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February 3, 2024

Big Health and EHIR introduce Mental Health Maturity Index, measuring employer progress toward better mental health


Survey of large employers covering more than two million lives finds companies embracing mental health support but lack meaningful measures of success.

Survey of large employers covering more than two million lives finds companies embracing mental health support; lack meaningful measures of success

New methodology empowers employers to create evidence-based action plans to more effectively address mental health benefit gaps

San Francisco, May 25, 2021 – Big Health, a digital therapeutics company dedicated to helping millions back to good mental health, along with the Employer Health Innovation Roundtable (EHIR), today introduced the results from the first-of-its-kind Mental Health Maturity Index (MHMI) survey examining the mental health ‘maturity’ levels of 35 large U.S.-based employers covering more than 2.5 million lives.

The Big Health MHMI methodology is designed to empower employers to create actionable and evidence-based plans for a psychologically healthy workplace, better equipping their employees to achieve good mental health.

“The past year has reinforced the importance of mental health care, and many employers responded by implementing mental health solutions at a record pace,” said EHIR Chief Executive Officer Michael Laquere. “While we are making significant progress expanding access to care, many benefits leaders still struggle to measure these programs and determine their true impact. Together with Big Health and other innovators, we are able to help identify gaps in mental health care while building sustainable long-term strategies, leading to measurable results.”

The survey examines the mental health ‘readiness’ of large enterprises in four distinct categories: Education & Engagement, Services & Solutions, Social Determinants of Health, and Meaningful Measurement. Participating companies are scored on a scale ranging from developing, emerging, strategic, and market leading.

“Investment in mental health is a new priority for many employers, but slow movement to support mental health impacts employee and customer experience and puts business resiliency at risk,” wrote Forrester Principal Analyst Arielle Trzcinski in her blog. “The survey was co-led by Big Health and the Employer Health Innovation Roundtable, and sheds a bright light on the different dimensions in the large disconnect that exists between senior management and workers within organizations when it comes to employee mental health.”

Working with Big Health, employers can use this information to develop detailed and measurable plans to address specific gaps in their mental health benefits strategy — ultimately leading to better support for employee populations and improved access, affordability, outcomes, and equity.

“As employers grapple with an increasingly crowded marketplace, they want to partner with organizations dedicated to delivering proven results across their entire population,” said Big Health Co-Founder and Chief Executive Officer Peter Hames. “Through the Mental Health Maturity Index, we can offer guidance on how to optimize employee mental health outcomes in a way that is equitable and inclusive.”

Big Health and EHIR conducted the 65 question survey from November 3, 2020 to March 15, 2021. Among the major findings:

1. Companies are implementing mental health programs, but they don’t know which ones are working.

Mental health measurement should include outcomes, not just engagement.

  • Almost every company (94 percent) said that mental health is a key pillar of their healthcare strategy.
  • However, only 54 percent of companies measure employee stress and mental wellbeing on an annual basis and only 20 percent of companies use a clinically validated assessment to do so (e.g., PHQ-9, GAD-7).
  • Beyond that, only 14 percent of companies assess the return on investment (ROI) of mental health services.

2. Senior leaders are advocates for employee mental health, but companies lack consistent internal initiatives.

Companies seeking to build a psychologically safe and supportive workplace should invest in communication and training.

  • Eighty-three percent of companies state that senior leadership visibly advocates for the importance of good mental health to the business, and 57 percent state that employee mental health is a board-level goal.
  • But, most companies only communicate about mental health benefits one to two times every six months (44 percent), or one to two times a year (15 percent).
  • And less than half of companies (49 percent) ran an anti-mental health stigma campaign in the last year.
  • Plus, only 34 percent of companies have trained managers or employee volunteers on mental health. As a result, only 17 percent of leadership and 11 percent of managers self-assess on how well they foster an emotionally safe workplace.

3. Current mental health care is not reaching all employees in need.

The majority of employees are unable or unwilling to access existing mental health services.

  • Sixty percent of people who meet diagnostic criteria for a mental health condition don’t receive care.
  • Only 26 percent of companies state that they have a mental health solution focused on reaching the silent sufferers – those who are unable or unwilling to access traditional care.
  • Less than half (49 percent) of companies provide a way for their employees to understand which mental health resource is right for them.

4. Supporting employee mental health goes beyond offering therapy.

Companies should take a broader view of what classifies as mental health support and provide benefits accordingly.

Many companies are already blazing the trail across important social determinants of health:  

  • Six percent of companies offer housing assistance.
  • Forty-five percent of companies offer child care assistance and 40 percent offer caregiver assistance.
  • Thirty-seven percent of companies have extended health care access to groups of employees that do not traditionally receive them (e.g., part-time or contract employees).

To access the full report and learn how to better support employee mental health in 2021 and beyond, please visit

You can learn more about how Big Health and the MHMI can help support your organization’s mental health goals by visiting or emailing

To read Forrester’s report, titled The State Of Employer Mental Health Support, please visit The report is available to Forrester subscribers or for purchase.

About EHIR

The Employer Health Innovation Roundtable (EHIR) is a private and independent network of the largest and most progressive employers collectively representing approximately 10M employees with a shared mission to accelerate the adoption of innovation for the sake of improving employee health, wellness and productivity.  Members convene throughout the year to share learnings and collectively review and evaluate new solutions with an intimate group of like-minded peers through a streamlined and efficient process.

About Big Health

Big Health’s mission is to help millions back to good mental health with evidence-based digital therapeutics for the most prevalent mental health issues. Big Health is charting the future of digital medicine by providing an inclusive, scalable, and affordable approach based on industry-leading peer-reviewed research and randomized control trials. By seamlessly integrating across the care pathway, from member engagement to billing via pharmacy benefit managers, Big Health simplifies adoption for both payers and patients, improving access to mental health care. For more information, please visit

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1. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125-133.2. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., … & Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700.3. Wilson, S., Anderson, K., Baldwin, D., Dijk, D. J., Espie, A., Espie, C., … & Sharpley, A. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update. Journal of Psychopharmacology, 33(8), 923-947.4. King’s Technology Evaluation Centre. (2017, November 9). Overview: Health app: SLEEPIO for adults with poor Sleep: Advice. NICE. Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. (2012). A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep, 35(6), 769-781.6. Carl, J. R., Miller, C. B., Henry, A. L., Davis, M. L., Stott, R., Smits, J. A., … & Espie, C. A. (2020). Efficacy of digital cognitive behavioral therapy for moderate‐to‐severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and Anxiety, 37(12), 1168-1178.

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