Throughout the year, Milliman conducts regular Pulse Surveys focused on benefits topics that employers find meaningful and strategically informative. The lasting effects of the COVID-19 pandemic highlight the need to continually examine mental health benefit offerings. How have employers’ mental health strategies changed? What are employers experiencing today with their employee populations? What changes do employers plan to make surrounding mental health benefits for 2024 and beyond?
The topic of mental health benefits drew a significant response from employers for a second year in a row, representing a broad range of industries and roughly 970,000 lives. In general, the results of the survey indicated that mental health benefits continue to remain important to organizations in support of employees beyond the pandemic. In this survey, we saw both continued expansion of, and increased investment in, organizational resources in mental health benefit offerings.
Virtually all respondents indicated they offer some form of mental health resources to employees. According to our survey, employee well-being was the most popular reason cited for offering mental health resources (94%), but there were clearly several other considerations. A majority of respondents (73%) also indicated that mental health offerings are either important or very important to recruiting and retaining employees. The cost of mental health resources was only the fourth most important consideration (58%), behind provider access and availability, such as provider gender, race, and social considerations (69%).
What is being offered?
For 2023, Employee Assistance Programs (EAPs) were the most popular resource offered (94%), followed closely by the medical carrier’s behavioral health programs (84%).
What mental health resources do you currently offer to your participants?
| 2022 | 2023 | 2024 | |
|---|---|---|---|
| None | - | 1% | 4% |
| EAP | 93% | 94% | 83% |
| Medical carrier’s embedded behavioral health program | 78% | 84% | 75% |
| Third party – stress management | 36% | 35% | 47% |
| Third party – Counseling and therapy | 36% | 41% | 52% |
| Onsite or near site clinics | 12% | 11% | 12% |
| Other | 25% | 14% | 12% |
| Not sure | - | - | 22% |
While both EAPs and medical carrier behavioral health programs are the most popular mental health resources being offered today, we did see a slight downward trend for both of these categories when comparing the results to last year’s survey. One likely explanation is the current upward trend in the use of third-party (point solutions) vendors—especially those focused on stress management, counseling, and therapy. It is evident that, as respondents indicated a continued importance in mental health resources, they are also exploring options on what resources to offer.
Access, engagement, and utilization
The demand for mental health resources continues, as 59% of respondents saw an increase in claims expense related to mental health over the past year and 62% of respondents saw an increase in mental health resource utilization. This increase is consistent with results from our 2022 survey, which indicated 62% of respondents had seen an increase in mental-health-related claims expense since the onset of the COVID-19 pandemic. Please note that approximately 25% of respondents were not sure whether this had increased or decreased, as they may not have received data on the performance of their plans yet. (Whereas 28% had indicated they were unsure in our 2022 Pulse Survey.)
With the sustained demand for mental health providers, the challenges of accessing these resources may be driving employers to look for creative solutions. From the comments we received, a few respondents indicated that they had hired full-time staff (either dedicated wellness team members or licensed clinical social workers) to provide more direct resources and support to employees. Other solutions cited included creating dedicated EAP lines for different segments of the workforce, as well as establishing their own EAP networks and mental health programs with travel assistance and 24-hour helplines offered to employees. Another innovative solution was the development of a peer-to-peer support program for employees.
Driving engagement
How has employee engagement with these mental health resources been so successful? A clear majority (91%) of respondents indicated that their organization’s leadership is either very engaged (37%) or somewhat engaged (54%) in supporting the importance of mental health in the workplace.
However, when asked how visibly engaged leadership is in advocating and promoting mental health, fewer respondents (78%) said leadership is either very visibly engaged (25%) or somewhat visibly engaged (53%).
Communications campaigns (77%), leadership messaging (51%), and vendor-driven engagement (47%) continue to be the most popular channels of driving engagement, as they were last year, with email blasts (80%) and electronic articles, FAQs, etc. (72%) being the most popular forms of media.
Data-driven decision making
With employers considering changes for next year, whether exploring third-party solutions or creatively offering their own in-house mental health resources, how good is the data to base these decisions on? Encouragingly, it seems that the quality of data respondents have access to is getting better compared to last year’s survey—47% indicated they receive at least minimal data, while 37% indicated that the data they receive is useful.
Have you been successful in tracking the utilization and engagement in these mental health resources?
| 2022 | 2023 | |
|---|---|---|
| Yes. We receive useful data and reporting through our vendors. | 34% | 37% |
| Somewhat. The data we receive is minimal and generally insufficient. | 41% | 47% |
| No. We do not receive any data on utilization or engagement from our vendors. | 24% | 16% |
Yet most respondents seemingly have not taken advantage of using their own employees’ input as a data set for additional feedback into future benefits decisions. Sixty-six percent of respondents indicated that they do not reach out to their employees as a data point to gauge their employee satisfaction with mental health resources. Thirty-nine percent of survey respondents indicated that they did not know whether their employees were either satisfied or dissatisfied with the mental health resources being offered.
Download the full results
For full details of this entire survey, including comprehensive results for each response, visit our library of past Pulse Surveys on What’s Trending in Benefits? at https://www.milliman.com/pulse-survey.
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Caveats
This survey summary has been prepared for informational purposes only. Milliman does not intend to benefit or create a legal duty to any recipient of this summary.