The Case for Evidence-based Care

Regardless of which industry you’re in, mental health care has likely become one of the hottest topics in your workplace. While mental illness was a mounting global crisis before COVID-19, the pandemic has exacerbated those concerns, bringing mental health to the forefront of many work-related conversations. People are talking openly about mental health and seeking care to treat it, which is an essential step forward. At the same time, not all care is created equal. Too many people still lack care that helps them improve or recover from their mental health conditions.

The mental health resource landscape is crowded, but not all services have the same impact. People-focused employers are looking to invest further in mental health options for employees; they know that, by addressing their workers’ mental health needs, they won’t only be supporting individuals but the collective workforce. When employees have access to effective mental health care, the returns are significant: lower turnover, lower absenteeism, a workforce that feels valued and engaged, and higher profitability.

The Mental Health Crisis Is at a Tipping Point

The pandemic has driven an increase in mental health challenges, including anxiety, depression, and substance use disorders. Burnout, especially, has soared to unprecedented levels. In a survey from Indeed, 52 percent of workers reported burnout in the past year. This work-related mental health problem is more pervasive, chronic, and impactful to daily functioning than everyday work stress.

Untreated or inadequately treated mental health issues can affect someone’s ability to perform their job functions. According to the Centers for Disease Control and Prevention (CDC), depression alone interferes with a person’s ability to complete physical job tasks about 20 percent of the time and reduces cognitive performance roughly 35 percent of the time.

With growing awareness comes a greater desire for action. Employees increasingly want and need their employers to support their mental health:
84 percent of employees in a new Lyra Health survey said that, when considering a new job, it’s at least somewhat important to them that the employer offers mental health benefits.
86 percent of employees in a survey by Mind Share Partners said they considered it important that their company’s culture support mental health.
With workers’ greater demand for mental health support from their employers, more companies are adding mental health care and resources to their list of benefits. According to a recent survey of companies across the United States, 98 percent of respondents said they’d either implemented or planned to implement a mental health benefit as part of their compensation package.

Dependents’ Mental Health Is Critical to Workforce Well-being

More leading employers are now providing mental health benefits not only for employees but for their dependents, too, including children. This is a logical move, given the major impact family health concerns can have on employee performance and as children are increasingly being diagnosed with mental health conditions.

For example, the U.S. surgeon general’s recent December 2021 health advisory outlines the drastic growth of mental health issues reported among children and adolescents. The mental health of parents and children is closely linked, so when there are barriers to care such as long wait lists, limited providers, or high costs, it can increase stress for the parents. Providing mental health benefits to dependents can have a significant impact on working parents.

Evidence-based Mental Health Care Means Proven Outcomes

To truly meet the breadth of a workforce’s needs, it’s not just about making any mental health care accessible—it’s about making the right care accessible. Only 20 percent of mental health treatments have been proven effective, according to the American Psychological Association (APA). But employer-provided mental health benefits can span a wide range of offerings. For example, some employers might provide a meditation app and call it mental health care. Or they may offer counseling through an employee assistance plan (EAP) but cap it at only a few sessions. But to be effective, it’s crucial to consider the type of care a workforce truly needs. This can be trickier than it needs to be, given that traditional mental health care services don’t often measure or provide insight into the outcomes of various care types for different conditions.

When seeing a doctor for physical ailments, you want a proven treatment and an estimated timeline for when you should start to feel relief from your symptoms. For mental health, there hasn’t been the same basic expectation for care. Not all mental health treatment options have been tested to see how effective they are, and there’s little information about when, if ever, you’ll start to feel better.

Another issue is that mental health care is often hard to access. For instance, a recent study of over 50,000 people found that 95.6 percent reported at least one barrier to accessing mental health care.

These barriers can include a lack of providers in their area, a lack of insurance coverage, high out-of-pocket costs, and long waiting lists.

Even when people can access care through their medical insurance or EAPs, these networks may lack access to evidence-based treatments or may not guarantee measurement of clients’ progress or recovery with care. As a result, employees may not see their symptoms improve despite receiving treatment, which may mean they stay in treatment that’s not helping them.

“There’s so much around mental health care that is unmonitored, is not evidence-based, doesn’t have an end date, isn’t technology-enabled, and it’s limited by state lines,” said Morgan Stanley’s Chief Human Resources Officer Jeff Brodsky.

Without a comprehensive mental health benefit that uses evidence-based therapy, employees may also:
• Pay out-of-pocket for more effective or specialized mental health treatment. The medians per session for care can differ by state and range from $100 to $200 per session.
• Give up on treating their mental health challenges altogether. Some studies have shown that nearly half of people abandon therapy because they are dissatisfied with their care.
“We had no way of knowing if this service was of benefit to our employees, and there was no bar set for provider quality. [Our EAP] couldn’t tell us if our employees were even progressing in care. For all we knew, someone could attend five sessions and get absolutely no benefit from them,” said Deborah Olson, lead well-being strategist, U.S. Roche & Genentech.

What Is Evidence-based Therapy?

Employers’ concerns about the efficacy of the care available to their workforces highlight the need for resources with a track record of beneficial outcomes. That’s where evidence-based therapies, or EBTs, come in. These therapies have been rigorously tested in randomized controlled trials or a series of case studies and proven to have effective outcomes.

