Benefit leaders may be creating obstacles to mental health support

• Key Insight: Learn why benefit design — not just insurance coverage — drives mental-health access failures.
• What's at Stake: Unaddressed access barriers raise ER usage, productivity losses, absenteeism, and turnover risks.
• Forward Look: Employers should prepare to broaden networks, expand virtual options, and redesign utilization policies.
• Source: Bullets generated by AI with editorial review

Benefit leaders have invested a significant amount of time and effort into improving mental health coverage, but employees are still struggling to use their insurance to get care they need.  

Anxiety, depression and ADHD disorders are the most frequently reported mental health conditions, according to a new survey from the Employee Benefit Research Institute (EBRI). Yet, employees with a mental health condition were twice as likely as those with none to be unable to get medical care, tests or treatment they or a doctor believed necessary over the past six months. Leaders may be inadvertently exacerbating this problem, whether they realize it or not. 

"The real challenge often comes down to access and usability," says Paul Fronstin, director of the health research program at EBRI. "Employees may technically have coverage, but if they can't find a provider who takes their insurance, can't get an appointment in a reasonable time, or can't take time off work, the benefit isn't meeting their needs." 

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According to EBRI's research, a doctor's refusal to accept their insurance was nearly twice as likely to be cited as the main barrier to care by respondents with a mental health condition compared with those without, ahead of other barriers such as lack of time off of work and childcare solutions. As a result, those employees were 50% more likely to utilize emergency care, with 62% having visited the ER in the past six months. 

Fronstin says that common hurdles include a solution that is incompatible with an employer's existing healthcare package, or drawbacks that make it difficult for employees to use them successfully, like a lack of in-network providers or long wait times for services. 

"Even well-intentioned efforts can fall short," Fronstin says.  

Going beyond just a mental health benefit

Complex plan designs, prior authorization requirements and narrow networks often create unnecessary obstacles, Fronstin says. While some of these challenges will require broader systemic policy change, many barriers to care are within employers' control. 

Employers can ensure provider networks are broad and that providers are actually accepting patients. They can also improve access through more flexible options, such as expanding virtual care, offering additional paid time off for appointments and supporting scheduling needs that make it easier for employees to use available services.

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"Benefit leaders should also regularly gather employee feedback to see what's working, what's not, and then adjust offerings so mental health care is as accessible as physical health care," Fronstin says. "Keep in mind that there are also similar barriers to physical health care — they're not unique to mental health."

Should the lack of access persist, employees with mental health conditions will keep turning to the ER, Fronstin says, which is costly for both workers and employers. Additionally, untreated or delayed care can also spill over into productivity losses, higher absenteeism and greater turnover, making improving the access to mental health support a top priority for benefit teams. 

"Benefits have come a long way on paper, but in practice there are still hurdles," Fronstin says. "Leaders need to act because supporting mental health isn't just a benefits issue — it's directly tied to workforce stability, performance and overall health costs."