Poll Finds Most Workers Can Get Mental Health Care, but a Third Worry About Seeking It

More than half of American workers say they can get mental health care through their employer, but more than 1 in 3 worry about the consequences of seeking help, according to results of a new poll released Monday by the American Psychiatric Association (APA). Results were presented during APA’s 175th Annual Meeting in San Francisco, California.

The poll found 60% of worker say their employers offer sufficient mental health resources, whether that includes coverage for care through health benefits, an employer assistance program (EAP), mental health days, wellness programs, or on-site mental health services. Employers are getting serious about mental health for a simple reason: failing to do so means lost productivity. A report prepared by the National Alliance on Mental Illness of Massachusetts found that 62% of missed work days were due to a mental health condition.

But while APA finds employers are increasingly working to reduce stigma surrounding mental health, employees themselves hold back on discussing the topic. There is a sharp generational divide: 62% of millennials, those born from 1981 to 1999, are comfortable discussing the topic, compared with only 32% of baby boomers, those born 1946 to 1964.

Nearly a decade after the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act took effect in 2010, there is less stigma surrounding mental health care and substance use treatment than there once was—but the poll found this has not entirely eroded, as younger men in particular fear retaliation or being fired for seeking help.

On the flip side, roughly 3 out of 4 workers say they would recognize signs of depression, anxiety, or other mental illness among colleagues, and most say they would help. The poll found 82% of women 18 to 49 years of age were more likely to recognize signs of distress among coworkers, while men older than age 49 were less likely (66%) to recognize these signs.

However, 1 in 4 say they would not know how to help a coworker who needed mental health services, and 27% said their employer does not offer adequate coverage for mental health. Another 13% are unsure.

Darcy Gruttadaro, JD, who is the director, APA Foundation Center for Workplace Mental Health, said that the poll did not directly address whether the respondents were new or long-term employees, but outside of the poll, the center often hears that employers only provide information about mental health coverage during the on-boarding process and open enrollment.

"We recommend that employers frequently remind employees about how to access mental health services and supports, often by coordinating regular updates through the organization’s EAP, during health fairs, on the organization’s Intranet and through organization-wide communications like E-Blasts, newsletters, virtual and physical bulletin boards and more," Gruttadaro said.

The fact that 27% of respondents said their employer does not offer sufficient mental health care coverage is "extremely concerning," but not surprising, she said. The 2017 Milliman report, recent lawsuits, and regulatory action by states, show noncompliance with parity laws and regulations. "The good news is that many more states are active, through their Insurance Departments and Attorneys General, in enforcing parity laws and regulations and holding third-party administrators and health plans accountable for parity compliance," Gruttardo said

“These results show both encouraging and concerning aspects of mental health in the workplace,” APA President Altha Stewart, MD, said in a statement. “The extent to which people are willing to reach out and help is encouraging. However, the continued hesitancy among many to talk about mental health concerns in the workplace is troubling. We have to get to the point where people are as comfortable talking about mental health concerns as they are about physical health concerns.”

It's not just the employees who struggle. Employers tell the APA Foundation that the top complaint they get from their workers about mental heath care is access, Gruttardo said. "This led the Center and the APA’s policy team to develop a set of recommendations for employers and health plans on how to improve access to quality mental health and substance use care by addressing 5 key policy issues. The recommendations outline concrete steps to address ensuring network adequacy, ensuring mental health parity compliance, advancing measurement-based care, expanding the collaborative care model, expanding telepsychiatry," she said.

Questions about mental health in the workplace were included in an APA-sponsored online survey of 1005 adults that took place April 4-7, 2019. Other topics in the survey included Americans’ overall level of anxiety and concerns about social media.

Anxiety Levels Among Americans

The APA poll found that about 2 in 3 Americans are extremely or somewhat anxious about keeping themselves and their family safe, maintaining health, and paying bills. This is the second year the poll found this level of anxiety among the population.

The poll also reported 32% say they are more anxious than they were last year, 43% say they have the same level of anxiety as last year, and 24% are less anxious than last year. These results are similar to results reported over the past 2 years. African Americans reported a drop in extreme anxiety about keeping their family safe, from 46% to 37%, and about paying bills, from 47% to 33%.

African Americans and Hispanic Americans also reported reduced overall anxiety over the past year, although their levels remain higher then Caucasians. Among African Americans, extreme anxiety about politics fell from 30% to 13%; this measure fell from 22% to 15% among Hispanic Americans.

Other measures of well-being have shown anxiety among African Americans and Hispanics taking a dip in 2017; the Gallup Well-being Index showed a sharp drop in well-being and a smaller one for 2018 among these 2 groups. Hispanics who primarily speak Spanish were especially hard hit in social measures of well-being in the Gallup index.

Use of Social Media

Americans feel social media brings more negative effects than positive ones, the APA poll found, with 38% of adults reporting that social media is harmful to mental health. Another 45% said it has both positive and negative effects on mental health, and just 5% said it has a positive impact.

More than two-thirds of respondents (67%) said social media contributes to loneliness and social isolation, with millennials more likely than baby boomers to report this sentiment (73% to 62%). When asked if they “completely agree” that social media contributes to loneliness, 33% of African Americans, 22% of Caucasians, and 25% of Hispanics agreed.

Yet younger adults are more likely to use mental health apps than older adults; 24% of millennials say they use a social media app, compared with 3% of baby boomers. By race, 27% of Hispanics, 17% of African Americans, and 9% of Caucasians reported using a social media app for mental health support.