Mental Health Is a Business Imperative

An estimated 51 million adults in the United States are living with a mental illness, according to the National Institute for Mental Health (NIMH), and the onset of COVID‑19 amplified the need for mental health support: The CVS Health 2021 Health Care Insights Report found that 37 percent of respondents are experiencing anxiety and 30 percent are dealing with depression.https://www.nimh.nih.gov/health/statistics/mentalillness.shtmlhttps://cvshealth.com/news-and-insights/programs/health-care-insights-study/2021-report

The impact of the COVID‑19 pandemic on mental health

The pandemic disrupted people’s health and lifestyle in many ways.

Impacted Anxiety 37%

Impacted Stress 35%

Depression 30%

Feelings of isolation and loneliness 37%

Impacted Anxiety 37%

Impacted Stress 35%

Depression 30%

Feelings of isolation and loneliness 37%

Unfortunately, only 57 percent of employees who report moderate depression and 40 percent of those who report severe depression receive treatment to control their symptoms.https://www.cdc.gov/workplacehealthpromotion/tools-resources/workplace-health/mental-health/index.html

The effects of poor mental health can affect all aspects of an individual’s life — including their work — translating to lower productivity, more absenteeism and higher health care costs.Lerner D and Henke RM. What Does Research Tell Us About Depression, Job Performance, and Work Productivity? J Occup Environ Med, 2008 April;50(4): 401-410.

Stress-related health care and missed work cost employers $300 billion per year. Other downstream impacts of mental health issues include:

• 12 percent increase in ER useJAMA: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707424, October 2018
• 3 times more likely to use an out-of-network providerNCBI; “Out-of-Network Provider Use More Likely in Mental Health than General Health Care Among Privately Insured”; 2016
• Increased incidence of such diseases as metabolic syndrome and cardiovascular diseaseScott KM, Lim C, Al-Hamzawi A, et al. Association of Mental Disorders with Subsequent Chronic Physical Conditions: Work Mental Health Surveys from 17 Countries. JAMA Psychiatry. 2016;73(2):150–158.
• 2 to 3 times higher health care costs for co-occurring illnessesMelek SP, Norris DT, Paulus J, Matthews K, Weaver A, Davenport S. Potential Economic Impact of Integrated Medical-Behavioral Healthcare: Updated Projections for 2017. Milliman Research Report. Seattle, WA: Milliman, Inc.; 2018.

Even after taking other health risks, like smoking and obesity, into account, employees at high risk of depression had the highest health care costs during the three years after an initial health risk assessment.Goetzel RZ, Pei X, Tabrizi MJ, et al. Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending. Health Aff. 2012;31(11):2474–2484.

The crucial role employers can play

Employer-sponsored health coverage provides valuable access to resources for employees and their family members seeking help with these concerns. According to the Business Group on Health, 87 percent of employers say they accelerated efforts to improve mental health access and services as a direct result of the COVID‑19 pandemic.Business Group on Health. 2022 Large Employers’ Health Care Strategy and Plan Design Survey. August 2021. https://www.businessgrouphealth.org/resources/2022-large-employers-health-care-strategy-and-plan-design-survey

However, a recent poll found that two-thirds (67 percent) of employees who are considering leaving their jobs agree that their employer has not followed through on early pandemic promises to focus on employee mental health.Harris Poll COVID‑19 Survey Wave 83, conducted September 24-26, 2021. http://theharrispoll-8654532.hs-sites.com/the-insight-wave-83?__hstc=78454539.117583393142f6017ca059efd4a951d7.1633286784915.1633286784915.1633286784915.1&__hssc=78454539.3.1633286784916&__hsfp=3010780102 The same poll also found that, of employees who report burnout, less than 20 percent are using the company benefits they believe are most helpful for mental health. “This signals that employees may not be fully aware of what’s available, or may not feel comfortable taking advantage of certain benefits,” the researchers wrote.Ibid.

