Mental health is the leading cause of disability for Canadian employers of all types, sectors and sizes, with 70 per cent of employers saying expanding access to mental-health care is a top priority.
Speaking during a Tech Insights spotlight session at Benefits Canada‘s 2021 Mental Health Summit, Anna Chif, co-founder and chief strategy and product officer at Dialogue, said its plan sponsor clients asked it “for help controlling mental-health costs and address mental-health issues before they escalated and resulted in a leave of absence.”
This led the organization to expand its offering to include mental health, employee assistance programs and internet-based cognitive behavioural therapy. “With iCBT, tools are available to help the individual learn at their own pace,” she said.
Before launching the offerings, Dialogue analyzed where current mental-health programs were falling short, said Chif, noting it isn’t easy to recognize early symptoms of mental-health issues. As well, for people who realize they need help, “finding a therapist who has time and [is] willing to take them on could take some time and their symptoms may worsen before their initial appointment.”
While some employers offer access to an EAP, it often includes a limited number of sessions and little followup, she added. In addition, an individual might drop out of therapy if the out-of-pocket costs become prohibitive. All of this could lead to a leave of absence from work or a disability claim.
Evidence shows that supporting an individual suffering from mental-health issues with a high touch multidisciplinary team “is the best approach to driving these positive outcomes and eventually remission,” said Chif, noting research shows that with monotherapy — either talk therapy or medication — the chance of achieving remission is 50 per cent. “However, when you combine medical and talk therapy, [the] success rate goes up to 86 per cent, which is a very significant difference.”
When building its iCBT program, Dialogue considered a few elements as very important: proven effectiveness through randomized controlled trials and peer-reviewed research “to validate that what you’re doing is working and brings individuals to remission,” said Chif. The organization also wanted a program that offered seamless transition to practitioner-led therapy when necessary, so there was no break in case management, with self-led therapy and practitioner-led therapy integrated into one platform. “Our mental-health program is built in a way to accompany an individual regardless of the path they want to take.”
It also used best practices to design its iCBT program, which includes a self-paced interactive toolkit that’s available anytime via a mobile app or a web browser and can be used independently or through a coach-supported model.
“We also ensure that there is always a case manager acting as an accountability partner to ensure that an individual follows through with their appointments and care plans and does everything prescribed to them to help them get better,” she said. In addition, case managers can help patients navigate to alternative resources or services as needed.
According to Chif, Dialogue has “an average improvement of 50 per cent, but for some of the more severe cases, it goes up to 60 per cent. We see fewer individuals go on leave and if they do go on leave, they come back much sooner.”
Read more coverage of the 2021 Mental Health Summit.