Among companies that offer health benefits, 81% of small companies with three to 199 workers and 82% of large companies employing 200 or more workers described their most popular health plans as having a broad provider network for mental health services, with a broad network defined as including most providers in the area, according to Kaiser Family Foundation (KFF)’s annual Employer Health Benefits Survey, which examines the costs and coverage of employer-sponsored health benefits.
Sixty-six percent of small companies and 76% of large ones reported to KFF that they were satisfied with the mental health provider networks available from their health insurer. Still, 9% of all companies surveyed and 23% of very large companies with 5,000 or more employees surveyed told the organization that they had asked their health insurer to increase access to in-network mental health and substance abuse providers within the past two years.
A caveat: KFF fielded its survey between January and July, with half of the interviews conducted in the first three months of 2020, before the pandemic’s true impacts could fully be felt across the US.
Researchers are finding plentiful evidence that the pandemic is dramatically increasing the prevalence of mental health issues among US workers. In a survey of 2,511 American consumers conducted by HRI in September, 30% with employer-based insurance said they had experienced symptoms of anxiety or depression as a result of the COVID-19 pandemic.
Between February and August, the risk of depression increased 56% among workers and the risk of generalized anxiety rose 45%, according to the Mental Health Index. Essential workers reported higher rates of mental health distress, including suicidality and substance use, during the crisis, according to a report published in August by the Centers for Disease Control and Prevention (CDC).
Workers may also be facing challenges with social determinants of health. In a survey of 10,003 US consumers conducted by HRI in April, 59% of individuals with employer-based insurance reported that they had been affected negatively in at least one social or environmental area, such as sleep, affordable housing, childcare, or feelings of isolation or loneliness during the pandemic. In comparison, 48% of consumers with employer-based insurance said they had been experiencing challenges with one or more of those areas before the pandemic.
Prescriptions for pharmaceuticals that treat mental health conditions also increased early in the pandemic. In April, a national pharmacy benefit manager reported that prescriptions filled per week for anti-anxiety medications, antidepressants and anti-insomnia drugs rose 21% between Feb. 16 and March 15, with anti-anxiety medicines seeing the greatest increase of 34%.
Employers invested more in mental health in recent years before the pandemic, beyond traditional mental health provider networks. They were offering disease management programs, addressing stigmas and integrating mental healthcare into primary care at worksite clinics.
Some employers responded to the pandemic by increasing mental health benefits. Nine percent of individuals with employer-based insurance surveyed by HRI in early April reported that they were offered new mental health or stress-related benefits as a result of the COVID-19 pandemic. Those new benefits could include new or expanded access to mental healthcare via telehealth or support via other digital platforms, such as meditation apps, emotional support coaching programs and even digital therapeutics used to treat mild to moderate anxiety and depression.
Twelve percent of consumers with employer-based insurance who said they had used virtual care during the pandemic (24% of all individuals with employer coverage) told HRI in its September consumer survey that they had used virtual care for mental health services. Mental health conditions remain the most common telehealth diagnosis, making up nearly 40% of all telehealth claims in May 2019 and May 2020.
The rise in mental health issues could strain traditional mental health provider networks. In a survey of 2,500 US consumers conducted by HRI in spring 2019, 21% of individuals with employer-based insurance who had sought treatment for a mental health issue in the past five years said it was difficult to find a mental health professional accepting new patients. Telehealth could help ease this and other pain points to accessing mental healthcare.