Assessing Employer Influence on Workplace Mental Health

Although employers serve as the predominant provider of health care coverage in the United States, significant gaps remain in availability of services that equally weigh mental and physical health.

Although employers serve as the predominant provider of health care coverage in the United States, significant gaps remain in availability of services that equally weigh mental and physical health, said Benjamin F. Miller, PsyD, chief strategy officer for Well Being Trust.


AJMC®: Hello, I'm Matthew Gavidia. Today on the MJH Life Sciences’ Medical World News, The American Journal of Managed Care® is pleased to welcome Dr Benjamin F. Miller, chief strategy officer for Well Being Trust.

Can you just introduce yourself and tell us a little bit more about your work?

Dr Miller: Sure, thanks, Matt, and thanks for having me! So, I'm the chief strategy officer for Well Being Trust, and I'm a clinical psychologist by training. Most of what I've done in my career has been at the intersection of mental health, public health, and primary care. So, as an academic, I spent years of my life studying how we can better integrate mental health into primary care, and now I'm on the foundation side where we make investments in solutions that can help accelerate the adoption of evidence-based strategies for mental health in this country.

AJMC®: Can you speak on the current state of mental health in the US workforce and how the pandemic has exacerbated this issue?

Dr Miller: Unfortunately, mental health and addiction in the United States has not been doing too terribly well for the last several years. Actually, we can go all the way back to the beginning of when we started collecting data from the CDC in 1999 to look at the depths of despair, the number of lives that we lost to drug, alcohol, and suicide, to see that we're going in the wrong direction for mental health in this nation.

What COVID-19 [coronavirus disease 2019] has done is it’s exacerbated a lot of the things that we knew to be problematic. If you look at rates of depression, you can see from survey after survey after survey, depression and anxiety are skyrocketing. In a Kaiser Family Foundation survey, they show that half the country has reported some type of symptoms of mental health in the last couple of months.

There was a published study in JAMA that looked at a 6-fold increase in depression since COVID-19 has started, which is substantial when you consider that depression was already the leading worldwide cause of disability and a lot of folks in this nation had it. So, what COVID-19 has done is, again, it's put a magnifying glass on top of something that I think many folks knew was a problem. Unfortunately, we've not been able to put those solutions into practice just yet. I'm optimistic, but we've not seen the solutions come to bear as of this moment.

AJMC®: In addressing mental health, employers can play a significant role based on their coverage options of behavioral health services. Can you first explain how mental health problems can be further exacerbated by workplaces that are not formally equipped to handle these issues?

Dr Miller: Yeah, absolutely. So, where we work is probably, at least before COVID-19, most of us when we go into the office, our work environments were the places that we spent most of our time. So, we had our social relationships there, we had interactions with folks all day, we were trying to make a livelihood and have a career for ourselves. Employers have, I think, a unique responsibility to ensure that the workplace environment is one that is safe, secure, and can ultimately allow for their employees to be the most productive.

What does that mean? It means that you've got a safe work environment, that you've got flexibility in how you allow for your employees to take time for themselves. Something as simple as having a “mental health day” and being able to stay home when you've just been up against it for the last several weeks.

These are things that we know aren't necessarily benefits that are purchased there. They're more perks of the job, but they add a substantial value to the employees’ experience and, ultimately, the productivity of that employee. So, employers can do a lot of just simple things that don't cost a lot of money. Things that do cost money, though, are also pretty basic, but we don't necessarily talk about it as much.

So, an example of this is coverage. Now, we still have a predominantly employer-based coverage in the United States. Most people get health insurance through their employer, and yet, we still find that a lot of the things that are purchased by employers aren't necessarily up to snuff for mental health. Sometimes, the plans that we're purchasing don't comply with mental health parity, a law that's been around for 10 years, that requires mental health and addiction treatment to be basically the same or treated the same as your medical surgical benefits. So, there's a lot that employers can do just to make sure that the products that they're purchasing through their health insurer are indeed at parity.

The second thing they can do is around service delivery. Let's make it easier for people to get access to services. If you are a large employer, why does it make sense to always have your employees go somewhere when they're not feeling well? Whether that's not feeling well emotionally or not feeling well physically.

If they're already on site, you know what, go ahead and take care of them. Having onsite primary care and mental health is a really simple way for you to immediately be able to impact the vast majority of your population and have them have an immediate intervention that doesn't take time away from their job. And frankly, it could be more effective because of how quickly you're able to respond to their needs.