Last week the U.S. Department of Labor announced that it’s launched a new toolkit for employers to help them understand mental health issues and create a supportive work culture.
The EARN Mental Health toolkit — created by the DOL’s Office of Disability Employment Policy and its Employee Assistance and Resource Network on Disability Inclusion, or EARN — includes an educational framework and a list of case studies of successful programs at organizations of various sizes.
The EARN Mental Health Toolkit hinges on “4 A’s”:
- Awareness: Build awareness and a supportive culture.
- Accommodation: Provide accommodations to employees.
- Assistance: Offer employee assistance.
- Access: Ensure Access to treatment.
I want to focus on access for now, because no matter how much you try to create a disability-friendly culture, if employees can’t access or afford medication, therapy or whatever medical assistance they need to treat their mental illness on a regular basis, then a huge piece of the treatment puzzle is missing.
APA Publishing, a division of the American Psychiatric Association, recently published an informative article on this issue of access. The article covers a February 2019 panel discussion hosted by the New York Academy of Medicine, the New York County Psychiatric Society, and the New York State Psychiatric Association.
There are a lot of points I find valuable in this panel discussion of several people in the medical community. First, one of the panelists noted how Aetna recently settled a lawsuit in Massachusetts after an investigation found that the insurer violated state law with its “inaccurate and deceptive provider directories and inadequate provider networks.” Basically, this means that patients couldn’t access timely behavioral health care because listed providers weren’t accepting new patients or had retired.
This isn’t necessarily an anomaly, the article noted. For example, it cited a very comprehensive report that’s worth a read for anyone interested in this.
The 2017 research report by Milliman Inc. found that compared to medical/surgical care, people seeking behavioral health care more often have to access an out-of-network provider. While in-network care generally has lower co-pays for patients, when they must seek out-of-network care that means more out-of-pocket costs and more expensive behavioral health care.
Also, the report stated, “Some patients may want to avoid the higher costs and delay seeking needed services from behavioral health care providers, which can lead to less effective care.”
The article also stated the employer’s role in this. An excerpt:
Schwartz said that the business community is a strong ally in improving access to behavioral health care given the high cost of not addressing these issues in productivity loss, lower employee retention, high rates of disability, and higher overall employee costs. “While employers are paying for benefits, they are not getting what they paid for when employees cannot access behavioral health care,” he said. “Businesses are well positioned to ask health plans for data on provider networks and to examine disparities to improve accountability.”
Also noteworthy was a list of actionable items that presenters believe could help improve access to care. For example, a suggestion from the National Alliance and the Center for Workplace Mental Health is that “employers obtain quantitative assessments from third-party administrators on how well their employees are accessing mental health and substance use benefits.”
Again, I don’t want to suggest that environmental factors in the workplace don’t impact people’s general well-being. But offering free yoga classes in your building or teaching employees how to use mindfulness to reduce stress are NOT the medical equivalent of seeing a therapist or accessing an outpatient center.
Self-care is not medical care. If your organization has a deluge of trendy perks to help employees de-stress but doesn’t have a sufficient behavioral health provider network, how much of a difference could that really make?