How to Build a Business Case for Mental Health in the Workplace

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How to Build a Business Case for Mental Health in the Workplace

Organizations often strategize to maximize financial performance and growth. To drive any kind of change in your organization, leadership support and commitment are essential. The primary factors considered by senior leaders are value creation and return on investment. Below, you can find a step-by-step guide on how to build an effective business case for mental health in the workplace designed for senior leadership.

Step 1: Identify the current resources and benefits for your organization for mental health

Rationale: To most effectively address mental health issues, you should first understand what resources and benefits your organization currently offers. If mental health coverage is minimal, why? Is it due to budgetary constraints? Here are some common questions you can ask vendors:

• Health plan
  • What mental health services are covered by our health plan?
  • Is our network adequate (e.g. number of psychiatrists and clinical psychologists covered within the geographical area where employees work and live)?
  • Do we cover telepsychiatry or telemedicine for behavioral health?
• Employee assistance program (EAP)
  • Do we have an EAP? If so, what mental health benefits are offered?
  • Who else in the family can utilize EAP services?
  • Does the contract allow an appropriate number of visits for individuals to establish rapport between patient and provider?
  • Does the network of behavioral health professionals overlap with the behavioral health professions on the medical network? This is important to maintain treatment continuity if the individual needs additional behavioral health sessions to finish treatment.
  • What other programs are offered related to mental health and what are the associated costs?
  • In addition to counseling services, does the EAP also offer mental health resources to share with employees (e.g. posters, slide shows for monitors, handouts, magnets, and other items)?
• Wellness vendor
  • Are employees requested to take a health risk assessment (HRA), and if so, does it contain questions related to stress, sources of stress, and other mental health concerns (such as questions found in the PHQ-9)?
  • What programming is offered for mental health and is it included?
  • What collateral can you provide about covered behavioral health services that we can post around the workplace?
• Communication
  • Do we have a central website where people can locate information on mental health benefits and resources?
  • How often are people sent information or email ‘reminders’ about their mental health benefits/resources?
  • Do we provide any mental health-specific information during onboarding or open enrollment?
  • Does our human resource department have handouts about the importance of mental health?
  • Do we have posters or handouts posted in different high-traffic areas about mental health and well-being?
  • Do our handouts clearly state where employees can go for help about a mental health condition?
  • What other forms of communication are we using to inform employees and leadership of available mental health resources (i.e. digital, social media, staff meetings, etc.)?
• Resources for help
  • Are human resource professionals trained on how to speak with someone who may be experiencing a mental health condition?
  • Are our human resource professionals trained on detailing our mental health benefits?
  • Are our human resource professionals trained on where to direct employees for help?
  • Does our human resource office have signs/handouts that address mental health, and are they visible?
  • Are front-line supervisors trained on how to speak with an employee who they believe may be experiencing a mental health issue? Do they know the organization’s resources and how to connect the employee to the necessary services?
  • What programs are in place that help with stress management and resiliency, how are these programs communicated to employees, and how can employees access this material?

Step 2: Impact assessment and data collection

Rationale: To gain leadership support, it is important to demonstrate 1) a clear assessment of the organization’s current mental health resources, 2) a clear vision on what changes need to be implemented, and 3) a cost comparison between making and not making changes that address mental health. This comparison is critical to show both the current costs associated with not addressing mental health, and the costs associated with making the needed changes. It provides a useful measuring stick for budgetary constraints and shows leadership that you recognize the importance of cost considerations.

• Basic statistics about mental health^1-3:
  • Mental health conditions are one of the largest cost drivers in the U.S. economy
  • Depression: 6-7% of the adult population (between ages 18-54) have experienced a major depressive episode in the last year (these figures do not include seasonal or postpartum depression).
  • Only 20% of people diagnosed with depression receive appropriate treatment.
  • Anxiety: 18.1% of the adult population (between ages 18-54) have had an anxiety disorder in the last year
  • Only 37% of people diagnosed with anxiety actively seek treatment
• Basic costs associated with depression and anxiety at the workplace
  • To calculate the estimated costs of depression on your workplace, use the following depression cost calculator: http://www.workplacementalhealth.org/depressioncalculator/
  • To calculate the estimated costs of anxiety at your workplace, multiply the number of employees by 0.18 (18% percent of adults had an anxiety disorder in the past year) and multiply the result by 800 ($800 is the estimated annual costs of anxiety per person derived from the estimated annual costs of anxiety in the U.S. [$45 billion] divided by anxiety prevalence in the U.S. [18% of 317 million people]).
• High return on investment
  • Studies have an estimated 3:1 return on investment for implementing policies and programs that help prevent and facilitate treatment of mental health conditions^5-6
• Overall costs of mental health to your workplace
  • Request quarterly reports from your medical provider on the costs of care associated with depression and anxiety in your employee population.
  • Top 20 drug utilization and drug spend – antidepressants, anxiolytics, etc.
  • Short and long-term disability claims
  • Family and medical leave for mental health claims
  • Absenteeism and presenteeism costs from lost productivity. Studies have estimated that the economic costs of lost productivity from depression alone is nearly equivalent to those incurred by direct medical costs.²

