By Kristen Wheeler, Vice President, Member Engagement, Quantum Health

 

We’ve all wondered how to answer this question: “If a tree falls in the forest and no one is there to hear it, does it make a sound?”

Today, some employees are asking a similar question, but for them it’s not philosophical. If their mental health falls to an all-time low and their employer doesn’t seem to care, does their overall health truly matter to the employer?

A 2020 survey by Lyra and the National Alliance of Healthcare Purchaser Coalitions found that 83% of employees were experiencing emotions tied to poor mental health. The survey also found that 40% believed their employer didn’t care, beyond how their mental health might affect productivity.

Meanwhile, a 2019 Mercer survey showed that more than half of employers ¾ and nearly 70% of the largest companies ¾ see behavioral health as a concern. Still, only 30% of employers feel they’re effective with outreach to employees who are struggling with mental health and substance use.

Clearly, the surveys reveal a gap. Most employers are concerned about employees’ well-being. Still, many employees aren’t feeling it. Which begs this question: How can employers adapt their benefits plans to provide more meaningful support for surging mental health issues?

 

Assessing the many facets of mental health

To find insights and answers, Quantum Health recently studied how consumers’ mental health challenges were being expressed and addressed in their engagements with our Personal Care Guide (PCG) nurses. We provide healthcare navigation and care coordination to more than 350 self-insured employers and their more than 1.7 million plan members. Analyzing thousands of 2020 member engagements, we found:

  • In most cases, members’ concerns ranged from feelings of depression, stress and anxiety to financial worries, loneliness and isolation, or fear of contracting COVID-19.
  • Only 11% of engagements ¾ including when we screened for major depression with the Patient Health Questionnaire-2 (PHQ-2) ¾ called for guiding the member to a specialist for diagnosis and treatment. In other words, cases in which their plan’s mental health benefits might be needed.
  • In 51% of cases, PCGs guided members to helpful nonmedical benefits within their plans. These included employee assistance programs, wellness offerings and short-term disability coverage. We also advised visits to primary care providers when it was clear those visits were overdue.
  • In 38% of engagements, we steered members to supplemental resources, including mindfulness and relaxation apps, condition-specific organizations (e.g., the American Diabetes Association, the American Cancer Society), and an array of local and regional community resources.

Perhaps most telling, a poll of our nurses found that the most effective support nearly half the time was the act of engagement itself. In those cases, members expressed relief from simply having their worries heard and validated. Their most meaningful benefit was unhurried conversation with an empathetic listener ¾ who also happened to be a healthcare and benefits navigation expert.

 

Exploring caring as a benefits plan upgrade

Employers are wise to focus on identifying and helping employees with major depression, anxiety and other disorders. The PHQ-2 screening is one critical way Quantum Health supports that priority.

However, our recent analysis shows most workplace mental health issues take other forms. It also shows that many benefits plans already offer significant mental health support, so layering on more benefits might not be the answer.

If anything, our analysis points to what might be missing when employees question whether employers care about their mental health. It’s a benefit that makes all other benefits more accessible to members in their moments of greatest need. Let’s call it, simply, “caring.”

Traditional member services models focus on providing concise, scripted answers to claims and eligibility questions. They’re often geared toward driving members to self-serve for benefits information online.

It’s another level of support entirely when members have a go-to resource for empathetic listening, expert benefits guidance and one-on-one clinical support. This is why healthcare navigation and care coordination can be foundational to a mental health benefits strategy.

As one of our nurses noted: “There are diagnosable mental illnesses, and then there are people struggling with stresses in life. To get at these issues, it’s critical that we’re in the flow of their overall care. It takes having conversations, so members can share not just their physical pains, but also their emotional ones.”

When employees question whether employers care, it probably means caring has never been a more important benefit. Maybe that’s why another recent survey, this one by Willis Towers Watson, found that nearly 70% of employers plan to improve their employees’ benefits experience with navigation and advocacy services.