about how to combat opioid and other substance abuse issues. It’s a difficult problem to track because benefits data comes from medical and Rx vendors, not from illegal sales of opioids. However, the CDC reports that health providers wrote 259 million prescriptions for painkillers in 2012, enough for every American to have a bottle.

Statistically, this is a nationwide problem affecting employees in all professions and from all walks of life. As Kristin Torres Mowat, Senior Vice President at Castlight, told Employee Benefit Adviser, “Sometimes the popular press gives them a misguided perspective that this is only a problem among the disenfranchised and the unemployed...this is a problem that’s happening among the employed and otherwise actively-engaged people.”

Employers should consider the cost of addiction treatment vs. the cost of employee absenteeism, subsequent health problems, liability, and loss of productivity. The cost of rehabilitation facilities can vary greatly - this piece estimates anywhere from $2,000 to $25,000 a month. While costly, we believe it’s worthwhile for employers to provide benefits for substance abuse that truly address the needs and challenges of struggling employees and their families.

Reason 3: It boosts employee engagement.

Providing mental health benefits and services is an investment in the success and productivity of your employees. Mentally healthy employees are better able to focus, less likely to miss work, and better able to adapt to changes on the job.

Employee engagement is very closely linked to health and well-being. Recent studies have found that managers who get the most out of their teams are those who mitigate stress (i.e. showing calm in the face of a fast-approaching deadline) instead of cultivating it.

Reason 4: If you have an EAP, it’s likely underutilized.

What percentage of your employees would you estimate need EAP services at some time in their tenure? 10 percent? 15?

Unfortunately, studies have shown EAP utilization hovers around 3%! These benefits have expanded, improved, and transformed to keep up with changes in the workforce, but many employees aren’t aware or engaging with them. Some think they’re only aimed at suicide prevention or only focused on substance abuse.

Most employees only hear about EAP benefits once a year. Even then, it might be on the second-to-last page of the open enrollment booklet. Employers need to step up efforts to publicize EAPs to employees and ensure they understand the value of these benefits. We’d encourage all employers to move those benefits to the front of their communications materials this year. EAP services need to be promoted throughout the year, as well - they’re a key component of a good mental health benefits strategy.

Reason 5: Disability claims are more expensive than comprehensive mental health benefits.

Did you know that the average length of a long-term disability claim is 34.6 months? This puts a tremendous strain on resources for employees and employers alike. Disability claims are often open-ended, and employers can’t predict costs for these benefits effectively.

Mental health is one big contributor to disability claims. Artemis Health’s analysis for one employer found that employees with depression racked up 9.7 times more disability work days absent than those without this diagnosis. Anxiety sufferers had 12.3 times more disability work days absent than those without anxiety.

Employers can help employees find resources and ensure they stay in their role and maintain their financial health during treatment - all while limiting the cost and risk of prolonged absences.

Reason 6: Employees shouldn’t encounter roadblocks when seeking treatment.

According to the National Business Group on Health, 1 in 5 employees sought mental health counseling last year, but 74% of these people experienced difficulty in getting treatment.

Employers spend a lot of time and effort making sure their members are directed to in-network resources, on-site clinics, wellness programs, and more. Why should it be easy for employees to identify physical health resources, but hard to find mental health resources?

Employers should actively engage in communications strategies that help employees get treatment when and where they need. Whether it’s through a company wiki, frequent webinars, or an internal ad campaign, employers should educate members on how and where to address mental health needs within their plan.

Reason 7: It’s part of progress in the workplace.

The barriers between our personal and professional lives are increasingly thinner. Only a few decades ago, it was rare for LGBT employees to disclose their sexual orientation to coworkers. These employees now have the freedom to be open about who they are, and to do so in all aspects of their lives.

For employees with mental illness, it could be highly beneficial to have this same freedom to be open without fear of stigma. A comprehensive mental health strategy may encourage those in treatment to share with coworkers who are dealing with similar issues. This can also combat feelings of isolation and encourage a sense of community.  

Reason 8: Employers need to address absenteeism.

Artemis did a recent analysis with a client on the relationship between absence hours and employees diagnosed with depression or anxiety. The results were very clear - those diagnosed with these mental illnesses were absent 1.3 to 1.7 times more than a control group.

