Evernorth: How employers can take the lead on addressing youth mental health

Mental health concerns among youth continue to rise, and employers can play a significant role in mitigating these challenges, according to a new study from Cigna's Evernorth division.

The analysis found that the number of young people with mental health needs has increased by 28% since 2018, and the number with at least two diagnoses grew by 48% in that same window. A quarter of parents said their child has a mental health need, either diagnosed or not.

In addition, the study found that care for young people with mental health needs is highly fragmented and incomplete, even as the need rises. A fifth of youths had not received any treatment within three months of a diagnosis, according to the report.

Close to a third (29%) of young people were treated with both medication and therapy, and many were treated solely with medication. The report said medication adherence increases in tandem with therapy.

Eva Borden, president of behavioral health for Evernorth, told Fierce Healthcare that the rising tide of mental health concerns among young people has effects that go beyond the patients themselves.

"We've really been thinking about how important to use mental health, not just for the individual who's going through that … but also for the parents and family and employer," Borden said. "Because there's really a ripple effect that impacts parents, workplaces and communities."

Fifty-five percent of working parents said they faced barriers in securing behavioral health care for their child, with 36% saying access challenges were the reason their child wasn't currently in therapy or counseling. 

The report highlights four key areas employers can focus on to better support parents who are managing their child's behavioral health needs: care delivery, customization, culture and community engagement.

This means designing benefits that make it easy for employees to find evidence-based and comprehensive mental health care that integrates medical services, pharmacy services and behavioral health. It also requires embracing data analytics to drive a more personalized experience, according to the report.

Employers can also drive a culture that reduces the stigma around seeking behavioral health care as well as invest in community partnerships that can enhance support, according to the report.

"The main thing we need to do is get access for these children, get access through these families, and make it easier and more understandable to get care," Borden said. "That's a major focus and what we've been about."

One way Evernorth is endeavoring to boost access within its own behavioral health unit is by eliminating prior authorization on most services. Routine outpatient services as well as substance abuse treatment do not require prior auth, allowing patients to seek out care from any in-network provider, the company said.

Clinicians are also not required to submit prior authorization requests to enroll a patient in an intensive outpatient program, Cigna said.

Borden said that for services that do still require prior authorization, Evernorth has a team available around the clock to answer those requests.

"We know behavioral health just doesn't happen during work hours," she said, "and we want to make sure we're there to support people in all of the moments when they may be facing these challenges."