What Should Employers Do to Increase Access to Mental Health Care?

Ken Dolan-Del Vecchio

Ken Dolan-Del Vecchio, LMFT, LCSW, DVS, CEAP, SPHR
Vice President, Health and Wellness, Prudential Financial, Inc.

I read Carolyn Beauchamp’s recent post CFYM with interest, but not surprise. Ms. Beacuchamp discusses the inadequacies of insurers’ behavioral health networks and highlights the challenges that insured patients encounter when seeking mental health care. Often network information is outdated or incorrect, and it can be extremely time-consuming and frustrating to obtain an appointment. For someone in a worsening mental health state, such obstacles are frustrating at best, catastrophic at worst.

While Carolyn’s piece sheds light on this important issue, it is—unfortunately—not news to those of us who work in the behavioral health field. As a practitioner, I experienced the frustrations of patients struggling to find an in-network provider or schedule an appointment within a reasonable time frame. Now, in my current role as Vice President, Health and Wellness, at Prudential Financial, I work to combat these challenges and reduce obstacles to care.

Creating a culture of health at Prudential
At Prudential, we know the health of a workforce is intrinsically linked to the health of the organization. In fact, an increasing body of research demonstrates that organizations that promote health achieve the best business results. Simply offering behavioral health benefits, however, is not the same as promoting mental health. Too many obstacles stand between an employee and covered mental health services, but Prudential is taking steps to remove barriers.

Boost provider networks
To ensure our employees can access care, we became an early adopter of mental health parity. Further, we put a great deal of effort into verifying and fortifying our behavioral health network, boosting the number of in-network providers near our largest employee sites.

Our internal behavioral health team identifies highly effective providers who practice near our largest sites and confirms they are in-network for the employee plans in that area. If the providers are out of network, our team facilitates quick inclusion. Creating these “sub-panels” helps to counter the often inadequate number of in-network providers and protects against shortage challenges.

Offer employees an “on-ramp” to care
People seeking mental health services are often overwhelmed by the pathway to obtaining care. For example, if you go online and search for therapists in your area, you will likely get a substantial list of therapists, some of whom are in network. But you likely won’t learn anything about them, and it could take numerous calls before you find someone who is both in network and accepting new patients.

To simplify this process, we offer employees an “on-ramp” to care via our Care Counselor program, available in plans chosen by the majority of our employees. The Care Counselors who are registered nurses and behavioral health specialists, are trained to assist employees in navigating the healthcare system and understanding treatment options. In the case of mental health issues, the Care Counselor team can make referrals and aid in scheduling appointments with conveniently located in-network psychiatrists, psychologists, counselors, and substance abuse treatment centers.

Bring behavioral health care to the workplace
With a work force of nearly 20,000 and eight on-site health clinics, Prudential is in the unique position to offer a variety of workplace health services. A team of eight behavioral health specialists provides counseling to employees at the Prudential sites with the largest numbers of employees. The behavioral health specialists offer assessments, short-term counseling, and referrals. We consider this to be the earliest stage of care, and it ideally occurs even before the employee has received a diagnostic classification. We want to help people when issues are just beginning to arise, and we do that by making the services as convenient and easy-to-access as possible.

Provide interim care
Our Employee Assistance Program (EAP), available to all employees and family members, provides another avenue for identifying and resolving behavioral health issues before they become serious problems for individuals and employers. An employee can call our EAP 24 hours a day and speak with a licensed behavioral health specialist who is skilled in assessment, early intervention techniques, and treatment. This specialist assesses all the important dimensions of health, specifically screening for work-related issues, intimate partner violence, addictions, and financial concerns. In most cases the specialist refers the employee or family member to a local EAP counselor for in-person assistance. People can receive up to four counseling sessions at no charge. In some cases, people only need interim support to get them through a short-term challenge; but if it’s determined that long-term counseling is appropriate, the counselor will make a referral to a therapist whose services are reimbursable by the health plan.

Create a culture of health
We understand that people are busy and most are not likely to think about behavioral health services and programs until a need arises. That’s why we promote our behavioral health programs all year long through a variety of communication channels, including our health, life, and wellness intranet site; webinars; daily online employee newsletter; weekly video magazine; town halls and employee meetings; and on-site posters and flyers. Though we utilize a multi-channel strategy, our messaging is consistent: if you have any personal or family need, get in touch with our health and wellness team and we’ll help to connect you to the services you need.

What lends punch to our behavioral health messaging is that it is reinforced from the highest levels of leadership. Our leadership and management training emphasizes the importance of being attuned to a person’s whole health, supporting our corporate belief that the company is at its best when our employees are at their best health.

By inviting people to seek support when they’re facing personal, emotional, or behavioral challenges, we create a culture where people feel welcome and valued. And that lends itself to a more inspired workplace. A place where people feel free to share ideas and innovations.

Lessons learned
Prudential is a leader when it comes to behavioral health programs and benefits, and I am fortunate to work in such an environment; but not everyone works at Prudential. If you have employer-sponsored insurance, you may not have access to such extensive programs and services, but you probably have access to some relevant resources. If there is a lesson from the Prudential experience, it is that employees should not be hesitant to ask what behavioral health assistance is available through employer-sponsored insurance or the employer itself. There might be more than you realize, and your employer may be able to point you to resources and care that will help you and your family.

Questions

  • What does your employer offer to its employees in the way of behavioral health services benefits? What changes do you think would be appropriate to better serve your company’s employees and their families?
  • What experiences – positive or negative – have you had with mental health services through your employer?
  • How can we ensure that more employers are offering workforce behavioral health services benefits?

