Employers are increasing access to mental health services, yet gaps remain

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Ingrid Stiver Senior Manager, Health Research Institute, PwC US September 18, 2019

Historically, employers have considered mental health benefits a lower priority than physical health benefits. This has shifted with the implementation of the Mental Health Parity and Addiction Equity Act of 2008, which changed the rules around cost sharing, treatment limits and scope of covered services for mental health services. This law likely is driving increased utilization as access is expanded to comply with the mental health parity requirements. Additionally, with initiatives such as the “Make It OK” program to destigmatize mental illness and the National Alliance on Mental Illness’ effort to foster open conversations about mental illness, a growing number of employers are encouraging employees to take care of their mental health by further expanding access to mental health services. These efforts are expected to increase utilization and spending in 2020.

PwC’s Health and Well-being Touchstone survey revealed that 75 percent of employers offered disease management programs focused on depression and mental health in 2018, up from 34 percent in 2014. Yet only 27 percent of individuals with employer-based insurance surveyed by HRI who face depression and mood disorders, post-traumatic stress disorder, addiction and/or suicidal ideations as their primary health issue report participating in a mental health and well-being program over the last two years.

Of consumers surveyed by HRI with employer-sponsored coverage, 81 percent said they had not sought out treatment for a mental health issue in the past five years. Eight percent of those consumers believe they should have, but many did not seek care because they thought they could handle their mental health on their own.

But finding the right care can be a challenge. Twenty-one percent of consumers surveyed by HRI with employer-based insurance who have sought treatment for a mental or behavioral health issue in the past five years said it was difficult to find a mental health professional accepting new patients for the services they required.

Health systems are working to address access issues and the intersection of physical and mental well-being. Ninety-five percent of provider executives responding to a 2018 HRI survey said it is important to partner with mental health organizations and 59 percent said they plan to invest more in extended care teams, including mental health professionals, over the next five years compared to the previous five years.


For citations, implications and insights, please read our full report, Medical cost trend: Behind the numbers 2020.

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Trine K. Tsouderos

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