2021 Workplace Mental Health Trends Forecast - January 2021 - Lyra Health
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January 2021 2021 Workplace Mental Health Trends Forecast 1 2021 Workplace Mental Health Trends Forecast
Introduction If 2020 was the year employers could no longer ignore workforce mental health, 2021 will be defined by how organizations handle the ongoing mental health crisis. The coronavirus pandemic has not only upended the way we live and work, it’s ushered in a new era for workplace mental health amid the heightened needs of employees grappling with unprecedented disruptions, uncertainty, and devastation. A rapidly growing number of companies have risen to the challenge and are seeking ways to support employees struggling with anxiety, depression, substance use, loneliness, concerns for their children’s mental health, and skyrocketing stress. “Mental health intersects with everything else–and employers viewed everything that happened in 2020 through a mental health impact lens,” said Joe Grasso, PhD, a clinical psychologist and Lyra’s Clinical Director of Partnerships. “Employers are thinking through the mental health implications of every life-disrupting event–and about not only having the benefits in place but how to communicate about them.” The surge in mental health needs did not end when the clock struck midnight on Jan. 1, and employers in 2021 will find growing pressure to provide support both for individual contributors and entire organizations. In our December survey of 300 human resources and benefits leaders, a whopping 86 percent said mental health became 2 2021 Workplace Mental Health Trends Forecast
a higher priority for their company in 2020, while 54 percent said their
employees now have higher expectations in regards to mental health
support from their employers.
With awareness and demand for better mental health solutions at
an all-time high, what are the best next steps for employers? Based
on our recent employer surveys as well as insights from leading
benefits and HR professionals, benefits consultants, and mental
health clinicians, these are the benefit trends we expect to see shape
workforce mental health in the year ahead.
Three
in four adults regularly feel stressed, according to
The American Psychological Association
40 percent of full-time U.S. employees said in a July survey
that they were either burned out or coming close to it
41 percent said the pandemic had put stress on their
relationships
3 2021 Workplace Mental Health Trends Forecast1. G
reater adoption of comprehensive
benefits that address the whole mental
health spectrum
In 2020, employers across all industries increasingly recognized that traditional
health care plans and employee assistance programs (EAPs) fail to address
the full spectrum of mental health needs. Even pre-pandemic, employers were
looking for mental health solutions that served a full spectrum of care–from
mild issues to severe conditions.
Lyra’s recent survey of HR and benefits leaders highlights the growing
recognition of the need for an alternative to the traditional EAP. When asked
how they believed the mental health care system could be improved within
companies, 41 percent said they would choose a “new, comprehensive solution
that spans existing services of EAPs and health plans, plus gaps beyond
traditional solutions.”
“I think a lot of employers are realizing that their EAPs are not being utilized and
are totally ill-equipped to meet the moment,” said Grasso. “As more people are
of employers said they would
41%
choose a “new, comprehensive
solution that spans existing services
of EAPs and health plans, plus gaps
beyond traditional solutions.”
4 2021 Workplace Mental Health Trends Forecastimpacted by the severity of their mental health symptoms, you’re going to have
more employees with clinical concerns where having robust benefits becomes
even more important.”
Meeting employees where they are also means adopting programs that offer
mental health care for their spouses and children. This is not lost on employers:
More than half of the HR and benefit professionals in our survey identified
“support for couples and children” among the top two priority coverage areas
for their company’s mental health benefit.
Comprehensive care providers include coverage for the typical workforce’s wide
variety of mental health needs–from undiagnosed issues such as stress and
burnout to depression or anxiety and more severe symptoms such as self-harm.
Which two areas would be most important for your
behavioral health benefit or EAP to include?
