Feb 26, 2019
By The Lyra Team
Mental health issues are on the rise and there is no shortage of options for how companies can address the needs of their employees. Considering the landscape of EAPs, health plan networks, and a bevy of tech-only solutions, there are five questions you should be asking all of your mental health vendors.
But first, some background on the various vendor options.
Employee Assistance Programs (EAPs) can be traced back to the 1930s when drinking on the job was commonplace and job-based alcoholism had a major negative impact on work performance and productivity. While EAPs have evolved to support employees and their families in more ways beyond substance abuse, they aren’t well-suited to address the diverse mental and emotional health needs of employees or help them reliably improve and recover. On average only 2% of employees ever engage with an EAP and only 18% experience any positive improvement.
EAPs are often only one part of the mental health solution and companies may look to their health plans and other point solutions to fill the gap for their employees. Unfortunately, most health plans and tech-only solutions can’t provide complete care for the issues affecting employees today.
For individuals with moderate to severe clinical needs, the health plan may be the logical place to turn, but unfortunately, the availability of in-network clinicians and mental health specialists proves to be a limitation. Only 50% of all therapists are in-network as compared to 91% of primary care physicians, leaving individuals searching outside of the health plan for support. Looking past the lack of options in-network, a mere 25% of providers are accepting new patients and it takes individuals an average of 21 days to get an appointment.
App-based solutions have risen in popularity – apps for mindfulness, virtual coaching, chat therapy, and more. Some apps can supplement a more robust mental health solution, but do not replace the need for an in-person network of therapists. Live video therapy and coaching, where you meet with a provider via a live video call, enables better access and convenience for busy employees, but only a fraction of your workforce will prefer these to in-person care. Also, it’s important to note that video therapy isn’t recommended for certain issues. Severe issues, like active suicidality and self-harm, require in-person care with a specialized provider. To make things more complicated, tech only solutions make it hard to escalate members to need higher levels of care when needed.
An enhanced EAP offers a different approach that delivers the fundamentals of an EAP with innovative enhancements and more expansive coverage and care options. It overcomes the limitations and challenges of traditional EAPs, health plan networks, and points solutions. As a result, enhanced EAPs achieve higher levels of engagement and are more likely to help members improve and recover.
How do your mental health vendors measure up?
Does your solution:
Your mental health solution should address your diverse employee population and offer a complete set of care options. The more modes of care you offer, the more likely your employees are to use it. Different options include in-person at a provider’s office, via a live video call from a convenient location of their choice, or through a self-guided app. Some companies even bring a mental health provider onsite, for added convenience. It’s important to meet people where they are, help them quickly access the right care, and make the entire experience seamless.
Technology is advancing by leaps and bounds everywhere, but the mental health space has been slow to adapt. The exception here is Enhanced EAPs, which offer the convenience and simplicity of modern web platforms and mobile applications as a core part of their offering.
Online platforms that streamline the member experience can collect data from individuals – symptoms, severity, and preferences – and intelligently match them to the right care. Smart technology also enables real-time online booking to make the process more approachable, convenient, and private.
High quality digital exercises and self-care resources are important for enhancing skill development between sessions with a provider and for those who prefer to tap into support anytime, anywhere.
Evidence-based treatments (EBTs) are therapies that have been proven to work in randomized controlled trials and repeatedly demonstrate positive results. Popular evidence-based therapies include Cognitive Behavioral Therapy (CBT), which is helpful for anxiety and depression; Dialectical Behavioral Therapy (DBT), helpful for those with Borderline Personality Disorder; and Exposure and Response Prevention (ERP), the gold standard for Obsessive Compulsive Disorder (OCD). The majority of therapies practiced today are not evidence-based, so if your EAP doesn’t screen these providers out, the odds are your employees are not receiving effective care.
An enhanced EAP that can easily vet providers, based on a variety of quality metrics, including whether or not they practice EBTs, may be the best option for your employees.
While many employers consider a large provider network a positive, the reality is that most EAP directories include clinicians who are not taking new patients, are retired, or even deceased. On average, 75 percent of in-network providers aren’t accepting new patients. Of the remaining 25 percent, even fewer practice evidence-based therapies. To effectively address employees’ needs, your network should have the right mix of providers.This includes therapists and coaches specializing in children, couples, parents, Millennials, diverse and sensitive populations, substance abuse, suicidality, and self-harm. You should also confirm that your network includes providers who practice near where your employees live and work, have the capacity to take on new clients, and offer appointments at convenient times.
Consider a mental health solution that uses technology and data to curate its network, based on your needs. An enhanced EAP will use smart data-driven tools to rapidly identify, qualify, and onboard high-quality providers who have availability to take on new clients and are a good fit for your workforce.
You deserve to know whether the mental health solution you’re paying for is working or not. Best practices for quality care include capturing a baseline assessment for each patient and gauging progress throughout treatment using standardized clinical measures. Unfortunately, most EAPs don’t take a data-driven approach to evaluating patient progress to ensure that people are actually getting better. Look for standardized measures that have been created by third-party researchers and validated for use with clients with common mental health problems, like the PHQ-9 (used for evaluating symptoms and severity of depression) and GAD-7 (used for evaluating symptoms and severity of anxiety).