Employers across the globe now recognize that protecting and supporting the mental health of employees is vital to the future of their business. This newfound awareness comes as the world enters the third year of the pandemic, and little is normal about the way we live and work. In 2021, the disruptions and mental health fallout from COVID-19, economic uncertainty, and social unrest continued, affecting even more of the workforce than in 2020. Meanwhile, more employees dealt with mental health challenges over the past year, from stress and burnout to anxiety, depression, post-traumatic stress disorder (PTSD), and substance use problems.
Mental health issues like burnout have contributed to many workers’ decisions to leave their jobs, if not the workforce entirely. “The pandemic has forced people to reflect on what really matters most to them, and if their employer does not support their ability to prioritize other values outside of work, then people may look elsewhere, or they may risk becoming burned out and frustrated,” said Joe Grasso, Lyra Health’s senior director of workforce mental health.
More employers are stepping up to this challenge, with leading organizations increasingly launching policies and programs that support struggling employees and evolve the conversation around mental health at work. “A pandemic is going to bring a lot of negatives, of course, but I think one of the most positive things to come out of it is, for the first time, you’re starting to see employers and employees on the same page,” said Trish McFarlane, CEO and principal analyst at H3 HR Advisors.
This shift represents a pivotal opportunity for organizations across industries to question the status quo. To seize this moment, what’s required is a new way of thinking about supporting workforce mental health—one that recognizes it as both a moral imperative and a core strategy to sustain employers’ most vital resource—their people. That includes breaking down long-standing barriers to mental health care inherent in traditional health insurance networks and employee assistance programs (EAPs). It also means embracing a holistic strategy that addresses pervasive workforce mental health challenges such as stigma and unsupportive work cultures.
To better understand the challenges, priorities, and attitudes shaping mental health at work today, we surveyed more than 1,000 full-time employees and 250 employee benefits leaders across the United States. Read on for benchmarks, analyses, and insights from employees, HR and benefits leaders, and clinicians as we navigate a new world of work and the “next normal” of workforce mental health.
7 Insights Into the Current State of Workforce Mental Health
1) The employee mental health crisis is worsening
Employees’ mental health is at an all-time low, the survey data suggest. Nearly a third (31 percent) of workers surveyed said their mental health has declined over the past year—up from 24 percent at the end of 2020.
While the majority of respondents (56 percent) said their mental health remained the same over the past year, that doesn’t necessarily mean they’re in good mental health. In fact, 84 percent of workers surveyed experienced at least one mental health challenge over the past year, from issues such as stress and burnout to diagnosable conditions including depression, anxiety, bipolar disorder, and PTSD.
In addition to more employees reporting declining mental health, workers were also more likely to say they’d faced stress, anxiety, burnout, and depression over the past year. The biggest jump was among employees with anxiety, which affected 14 percent more employees than in 2020.
Regardless of industry or seniority level, employees’ mental health problems are affecting them at work. Fifty-nine percent reported this in 2021, up from 48 percent in 2020. This isn’t surprising, considering the host of research studies showing that people with mental health conditions like depression and anxiety are more likely to face job-related difficulties. For example, one study showed that workers with depression are five times more likely than those without it to become unemployed, and it’s been established that depression is the leading cause of disability globally.
While the mental health conditions employees lived with over the past year were already prevalent pre-2020, the pandemic has only accelerated them. In addition, employees still had to contend with a flurry of stress-inducing circumstances that weakened their mental health. Whether dealing with health anxiety, grief over losing loved ones, canceled plans, stress, and burnout due to staffing or supply shortages at work or attempting impossible work-caregiving juggles, the pandemic has deeply affected employees’ mental and emotional well-being.
2) Most employers are prioritizing workforce mental health
Our survey of employee benefits leaders shows that organizations are well aware of the greater need for workforce mental health resources and support and consider it a priority. The vast majority—92 percent—said providing mental health support for their people became a higher priority for their company in 2021, and 93 percent said they expect it to stay that way over the next three years.
Most benefits professionals surveyed (62 percent) also said they had had higher expectations of their companies’ medical plan, employee assistance program (EAP), or dedicated mental health benefits since the start of 2021. About the same amount (60 percent) believe their employees hold the same higher expectations, and 87 percent believe workers’ expectations for greater mental health support will continue over the next three years.
Today’s employee benefits leaders are relatively accurate in their assessments of the scale and types of mental health challenges employees face. More than half of benefits leaders surveyed said they believe “many” or “a lot” of their employees are “actively dealing with one or more mental health issues.” And about one-third of benefits leaders surveyed believe their employees’ mental health declined over the past year— mirroring the third of employees who said their mental health declined in the past year.
