Most employees with mental health conditions don’t utilize the resources provided by their employers. While underutilization may sound like a bad thing, the opposite could be worse. Hear from a mental health expert on how to better understand the impact of underutilization as well as the opportunity and solutions available for employees.
The prevalence of mental health conditions is rising – on average, 20% of a company’s employee population are suffering from a clinical mental health condition at any given time. Despite an increase in mental health concerns and an overall decrease in mental health stigma, only 10% of employees are using the services employers offer. So, if rates of mental health conditions show no indication of slowing down, and many employers have prioritized mental health resources as part of their benefits offerings – why are they so underutilized? Additionally, what would happen if more employees took advantage of these services? Spoiler: it would be problematic.
Dr. Marie Atallah, psychologist and Clinical Communications Lead at Big Health, helps us answer these pressing questions and breaks down what employers need to know about utilization and the evidence-based solutions available.
What leads to underutilization?
Cognitive behavioral therapy is the first line of treatment recommended for most mental health conditions and insomnia. However, according to Dr. Atallah, there are many barriers to accessing this type of care. While the mental health provider shortage is not a new issue, the problem gets intensified when it comes to finding therapists trained in the evidence-based treatments that are recommended. Additionally, individuals looking for care face other barriers such as stigma, affordability, treatment-seeking behavior, cultural barriers, and time. “While virtual care has been able to reduce some of these barriers, the traditional model of care continues to be unable to meet demand,” says Dr. Atallah. Virtual therapy shows great promise for making therapy more accessible and convenient; however, it continues to be underutilized, does not adequately address the provider shortage, and cannot guarantee consistent and equitable evidence-based care is delivered.
“Wait times are a major deterrent to seeking mental health care, especially to someone who is already reluctant to reach out for help,” says Dr. Atallah. “While efforts to increase mental health awareness have been effective, more people reaching out for care has the potential to further flood the already burdened mental health system.”
Risks and impacts of a therapist shortage
Traditional models of therapy, i.e., talk therapy, are only one model of mental health care available. And it’s important to understand that this model of care isn’t sustainable for meeting higher demands. Simply put, there aren’t enough trained mental health professionals available to care for the growing number of people in need. One study of psychiatrist’s availability across 3 major U.S. cities found that the average wait time for an initial appointment was 25 days. Given there is already a noticeable delay for care, any increase in demand could quickly escalate access issues – leaving many without any option. Delays in care can also increase the risk of catastrophic events occurring, especially from those that need more acute help.
So, what are the potential impacts and risks of this therapist shortage for organizations? According to Dr. Atallah, primary care providers have historically been the more accessible option to address mental health care needs. While there are some positive impacts of this – such as faster access to care, the ability to receive medications for symptoms, and a sense of support – there are also real risks. Primary care providers are not trained therapists that specialize in mental health care. They are primarily trained in administering medications which carry a side-effect risk profile that can be habit forming and not the preferred treatment method of many people looking for help.
Identifying a supplemental care model
It’s clear that there is a need for a more sustainable and scalable model of care to help avoid these risks and ensure faster access to evidence-based therapy – not to serve as a replacement for talk therapy for those with access, but as an aid to help meet demands when therapists are not available. Digital, evidence-based solutions are more scalable and consistent, which makes them better able to ensure that everyone has access to the gold-standard of care regardless of other social determinants of health.
Automated interventions such as Sleepio and Daylight show potential for addressing the inconsistencies that are present with human-delivered care. For example, research on Sleepio showed that effectiveness did not vary across ethnicity. On the contrary, there is a cultural and racial underrepresentation of mental health providers.
For employers looking to provide their workforce with timely and equitable mental health care without adding stress to the already overburdened system, digital-based solutions are the clear answer.
Disclaimer: Sleepio and Daylight are available as an adjunct to usual medical care for insomnia disorder or generalized anxiety disorder, respectively, for adults ages 18 and older, without FDA review under their COVID-19 policy.
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