200
159
(53.2%)
140 118 117
(39.5%) (39.1%)
100
(33.4%)
RES PON DEN TS
80 55
(18.4%)
20
0
0
International Support Substance Seamless Transition to Other
support & care for & alcohol use process for & from higher
couples & disorder disability forms of care
children programs & leave (complex case
evaluations management)
5 2021 Workplace Mental Health Trends Forecast2. Higher demand for measurement-based care In 2020, more employers turned to mental health solutions that offer measurement-based care: providers who offer insights and reporting to demonstrate quantifiable value to the workforce. We expect these solutions to become the de facto standard in 2021. At the core of these programs is a commitment to measuring members’ clinical outcomes to verify that the care they’re getting is effective. “There’s so much around mental health care that is unmonitored, is not evidence-based, doesn’t have an end date, isn’t technology-enabled, and it’s limited by state lines,” said Jeff Brodsky, Chief Human Resources Officer at Morgan Stanley. Traditional EAPs and health care plans tend to lack transparency, in many cases sharing utilization rates but little to no data measuring members’ improvement or recovery with treatment. Next-generation mental health solutions will continue to deliver innovative new care models. Using a digital provider network means these solutions can now provide a robust technology platform that not only links providers to clients, but also tools for measuring improvement. Add to this innovation new approaches to outcome-based provider incentives, and we see significant strides in both access to care and positive outcomes. Also known as a “value-based” model of care, this configuration requires providers to regularly assess their clients’ progress, too, with clinically validated measures such as the Patient Health Questionnaire 9 (PHQ-9) for depression or the Generalized Anxiety Disorder 7-item Scale (GAD-7) for anxiety. 6 2021 Workplace Mental Health Trends Forecast
Measurement-based care not only tends to yield better mental health
outcomes for members, but lower overall costs for employers. HR and benefit
leaders have clearly taken notice, with 47 percent of survey respondents
preferring a value-based pricing model for their behavioral health solution.
Not coincidentally, roughly half also identified “health improvement and
recovery” and “employee satisfaction” as the two criteria they value most when
evaluating new mental health benefits.
“When people have such acute needs, this is not a time to be wasting time
and money on things that are not proven and not getting people better,” said
Lyra’s Chief Medical Officer, Connie Chen, MD. “Every month that goes by where
members are in treatment and not making improvement is really a missed
opportunity, and a tremendous amount of hardship for them.”
When evaluating mental health benefits, what data
do you value most to inform your decision?
200
148
143 (49.5%)
(47.8%)
140
81
RES PO NDE NTS
(27.1%) 71
80 (23.7%)
47
39
(15.7%)
(13.0%)
20
0
Employee Employee Health Employee Employee ROI (return on
engagement satisfaction improvement productivity retention investment)
& recovery & cost-savings
7 2021 Workplace Mental Health Trends Forecast3. More tailored mental health support for
underrepresented employee groups
In addition to the pandemic, employers in 2020 were confronted head-on with
the long-overdue need to prioritize diversity, equity, and inclusion at every
level of the workplace–including the mental health benefits available to their
workforces. As Nikki Smith-Bartley, Chief Diversity and Talent Strategy Officer
at Asurion, said in August, “The recognition in this moment is that there have
been 400-plus years of systemic oppression that’s been directed specifically
at Black people. I think the focus now is overdue and needs to be intentional,
because we’ve got many years to make up.”
In 2021, we recommend that leaders prepare to focus more deeply on mental
health care and support that addresses the needs of Black employees, as well
as other underrepresented employee groups, including Indigenous people,
people of color, LGBTQ+ employees, parents, and other family caregivers.
Grasso foresees these initiatives playing an important role in how companies
will rethink a one-size-fits-all approach to employee benefit programs in the
It’s about taking a look at how your benefits fit the needs of
any underrepresented populations as well as the larger whole.”
— Joe Grasso, PhD, clinical psychologist at Lyra
8 2021 Workplace Mental Health Trends Forecastyear ahead: “It’s about taking a look at how your benefits fit the needs of any underrepresented populations as well as the larger whole.” Among other things, this will mean a focus on access to culturally responsive mental health care providers who are trained to treat race-based stress and trauma, and seeking benefits vendors with a provider network that reflects companies’ workforce diversity. Another emerging trend we’ve observed at companies including Asurion, Genentech, and Brown Brothers Harriman (BBH) is employers’ growing engagement with employee resource groups (ERGs), or affinity groups of different underrepresented workforce demographics–from women to Black employees, LGBTQ+ workers, and veterans. Working together, employers can better understand the unique mental health challenges and stressors these groups face and provide commensurate support. 9 2021 Workplace Mental Health Trends Forecast
4. T
elehealth will still be a fixture, even as
in-person care returns
Similar to the millions of workers who adapted to–and in many cases found
they preferred–working from home due to the coronavirus, many employers
who initially turned to teletherapy out of necessity in 2020 will continue to
embrace it this year.
Besides ongoing social distancing rules, another factor behind teletherapy’s
continued popularity is that employers and employees alike have seen how
effective virtual care can be, particularly when the care is evidence-based.