We’re here to help It’s hard for people to seek mental health treatment for multiple reasons including social stigma, lack of awareness, access and cost. Working together, we can help to make mental health a reality for all. 28% of respondents said they did not visit a mental or behavioral health specialist when they needed support due to cost/affordabilityhttps://cvshealth.com/news-and-insights/programs/health-care-insights-study/2021-report 61% of respondents said they have high/moderate concern about being able to afford treatment for mental/behavioral health conditionsIbid. Starting at a familiar place can be a great first step. Solutions available through CVS Health are designed to remove barriers and increase access to mental health care. There is a continuum of opportunities to engage plan members in need.
	Awareness begins with openness. Today, CVS Health is launching "Stop. Ask. Listen.", a new initiative that underscores the importance of checking in with ourselves and with others we care about. There are opportunities every day to help yourself and others with mental health — the key is asking the right questions to start a conversation. Listening well makes people feel safe and can help identify early symptoms that are often missed. The goal is to make asking “How are you?” more than small talk. We’re encouraging everyone to commit to having a real conversation and to encourage others to do so also by reinforcing the #mentalhealthcheckin and #stopactlisten actions. Resources on how to start the conversation can be found at cvshealth.com/mentalwellness. To ensure a strong national ecosystem for mental health, our partnerships support numerous organizations that work in areas ranging from providing resources for health care workers, to social isolation. These organizations include AmeriCares, the Crisis Text Line, Meals on Wheels and others. The company promotes Stamp Out Stigma, an initiative led by the Association for Behavioral Health and Wellness that seeks to reduce the stigma surrounding mental illness and substance use disorders.
	Screening can provide the opportunity to identify members in need. Project Health provides free biometric screenings in 25 CVS Pharmacy markets as well as throughout the communities we serve, with four mobile units in the United States and Puerto Rico. Through Project Health, we also provide free mental health education and resources at clinics and community health centers. More than 1,700 free health events have been held in 2021, including more than 500 mobile health unit events. Depression screening is available in our more than 1,100 MinuteClinic locations inside CVS Pharmacy and Target stores in 33 states and the District of Columbia. Physical exams and lab work also may be ordered to identify other potential causes of depression. If clinically appropriate, providers can prescribe medication. Prevention is possible through enhanced screening and safety planning. Ninety percent of people who die by suicide have a potentially treatable mental health condition. We are committed to reducing suicide attempts. With the right intervention and support, resources and management of suicidal thoughts, suicide can be prevented.

Treatment needs can run the gamut from occasional counseling and support to drug therapy, and our solutions span the range of engagement options, from telephonic and digital to hybrid and in-person. These varied options can help reduce concerns about stigma; patient privacy is assured. Telephonic Through Resources for Living, which provides Employee Assistance Program (EAP) services, members can call 24 hours a day, seven days a week, to receive free emotional support and daily life assistance. No matter where they are on their mental health journey, they can embark on a personalized path to resilience. Select Resources for Living services are available to anyone, regardless of membership status. Digital The CVS Caremark Point Solutions Management portfolio offers four digital solutions to help employers support their members’ mental well-being: Daylight is a personalized digital program based on cognitive behavioral therapy for reducing worry and anxiety. Whil is a leading enterprise solution for employee mindfulness, stress resilience, well-being, sleep and mental health. Sleepio is a personalized digital sleep improvement program using cognitive behavioral techniques. Torchlight offers real-time caregiver decision-support services with guidance, tools and step-by-step action plans. In-person and virtual Mental health counseling is accessible and convenient through MinuteClinics in select HealthHUB locations in Florida, New Jersey, Pennsylvania and Texas, providing real-time support and connection to appropriate mental health care. Licensed clinical social workers can provide counseling and personalized treatment plans for life adjustments, depression, stress, anxiety and more — in person or virtually.

These solutions lead to cost savings by providing lower-cost, in-network care options and helping to avoid emergency room visits. Guiding employees to the appropriate level of care can help to keep them engaged with other health care priorities and maintain medication adherence. With convenient access, employees are more likely to seek care earlier and receive support for chronic conditions, helping to manage payor costs.

Addressing workforce mental health is a business imperative. Plan sponsors can partner with us to help improve the mental health of their populations.