Step 3: Develop a plan

Rationale: Senior leaders are more likely to support initiatives with well-though-out plan.

• Communication is the low-hanging fruit
  • Share a central message of support from senior leaders acknowledging the importance of mental health, confirming the organization’s commitment to provide resources, and encouraging openness, compassion, and help-seeking
  • Broaden visibility of workplace mental health as an organizational priority
  • Disseminate high-impact programs and resources
    • Fact sheets on common conditions, such as depression and anxiety
    • Posters/handouts that clearly indicate where employees can get help
  • Inform management and human resource staff about common signs mental health conditions, such as depression and anxiety, and how to talk with employees who may be experiencing these conditions
  • Inform management, supervisors, and human resource staff members on where and how to direct employees to the appropriate help and support
  • Ensure mental health information and resources are easily accessible to employees on all shifts and worksites, whenever possible
  • Share monthly reminders on the importance of self-care (free external articles, webinars, etc.) and available resources (i.e. resilience training, meditation, mindfulness, etc.) provided by your organization
  • Conduct annual or bi-annual benefit and resource satisfaction surveys
• Other effective options:
  • Get an EAP if you do not have one; if you have an EAP, actively engage the vendor – ask for printed materials on mental health services and reach for help planning seminars, workshops, and more
  • Consider expanding mental health coverage for counseling and appointments
  • Review the organization’s policies and consider offering flexible work arrangements and leave policies for mental health-related issues
  • Develop a mental health policy that aligns with the organization values/mission statement and communicates the organizational commitment to mental health to employees
  • Provide workplace accommodations for employees that help reduce stress and burnout
  • Encourage and supply opportunities for manager training on mental health
  • Host mental health booths and seminars at health benefit fairs and during open enrollment
  • Plan workshops and programs focused on skill learning surrounding resiliency, gratitude, stress management, mindfulness, motivation, self-improvement, meditation and more
  • Modify dietary offerings to encourage healthy eating habits

Step 4. Present your business case to leadership 

• Tips: For the first slide, use 2-3 sentences to summarize the problem and your solution.
  • The problem should include data on costs identified above
  • Present how your plan on workplace mental health improves recruitment, retention, performance, productivity, and lowers costs
• Clearly communicate why your organization should address mental health by emphasizing the value of the employees, the health costs, and the social good that comes from effectively addressing employee mental health
• Indicate how you will use existing resources, coordinate with vendors and support staff to address mental health issues, and document the effectiveness of the initiative
• Keep your presentation short and focused
• Be realistic with your goals and implementation plan timeline. Change takes time.

Once your initiative has started, continue to collect data over multiple years and update leadership on the impact of your mental health initiative over time. As positive data is generated, it offers you the chance to build
and grow your workplace initiative.

References:

1. Trautmann S, et al. (2016) The economic costs of mental disorders. EMBO Reports.

2. Greenberg PE, et al. (2015) The economic burden of adults with major depressive disorder in the University States. J Clin Psychiatry.

3. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/

4. Kellers RC and Greenberg PE. (2002) The economic burden of anxiety and stress disorders. Neuropsychopharmacology: The Fifth Generation of Progress. Ed. Davis KL, Charney D, Coyle JT, and Nemeroff C.

5. World Health Organization on return on investment costs for addressing depression and anxiety: https://www.who.int/news-room/detail/13-04-2016-investing-in-treatment-for-depression-and-anxiety-leads-to-fourfold-return

6. Chisholm D, et al. (2016) Scaling-up treatment of depression and anxiety: a global return on investment. Lancet Psychiatry.