Even before COVID-19 disrupted society as we knew it, behavioral health—the umbrella term commonly used for mental health and substance use disorders in the United States—was emerging as a public health crisis. With approximately 1 in 5 adults experiencing some type of behavioral health condition each year, the impact of the associated symptoms had begun to have a cumulative impact warranting action from employers.
Although the cost directly associated with behavioral health diagnoses is relatively low (3-5% of total medical spend), there is a broader financial impact on employers each year. As indicated by a recent Milliman report reviewing 21 million insured lives, members with medical and behavioral comorbidities accounted for 2.8 to 6.2 times higher medical/surgical costs (depending on the condition) compared to those without a behavioral health condition. Additionally, U.S. employers lose millions of dollars in absenteeism, and productivity each year, particularly due to unmitigated stress and unaddressed risky alcohol use.
The Evolving Behavioral Health Needs Amidst the Pandemic
Now we’re seeing a bad situation get worse. A number of risk factors have emerged during the pandemic that could contribute to potential behavioral health concerns, including issues with work-life balance, isolation, lack of sleep, increased alcohol consumption and financial stress. Further, nearly half of employees believe their behavioral health has declined since the beginning of the pandemic.
With all this, you’d think that medical claims for behavioral health must be going through the roof. But it’s quite the contrary. Based on over one million members in Mercer’s database of claims information, from March to May of 2020 the number of individuals with newly diagnosed behavioral health claimants was down 25% from the same timeframe last year, with a 24% decrease in those newly diagnosed with mental health problems and 27% decrease in those newly diagnosed with substance use disorders. Additionally, many EAP vendors have reported dips in clinical utilization throughout their member populations.
Clearly, employees and their families are not getting the resources they need. While the recent dip in utilization can be blamed on the difficulty of accessing care during a pandemic, even before the pandemic too many behavioral health issues were going untreated.
What you can do now to address behavioral health
While there is no one perfect solution to this tough problem, there are a number of steps employers can take now that will help.
- Examine your current state: Review your existing programs and associated utilization patterns to identify where you should be investing your time and resources. Ensure your vendors are integrated to support your members across the continuum of behavioral health care.
- Evaluate your employee assistance program (EAP): Test your EAP as a user to determine if your vendor is operating as expected, press for improvement, or evaluate new vendors.
- Identify gaps: What are the user preferences for your population relative to technology? Are your current vendors leveraging the latest approaches for care delivery? Evaluate vendor options that can meet the needs and desired member experience for your members.
- Ensure supports are in place for managers/supervisors: These individuals are uniquely positioned to support their direct reports by assisting them in navigating to services to address low-acuity behavioral health challenges.
- Encourage a culture of openness: Provide transparent communications and let employees know that it is okay to speak up. The pandemic has brought mental health needs to light – in media, television and in the work place. Leverage this time to continue reducing stigma
The demand for behavioral health resources continues to grow. Employers have a responsibility to their employees, their communities – and to their businesses – to respond. By investing in the behavioral health of your employees, you create a ripple effect that can cultivate a positive culture, organizational resilience and better business outcomes in these uncertain times. Much of the research suggests that organizations reap at least a 2:1 return on investments in behavioral health -- in improved productivity, decreased absenteeism and presenteeism and reduced claims. That’s what we’d call a good investment, in every sense of the word.