What is the problem?

The adverse social determinants of health (SDOH) that stem from structural racism and economic injustice can lead to—and exacerbate—behavioral health conditions. In particular, financial issues can harm behavioral health by creating sleep problems, causing anxiety, and making it difficult to afford basic goods that keep people healthy.

What can employers do?

Employers can positively impact many SDOHs, but they have a unique opportunity to improve the financial health of their employees by offering sufficient compensation and robust benefits.

1. Ensure employee compensation reaches local standards for a living wage, at minimum.

If employees are earning a livable wage, they will have less stress (and therefore a lower likelihood to develop or worsen a behavioral health condition) and are less likely to struggle with other SDOHs. Unlike a minimum wage, a living wage accounts for the ability to afford essentials like food, housing, health care, and childcare in the context of local cost of living. Regularly assess compensation to align wage growth with inflation growth.

2. Design employee benefits packages to include services that address the other primary SDOHs.

For example, include benefits like paid parental leave, childcare options, transportation benefits, loan forgiveness, and housing support. Survey your employees to determine which benefits would be most valuable to them, including improvements to existing benefits as well as net new additions. To ensure that employees are using their benefits, make these resources easy to locate and navigate. See our cheat sheets on supplemental employee benefits for more.

3. Evaluate your scheduling and leave policies to ensure they provide ample support for employee well-being.

Many employees are unable to take time outside of work to seek behavioral health care because they have other competing priorities like family responsibilities. And it can be expensive to take time off work because this means a loss of an hourly wage or productivity at a salaried job. Employers can make it easier and less costly to access care by offering mental health days and flexible scheduling. Both strategies will ultimately increase productivity and can be implemented by adjusting the organization’s sick leave or paid time off policy.

What is the problem?

Eight out of ten employees say shame and stigma prevent them from seeking treatment, leading to worse outcomes. And individuals from marginalized groups often face even greater stigma around accessing behavioral health care, exacerbating inequities in access and outcomes. Unmet behavioral health needs can worsen employee engagement, productivity, and retention.

What can employers do?

Employer organizations can meaningfully combat stigma by improving employees’ understanding of behavioral health needs and normalizing the need for professional care.

1. Educate leaders on the organization’s policies related to behavioral health.

Ensure that leaders understand that behavioral health conditions are as important to address as physical health conditions and that employers cannot discriminate against people with behavioral health conditions under the Americans with Disabilities Act. Leaders should also be well versed in the organization’s policies related to behavioral health needs and how to provide reasonable accommodations.

2. Provide behavioral health literacy training to all leaders and employees.

Behavioral health literacy training, such as mental health first aid and the Just Five program, promotes a culture of acceptance around mental health conditions and substance use disorders and improves leaders’ and employees’ understanding of care options. This culture of acceptance is foundational to creating a trauma-informed environment in the workplace. Training should promote an accurate understanding of behavioral health conditions, including their causes and prevalence. This information can normalize behavioral health needs and help people understand them as health conditions rather than personal weaknesses. Ensure that training helps leaders and managers learn to identify signs of emotional distress and connect team members with resources for support.

3. Solicit feedback from employees on their behavioral health and well-being through employee resource groups or other channels.

Ask about employees’ experiences at the organization with specific questions about behavioral health and well-being. For example, ask individuals if they feel comfortable talking about behavioral health at work and if they feel supported by the organization's behavioral health benefits. Take care to source feedback from employee resource groups to understand how perspectives might vary by demographic or social groups, especially for groups who are underrepresented in the workplace. After collecting feedback, make sure that results are shared transparently across the organization. Renew this data regularly and create time-bound plans for improvement. Follow up with surveyed groups to let them know how their feedback is being used.

What is the problem?

There is an insufficient supply of the “right” behavioral health providers to meet patient need. This means employees struggle to find providers who match their geographic location, have capacity to accept new patients, have the right expertise required, have training to provide care with cultural humility, offer affordable rates, and accept patients’ insurance.

What can employers do?

Employers should focus on increasing accessibility to the right behavioral health providers as part of the benefits offered to employees.

1. Create standardized criteria for vetting digital health vendors to ensure the best possible quality and accessibility for employees. Depending on their models, ideal vendors should:

• Provide research-backed services and tools with demonstrated quality and safety outcomes over time
• Offer an easily navigable platform that allows employees to select and schedule the support that best suits their needs, no matter their language skills, broadband connectivity, technological literacy, and ability status
• Connect to a strong network of providers taking on new patients (avoiding the phenomenon of “ghost” or “phantom” networks), with a special focus on high quality, in-network options for substance use disorders and serious mental illnesses, which are typically the most challenging to find

2. Use workforce REGAL (race, ethnicity, gender, age, language) data and employee input to offer behavioral health resources and benefits that meet the needs of employees from underrepresented groups.

This may include ensuring access to resources available in different languages and providers equipped to deliver culturally humble care. For more information on how to collect and analyze REGAL data, see our strategies for how to take a data-driven approach to equity initiatives.