March 27, 2019

HR's Next Frontier: Addressing the Behavioral Health Needs of Employees and their Families

By Peggy Fischer

An integrated, personalized approach to medical and behavioral health is key.

HR is caught between a rock and a hard place—between reining in employee healthcare costs and, at the same time, delivering an exceptional employee experience, one that promotes a healthy, happy, productive and loyal workforce. Striking a balance between cost control and a differentiated employee experience is hard, but there's another factor at play that makes it even more challenging: the mental and behavioral health crisis facing our country.

  • In a given year in the U.S., 1 in 5 people experience mental illness.¹
  • More than 1 in 5 of adults with mental illness also have a substance use disorder.²
  • Nearly 70% of adults with a mental illness have one or more chronic physical conditions.³
  • Up to 30% of people with diabetes, and up to 25% of people with cancer, have depression.4
  • Nearly 60% of adults with a mental illness did not receive mental health services in the previous year.5
  • Suicide is now the 10th leading cause of death in the U.S.6

For employers, it means a 10% growth in behavioral health expenses each year—a growth rate two times faster than other medical expenses7—and a huge toll on employee wellbeing and productivity. This impact, reinforced by growing concern about the opioid epidemic, is prompting employers of all sizes to take action.

Employers are trying a wide range of strategies.

Employers say they're pursuing a variety of strategies to improve employees' understanding of mental health issues and the resources available to them.

  • Nearly 60% of employers are prioritizing mental/behavioral health as a chronic condition to support, just behind diabetes and musculoskeletal disease.8
  • 54% of large employers offer telebehavioral health services, with an additional 29% considering it by 2020, and 25% plan to offer on-site behavioral health counseling beyond what a typical EAP offers (up from 18%).9
  • 30% of large employers say they will launch anti-stigma campaigns in 2019 (up from 18%) in 2018.10
  • Other common behavioral health strategies include providing self-directed online resources (58%), offering flexible work schedules so employees can get care during the business day (39%), and manager training to recognize behavioral health issues and direct employees to services (30%).11 flexible work schedules manager training
  • Supporting behavioral health as a chronic condition requires a way to identify individuals who can benefit from the program, but people with anxiety, depression or other mental health issues are often reluctant to seek support. How are they identified in a timely fashion, before an acute event occurs?
  • Onsite counseling and telebehavioral health services simplify employee access to mental health support, but building employee awareness of these programs—and alleviating privacy concerns—can be difficult.
  • Offering employees the opportunity to get care during the business day is important, but how do they find a high-quality, cost-effective behavioral health provider once they have decided to seek care?
  • Anti-stigma campaigns have been shown to lead to more supportive behavior towards individuals affected by mental health issues. Less clear is how much these campaigns influence an affected person to seek help earlier, given the lack of personalization in the approach.
  • Even with training, managers may feel unprepared to help an employee with behavioral health needs.

An independent, integrated and personalized approach is key.

Employers can take additional steps to give their people the support they need before an acute event occurs or a person has entered the healthcare system for mental health treatment. Personalized advocacy works in conjunction with health plans and providers to transform the behavioral healthcare experience from a reactive, siloed approach focused on acute conditions to a proactive and integrated approach focused on the whole person and their full life context.

Personalized advocacy:

  • Provides completely independent support from dedicated Health Assistants, Nurses and Behavioral Health Clinicians whose sole focus is helping a person get the right care at the right time and become a better healthcare consumer.
  • Identifies and engages people early— before an acute behavioral health event, when they or their loved one is experiencing symptoms or behaviors that “aren't quite right”—by using data and building trusted, long-term relationships based on empathy and expertise.
  • Enables each person to be heard, understood and guided at every stage of health— before, during and after experiencing behavioral health needs—and in the context of their unique life circumstances.
  • Fully integrates support for behavioral health conditions with support for chronic conditions (e.g., diabetes or cancer), because research shows they drive each other and also drive up costs. For instance, treating a person with diabetes and depression can cost up to three times more than treating a person with diabetes alone.
  • Provides information and support on mental health and substance abuse diagnoses, treatments and medications in a way that's easy to understand and supportive of the individual.
  • Drives collaboration and care coordination among the patient, behavioral health clinicians and healthcare system providers to create a personalized care plan and facilitate compliance.
  • Simplifies access to benefits and optimizes utilization of telemedicine, EAP and other behavioral health resources.

The result? A differentiated employee experience and reduced healthcare costs for employers.

What some of our customers' employees and family members are saying:

“Today I almost cried when my nurse Marci called me. I've been dealing with so much emotionally and personally. I recently got diagnosed with two chronic diseases. Emotionally the diagnoses were pretty devastating. Everything happened during a very difficult time in my life when I was dealing with many other issues. Many times, I felt like I would be alone in the process, so today when unexpectedly my nurse Marci called, I was so pleased. To hear another person ask about how I was doing, and could provide an educated ear was just so refreshing and empowering. I simply cannot explain how much the call meant to me, and how incredibly happy it made me during a time of my life when hope can seem scarce. Thank you, Marci!” - Accolade member

“I just wanted to give a shout out to my nurse and also the whole team of Accolade. She has helped with both of my kids— one has been suffering with depression, and the other has dyslexia, so I have been using your service to navigate my kids through to good health. I hope we will always have Accolade in our life. Thank you.” - Accolade member

My Accolade Health Assistant was wonderful. She helped me connect with the mental health people I needed for my son. She called several times to make sure that my needs were being met. It was a lot of help connecting me with the people I needed for my son. This is a difficult time in our lives and Accolade made it a lot easier.” - Accolade member

“I could not be happier with the services of Accolade as they have helped me through the years with my husband's job loss, depression, DUIs, rehab due to alcoholism, and now his death and my back pain and depression. I'm suffering through these things, and I am thankful for all these people at Accolade who have helped me. I am so grateful that Comcast has these benefits for us. Thank you." - Accolade member

I couldn't have made this impact anywhere else. I couldn't have done it in a hospital, because once a patient is discharged, psychiatric nurses won't see him again until there is a relapse. I couldn't have done it in an environment in which first-call resolution is the primary goal. I could have only done this at Accolade, where long-term relationships are encouraged and resources are well-developed and we're given the time and the room to keep trying until a good solution is found. ” - Accolade Clinical Steward, Behavioral Health

Learn more about how Personalized Advocacy works:


¹ Mental Health By The Numbers, National Alliance on Mental Illness, retrieved from:

² Infographic, "Can We Live Longer? Integrated Healthcare's Promise," Substance Abuse and Mental Health Services Administration, retrieved from

³ Mental Health By The Numbers, National Alliance on Mental Illness

4 Ibid.

5 Mental Health By The Numbers, National Alliance on Mental Illness

6 National Institute of Mental Health, retrieved from:

7 LaVito, A., (Sept 2018), Anxiety is Expensive, CNBC, retrieved from:

8 Willis Towers Watson 23rd Annual Best Practices in Healthcare Employer Survey, retrieved from:

9-11 National Business Group on Health 2019 Large Employer Healthcare Strategy and Plan Design Survey, retrieved from: