New digital therapeutic solutions for behavioral health will revolutionize the role that human resources groups play in managing the overall well-being, productivity, and psychological resilience of corporate workforces. Large, self-insured companies are already beginning to integrate new digital offerings into their employee onboarding processes and employee benefit programs to provide safe, affordable, and highly effective personal growth, stress reduction, and psychological resilience programs to their entire workforce.
Let us begin making our argument by stating three indisputable facts:
• Over 30 million Americans who have treatable mental illness are not receiving treatment because they cannot access effective care.
• Employers need their employees to be as productive, healthy, and successful at work and at home as possible, because their workforce is their company’s single most important corporate asset.
• New digital solutions that can reach millions of people across the United States and around the world are coming to market, combining the benefits of evidence-based treatment; online learning; and the healing power of groups to deliver a user experience that is engaging and relatable, so many more employees complete their program and benefit from it.
The problem is not that we don’t have a good treatment for the most common mental illnesses. Cognitive Behavioral Therapy, or CBT, is very safe and highly effective, with 80% of people who complete a course of CBT therapy having positive clinical outcomes and sustained recovery. Cognitive Behavioral Therapy has been scientifically validated by hundreds of researched studies for over the past 40 years. It is the first line treatment in the United States and much of the world for stress, depression, anxiety, trauma, insomnia, and eating disorders. Dialectical Behavior Therapy, or DBT, is a form of CBT that is particularly effective in the treatment of addiction and substance abuse.
The problem is that most people cannot access these treatments. According to the National Institute of Mental Health, over 30 million Americans who have a treatable mental illness are not receiving treatment because of shortages in the supply of care, with over half of U.S. counties having no affordable options for treatment. Ten million of these Americans have both a major chronic non-psychiatric medical illness and co-occurring treatable mental Illness. These are the most expensive people in our healthcare system, and, according to the Centers for Disease Control, one-third the total cost of their care is directly attributable to untreated mental illness.
Employers must be part of the solution to this problem because they bear much of its cost. Collectively, employers lose $200 billion dollars in productivity each year due to untreated mental illness, while spending another $200 billion dollars to treat anxiety and depression in the workforce. That said, lost productivity costs and the direct cost of mental health care are just the tip of the proverbial iceberg for self-insured employers. The largest and most difficult-to-quantify part of their corporate healthcare budgets is spent indirectly on mental illness, i.e., hundreds of billions of dollars of healthcare spending on chronic gastrointestinal illnesses, musculoskeletal illnesses, insomnia, pre-diabetic conditions, heart disease, substance abuse, migraine, and other chronic illnesses that are greatly exacerbated by untreated co-occurring mental illness.
One of my company’s advisors often quotes a saying that we think about a lot: “The body always keeps the score.” He means that the stress and insomnia that is rampant in American life – along with the depression, anxiety and trauma that 50% of Americans will suffer in their lifetimes – will inevitably place a heavy toll on physical health. It is a fact that if you are healthy, mental illness will make you less able to deal successfully with daily life and make you far more susceptible to physical illness. If you are already sick, mental illness will make you sicker and far less able to do what is necessary to heal.
The unhappy nexus between chronic disease and untreated mental illness makes behavioral health the horizontal play for all chronic disease care. We are convinced that this is the one big thing that can move the needle on healthcare utilization rates and costs for large, self-insured companies. It is where CEOs and C-level HR executives can make the biggest impact on the overall health and productivity of their entire workforce.
Employers increasingly understand that underspending on mental health results in overspending on physical health. They understand that the key to lowering their corporate healthcare costs is to provide access to effective mental health care. What they need are affordable, evidenced-based behavioral health and psychological resilience services that can scale to reach their entire workforce.
Many large employers are already offering mobile wellness apps and on-demand mental health services through their employee benefit programs. Some mobile apps work very well for some employees, although the C-level HR leaders that we have talked to generally view them as being ‘pointy’ solutions with short shelf lives as employees frequently lose interest in them over a period of several weeks. They tell us that current on demand behavioral healthcare solutions are not fully responsive to their needs, because they do not have the ability to scale to reach their entire workforce. They describe them as being ‘thin’ services, when what they need for their employees are ‘deep’ solutions, meaning behavioral health solutions that deliver evidence-based care services leading to quantifiable improvements to the well-being and psychological resilience of their entire workforce.
CEOs and C-level HR executives should be thinking about, “What can we do to make our entire workforce more psychologically resilient at work and at home?” The ability to scale to reach all employees is key: if you are the CEO or C-level HR executive of a company that is expanding its operations in Indiana or Mississippi or Germany or Mexico or the Philippines – or in many other regions of the United States and abroad – you really need to think about how you are going to ensure that your entire workforce will be able to access effective mental health care services. Given the critical national shortage in the supply of behavioral health care services, the only solutions to this problem that can achieve the scale and reach that is needed will be technology-based.