In fact, research shows that evidence-based therapy administered via live
video sessions and supported by digital tools can lead to even better clinical
outcomes than in-person care alone.
“2020 was like a pilot to see if employees would use video therapy; and, now
that they have, I think there will be more acceptance of it, and maybe that
expands the care options of what an employer is willing to offer,” said Grasso.
020 was like a pilot to see if employees would use video
2
therapy; and, now that they have, I think there will be more
acceptance of it, and maybe that expands the care options of
what an employer is willing to offer.”
— Joe Grasso, PhD, clinical psychologist at Lyra
10 2021 Workplace Mental Health Trends ForecastOn top of the potential for exceptional mental health outcomes, teletherapy’s inherent convenience, safety (especially among those in high-risk health populations), and lower cost make it a no-brainer for companies that want to expand access to mental health care. However, we strongly recommend employers continue to look for mental health benefits with a robust network of in-person care providers. Personalized care options are critical to ensure clients stay with their care programs. And there will always be conditions that are better treated face-to-face (for example, severe eating disorders or suicidality). 11 2021 Workplace Mental Health Trends Forecast
5. More robust preventive mental health options Employers are understandably feeling urgency to address the needs of workers with severe mental health symptoms–such as those at risk of self- harm or suicide. In 2021, we also expect an expanding focus on effective ways to address less acute issues that still significantly impact daily life, workforce productivity, and physical health. The American Psychological Association reports that three in four adults regularly feel stressed. And 40 percent of full-time U.S. employees said in a survey conducted by Lyra that they were either burned out or coming close to it, while 41 percent said the pandemic had put stress on their relationships. Employers were already paying attention to the impact of these undiagnosed issues on their employees. Pre-pandemic research by Willis Towers Watson found that the number of companies measuring workforce stress was on track to triple by this year. With many of the same disrupted routines, isolation, and uncertainty still prevalent in 2021, it will be crucial for employers to offer high- quality preventive mental health care and support. We anticipate new care modalities and innovations to expand options for individuals and organizations dealing with less acute conditions. Mental health coaching is among the most promising new offerings, providing broader care access, lower costs, and a demonstrated track record for client improvement. A 2020 study published in Telemedicine and e-Health shows that mental health coaching based in Cognitive Behavioral Therapy principles can be highly 12 2021 Workplace Mental Health Trends Forecast
effective in reducing stress and improving overall mental health. This is often a
more time- and cost-effective option than therapy for the many people without
a diagnosable condition who still need mental health support.
For these reasons, we expect HR and benefit leaders this year to continue to
adopt more supportive, evidence-based options to help employees cope with
stress and manage high behavioral health costs.
Average decrease in stress reduction scores
28 PSS - All participants
24.19
PSS - Started in high
stress range
23
AVERAGE PSS SCORE
18 16.36
18.15
13
13.63
8
3
-2
Baseline Follow-up
Source: (2020), Effectiveness of a Cognitive Behavioral Coaching Program Delivered Via Video in Real
World Settings, Telemedicine and e-Health.
13 2021 Workplace Mental Health Trends Forecast6. De-stigmatization as a cultural pillar In 2020, the intersection of the COVID-19 pandemic and escalating racial tensions catalyzed major cultural shifts toward more openness around mental health issues and care-seeking–a movement we expect will pick up even more steam this year. Organizations across industries—including Genentech, Starbucks, BBH, and Pinterest—rallied in 2020 to not only offer high-quality mental health benefits, but programming that fights mental health-related stigma. At BBH and Genentech, this included virtual forums where employees from all levels of the company shared their mental health struggles and experiences with getting care. These companies have also doubled down on mental health awareness by weaving it into organizational processes such as manager training and new hire onboarding programs. “We are embedding it in everything we do: our conversations, our communications,” said Deborah Olson, Principal Benefits Manager at Genentech and Roche. “We want to make sure that, from the very beginning, employees are aware our culture supports them to thrive and really focus on mental health and mental well-being.” These types of communications are essential not only for culture shifts to occur, but also to help ensure employees feel comfortable using the mental health benefits available to them, said Grasso. “The benefit is the endpoint, but you really have to get people to want to get there by helping them overcome stigma and normalizing mental health as an acceptable topic at work.” 14 2021 Workplace Mental Health Trends Forecast
Employers’ ongoing efforts to promote mental health awareness should include
workers from across the organization in order to create lasting change. “Real
culture change happens at every level, and companies need to make clear that
everyone has a role to play in becoming a mental health-friendly company,”
said Grasso.