Employers are seeking ways to combat absenteeism because:

  • Those absent lose out on valuable training and professional development
  • It affects relationships with team members who pick up the slack
  • It can impact the overall success of company initiatives and projects

Reducing absenteeism is on the radar of just about every benefits team, and mental health programs should be one chapter in this story.

Reason 9: It’s a factor in your Rx spend.

In his book “Brain Maker,” Dr. David Perlmutter writes, “Last year, 30 million Americans were prescribed $12 billion worth of antidepressants.” The percentage of Americans taking these drugs continues to rise at incredible rates, and while some are inexpensive generics, pharmaceutical companies continue to develop and advertise patented versions that patients ask for by name.

By some estimates, as many as 1 in 4 women in their 40s and 50s take an antidepressant, and 1 in 10 people are on medication for mood disorders. These are big contributors to any employer’s overall Rx spend. Many psychologists recommend therapy along with medication as a more effective way to treat mental illnesses. Access to this type of care could not only improve patient outcomes, but also save on prescription spending in the long run.

Reason 10: It may protect against workplace violence.

This disturbing infographic provides an overview of some stats around workplace violence:

  • Workplace violence accounts for 17.8% of simple assaults and 12.9% of aggravated assaults
  • There were 403 workplace homicides in 2014 (but the rate is dropping)
  • The perpetrators are usually strangers, but a staggering 25 of the workplace homicides in 2014 were committed by colleagues

The availability of mental health services can help workers deal with interpersonal relationships in a healthy way. And don’t forget, these benefits also impact covered family members. Domestic and partner violence can overflow into the workplace, so it’s crucial to offer counseling and mental health services to those facing violence at home.

Reason 11: Stress is a fact of life.

54% of employees report high stress on the job, and that’s only counting work-related issues. Even in a low-stress role at work, many employees are facing stressors at home that impact their performance. This Forbes piece examines the major causes of absenteeism in the workplace, and they identify stress as a top cause right alongside illness, injury and job hunting.

A strategic mental health benefits package sends employees a clear signal that their employer cares about their stress level. So do fitness and wellness programs. After all, exercise and physical fitness are widely shown to relieve stress and improve mental health. We recommend considering both traditional mental health services and fitness/wellness programs as part of a comprehensive benefits strategy.

Reason 12: Great benefits attract and retain talent.

Employers are running a continual race to find, court and keep the highest performing workers. Let’s imagine a top-performing manager with a reputation for building productive and happy teams that add incredible value to the company. This manager is looking to move up and start a new challenge, and she’s being wined and dined by two of your competitors. Unbeknownst to you or your competitors, she has a son diagnosed with autism.

Her child needs Applied Behavior Analysis (ABA) therapy to socialize him and teach positive behaviors. Out-of-pocket costs are ridiculously expensive, so she’s only considering a new role with a company who offers coverage for ABA. Your company might pay $60,000 a year for this benefit per child, but you also know the value she could bring to your organization is many times this amount.

This is just one scenario in which mental health benefits could be the deciding factor for a great job candidate. Employers might be missing out on the best of the best if they aren’t factoring mental health into their strategy.

Reason 13: Mental health resources can reach a remote workforce.

Workers at large, self-insured employers are likely to be spread across vast geographic areas, where mental health treatment options are inconsistent from city to city. Employers might have white collar employees in large metro areas who have consistent access to high-quality practitioners, while those in a fabrication plant in a rural area would struggle to find more than one licensed therapist in a town 20 miles away.

A 21st century benefits strategy can address this divide. Think beyond medical insurance to telemedicine, EAPs, on-site clinics and other resources that are place-agnostic. Employers might not immediately think of these resources as part of a larger mental health strategy, but they can all work in tandem to dispense quality services to a remote workforce.

Bonus: Because benefits teams truly care about employees.

HR teams are the standard bearers for their organizations. These dedicated professionals are on the cutting-edge, setting workplace policy and implementing changes with lasting effects for years to come. While the C-suite looks at fiscal data, benefits administrators look at human data.

Fundamentally, all of this work comes down to helping employees do their best work, so it’s up to HR professionals to make the case for better mental health strategies on behalf of employees.

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