Benefits professionals also seem attuned to the main factors affecting their employees’ mental health:
• Survey respondents correctly identified the pandemic, economic uncertainty, employment uncertainty, and job loss among the top factors affecting their employees’ mental health today.
• Nearly a quarter (23 percent) of benefits professionals surveyed cited family and relationships as a factor negatively affecting employees’ mental health, close to the 30% of workers who reported this.
• Benefits professionals’ awareness of people’s growing mental health needs also seems to correlate with their companies’ changing plans to address these needs. When asked, “Does your organization have plans to change your workforce mental health strategy in 2022?” 57 percent said “Yes.”
3) Employers can break down barriers to care
As more workers face mental health challenges and companies are expanding access to mental health support, more people are getting care, the survey data show. A third of employees surveyed (33 percent) said they sought mental health care in 2021, up from just 19 percent who received treatment in 2020.
The higher prevalence of mental health issues among the workforce isn’t the only thing driving more people to get related care. Our survey findings indicate that for more employees, it’s becoming easier to seek mental health treatment. For one, more employers today are easing the financial barriers to this care—historically a formidable roadblock to getting therapy or psychiatric services. Although many workers are still paying out of pocket for mental health care, their numbers are dropping.
In 2020, 45 percent of employees said the mental health care they’d received that year was not fully covered by their employer. Just 19 percent said this is the case today. What’s more, a growing number of employees now say their mental health benefits are easy to use:
• In 2020, 54 percent of employees said it was “easy” for them to access mental health care using the benefits provided to them.
• In 2021, 65 percent of those who sought care or support over the past year said it was either “easy” (35 percent) or “very easy” (30 percent).
• • Those who said they had access to a dedicated mental health benefit were likelier to say this process was “very easy” (39 percent), compared to 27 percent of those who sought care without a dedicated mental health benefit.
As an employer, part of making care easier to access is communicating effectively about available benefits. Companies appear to be doing a better job of this, with more employees now reporting that their organizations offer an EAP or a dedicated mental health benefit. Meanwhile, more workers are signaling their awareness of the mental health resources their employer provides:
• 54 percent of employees at the end of 2021 said their employer offered an EAP, compared to 44 percent the year before.
• 25 percent said their employer offers a dedicated mental health benefit, compared to 16 percent in 2020.
• Fewer employees in 2021 said they “weren’t sure” about the mental health resources their employer offers: 12 percent reported this vs. 31 percent in 2020.
• Less than half the number of workers this year (15 percent) said they hadn’t tried to access mental health care using their employer-sponsored benefits compared to those surveyed at the end of 2020 (36 percent).
Unfortunately, this doesn’t mean everyone who needs mental health care gets it. The number of employees with a self-reported mental health condition (such as anxiety, depression, bipolar disorder, or PTSD) who did not receive care remained unchanged from the year before, at 44 percent. These findings highlight the ongoing need to ensure workers with the greatest mental health burdens can easily access care.
4) Employers overestimate their benefits’ ability to effectively address workers’ mental health challenges
Employers are clearly gaining awareness about the magnitude and range of mental health issues workers face. They also report how hard it is to make sure their employees have the support they need. About two-thirds (66 percent) of benefits leaders cited “supporting employee mental health” as one of the top challenges they face in their jobs.
However, there’s still a considerable gap between benefits professionals’ and other workers’ perceptions of how effective their benefits are at addressing employees’ mental health needs.
One notable difference? Employees with access to a dedicated mental health benefit are more likely to say the care they received over the past year was effective. Fifty-two percent of those with a dedicated mental health benefit said their current benefits help them “effectively address” their mental health needs, compared to 42 percent of workers without a dedicated mental health benefit.
Benefits leaders themselves are more likely to say their benefits are more effective at addressing employees’ mental health needs if their organization offers a dedicated mental health benefit.
81 percent of benefits leaders whose companies have a dedicated mental health benefit believe their current benefits effectively address employees’ mental health needs vs. 70 percent of those without.
5) For employees, comprehensive mental health benefits are fast becoming a requirement—not a perk
Having employer-provided mental health benefits has become a bigger priority for today’s workers and influences their decisions about staying in their current jobs and in searching for new ones. A staggering 84 percent of employees surveyed said it’s important that a prospective employer offer “robust and comprehensive mental health benefits”:
• 29 percent said it’s “very important.”
• 55 percent called it “somewhat important.”
Employees who said their company offers a dedicated mental health benefit reported better perceptions of their employers. While employers see that people have higher expectations, it appears they may not recognize that comprehensive mental health benefits are directly linked to turnover. The benefits leaders surveyed cited employee retention as a major pain point: 43 percent said it’s among the top three challenges they face in their role heading into 2022.
