Good mental health benefits pay off. An article in the peer-reviewed Journal of Occupational and Environmental Medicine found that about 86 percent of employees reported improved work performance and lower rates of absenteeism after receiving treatment for depression.2 A Harvard Business Review article noted that “$4 is returned to the economy for every $1 spent caring for people with mental health issues.”3
Some leading companies understand this payoff and are taking action. A McKinsey study of about 1,000 employers noted that about 60 percent said they were starting, continuing, or expanding their behavioral health services. Drawing from their examples, we’ve created a list of key actions that every organization can and should take to improve employees’ mental health and benefit from the ensuing economic gains.
Measure behavioral health
Measurement of employee stress and mental well-being is on the rise, but still lacking. A prepandemic (2019) survey of more than 600 firms by benefits consultant Willis Towers Watson reported that the proportion of employers measuring the stress level of their employees was projected to increase from 16 percent to 53 percent by 2021. That increase would still leave a significant fraction of employers with no data on the empirical dimensions of employee behavioral health challenges.
Furthermore, employer surveys and measures of behavioral health often use ad hoc, idiosyncratic questions. To detect current mental health problems, we recommend a 12-item general-health questionnaire first developed in 1970. The instrument has been translated into 38 languages and extensively validated worldwide, including in Spain, Germany, and Australia. Consistently using validated, reliable measures permits better comparisons across study settings and over time, and gives companies the best chance to measure progress and benchmark their mental health status against other populations.
Given the economic toll of mental and substance use disorders, employers should be highly motivated to invest in behavioral health else risk increased healthcare costs and employee attrition.
Make behavioral health a transparent priority
It’s incumbent on company leaders to drive awareness and action on mental health. By talking about mental health openly and backing up that talk with significant action, leaders can destigmatize mental illness and signal that people can and should access the support the company provides. EY (formerly Ernst and Young) launched a WeCare program to educate its people about mental health, urge them to seek any necessary assistance, and support others who might struggle with mental illness. At SAP, Vivek Bapat, who drives purpose initiatives, which include mental health, commented: “We’ve created a virtual team of representatives across the entire business. We have representation from our product area, customer engagement, HR—including the diversity and inclusion officer—and from our chief medical officer.” This group meets regularly to discuss the company’s mental health initiatives. “It’s a diversity and inclusion conversation,” added Bapat. “It’s a product conversation, it’s a customer conversation, it’s an employee-engagement conversation, it’s a leadership conversation, it’s a brand conversation. It’s all of those conversations. Together.”
A company’s actions will be significant only if senior management and even the board of directors ensure continuity of effort and follow-through. Sometimes, mental health becomes a priority at the company’s highest levels because of personal experience. The head of one intellectual-property practice for a leading international law firm became interested in mental health because of the struggles of his brother. Brian Heyworth, the global head of institutional business at HSBC Global Asset Management, joined HSBC in 2006. Heyworth struggled with anxiety and depression when he was in his 20s and 30s, and in 2006, shortly before joining HSBC, he had “a full-scale psychiatric breakdown, which led to spending two months in a hospital in the United Kingdom called the Priory.” He currently serves as chair of the City Mental Health Alliance in London, a group of some two dozen financial-services companies, banks, law firms, accountancies, and insurance companies that explores how to improve the environment for mental health.
Company values can also play a part in prioritizing mental health. John Flint, the former CEO of HSBC, felt called to provide a duty of care for HSBC’s 240,000 employees and their families. He also believed that improving employee health and well-being was the most important enabler of executing the company’s commercial strategy.
Jonathan McBride, the former head of diversity and inclusion for BlackRock, noted that the company became interested in mental health as part of its effort to advocate for social issues and to create a culture that nurtured diversity. McBride noted three pathways that can encourage a greater focus on mental health. One was to educate people via data-backed awareness campaigns about the empirical realities of mental illnesses. Second, he said, “You ennoble the topic. You talk about overcoming [behavioral health challenges].” The third pathway is a “Be Kind” campaign, where you interrupt the rush to judgment by helping people understand that “it’s entirely possible that people around me are going through something you can’t possibly understand.”
