The Frequency

The benefit lives or dies on the provider directory, and most directories are fiction. We have a lot of numbers that are disconnected, previously-retired clinicians, and those who have been off the plan for years. It’s not just our plan. A team of Senate Finance staffers did a study where they did a secret shopper approach, and out of 120 mental health listings they actually booked an appointment 18 percent of the time (May 2023). Before I trusted ours, I had someone call down the behavioral health list in our own plan the way a patient would. An employee who finally works up the nerve to call and gets three dead ends reads it as rejection, and they don’t try again next quarter.

We keep a short verified list instead: it is confirmed, these are the real names, confirmed openings, confirmed wait times, and the list is re-checked on a schedule. That costs staff hours, not premium dollars. This is the whole point of a fixed budget.

The other move was killing duplication, so My EAP and my health plan were both selling me counseling sessions, and we were paying twice for this service that our employees couldn’t navigate either way, so we had to make one door, clearly labeled.

I just see the totals and nothing else on trust. No department breakdown is given because in a building our size a department is a person. Running an addiction treatment center, I know exactly what a two-week wait does to someone who just decided to ask.

Design mental health support by selecting a small set of high-impact, confidential services chosen from utilization and claims signals, then back those services with clear, repeated communication and leadership modeling so employees know using them is safe. Manage budget by investing only in programs with measurable outcomes and reviewing progress quarterly so funds move to what actually helps employees. Avoid an overwhelming lineup by offering navigation support and limiting choices to the options with the clearest value. One change I made was shifting from a long menu of perks to a targeted program chosen from data and paired with visible leader endorsement, which created clearer pathways and increased employee comfort in using mental health resources.

Start by auditing what your current plan actually pays for behavioral health, because coverage and access are not the same thing. Most plans look generous on paper and fall apart at the network.

The detail almost nobody checks is the carve-out. Mental health benefits are frequently administered by a separate behavioral health company sitting behind your medical plan, with its own, much thinner network.

Your medical directory looks deep. The behavioral network an employee actually has to book with can be a fraction of it. That gap is why people say they used their benefit and could not find anyone taking new patients.

As a CFO, I stopped evaluating mental health benefits by the brochure and started evaluating them by access.

Before we added anything, we checked the real behavioral network in the zip codes our people live in, and how many of those providers were open to new patients.

The change that moved trust the most was not a bigger benefit. We added a small set of pre-vetted, in-network telehealth options and told employees plainly which ones were confirmed to be taking patients and roughly what they would owe.

Certainty did more for usage than generosity ever did.

On budget, the honest tradeoff is this. A rich benefit nobody can access is the most expensive kind, because you pay the premium and get no engagement and no goodwill.

Spending a little to verify access beats spending a lot to expand a benefit that stalls at a network nobody can reach.

For us this comes down to a pretty simple belief: if we’re building apps that help other people take care of their mental health, it would be a little ridiculous if our own team wasn’t actually doing that themselves. So a lot of what we’ve built isn’t really a traditional benefits lineup, it’s closer to just giving people permission and time.

The biggest change was adding a quarterly mental health break, about five days off every quarter on top of regular time off. Not framed as sick leave, not something you have to justify or explain in a Slack message to your manager. It’s just built into the calendar the same way a public holiday is. What I noticed almost immediately was how differently people used it compared to regular PTO. Nobody was saving it up for a trip. People were actually using it to rest, and admitting that out loud, which felt like a real shift from the culture we had before.

The other piece is less formal but honestly might matter more. I encourage everyone on the team to actually use the apps we build. We work with wellness teachers across yoga, breathwork, meditation, hypnosis, that whole range, and I ask people to pick one and build some kind of after-work wind-down practice with it, even fifteen minutes. Not as a mandate with a tracker attached, because the second something like this becomes a metric you’re supposed to hit, it stops being care and starts being another task. Just a standing, repeated nudge that using the product isn’t just market research, it’s supposed to actually be good for you.

What made people trust it, I think, is that I’m doing the same things I’m asking of them. I take my own quarterly break. I’ve got a class I go back to on one of our partner apps most evenings. When a founder is visibly doing the thing rather than just approving a line item for it, people stop treating mental health support as a perk with an asterisk on it and start treating it like it’s actually meant to be used.

