Big Employers Unhappy with Workers' Mental Health Access: Is Telehealth the Answer?

Tele-behavioral health was important to 95% of employers and 65% were satisfied around these services.

A new survey of more than 200 large employers finds near-universal recognition of the need for effective mental healthcare in their employee health plans, but also widespread dissatisfaction with the quality of and access to that care.

The survey, conducted in March by the National Alliance of Healthcare Purchaser Coalitions and HR Policy Association, found that while 99% of employers agreed that timely and effective access to mental healthcare is important, only 31% of the 221 respondents are satisfied with mental healthcare access in their company health plans, which combined cover 10 million people.

"Our study found a strong employer consensus on what is critical and significant variation in health plan and vendor performance," says Michael Thompson, National Alliance president and CEO.

"Many of the services provided, particularly in managing network access, continue to fall short of employer expectations. While there are bright spots, as an industry we still have a long way to go to meet the needs of employees and their families," he says.

The findings were presented Tuesday at a Path Forward mental healthcare meeting of employers, business health coalitions, mental and behavioral health service providers and health plans, and other stakeholders.

The survey asked employers to rank the importance in specific areas and their satisfaction with their service providers' performance.

The survey found that:

• While 99% agreed that effective and timely access to in-network behavioral health is important; 31% were unhappy with efforts to identify and address gaps in network access.
   
• Tele-behavioral health was important to 95% of employers and 65% were satisfied around these services.
   
• Only 34% of employers agreed that their behavioral health directories were an accurate reflection of available providers.
   
• While 54% were satisfied with the promotion of standardized measurement for behavioral health services, only 33% were satisfied with engagement and reporting of behavioral health outcomes.
   
• 84% agreed that it was important that plans support integration of behavioral health into primary care, but only 28% were satisfied.
   
• 64% agreed that early identification using tele-behavioral health can mitigate the severity of mental health issues.
   
• Achieving high engagement in workplace behavioral health programs was important to 92%, but only 39% were satisfied.
   
• Only 27% of employers were satisfied that their service providers evaluate and tailor behavioral health services to diverse communities.
   
• Only 14% of employers were satisfied with service provider support of whole person program integration through data and process coordination.

The responses to this most-recent survey are depressingly similar to responses given in a similar survey five years ago, which found  disparities for access to behavioral health when compared to physical health services. "While some progress is evident, many of the issues we cited in 2018 have persisted and we must double down on industry commitment and accountability to address these issues moving forward," Thompson says.