Mental healthcare under-utilization is a revenue problem

From the beginning of my career, I knew I wanted to help others. And for the people asking why I didn’t become a care provider, I did, in my own way. I’m a mom with three kids, a business leader, and a proud pet parent to Stella the bulldog, who is snoring through her midday nap as I write this. I believe supporting other humans matters, and I take immense pride in looking after the people I care about.

However, I still believe now what I believed when I accepted my first job out of college as a financial underwriter for Cigna: Everyone involved in care—from providers to payers—plays a key role in getting people the support they need. Over my years leading teams at healthcare organizations, I’ve witnessed individuals across all roles exhibit a genuine dedication to improving outcomes and access, having a meaningful impact on lives. I’ve seen this hold true whether someone is responsible for the direct delivery of care or reducing costs and streamlining processes to ensure systems can serve as many people as possible. 

Access to mental health care is not the issue

However, the longer I work in the healthcare and wellness sectors, the clearer it becomes to me that improving access to mental health services is only a step along the way (albeit a very crucial one) to the primary goal of increasing utilization. Because when people don’t actually engage with and use the resources organizations invest in to support them, no one benefits. 

And when it comes to mental health, poor utilization isn’t just a return-on-investment issue for organizations. The yearly cost to organizations for people not accessing the support they need is in the billions in lost productivity alone. Beyond well-known business risks such as low performance, absenteeism, and turnover, poor mental health endangers employees’ overall health and well-being and has been linked to higher incidences of safety and compliance infractions. 

The unfiltered reality is that workplace mental health has a utilization problem, which has become a revenue problem. This is terrible news for everyone—individuals and organizations. So the question is, what can businesses do to turn this situation around? How can leaders limit their risk exposure and safeguard employee well-being? Here are three ideas to guide your next steps.

Identify the problem (it’s probably not a lack of benefits)

In my experience on both sides of the table—as a buyer and a vendor— the problem typically isn’t a lack of benefits: 98% of large employers currently offer mental health benefits to their teams. The real issues that need to be tackled are uptake and engagement. 

Poor uptake and engagement can reflect marketing or accessibility issues, but it’s often that the mental health benefits offered (typically therapy) aren’t a good fit for most employees. The majority—up to 75%—don’t want or require one-on-one therapy. It’s great that companies are providing face-to-face clinical treatment, and I’ve seen people in my inner circle benefit from it greatly . . . but it’s not a one-size-fits-all solution. If you’ve invested in and are regularly promoting a solution to your employees and are not seeing any uptick in engagement or usage, I’d urge you to look closely at this possibility.

Ensure benefits are easy to find, understand, and access

Healthcare pathways are notoriously difficult to navigate. The same challenges my mother faced 40 years ago as the care navigator during my grandfather’s cancer diagnosis look all too similar to what remains consistent in modern times. This is why I know that expecting someone who is already juggling responsibilities at work and home while struggling with symptoms of anxiety or depression to find their own way to the right care for their needs is a huge ask. 

If we want employees to get the care they need, mental health benefits must be simple to find, understand, and access without specialized training, excessive paperwork, or complicated onboarding. A complex process is a deal-breaker for most. I’ve seen it again and again across different healthcare and well-being organizations: The more steps required for people to get to the resources they need, the higher the drop-off. At one company, we saw a significant increase in people creating their accounts and scheduling a first appointment by eliminating just one step in the sign-up process.

​​Make sure your benefits are proactively marketed to your population

After you’ve ensured your mental health benefits are the right fit for your population and are easy to navigate, driving ongoing uptake and engagement requires regular and impactful communications with your workforce. 

While the right cadence and medium will depend on your company’s culture, it’s important to remember that mental health challenges are common. Nearly six in 10 working adults say they’ve experienced at least one mental health challenge. In my mind, the best way to make sure people know what to do and where to go when they’re struggling is not to wait until things are at a breaking point. One way we like to help our customers keep their employee populations engaged in mental health benefits is with webinars around topics of interest—we’ve seen a direct correlation between lunch and learn sessions, new signups, and increased activity across services. 

During difficult economic times, many companies are between a rock and a hard place. They’re doing what they can to deliver the support employees need while simultaneously focusing tightly on the numbers. So while cost containment, risk reduction, and supplier vetting aren’t always popular topics (this one really depends on who you’re speaking with), they’re a necessary part of the conversation around mental health benefits, which in turn are a crucial piece of safeguarding employee wellbeing, safety, and compliance. But all of this becomes irrelevant if the utilization isn’t there—no matter how great the potential may be.

Melissa Frieswick is president and managing director of Koa Health.