The pandemic and fights for social justice are taking a toll on Americans’ mental health. But social distancing means that accessing care has become even more difficult than it was before COVID-19. Employers have a role to play in relieving this barrier to care.
Up to one-third of workers say their mental health has been affected by COVID-19, according to research by SHRM. Work-related worries have caused 40% of employees to feel hopeless, burned out or exhausted during the pandemic.
However, while half of employers say they offer some sort of mental health support during COVID-19, only 7% of workers have actually contacted a mental health professional.
The problem is that not all organizations understand the barriers to care, and many do not evaluate the effectiveness of the care they offer to ensure that it’s supporting the mental well-being of their workers.
Barriers to Care
Getting mental healthcare was a challenge even before COVID-19 for several reasons.
First, America has a shortage of mental healthcare providers. There are, on average, 20 mental healthcare providers for every 100,000 people, and three out of four counties report a “severe psychiatrist shortage.” Half of counties — in particular, those in rural areas — don’t have even one psychiatrist.
Cost can also be a barrier. A therapy session in New York City costs, on average, $220, and insurance coverage may be limited.
Then there’s demographics and stigma. Men — who may be raised to be “strong and silent” and to avoid showing their feelings — experience the stigma of asking for help, even though they are far more at risk of dying of suicide or substance abuse.
People of color (POC) also face significant stigma and barriers to care, such as finding therapists who understand the specific problems they face. POC experience high rates of stress and depression, often specifically caused or exacerbated by racism.
Employers Have Options
What options do employers have to help their employees get the care they need? Let’s take a look.
Many therapists are currently offering care via video chat or phone. The CARES Act, passed in response to COVID-19, expanded Medicare access to virtual care services, allowing patients to speak with their provider remotely, instead of risking exposure at their therapist's office.
Employees who already have a therapist may have transitioned smoothly to virtual care with their current provider. However, this model doesn’t solve the problems of high costs and the difficulty of finding a provider.
Employee Assistance Programs
The vast majority of mid- to large-sized companies offer Employee Assistance Programs (EAPs), which provide a handful of services to support employees’ emotional and behavioral well-being. These programs are provided by employers at little to no cost to employees.
The biggest problem: hardly anyone uses them. Just 6.9% of employees in North America use theirs. In fact, employees often don’t know they have an EAP. And even if they do know, EAPs offer an overwhelming number of services, from writing a will to finding substance abuse treatment. Worse yet, the information is hidden in a confusing benefits portal.
For those who do take advantage of EAPs, the counseling services are typically underwhelming. The number of sessions is often capped at just a handful, at which time employees can be referred to outside services, where they must bear the cost.
Over the past few years, we have seen the emergence of text-based therapy apps. These apps allow patients to chat with their therapist, and sometimes offer video sessions at an additional cost.
Text-based apps are convenient and can be particularly helpful for those who may be reluctant to get in-person care from a traditional talk therapist. However, they cannot provide the robust care offered by half-hour or hour-long in-person therapy sessions.
While employees can sometimes use their Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for these services, they are usually not covered by insurance, which is a problem because they can cost more than $100 per month. However, some of these services have partnered with health plans and EAPs. Nevertheless, the problem of low utilization remains, similarly to EAPs.
Virtual Mental Health
Virtual mental health options provide employees with remote, talk-based therapy not unlike what they would receive at a therapist's office. These services help employees find a therapist who specializes in their unique needs and costs them little to nothing.
The virtual care approach is becoming more common as more employers prioritize employee mental health. For example, Starbucks recently made headlines when they began offering 20 sessions of virtual mental health to their employees earlier in 2020. This is a great start, but employers shouldn’t limit counseling sessions, a practice that can pose a barrier to mental well-being.
As employers and their employees face new and unanticipated challenges, the need for mental health care will only increase. Companies must make sure that their employees have access to the care they need so they can do their best in the workplace and in life.