From traditional employee assistance programs (EAPs) to bots that use artificial intelligence, the range of options to address worker mental health challenges has grown. What should employers and plan sponsors consider when deciding which mental health benefits tools to use and promote?
In their article “Can Robots Improve the Mental Health of the Workforce?” in the May issue of Benefits Magazine, Eric Parmenter, CEBS, ISCEBS-Fellow, and Mark Attridge, Ph.D., offer insight into some of the newer tools in addition to traditional benefits. Parmenter is a longtime employee benefits professional who recently became CEO of OnSomble, a Nashville, Tennessee software company. Attridge is president of Attridge Consulting, Inc, an applied research and business advisory firm based in Minneapolis, Minnesota.
Below is a look at the mental health benefit options that the authors discuss.
EAPs
What are they?
- Internal or external programs that provide employees with access to services including face-to-face, telephonic and text/email-based counseling visits, on-site counseling, training and crisis response services, and digital self-care and educational programs.
Advantages
- Typically low cost. Full-service EAPs have a dual focus on managing behavioral health risks of a business at both the individual employee level and at the organizational level.
Challenges
- Low usage levels when not integrated into other benefit services, worker concerns about stigma and privacy.
Traditional Behavioral Health Benefits
What are they?
- Typically provide coverage for diagnosed mental health conditions through managed care networks of psychologists, social workers, psychiatrists, inpatient mental health care, and substance abuse and rehabilitation. Usually covered with employee/employer cost sharing that is the same or richer than that of medical benefits.
Advantages
- More successful at treating serious disorders and providing long-term care.
Challenges
- Patients may experience long wait times to receive treatment. Patient copays may be required, and employees may be concerned about stigma.
Telebehavioral Health
What is it?
- Live synchronous video counseling sessions with licensed therapists. Available through standalone platforms (e.g., TalkSpace, BetterHelp,), from providers that offer both medical and behavioral health visits (e.g., Teladoc, MDLive in the U.S. and Akira and Maple in Canada) or from health care systems. Some platforms use algorithms to match patients with caregivers based on geography, area of focus and preferences.
Advantages
- Increased access to therapists, confidentiality, similar quality to in-person visits for promotion of mental health and risk screening.
Challenges
- Wait times and access problems may exist, often due to licensure rules that prohibit clinicians from delivering care to a patient in a state in which that clinician is not licensed. Lack of focus on the workplace.
Self-Service Apps and Digital Programs
What are they?
- Examples include apps such as Happify, Calm, Headspace, MoodTools and many others.
Advantages
- Help users with preclinical or moderate levels of behavioral health disorders manage stress and provide useful tips. Clinicians may recommend apps and digital programs for clients who could benefit from specific skill-building tasks and habit formation in between treatment visits. Good for use as risk assessment tools to self-identify potential behavioral health issues in a nonthreatening way.
Challenges
- Benefits are limited for complex or severe issues, and they have high drop-out rates for the full set of preprogrammed treatment modules or sessions. Lack of referrals for high-risk users into other existing employee benefit programs with live clinical contact (i.e., EAPs or other outpatient mental health benefits) Structured content may not fit many users who have more specific or unique needs that may be better handled by live counselors or dynamic interactive AI (see below).
Artificial Intelligence (AI)
What is it?
- A mental health chatbot might coach people through tough times through live text message conversations, while another offers asynchronous coaching, digital programs and telebehavioral health.
Advantages
- Have the potential to reduce diagnosis errors, process large amounts of data and drive conversation. Effective treatment can be delivered without a human clinician under certain circumstances and may reduce symptoms of common mental health problems such as anxiety, depression, social phobias and insomnia.
Challenges
- Not intended for users with greater than mild levels of clinical severity. High drop-out rates among users. Lack of referrals for high-risk users into other existing employee benefit programs with live clinical contact (i.e., EAPs or other outpatient mental health benefits).
Can a Mixed Model Work?
A mixed model that includes several components—from proven full-service EAPs that integrate with behavioral health networks for continuity of care to digital programs that leverage AI and tele-behavioral health—may offer the greatest opportunity to drive success, Parmenter and Attridge suggest. This model can offer a tailored approach to employees based on their needs and engagement preferences.
“Not all employees have access to devices, and some prefer a telephonic or face-to-face approach. Through multiple entry points, a mixed model can help to close the gap between those who need mental health support and those who receive such support by providing more ways to connect individuals to effective resources with less stigma and lower wait times based on sound scientific approaches,” they explain.
Employers will reap the benefits of investing in mental health of their employees, the authors contend. “In addition to improving well-being and job performance, employers may also see lower direct and indirect benefit costs,” they write. “But, more importantly, a thoughtful employer mental health strategy can reduce pain and suffering and make a real difference in employee well-being.”
[Learn More: Workplace Mental Health Resources]
Kathy Bergstrom, CEBS
Senior Editor, Publications at the International Foundation of Employee Benefit Plans
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