• Just 51 percent said their organization offers a dedicated mental health benefit.
• 61 percent indicated that the resources their company provides already “fully address employees’ mental health needs.”
6) Working caregivers bear a heavier mental health burden— and need more support
Working parents and caregivers of elderly or disabled loved ones are more likely to face mental health challenges than their non-caregiving peers, the survey findings and other recent research show. Pre-pandemic, this workforce segment was already grappling with burnout, stress, and other caregiving-related mental health issues, along with a dearth of institutional support. The pandemic laid bare these realities as a growing number of caregivers, disproportionately women, either faced an impossible juggling act of full-time work and child or elder care (or all three in some cases) or left the workforce altogether.
A whopping 89 percent of caregivers surveyed said they experienced at least one mental health challenge in 2021, compared to 81 percent of non-caregivers. Those with child or elder caregiving responsibilities were also more likely to experience worsening mental health over the past year.
Working caregivers demand more when it comes to care – Along with more mental health struggles, working parents and other family caregivers have higher expectations of their employers to provide support. About a third (32 percent) of caregivers said they have higher expectations for mental health support from their employers, while 14 percent of non-caregivers voiced the same. This may be because more working caregivers are seeking mental health care to treat their anxiety, depression, and other mental health problems: 41 percent sought care in 2021 compared to 29 percent of employees without caregiving responsibilities.
7) Workforce mental health demands an open, supportive culture
One potential silver lining amid today’s myriad workforce mental health obstacles is the apparent positive impact of more open, supportive company cultures where employees feel comfortable discussing their mental health struggles. While there’s still a disconnect between employers’ and employees’ perceptions of openness around mental health at work—an alarming 32 percent of workers said mental health is “not discussed at all” in their workplaces, while 6 percent of benefits leaders said the same—employers appear to be fostering more mental health-related discussions, and employees are paying attention.
In 2021, more than a third of employees (36 percent) said their company had discussions about mental health “with all employees in open forums,” up from just one in five employees who reported this in 2020. More employees this year (19 percent) said their company leaders “regularly discuss mental health,” compared to 13 percent who said the same in 2020.
During the same time span, the number of employees who said they discussed their mental health in the workplace over the past year nearly doubled, from 23 percent in 2020 to 43 percent in 2021. Far more people now report a higher comfort level around bringing up their own mental health challenges with managers and peers.
Forward-looking employers are leading the charge on cultural transformation – What’s more, employees who believe their employer cares about their well-being—and workforce mental health more broadly—were significantly more likely to have discussed their own mental health at work over the past year.
Half of workers who believe their employer cares about their mental well-being discussed their mental health in the workplace in 2021, versus 34 percent of respondents who said they did not believe their employer cared about their mental well-being. Respondents who said their company believes it’s important for managers and other leaders to model mentally healthy behaviors were also likelier (at 53 percent) to broach the topic of their own mental health at work last year than those who said they do not believe their employer values this (30 percent).
All of these findings signal an important shift in the right direction; both company leaders and individual contributors are increasingly speaking up about their mental health in the workplace. At the same time, they underscore the work still ahead to ensure more employees feel safe and comfortable discussing mental health at work and know that their employers care about their mental well-being.
The New World of Work Requires a Commitment to Workforce Mental Health
Seemingly endless stressors in an uncertain world, along with a historic reshaping of the labor market, have transformed the landscape of work as we know it. The data collected here underscore a significant shift in workers’ expectations of their employer and their support for workers’ mental health.
As the survey data suggest, employers today understand this. But with so much at stake for organizational success and employees’ well-being, tackling workforce mental health can understandably feel daunting. From determining how best to broach sensitive mental health topics to providing mental health-related training and education and ensuring benefits are equipped to meet workers’ needs, there’s no shortage of work to be done.
It’s important to remember that employers don’t have to do everything perfectly in order to make a positive impact on their people’s mental health. Their ongoing efforts and commitment to strengthening workforce mental health will go a long way toward ensuring lasting change that benefits employees, their families, and entire organizations.
Next Steps for Employers
1) Establish workplace structures that support mental health
Work-related stress took a major toll on employees’ mental health in 2021, with 37 percent citing it as a top factor affecting their mental health. With so much beyond employers’ control today—the pandemic, social unrest, economic uncertainty, workers’ home lives—it has become even more crucial to focus on the factors you can influence to help prevent work-related mental health problems.
