In the decades leading up to COVID-19, experts sounded the alarm about the structural problems with mental healthcare in the United States, including a lack of providers to care for a growing number of people who need help, partly because of the opioid epidemic and a surge in suicides.
Then came the pandemic, which not only increased the number of individuals seeking mental healthcare but also glaringly revealed and exacerbated the barriers patients encounter in obtaining that care for themselves and their families.
According to a study by the Pew Research Center, parents now rank whether their children suffer from anxiety and depression as their chief parental concern, as Fierce Healthcare reported.
Employers see the need because a healthy workforce benefits society. Many companies and industries want to address the problem.
Fierce Healthcare caught up with Michael Thompson, the president and CEO of the National Alliance of Healthcare Purchaser Coalitions, to discuss his views about how much of a concern mental health has become for employers and possible approaches to overcoming systemic obstacles.
The Alliance is a not-for-profit organization that represents over 12,000 employers/purchasers and 45 million Americans who spend over $300 billion annually on healthcare.
Here's more from the conversation, conducted via email:
Fierce Healthcare: The Affordable Care Act allows parents to keep their children on their health plans up until age 26. Does this help children and young adults better access to mental health coverage? Does it go far enough?
Michael Thompson: While the ACA improved access to and affordability of coverage for children up to age 26, access to coverage and access to care has not always been equivalent, particularly as it relates to mental health. Behavioral health networks have struggled to provide consistent and timely access to care with many of those in directories not serving new patients. This is particularly concerning for this younger population where the onset of mental illness is most prevalent.
FH: Considering the Great Resignation, greater interest in working at home and the labor shortage, how should mental health coverage expand and evolve in this new employer-employee dynamic?
MT: The U.S. workforce has changed dramatically over the last few years and our last employer survey found that almost two out of three employers now have some form of remote work. This presents a new set of challenges (potential for isolation and need for flexibility) and it’s important that we find ways to adapt health and wellbeing strategies that meet employees where they are such as more virtual options and the use of digital therapies.
FH: What challenges has the COVID-19 pandemic presented and how might they best be met?
MT: The long-term effects of COVID-19 to our mental health and wellbeing are far reaching and have the potential to be as serious as the core pandemic. The fallout of the economic distress, fear of the virus, work/life pressures, illness and social isolation has caused a surge in mental illness, increased risks of suicide and overdose. Employers have reacted by being very intentional with strategies to encourage supervisors to stay connected, flexibility to accommodate personal needs, and increased complementary resources to support the mental health needs of their employees and their families.
To address the growing demand for care we also must ensure that telehealth and tele-behavioral health services are widely available and regulatory barriers removed. We’ve encouraged employers to ensure that their health plans offer employees and their family members a variety of choices to access behavioral healthcare—be it virtual, digital, or in-person solutions. It’s also important that screening and testing be expanded as early intervention and treatment is just as impactful for mental health as it is for physical health. Rather than going back to “normal” post-pandemic, we should expand on the innovations that have resulted to get to a more effective and responsive behavioral health system.”
FH: Mental health has become a big concern for employers. How does that carry over to concern for employees' children, even beyond coverage?
MT: The mental health of employees has a direct impact on healthcare costs, well beyond expenses to treat mental illnesses [as] the incremental costs of comorbidities are even higher than the costs of mental health treatment, and productivity. Attraction and retention is also a higher priority for employers post-pandemic and ensuring that health and wellbeing benefits meet the needs of not only employees but that of their children is an important strategy. The mental health and wellbeing of children also impacts the wellbeing and productivity of their parents.
FH: What steps is the National Alliance taking to address these concerns?
MT: The National Alliance is active in promoting workplace mental health programs and strategies and is a founding member of “The Path Forward for Mental Health and Substance Use” an initiative of purchasers and HR/benefit and mental health associations and non-profits working to improve access and quality to behavioral health services. Other partners involved in this effort include the American Psychological Association, HR Policy Association, Jed Foundation, and the Meadows Mental Health Policy Institute.
This interview has been edited for clarity and length.