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Large employers see ‘dire need’ for mental health services



Of all the pandemic’s impacts on employer-sponsored health plans, none are as widespread as declining mental health, according to survey results from the Business Group on Health released Tuesday.

The nonprofit’s annual survey of large employers found that 77% were seeing increased mental health issues, such as depression, anxiety and substance abuse disorder, while an additional 16% said they anticipated mental health impacts in the future.

That share represents “a stark jump” from BGH’s 2022 survey, in which 44% of employers said they were seeing mental health impacts, President and CEO Ellen Kelsay said during a press call Tuesday. “Certainly, a key finding here is the dire need for mental health services and supporting employees as they’re navigating their myriad needs.”

Mental health concerns outpaced other impacts measured by the survey, including healthcare labor shortages, worsening population health and increased chronic condition management needs. BGH’s survey data include responses from 152 large employers whose health plans cover more than 19 million people.

The survey tracked several focus areas for mental health for 2023 and 2024, with 80% of respondents stating that access to mental healthcare was their top such focus this year. Employers said they were also focusing on burnout, quality of care, and addressing cultural awareness of mental health over the next two years, among other areas.

By the numbers



Share of employers planning to increase access to online mental health resources, such as apps, articles, videos and webinars, in 2024


Nearly half

Share of employers that already require, or will require by 2024, health equity reporting from vendors and/or health plan partners



Share of employers will implement training for employees to recognize mental health issues and direct their peers to appropriate services in 2024

Aside from increasing access to mental health resources, particularly online resources such as apps and webinars, BGH found that employers are looking to improve care provider networks for mental health needs.

A majority of respondents said they would work with their health plans and other vendors to expand mental health networks in 2024, and nearly half, 44%, said they would offer mental health-specific navigation programs.

One challenge employers have encountered in improving mental health access has to do with provider directories. “It’s probably fact or fiction, or somewhere in between, [but] we often hear that the directories are very antiquated and not kept up to date,” Kelsay said. “Having accuracy in those directories is critically important.”

These challenges overlap with concerns about diversity and inclusion, Kelsay said. Black workers in particular face greater barriers to mental health support in the U.S., according to a July survey by The Hartford and the National Alliance on Mental Illness. Access to diverse providers is one such barrier, sources previously told HR Dive.

Slightly fewer than half of BGH respondents said they were already expanding provider networks to include more diverse healthcare and mental health professionals. Employee resource groups also figure prominently in health equity strategies, with 79% of employers reporting that they had worked with ERGs to promote benefits and target well-being initiatives to specific groups.

On two other oft-discussed aspects of mental health — cost and culture — employers have converged on at least one approach in 2023, BGH found. Seventy-five percent of employers offered no- or low-cost virtual counseling or telehealth for mental health treatment in 2022, a share that increased to 77% this year. More than one-third currently cover out-of-network treatment for mental health and substance use disorder services, which is “another reflection of the shortage of providers that employees are facing,” Brenna Shebel, VP at BGH said Tuesday.

Cultural improvement strategies included managerial training to recognize mental health issues and direct employees to appropriate services, adopted by 74% of respondents. By 2024, 52% said they planned to implement similar training for employees.

Meanwhile, BGH found that the share of employers running “anti-stigma” campaigns for mental health is projected to decline within the next year. “This is one area where we don’t necessarily think it’s a bad thing,” Shebel said. “It’s really reflective of the progress that employers have made in addressing stigma of mental health within the workplace.”

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