“We are all doing the best we can with the resources we have available to us, but that sentiment is even more important in navigating the challenges we face today,” noted Kelli McElhinny, a clinical therapist in Pennsylvania. “Show your employees—and yourself—some grace and compassion and take as many opportunities as possible to express your support for them.”
More than ever, it’s imperative to rethink workplace norms and practices that contribute to stress, burnout, and other common mental health challenges. Giving employees more say over how and where they get work done is an important first step. “Evidence-based findings originating decades ago have shown that a sense of control over one’s work is a key to mental health and psychological well-being, even more than being overwhelmed by volume of work,” said Chester Spell, Ph.D., a professor of management at Rutgers University who studies psychological health and well-being in companies.
Offering employees more input over how, where, and when their work is done is just one strategy organizations can use to bolster workforce well-being, said Joe Grasso, senior director of workforce mental health at Lyra. Curtailing a work culture that leads to burnout—for example, a workplace where results are valued over people, overwork is rampant, and employees are afraid to voice concerns—is also essential.
“You have to create the environment and circumstances that allow them to be resilient,” he said. “You can’t give employees resilience training and then micromanage them—or overload them with excess work and under-equip them with resources— and expect positive outcomes.”
Other preventive best practices to consider:
• Evaluate and balance employee workloads, empowering them to delegate or reprioritize work as needed and appropriate.
• • Ensure role clarity and avoid role overload by providing clear expectations of what employees should achieve and to who they should report.
• Tackle workplace bullying, unfair treatment, and policies that are disproportionately enforced for different groups (for example, ensure equitable treatment of remote and in-person employees).
• Encourage and respect regular breaks, paid time off, and boundaries around workdays.
It’s best to provide targeted manager training to ensure leaders throughout the organization follow and promote these practices consistently.
2) Listen to your people and put their mental health needs first
Whether via direct feedback from surveys, one-on-one conversations, reactions to policy changes, or indirect consequences such as lower engagement and higher turnover, employers must listen to the messages employees are sending about their mental health needs. As this survey data suggests, that will likely include flexible work policies and robust mental health benefits.
Providing regular opportunities for employees to share their top needs, concerns, and priorities is a good place to start.
Gathering regular feedback from employee surveys can help make your workforce feel heard, especially when they may be feeling disconnected. It’s important to follow up by sharing a summary of the results and information about how the company will address major themes reported in the survey. Regularly soliciting input from managers about their team members’ top pain points is another important conduit to stay informed about employees’ needs.
“This is where transparency, communication, and the spirit of working together go a long way toward mitigating the stress and paving the way toward better mental health,” said Vishwanaith Baba, Ph.D., a professor of management at McMaster University. He noted that employers also need to “walk the talk” and that “strategies to support employee mental health have to be multifaceted and comprehensive.”
For a growing number of organizations, these strategies include offering a comprehensive mental health benefit— something most employees surveyed cited as a key factor in whether to stay in their jobs and when considering new opportunities.
This was the case for VCA Animal Hospitals, whose benefits team decided to find a comprehensive mental health care benefit after hearing concerning feedback from workers.
3) Make sure your employees can access quality mental health care
Not all employee benefit programs are created equal, which is especially evident when it comes to mental health care. Too often, traditional EAPs and health insurance plans don’t provide timely access to therapy, psychiatry, or other behavioral health care. These networks also tend to offer a limited range of available providers, care types, and specializations, meaning they’re less equipped to treat employees’ unique needs.
In traditional networks, the lack of available providers typically prompts people to hunt through spreadsheets for a therapist or psychiatrist who might return a phone call. Even when a provider is available, mental health care is rarely tracked or measured to monitor patient outcomes with treatment.
Johanna Baldwin, director of associate well-being at VCA, said that, before the company offered mental health benefits via Lyra, they often heard from employees that it was tough to get care.
This state of affairs means employees are left to decide between in-network care options that don’t address their unique mental health needs or more expensive, out-of-network services. Or, as our survey data indicates, this can lead people who need treatment—56 percent of those with a self-reported mental health condition, despite having employer-sponsored health insurance—to forego care altogether.
For all of these reasons, it’s essential to vet mental health benefit vendors to ensure they provide the following:
• Support for the full spectrum of mental health needs, from stress and burnout to depression, anxiety, and more complex conditions such as bipolar disorder and substance use disorders.
• A diverse, vetted provider network that can meet the needs of Black, Indigenous, and people of color (BIPOC) and LGBTQIA+ employees.
• Technology and a provider network that makes care easily accessible in a variety of ways, such as video, telephone, live chat, and in-person.
• A commitment to care approaches that have been researched and tested, with anonymized patient outcomes metrics to prove results. “Vendors should be able to clearly share best practices on driving utilization and tell you about what outcomes data they’re measuring that will be available to you,” said Dunbar.