Bio
As a member of the Prudential Financial Inc. Health and Wellness’ leadership team, Ken is responsible for behavioral health and employee assistance program (EAP) services, implementation of Prudential’s work-life resource and referral services, and coordinating Prudential’s Incident Oversight Team. He provides consultation to managers, HR professionals, and work groups on issues related to leadership skills, interpersonal behavior, addictions, and violence prevention. Ken is a member of the American Family Therapy Academy, a national association for family therapy educators, clinicians, and researchers, a member of the boards of directors of The Multicultural Family Institute in Highland Park, New Jersey, and the Corporate Alliance to End Partner Violence. He is a past member of the board of directors of the New Jersey Association of Domestic Violence Professionals. Ken is the author of two nonfiction books, a family therapy textbook, and several articles/chapters in family therapy texts and journals.

Facebook Comments

3 comments
VirginiaJolly
VirginiaJolly

I had no idea I had a mental illness when I worked at a large laboratory company, but I was pouring my woes out to one person who seemed sympathetic. Yes, EAP was available, but I had no idea what it did. Moreover, I had no idea that my desperate woes were red flags for mental illness. No one suggested to me-not even this gentleman I confided in-to even try the EAP or any other service. Ultimately I was fired without cause and soon after found out I had bipolar. (There was no connection in my mind between the firing and my diagnosis.)

Bipolar affects so much of my life including focus, concentration, energy, and schedule as well as mental balance issues due to things like sleep deprivation and exhaustion that there seem to be few ways to accommodate reasonably the problems that arise due to bipolar. It makes me afraid to get a job, even if I am stable. Stability does not mean productivity, and being on time, no absences, and work are an employer'# bread and butter. And there are so many employers who do not know what to do with us, much less Co - workers.

careforyourmind
careforyourmind moderator

From Ken Dolan-DelVecchio

First, I'd like to comment on stigma and the important work that many organizations are doing to combat it. For example, here at Prudential on 9/16/13 we held Ending the Myths and Stigma: What Everyone Should Know about Depression, Addiction, and PTSD, an event that took place in our headquarters auditorium here in Newark. I had the privilege of opening the event by delivering a talk about the challenge before us, both within our workplaces and within our communities, to build a culture in which no health concern--whether diabetes, heart disease, obesity, HIV, anxiety, depression, addiction, or any other condition--is met with a response other than concern, understanding, and ready referral to sources of help. The event's centerpiece was a panel discussion in which three business leaders, one who is in recovery from alcoholism, one who has experienced several bouts of depression, and another who lives with PTSD, shared their stories. The event was closed by Prudential's Executive Vice President for US businesses encouraging the hundreds who attended to carry the message forward. The event is available for video replay and has been viewed by a substantial number of employees. We worked with Rutgers University, EAPA-NJ, the Northeast Business Group on Health, NAMI-NYC Metro, and a host of other partners to deliver a day long conference that brought the same message to the community on 11/19/14. That event, A Brave New Workplace: Ending Stigma and Promoting Behavioral Health as a Key to Wellness, drew 340 participants and was by all measures a great success.

In response to the question about offsite EAP and Behavioral Health Services, Prudential has a hybrid EAP model. We have a small internal team of Behavioral Health Services professionals (until recently called our internal EAP, and since renamed Behavioral Health Services) who devote a great deal of their time and energy to organizational consultation, training, and coaching. This team delivers some counseling, mostly for individuals whose primary concerns are in some way related to the workplace, perhaps having to do with workplace conflict, stress, or change. They also deliver life coaching for employees. I am responsible for this team, as well as Prudential's external EAP vendor, which is available by phone 24/7/365 and provides up to four in person counseling sessions annually for employees and their eligible family members. The vendor has a nationwide network of affiliates, making services readily available to employees and their family members near work or home, whichever they prefer. Employees have their choice when it comes to accessing the internal Behavioral Health Services team or the external EAP. Both teams work to smoothly refer those clients in need of longer term counseling to therapists who will be reimbursable by the client's medical program.

I might note that the entire web of internal and vendored services offered by Prudential's Health and Wellness and Employee Benefits organizations (which, in addition to EAP provides services such as health coaching, personal budget coaching, work/life resource and referral, care counseling, etc) are kept in contact through regularly scheduled vendor summits and cross-training opportunities. We expect each program to be well aware of the others and to assist clients in getting their needs met through close collaboration and referral across these services.

kimgallen
kimgallen

It is refreshing to see this article and stance taken by Prudential. I am the past President of two EAPA chapters in Texas. I also have worked for a large managed behavioral health company who sold EAP services. In addition, I have worked for a stand-alone "carve out" EAP group. I certainly believe in EAP, yet I also recall that when I sold those services to various employers, they did not take advantage of our promoting those services. I will agree that the exposure to the information and any form of reward system for employees who attend gyms etc... makes the difference in how employees respond to EAP and other services. 


Mental illness is stigmatized, as we know. Wellness and prevention certainly matters. Having on-site BH care is really a luxury. I wonder if you provide off-site care(?) I have seen companies do both, so employees are not concerned about someone seeing them walk down the MH hall, so to speak. 


Regardless, I appreciate your approach to managing health risk and to promoting health and wellness. I am glad to see you mention EAP.

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  1. […] to expect leaders to be mental health professionals, they can make employees aware of the resources that are available to them. Many health benefits, for example, have affordable options for employees to take […]