Self-insured employers are in whiteboard mode when it comes to supporting mental health in the workplace. Recent research shows that HR and benefits leaders are focused — perhaps as never before — on finding ways to expand the scope or improve the effectiveness of the mental health benefits their organizations offer.

What should benefits pros consider as they rethink and restructure employee mental health programs? For expert insights, Quantum Health recently moderated a panel discussion featuring a trio of experienced behavioral health clinicians. Titled Building a Comprehensive Mental Health Benefits Program, the panel was one of several breakout sessions presented during the Society of Human Resource Management’s May 11 Mental Health Virtual Retreat.

Moderated by Veronica Knuth, Quantum Health’s chief people officer, the panel included clinical leaders from three premier mental health point solution and EAP benefits companies:

  • Caroline Carney, chief medical officer, Magellan Health
  • Dana Udall, chief clinical officer, Headspace Health
  • Alethea Varra, SVP, Clinical Care, Lyra Health

Following are just some of the planning priorities and thought-starting ideas that surfaced during their hour-long discussion. To view the panel discussion in full, click here.

Covering care in all its dimensions

Where does an HR leader begin when planning for comprehensive mental health benefits coverage? Based on the panelists’ views, it’s important to keep at least two dimensions in mind.

One is providing coverage across the range of services and treatment acuity levels a member might need on a behavioral health journey. On a spectrum of clinical intensity (and cost), these can range from mindfulness and meditation apps, to online or phone coaching, to coverage for traditional in-office therapy visits, all the way to inpatient hospital or residential treatment.

Typically, employers’ core health plans cover more-acute levels of care, at least partially. But failing to add services for less-acute needs is a missed opportunity. Udall said many members can get all the support they need at the health coaching level of service. Those members also will have an easier time reaching coaches when needed, versus having to schedule in-office therapy appointments.

A second dimension requires accounting for specialized needs and risk factors. For example, populations weighted toward members of family-forming ages might need more coverage for postpartum depression counseling. Groups with many adolescents and teens generate stronger demand for benefits and providers focused on issues such as self-harm and eating disorders.

As employers work with benefits partners to plan network and coverage specifics, Varra said, “asking lots of questions to make sure that a core benefit plan has some of that more specialized coverage can be incredibly helpful going forward.”

Grounding your planning in data

The panelists unanimously advised that employers approach mental health benefits design informed by as much relevant data as possible. That includes data regarding:

  • Member demographics and claims
  • Provider diversity and clinical effectiveness
  • Third-party-validated outcomes and ROI from partners you work with or might be considering

If it’s been a while since you analyzed your member population, conducting a survey or focus groups, along with studying past claims data, can be invaluable for aligning provider networks and benefits design to member needs and risk factors. “The data will tell us, directionally, what’s really most important and timely in the population,” Carney said.

Understanding the diversity of your members also matters. It will help in evaluating whether providers available through carrier and benefits partners will consistently allow for good provider-patient matching on factors such as race and gender identity.

And having partners share data on providers’ performance, and the effectiveness of care-delivery models, helps employers focus on those delivering measurement-based care and tangible health outcomes. 

 “… it’s really powerful to think of mental health as a vitamin — something we do every day to build ourselves up. As leaders, we can think along those lines and encourage our teammates to take those daily vitamins.”
-Dr. Dana Udall, Headspace Health

Opportunities for innovation

Looking for a benefit that will speak loud and clear to your organization’s support for mental health? Consider working with partners to offer an annual, free mental wellbeing checkup, similar to the preventive screenings that support members’ physical health.

“It’s really important to think about mental health as continuous, as across the lifespan,” Udall said. “What if you had a regular mental health checkup? If we can reach people early, if we do prevention and teach them lifelong skills, that will tend to shorten the course of care if they need clinical services.”

Such a benefit would be a step forward in improving parity between physical and mental health benefits. It can also act as a prevention and cost-control mechanism, helping identify and steer members with emerging illness and substance use issues to appropriate care before their needs become more acute.

Here’s another change that would be easy for employees to understand and set the stage for increased utilization and prevention: eliminating the copay for mental health office visits. “There may be a fear that will lead to abuse of the services, or increased cost of care,” Carney said. “But we see in the preventive care world — whether it was for cancer screenings or primary care — [eliminating copays] was very effective in getting those services delivered to individuals who do have a barrier in terms of finances.”

Destigmatizing mental health in the workplace

HR leaders, front-line managers and C-suite executives all play important roles in making workplaces feel safe for employees to talk about — and seek help for — behavioral health issues.

“I think we all need to recognize that we’re one degree of freedom away from someone with mental illness or having our own mental illness or substance use disorder,” Carney said. “If we can encourage employers to think about it that way, it starts becoming another equalizer between employers, employees and the kinds of services that are needed.”

Other insights shared by the panelists included:

  • Strive to be an authentic role model. To the degree leaders feel comfortable doing so, demonstrating a personal growth mindset when it comes to mental health can be a powerful, culture-shaping signal. Udall shared this example: If a team’s employees routinely post “doctor” and “dentist” visits on their calendars, think of the positive signal it would send if the team leader posts a recurring “therapy” appointment on their schedule.
  • Embed mental health in everyday communications. In some workplaces — including those with heavily male populations — conversations about mental health concerns and benefits don’t always arise spontaneously or flow easily. Varra noted that employers in manufacturing, construction and similar categories might find that weaving mental health messages into safety training can be an effective, organic way to raise awareness and open lines of communication.
  • Clean up the language. Words such as “crazy,” “psycho” and similar slang send a less than open-minded signal to employees. Leaders should look for opportunities — in their own speech, and in overheard conversations — to correct language that makes light of or stigmatizes mental illness.
  • Communicate from a positive perspective. Whether it’s in open enrollment materials, on breakroom posters, or during one-on-ones between leaders and direct reports, it helps to convey a consistently positive message about how your organization views mental health.

A blueprint for benefits planning

As their discussion wrapped, the panelists were asked what they’d advise employers to prioritize when building a comprehensive mental health benefits program. Their answers, taken together, suggest the broad outlines of a benefits-planning blueprint.

  • Carney, on anticipating and spanning members’ mental health needs: “It’s using all of the data an employer has in hand to build that right benefit that recognizes the full spectrum of need for the employee and his or her dependents.”
  • Udall, on factoring in care modalities and utilization: “Rather than thinking about just moving therapists and psychiatrists online, it’s really thinking about offering a comprehensive solution that is multimodal and that empowers members to use it. And thinking about care in a more ongoing, rather than episodic, way.”
  • Varra, on choosing benefits partners: “I would recommend that you ask for a real partner. That should be clear throughout the process as you’re talking with them. Are they able to help you really develop a strategic plan, together, that brings the highest quality care to all of your employees?”

Judging by the panelists’ conversation, HR leaders who focus on supporting employee mental health should feel assured they are spending time and effort on a business-critical opportunity.

“There has been a shift in terms of expectations for these types of benefits,” Varra said. “I think 10 years ago almost nobody had any additional mental health benefits that they were adding on. And so, when someone moved from one employer to the next, it was not something they even asked about or expected. But that’s really changed. As more and more employers are really investing in these benefits, it’s becoming something that will enhance an employer’s ability to attract and also retain employees.”

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