It’s incumbent on company leaders to drive awareness and action on mental health. By talking about mental health openly and backing up that talk with significant action, leaders can destigmatize mental illness and signal that people can and should access the support the company provides.
Hold leaders accountable for making progress on employee mental health
Things that are measured and receive management attention lead to accountability, and mental health is no different. Michael Fenlon, the chief people officer at PwC, told us that the company “asked all of our teams to create well-being plans using the framework of mental, emotional, physical, and spiritual well-being, where spiritual refers to having a sense of purpose. We provided tools and examples and asked everyone on the team to have both a personal goal and a team goal. I think we got about 5,200 team plans. We asked teams to visit progress against those plans on a regular basis. And we asked all of our leaders to lead from the front, to share goals they’re working on, and to serve as role models. Our CEO, for instance, talks openly about vacations and how he plans vacations throughout the year.” The combination of visible plans with accountability for progress ensures that mental health receives the attention it deserves on the company agenda.
Explore a range of new services, including online interventions
A Society for Human Resource Management article noted that a rising number of employers are providing a variety of subsidized or fully covered digital mental health solutions.4 Just as telemedicine visits with doctors for conventional physical ailments are growing, so are various online applications to help deal with behavioral health issues. Many companies now offer Calm and Headspace, apps that help with meditation and sleep. Companies such as Talkspace, BetterHelp, and Ginger work with companies to ensure that employees have easy access to trained therapists. There are even start-ups, such as Toronto-based Animo, that try to apply natural language processing to social-media posts and emails to discern the psychological health of a population, track the effectiveness of interventions, and predict trends in mental well-being.
Given the pace of innovation in the mental health space, companies would be well advised to learn about this ecosystem as part of their efforts to give the best mental healthcare to their employees.
Work closely with your health-benefits administrator to ensure adequate behavioral health coverage
In the United States, most people receive their health insurance through their employer. Most of those employers use health-benefits administrators—health insurance companies—to run their plan, including contracting for access to behavioral health providers. That’s why it’s critical for business leaders to collaborate with their plan administrators to review their company health plans regularly and thoroughly, carefully examining how the plans operate and what they provide. Business leaders can make clear to health-plan administrators that investing in mental health is key to their companies’ organizational success. They can ensure availability of behavioral health services by assessing barriers to access, the breadth of provider networks, reimbursement rates for providers, utilization-management practices, and out-of-pocket costs confronted by employees. Organizations that prioritize access to mental health services and workplace supports have the potential to realize significant return on their investment.
The pandemic has made painfully clear that our collective emotional health is in jeopardy, and many employers are scrambling to meet burgeoning demands.
Consider on-site mental health services
More large employers are providing onsite medical care. Providing care onsite cuts out employee travel time and can save costs. Company-paid doctors are often less expensive than fee-for-service arrangements or care provided in settings with large facility charges.
Now there is a growing movement to make behavioral health services available at the workplace as well. According to the Business Group on Health, one-third of employers with more than 5,000 employees said they would offer behavioral health counseling on-site in 2020, a big increase from the one-fifth that did so in 2018. Presumably, this trend—together with increased access to virtual care—will continue when employees return to traditional office settings post-COVID-19.
The spread of the novel coronavirus has accelerated many shifts that had started in the months and years before the pandemic. Better mental health coverage for employees is one of those. The pandemic has made painfully clear that our collective emotional health is in jeopardy, and many employers are scrambling to meet burgeoning demands. Combine this with the openness of young people toward mental health discussions, and that good mental health coverage for employees translates into success for companies, and you’ve got the foundation of a revolution. The six steps we’ve laid out in the article can give companies a head start on this inevitable, welcome, and profound change.
Source: Jeffrey Pfeffer is the Thomas D. Dee II Professor of Organizational Behavior at the Graduate School of Business, Stanford University. Leanne Williams is a professor in psychiatry and behavioral sciences at Stanford University and the founding director of the Stanford Center for Precision Mental Health and Wellness.