In less than two years, the COVID-19 pandemic has created new mental health challenges or intensified existing issues for workers across the United States and Canada. Organizations are expanding and enhancing benefit offerings, according to a new report from the International Foundation, Mental Health and Substance Use Disorder Benefits: 2021 Survey Results. The report reveals the prevalence of mental health and substance use disorder conditions, their impact on the workplace and how employers are responding.

COVID-19 Creates Shift in Mental Health Benefits Over Past Two Years

Mental Health/Substance Use Challenges on the Rise

When asked for a two-year comparison, 91% of US employers (68% of Canadian) say mental health/substance use disorder challenges among workers have significantly or somewhat increased. The majority (97%) of US employers (92% in Canada) reported that their overall worker population is somewhat or very stressed now.

I spoke with Julie Stich, VP of Content at the Foundation. She said that mental well-being was a big challenge before the COVID-19 pandemic, and concern is only growing as our worker populations deal with the continual unknowns of the pandemic. Employers are working to effectively connect with and provide benefits for employees, from offering more digital tools to facilitating peer-support groups to expanding mental health crisis training initiatives.

Mental health benefits growing in popularity include access to online resources/tools (87% of US and 81% of Canadian employers offer), telepsychiatry treatment sessions (72% of US and 49% of Canadian employers offer), and mental health crisis training (23% of US and 30% of Canadian employers offer).

Prevalent Conditions

When asked to share the prevalence of several mental health/substance use disorders, the top five (either “very” or “prevalent”) conditions employers are reporting include:

  • Depression (52% in US, 24% in Canada)
  • Anxiety disorders (49% in US, 25% in Canada)
  • Sleep deprivation/disorders (32% in US, 8% in Canada)  
  • ADD/ADHD (23% in US, 8% in Canada)
  • Alcohol addiction (17% in US, 8% in Canada)

Because many employees are working from home, employers and co-workers aren’t able to easily observe and monitor certain mental health/substance use conditions—They are easy to hide in a virtual working environment.

Top Conditions Covered by Employers

Are the most prevalent conditions covered by employers? Here’s what the survey report revealed:

  • Depression—72% cover in US, 54% in Canada
  • Anxiety disorders—69% cover in US, 60% in Canada
  • Sleep deprivation/disorders—50% cover in US, 43% in Canada
  • ADD/ADHD—57% cover in US, 32% in Canada
  • Alcohol addiction—68% cover in US, 57% in Canada.

Other covered conditions include autism (55% in US, 19% in Canada), bipolar disorder (62% in US, 46% in Canada), eating disorders (61% in US, 51% in Canada), gambling addictions (36% in US, 41% in Canada), nonprescription drug addiction (60% in US, 35% in Canada), obsessive compulsive disorder (OCD) (54% in US, 41% in Canada), post-traumatic stress disorder (59% in US, 49% in Canada) and prescription drug addiction (63% in US, 43% in Canada).

Barriers and Solutions

Not all employers are covering the most prevalent mental health/substance use disorder conditions. Organizations reported many barriers in implementing/advancing mental health and substance use disorder initiatives, including worker fears and management concerns. Specifically, employers reported that workers fear that confidentiality may be breached or that admitting a problem may negatively impact their job security. Supervisors are reportedly uncomfortable addressing issues with workers and are concerned about breaching workers’ privacy.

Julie noted that how an employer overcomes these and other barriers is specific to their own organization. By communicating resources and benefits in place and continuing to destigmatize mental health and substance use disorders, organizations can support employees facing these issues with the hopes of preventing an even greater crisis from occurring.

Learn More About Mental Health Benefits

To access the full report: Mental Health and Substance Use Disorder Benefits: 2021 Survey Results, visit

For more information on mental health and the workplace, visit the International Foundation Workplace Mental Health Resources webpage.

Just a note—The survey report breaks down data in the following categories: Corporations/single employer plans (including nonprofits), public employer plans, and multiemployer funds. This blog post features data from the “corporations” category.   

Anne Patterson
Marketing Communications Manager

The latest from Word on Benefits:

Anne Patterson

Marketing Communications Manager at the International Foundation

Favorite Foundation Product: Foundation Community. It’s like LinkedIn but only for Foundation members. They can post questions, share best practices, etcall with fellow members who also live and breathe employee benefits.

Benefits-related Topics That Interest Her Most: Workplace wellness (especially mental health), diversity, equity and inclusion, behavioral decision making, family-friendly benefits, payroll audits.

Personal Insight: When she’s not busy analyzing the inner workings of her toddler’s brain (does anyone actually know?!), Anne finds joy in home renovation and décor, haiku writing, watching Jeopardy, creating charcuterie boards, and bicycling.

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