It would be easy to think that the issue of mental health care in the United States—both the way it’s talked about and treated—has been resolved.
Insurers are now required to ensure equal coverage and treatment of mental health conditions and addiction. A growing number of grassroots organizations and social media campaigns are raising awareness about the roughly one in five Americans who will be affected by a mental health condition in their lifetime. Celebrities are speaking candidly about their own struggles. Society is having a compassionate conversation and pushing for legislation in a way it wasn’t 20 years ago.
But the work is hardly done.
Mental Health Month kicks off this week, and one place organizers will look to make that point is in the actual workplace. The World Health Organization reports mental disorders are one of the three leading causes of disability, which impacts both an employee’s and their caregiver’s health and well-being. Undiagnosed or untreated conditions can increase absenteeism and diminish overall work performance and relationships. As for a business’s bottom line, a 2013 Gallup poll revealed depression alone costs U.S. workplaces an estimated $23 billion in lost productivity each year. By 2030, the World Economic Forum projects mental health disorders will drive $6 trillion in global costs, up from $2.5 trillion in 2010.
There’s room for employers to get creative here. For LAIKA, the animation film studio behind Coraline and Kubo and the Two Strings, that meant working with Talkspace. Launched in 2012, Talkspace is an online therapy company that aims to cut down on traditional therapy costs and inconvenience by matching users with licensed (and thoroughly vetted) therapists over its app. Users then have the option to chat with their therapists over text, audio, or video—whenever, wherever.
LAIKA says its employees have been open about mental health awareness. But benefits manager Beverley Menillo explained to Fortune how she noticed early last year that her employees were frequently discussing these matters on their phones. After a fellow HR manager wondered aloud if there could be a way for employees to text their therapists, Menillo consulted the Internet and came across Talkspace. That was before the company offered an employer-based solution, but Menillo reached out to the general customer service address anyway.
Now, LAIKA is one of 40 companies piloting Talkspace’s business plan.
“It’s new, different, and really needed,”said Lynn Hamilton, Talkspace’s Chief Commercial Officer. Hamilton joined the team after seven years with Magellan Health (one of Fortune’s Most Admired Companies of 2017), where she saw first hand how underutilized benefits programs and Employee Assistance Plans (EAPs) were. This can happen for a variety of reasons, including due to high costs matched by a limited number of health providers able to meet employee demand—if they even take an employee’s insurance. Not to mention it can take weeks before an employee can get an appointment.
Quite simply, according to Hamilton, it’s a waiting game.
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With Talkspace, employees can access therapists in real time. This immediacy translates to employees not having to take as much time off work, which certainly piques employers’ interest, Hamilton said.
“Companies [know mental health care] is a challenge and they are looking for solutions that can have an impact on productivity and morale,” Hamilton explained.
Once a company is signed up with Talkspace, the company sends over posters for advertisements, as well as user handbooks, content calendars, and email reminders. Just over 5% of LAIKA’s 500 employees have utilized the plan to date, which is about the amount of use reported for EAPs. It’s still early, Menillo argued, but she’s been really happy with the level of engagement so far.
Online solutions for mental health care challenges may be especially prevalent if President Donald Trump repeals Obamacare. The first three attempts of this repeal have failed. But if the new bill is anything like the first—it slashes health benefits and Medicaid expansion—it would be a major step backwards, opponents say. “I would argue that people with mental illness would be most adversely affected,” said Ron Honberg, senior policy advisor for the National Alliance on Mental Illness (NAMI).
Medicaid, in particular, has been the most generous in terms of mental health coverage, according to Honberg. It includes coverage for rehabilitative services and not just medications. “When you’re talking about serious illnesses, treatment and recovery entails more than medical treatment,” Honberg said. “People need help with navigating the system, like case management, finding housing, and help for simultaneous chronic diseases like cardiovascular disease.”
Part of the reason employees need this help is because mental health care still largely exists as a separate system. It’s not integrated with primary or specialty care, Honberg continued. Hence companies using EAPs, which are dedicated to personal problems such as financial issues and substance abuse. But as those plans go unused, companies are starting to do away with them altogether, Hamilton said.
“I don’t know a company that isn’t struggling to provide employees [mental health care] access,” Hamilton said.
Mental health reform in the workplace doesn’t stop at insurance coverage and provider accessibility—it has to do with office culture, too. But employers willing to creatively engage with their employees when it comes to mental health can start shifting culture in the right direction. It’s not just an investment in the work force, said Bob Carolla, J.D., who works with Honberg at NAMI—but it’s protecting the investment companies already made.
“Often times mental health issues can arise in a position after 10 years, in a trusted, very valued employee,” Carolla said. “No one is immune.”