4) Create an open conversation around mental health
Mental health-related stigma has long been a barrier to seeking needed care, but more openness and support for mental health at work seems to be helping to change the tide. As the survey data shows, more employees in 2021 spoke up about their mental health at work, and their self-reported comfort level doing this soared. At the same time, more employees said company leaders brought up mental health in the workplace.
At Cargill, Inc., both leaders and employees have engaged in “new conversations” about mental health over the past year, said Andi Blaylock, an employee relations leader with the company. “Leaders are modeling openness and self-care behaviors, and employees are asking for what they need to perform their best. Through training, we have given basic skills and vocabulary in talking about mental health and, as a result, are being more vulnerable with each other and creating safety for these types of discussions.”
Meanwhile, a significantly higher proportion of employees said they sought mental health care over the past year. And more employees surveyed this year signaled their awareness of available employer-provided mental health benefits and resources.
Employers deserve at least some of the credit for these shifts since it’s unlikely workers would have this information without their companies communicating about them. More communication about mental health benefits and resources means more people know about the care options available to them and can seek them out when needed.
Connecting these resources to a company’s values and approach to mental health may also have an impact: Survey respondents whose employers offered a wide range of mental health resources were also more likely to say their employer cares about whether managers and leaders model mentally healthy behavior.
Unsurprisingly, employees who said they were “not sure” about the employer-provided mental health resources available to them were less likely to seek care in 2021. Just 10 percent of employees in this group said they sought mental health care in 2021, compared to 40 percent of workers who said their employer provides a wide range of resources that “completely address” their mental health needs, and 41 percent of those who said, “Some resources for mental health are provided, but there is room to offer additional resources.” This may indicate a lack of communication about available benefits in some organizations—something these employers have an important opportunity, if not an obligation, to remedy.
In addition to regular communication about available resources, the following are some actionable ways to help normalize discussing mental health at work:
• Proactively check in with your teams and share useful mental health resources.
• Talk about mental health in all-company meetings.
• Share internal videos or hold conversations where company leaders discuss their mental health. This signals that vulnerability is a strength and helps combat beliefs people may have about mental illness being unknown or scary.
• Model healthy behaviors by using paid time off (PTO) or telling employees you took time for a mid-day walk, therapy appointment, or other forms of self-care.
• Create ongoing mental health awareness campaigns, training, or workshops that educate employees about mental illness and encourage them to seek help. (Ask your mental health benefits provider for help or guidance in launching these training regimens or workshops).
• Develop a team of “mental health champions” in your workplace who build awareness of mental health and are non-judgmental sources of support.
5) The caregiver mental health crisis is real — seek out policies and programs that address it
Working parents and other family caregivers “literally don’t have enough time during the day,” said therapist Courtney Shipp, a licensed clinical social worker in Fort Worth, Texas. “If a person is working from home and also a caregiver to either adults or children, they never get a break in the form of space. This takes its toll after two years.”
Sherry Lyn Kaplan, another Texas-based therapist, said, “Many of my clients who are also caregivers or parents are trying to ‘do it all’ and feel like they’re failing in one or both areas (family and work). Some have expressed feeling as though they must sacrifice time with their kids in order to be a high achiever at work, or they feel so burnt out or anxious about work that they’re not present even when spending time with family.”
While employers may not be able to resolve some of the more persistent issues that affect these employees, such as the lack of affordable child or elder care, they do have an opportunity to make it easier to balance work and caregiving. Their efforts can create a more equitable and inclusive workplace where people don’t feel they have to choose between their caregiving responsibilities and careers.
With fewer support systems available to working parents and other family caregivers due to the pandemic, juggling work and caregiving can feel even more impossible than it did pre-pandemic, especially if they’re expected to return to in-person work. To help remedy this, consider offering the following:
• Additional paid parental leave and paid time off to care for adult relatives, and a workplace culture where taking needed time off is accepted and encouraged.
• Child and elder care benefits: Child care and elder care benefits can provide the much-needed support they need to balance work and caregiving responsibilities
• Flexible schedules that give working parents and other family caregivers time for attending medical appointments, facilitating child or elder care, and other caregiving-related activities.
• Employee resource groups (ERGs) for parents and other family caregivers that allow them to connect and get support from peers experiencing similar challenges.
• A mental health benefit that provides high-quality care for dependents, including children and spouses.
Pinterest is another leading employer-focused on taking care of the caregivers in its workforce. The company offers targeted resources such as additional parental leave, child care options, and parent and caregiver support for its sizable population of parents.
By: Lyra Health