Many companies offered mental health programs and benefits before the pandemic but were still unprepared for the increase in mental health needs during the pandemic, says Matthew Rae, a coauthor of the report and associate director of KFF’s Program on the Health Care Marketplace. “It really felt like they were scrambling to figure out all of the options they had, what things they could be bringing in as part of their wellness program that would be useful,” Rae says.

But the degree to which companies are making changes that bring down the cost for employees varies. Nearly a third of companies with more than 50 employees increased the ways in which workers can get mental health services, including telehealth access, according to KFF’s annual survey.

Yet only a small number of companies surveyed, 4%, actually waived or reduced cost-sharing for mental health services and just 3% increased coverage for out-of-network providers. About 6% of employers surveyed increased the mental health and substance abuse providers considered in-network. 

Expanding provider networks and increasing out-of-network coverage are critical steps to making mental health and substance abuse services more affordable. About one in four patients report they don't have access to an in-network therapist, while only one in 10 do not have an in-network medical specialist, according to the National Alliance on Mental Illness.

"Mental health provider networks are very narrow. They're very hard to navigate," Rae says. It's often difficult to find a in-network provider for mental health services, he adds. And while telehealth is part of the solution here—many Americans were using telehealth benefits for their mental health needs during the pandemic—a lot of people still needed to go out-of-network for mental health services. "That's when you really get hit hard with cost," Rae says. "You can be stuck with huge bills with no limit, and that's a tremendous financial challenge for households."

Yet building out cost-effective mental health resources for employees is more critical than ever, with about 12% of all companies surveyed reporting that they’ve seen an increase in worker enrollment. Nearly half (46%) of companies with more than 5,000 employees saw a marked increase in the number of workers using mental health services since the pandemic started. 

About two-thirds of employees have clinically measurable mental health symptoms of anxiety or depression, according to SilverCloud Health’s 2021 Employee Mental Health and Wellbeing Checkup, which surveyed over 2,000 employed U.S. adults in July 2021. 

And many workers want employers to do more to help alleviate these mental health burdens. About four in 10 workers report their employer hasn’t done enough to support their mental health during the pandemic, according to an October survey of 3,000 full-time workers conducted by Calm for Business, Calm's employer arm. 

In fact, mental health benefits could start to become a competitive advantage in recruiting and retaining talent. Calm’s survey found that 76% of workers say they consider mental health benefits as critical when evaluating new jobs.

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