Some examples of EBTs include:
Cognitive Behavioral Therapy (CBT): A therapy approach that leverages the relationship between thoughts, emotions, and behaviors to improve mental health and functioning.
Interpersonal Therapy (IPT): A time-limited, focused approach to treating mood disorders. The main goal of IPT is to improve the quality of a client’s interpersonal relationships and social functioning to help reduce their distress.
Behavioral Activation: An approach to mental health that focuses on using behaviors to “activate” positive emotions.
Dialectical Behavior Therapy (DBT):  An approach that helps people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply.

Through randomized controlled trials and case studies, these treatment methods have been shown to yield similar results repeatedly, much like trials for a type of surgery, medical device, or medication. “People feel strongly about evidence-based treatment in medical care. They want a medicine or a surgery that has been shown to work. It’s important to hold therapy to the same standard,” said Alethea Varra, Ph.D., vice president of clinical care at Lyra Health.

When certain therapies are repeatedly shown to be effective at treating mental health disorders, there’s more evidence that they help people get better, and, in many cases, there may be estimated time frames for symptom reduction or recovery.

The bottom line is – Empirically supported treatments represent the best opportunity to help most people with their behavioral health problems.

Better Care Outcomes and More Resilient Employees

A significant goal in addressing mental health concerns is building resilience, which has been shown to help employees manage stress, be more active in self-care, avoid burnout, and achieve a better work-life balance.

An evidence-based mental health benefit can translate to more resilient employees and reduced turnover. When people with mental health conditions get effective care, they’re able to re-engage in activities and thrive, both at work and outside of it. A recent study found that, over a yearlong period, employees who used Lyra as an evidence-based mental health benefit were twice as likely to stay with their company than employees who did not use the benefit. Having an evidence-based mental health benefit available for employees can also create a sense of psychological safety, so they know it’s OK to acknowledge when they’re struggling and that there are resources for help.

Therapy and medication have been proven highly effective at helping people improve and recover from common conditions like anxiety and depression and regain their footing at work. Unfortunately, not all health plans, mental health benefits, or EAPs offer evidence-based, proven treatment methods.

“It can be hard to tell if a provider is using evidence-based treatments because many providers have been trained in evidence-based care, but that may not be what they are using day-to-day,” said Dr. Varra. “It’s important to match the right EBT for the specific issue and stay true to their training. Without processes in place, there can be significant drift from providing that high level of care.”

It’s critical to ask your mental health benefits provider how they ensure their mental health care providers are practicing EBTs. Lyra, for example, does this by:
• Curating a high-quality, selective network.
• Providing continuing education for providers.  
• Having consultations with and supervision for providers to ensure their use of EBTs.
• Tracking outcomes data; if members do not show signs of improvement, it often indicates the need to adjust the treatment approach.

At Lyra, this commitment to EBTs has been found to drive better care outcomes and reduce medical costs. Studies have found that:
• Easy access to evidence-based, proven care has led to 83% of Lyra members showing improvement or recovery, as well as 83 percent of participants with anxiety or depression. (Sources: Journal of Medical Internet Research and Frontiers in Psychology)
• Lyra’s evidence-based therapies led to a 73% decrease in those who had suicidal ideation when they started therapy, with Lyra having none at follow-up. (Source: BMC Psychiatry)
• Using medication management combined with Lyra’s evidence-based telehealth therapy saw clinical improvement or remission in 12 weeks for 68 percent of people. (Source: Telemedicine and e-Health)
• Lyra reduces overall health care claims costs for participants and their employers. Lyra members and their dependents see reduced costs related to general health care, prescription medications, and emergency department visits. This lowers claims costs by about $2,300 per participant per year, including $585 in non-mental health plan claims. (Source: Aon Health Solutions)

“If employers are looking to reduce the stress and suffering of their employees, then they’ll want to offer EBTs,” said Dr. Varra. “We have proof that these treatments can make a real and positive difference in their employees’ lives.”

About the author:
Alethea Varra, Ph.D., is a licensed clinical psychologist and vice president of Clinical Care for Lyra Health. She serves as the senior clinical leader for therapy programs and is responsible for driving overall clinical strategy and oversight of clinical quality and training. Alethea received her bachelor’s degree from Dartmouth College and a doctorate degree in clinical psychology from the University of Nevada, Reno. She completed her internship training at VA Puget Sound Healthcare System and a research fellowship at the Mental Illness Research and Education Center (MIRECC) in Seattle. She has over 15 years of experience in mental health and clinical operations. Her focus is on healthcare innovation and program development, and she is passionate about improving access to evidence-based mental health care, especially to underserved populations.

About Lyra Health:
Lyra Health is the leading provider of workforce mental health benefits, serving 10 million global employees and their dependents. Lyra is transforming mental health care using intelligent matching technology, concierge support, and an innovative digital platform to deliver a frictionless experience for members, providers, and employers. Lyra quickly connects members to an exclusive network of evidence-based providers, mental health coaches, digital wellness tools, and personalized medication programs. Lyra’s approach to mental health care has been proven to help members improve or recover faster and reduce medical claims costs for employers. For more information, visit lyrahealth.com.

All statistics and quotes found in this piece were sourced from the following document.

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