Employers see 507% ROI from behavioral healthcare, new study shows

• Key Insight: Learn how employer behavioral health converts clinical improvements into quantifiable employer cost savings.
• What's at Stake: Rising mental-health needs could materially affect healthcare spending, productivity, and disability liabilities.
• Supporting Data: 507% projected ROI; $6.07 returned per $1 invested.
  Source: Bullets generated by AI with editorial review

Behavioral health services can deliver outsized financial returns for employers while improving depression and anxiety outcomes among workers, according to a new study that found a projected 507% return on investment. 

The Integrated Benefits Institute analyzed thousands of anonymized patient records from ComPsych and found employers saw an average annual return of $6.07 for every $1 invested in behavioral health services.

Those savings were driven by a mix of factors, from avoiding costly ER visits and lowering prescription and medical spending to preventing disability claims through earlier treatment and boosting productivity with fewer absences and better on-the-job focus.

Employees who received counseling also saw significant mental health gains, with 63% showing reliable improvement in depression and 73% in anxiety. Additionally, 76% showed reduced workplace absenteeism and 90% reported strong therapeutic alliance with their counselor.

"The clinical outcomes for depression and anxiety are not small or incremental changes," says Dr. Jennifer Birdsall, chief clinical officer at ComPsych. "They show genuine clinical improvement for employees who need it most."

Read more: How workers can spend HSA and FSA dollars to support their mental health

Birdsall, a psychologist, said clinicians have long understood the benefits of counseling, but the study stands out for putting an economic value on those gains.

"We're seeing more and more stress on the HR and benefits folks to show the financial impact," Birdsall says. "So it's really great timing for us to be able to do that."

Birdsall recently spoke to Employee Benefit News about the study and how companies can reduce the stigma around mental health. 

What are some of the most common reasons that people seek out counseling?
Anxiety, stress, depression and relationship issues. Those are typically the top four that we see when it comes to individuals in the adult workforce. Things like grief and loss might come into play, and then it moves down to other types of concerns.

How much does stigma still discourage people from using behavioral health benefits?
You will hear people say that since the pandemic, the silver lining was this increased awareness of mental health. Everybody experiences it … and it's really opened up the discussion, communication and engagement. That's great but with that said, stigma is still present. You might see it more in certain countries, regions, industries and job types. That's why we work very closely to really partner with organizations to think about how they can reduce stigma. It's so important. We'll strategize on so many things around communication, normalization, really encouraging storytelling, and leadership sharing what services they use, why they used it, and what they were going through.

Read more: What does it take to have mental health offerings that actually work?

When people hear those stories — about losing a partner, feeling grief, going through a traumatic experience, feeling stressed, managing being a caregiver or a parent, and struggling with work-life balance —  it makes a huge difference.

Has the growth of digital and virtual care since the pandemic improved access to behavioral health services?
That's absolutely increased access. We have the largest network of providers — over 120,000 — and most of them previously operated in person. Then the pandemic came, and everyone moved to telehealth. Now we're seeing more people return to a preference for hybrid services. They want a local provider that they can see in person, but they may also choose to engage in telehealth when they're a caregiver and it's a busy week.

Read more: What mental health benefits should your company offer?

And then there are also digital services with self-guided tools. We've seen a huge increase in that. We have something called cognitive behavioral therapy, which is highly effective. If it's someone who just wants to engage in preventative resiliency building, even before experiencing low acuity needs or requiring counseling, they can access resources that help them stay healthy and build their resilience.

What are employers still getting wrong about mental health benefits? 
It comes down to culture. I think having benefits people can engage in — whether it's mental health or work-life services — is important, and they're all connected. One of the things we do is offer caregiver support, parent support, and legal support. I always think about how people don't live in silos. If someone is depressed or anxious, what's contributing to that? How can we get to the root causes? They could have access to an excellent service, but if the culture isn't there — if it's not communicated, not normalized, and not talked about regularly — then it won't be used.

What does the 507% return on investment actually mean in real terms for employers and workers — financially and operationally?
On the worker side, it means that for every dollar spent, there is roughly a $6 return. That's significant. This is a general figure modeled in our study, and while it may vary based on the size and characteristics of each organization, it serves as a strong benchmark. From an employer standpoint, the impact centers on three core areas: health care costs, disability, and productivity. Productivity is considered a soft dollar, while the other two are hard dollars. Some organizations choose to exclude productivity because it is more difficult to measure, but even without it, the ROI remains very strong.

What the study shows is that when we reduce depression and anxiety — which directly affect medical claims, disability rates, length of disability, and productivity — we see improvements across all three areas. When employees feel better and function better, they tend to use less medical care, are more focused and engaged at work, and are less likely to go on disability or remain on it for extended periods.