Among other things, this could mean integrating discussions of mental health
and wellness into regular meetings, with managers leading the way to seeking
support for mental health struggles. Meanwhile, greater willingness among
individuals–particularly millennial and Gen Z employees–to speak out about
mental health will continue to be an important driver of culture-wide change.
he benefit is the endpoint, but you really have to get people
T
to want to get there by helping them overcome stigma and
normalizing mental health as an acceptable topic at work.”
— Joe Grasso, PhD, clinical psychologist at Lyra
15 2021 Workplace Mental Health Trends Forecast7. A spotlight on the mental health access crisis
As workers’ need for mental health care surged amid the myriad hardships
of 2020, employers were forced to confront the reality that existing care
mechanisms were ill-equipped to support their people. Traditional EAPs, with
relatively weak provider networks focused on care for mild issues, failed to
keep up with need. We believe that fallout from the pandemic, following a long
history of limited access to behavioral health care even among people with
health insurance, will make this an ongoing imperative in the year ahead.
A number of leading employers in recent years have cited the lack of access
to mental health care as one of the most pressing reasons for rethinking their
company’s approach to behavioral health benefits.
The shortage of mental health care providers in most health care networks
means many insured employees—60 percent in our July survey—are forced to
pay out-of-pocket for therapy and psychiatry.
60%
of employees paid for mental health
care out-of-pocket in 2020 despite
being insured through their employer.
Source: (2020) Lyra Health, American Worker in Crisis report.
16 2021 Workplace Mental Health Trends ForecastWhen Pinterest decided to find a mental health benefit to replace their
traditional EAP, “the access problem” was the key issue they were hoping to
solve, said Jacquelyn Ainsley, a benefits program manager at the company.
“So being able to quickly get people to care, and care that’s not exorbitantly
expensive for them–making sure that cost is not a barrier.”
In addition to addressing these persistent roadblocks to care, leading
employers are also increasingly focused this year on ensuring access to quality
care, having seen firsthand the pitfalls of quick-fix, check-the-box mental
health benefits.
“We have massive amounts of unmet needs in this space as a country, and the
quality issue is pervasive...so we stopped looking for a quote-unquote ‘new
EAP’ and started looking for something radically different,” said Starbucks
CHRO Ron Crawford, explaining why the company opted for a comprehensive
mental health solution for its U.S. employees in 2020. “As we get back to this
return to work— whenever that happens—we’re going to need to come back to
the fact that we still have a systemic problem with mental health in this country.
I think we’ve made some steps forward, and I feel good about our approach to
it. But we’re not done–we’re not done at all.”
s we get back to this return to work—whenever that happens—
A
we’re going to need to come back to the fact that we still have a
systemic problem with mental health in this country.”
— Ron Crawford, Chief Human Resource Officer at Starbucks
17 2021 Workplace Mental Health Trends ForecastMethodology
This survey was conducted by Lyra Health with the goal of better understanding
HR and benefits professionals’ views and attitudes toward workforce mental
health. We gathered responses from 300 individuals via an online survey from
independent brand intelligence firm Upwave between Oct. 13, 2020, and Dec.
19, 2020. All respondents were at least 18 years of age, employed full-time, and
living in the U.S. when the survey was completed.
Upwave gathered survey data with a combination of proprietary measurement
tools and third-party data validation with panel choices verified to provide
consistent access to B2B respondents from different job levels, titles,
departments and industries. Respondents were given monetary compensation
for completing the survey.
Interested in learning more about how you can
transform your company’s mental health solution
with Lyra? Get in touch.
18 2021 Workplace Mental Health Trends ForecastAbout Lyra Health Lyra Health, a leading provider of innovative mental health benefits for more than 2 million U.S. employees and dependents, is transforming mental health care by creating a frictionless experience for members, providers, and employers. Using matching technology and an innovative digital platform, Lyra connects companies and their employees—plus spouses and children—to world-class therapists, mental health coaches, and personalized medication prescribing. Leading self-insured employers partner with Lyra to tailor value-driven mental health benefits programs specific to their workforce. With Lyra, benefits leaders can offer employees fast, reliable access to clinicians who practice evidence-based mental health care approaches that have been proven effective. For more information, visit: lyrahealth.com, and follow us on LinkedIn, Facebook, and Twitter.
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