Budget-wise, this approach worked in our favor too, since most of it isn’t a new expense, it’s time and encouragement rather than another subscription or program to fund. The access problem for a lot of workplace mental health benefits isn’t that the resource doesn’t exist, it’s that nobody feels like they’re allowed to actually use it without judgment. Once we removed that hesitation, usage went up without us spending anything extra to make it happen.

From a benefits provider perspective, benefit overwhelm is something we often see. Unfortunately, employees often can’t access what they really need because they don’t know where to start.

I always recommend employers review what they’re already offering, see how the benefits fit together, and find out whether employees actually know what’s on offer and how to access it. We have seen cases where an employer is already paying for counselling through an EAP or mental health support within another benefit, but employees are not engaging with it. Our approach is all about creating usable health and wellbeing programmes.

That’s when having one platform to access all benefits is a game changer. We’ve helped employers bring their wellbeing support together in one place through our Smart Hive platform, with much clearer communication around what each service is for and how it can be accessed. We also encourage employers to be very clear about confidentiality, particularly with services such as EAPs. Employees need to know that asking for help is private and isn’t going to be reported back to their manager. Mental Health First Aiders can also help by being able to spot the first signs of distress and address mental health concerns before they escalate, particularly if someone is struggling and doesn’t know which service they need.

For me, that’s where you can balance access with budget. I recommend that before spending money on another mental health benefit, make sure the support you already have is easy to find and easy to understand.

In terms of operations I feel there should be mental health support built into how your teams already operate. Many positions within these businesses are driven by customer service levels, sales targets etc. So having access to an array of benefits to navigate through could be daunting for some. I would offer a smaller range of options and educate managers on how to direct their team members towards a confidential resource without asking too many questions. It allows you to support your team member but not get involved in their life.

Something that I would implement is more well being sign posting within management and teams. Managers could have a procedure of informing their team members where they can find confidential help and what they should not be asking their team members about. Allowing the current resources to be used more. I don’t think you would need to provide extra benefits that cost the business money. My key measure would be if my team knew where to go and felt comfortable going to that source. They shouldn’t feel as though its going to reflect on them in the workplace.

Psychological safety is not simply a budget item, but a crucial element that determines whether the company’s employees would actually make use of the mental health benefits they have access to. It is impossible to establish a basis of trust with the help of a repertoire of wellness apps if the culture of the organization holds that admitting one’s stress is a risk to one’s performance as an employee. In order to maintain the levels of expenditure while maintaining an impact, we remain committed to offering only one, high-quality Employee Assistance Program instead of numerous services in the form of various options on the menu. It should be noted that access to these services is determined not by the brochures informing about them, but by the day-to-day work meetings at which certain leadership behaviors define what is acceptable or not.

In high stakes working environments, such as the contexts of enterprise software rollouts, workers are often silent about their burnout in order to demonstrate their professional integrity. What made it possible to change this feeling in an efficient way was the purposeful use of vulnerability in our regular reviews. Rather than only discussing technical barriers to successful software implementation, I started talking openly about the implications of the anxiety caused by the functioning of an organization under these circumstances and sharing my own techniques of stress management. When a manager integrates mental health into the elements of operational excellence, the team members are encouraged to embrace their humanity.

This change in leadership behavior influences utilization rates. When employees see their managers valuing mental recovery after an important project, the social stigma associated with using counseling services is reduced. Confidence in care is achieved through evidence from peers. By facilitating the discussion of mental health on the leadership level, one may ensure that the resources available to workers are regarded as proactive measures helping them work rather than reactive measures deployed in the moments of crisis.

As a pharmacist, I’ve worked for a number of companies, and have always found it interesting that mental health benefits for employees usually don’t cover the medication component. Employees that take medication for their mental health typically don’t talk about other supplements or over the counter medications that they may also be taking. Taking medication is often a last resort for many, and a lot of people feel uncomfortable talking to their employer about the need to see a counselor or therapist. Talking to a pharmacist in a confidential setting about medications is less threatening than meeting with a counselor, and doesn’t require the individual to disclose their personal reasons for seeking help. It may provide the motivation an individual needs to take the first step and ask for the help that they need.

To control expenses, I would offer employees a choice of counseling sessions, an employee assistance line, and a pharmacist consultation. Of these, I would prioritize the pharmacist consultation because it allows employees to seek information about their medications without needing to disclose the reason to their employer.