Canada has done a good job at reducing the stigma around discussing and seeking help for mental-health challenges, but two-thirds of Canadians who are struggling still don’t seek help.
That’s a likely symptom of the country’s “fractured and fragmented” health-care system, said Joe Blomeley, executive vice-president and head of health services and enterprise growth at Green Shield Canada, speaking during Benefits Canada’s 2022 Mental Health Summit in November.
“The Canadian public health-care system is really only equipped to deal with acute mental illness, but if you’re dealing with mild to moderate mental-health issues, you’re dealing with a highly fragmented system right now, complex navigation, sub-optimal delivery . . . and, unfortunately, ambiguous coverage in terms of what’s available to you through your employer plan.”
There are multiple challenges with employers’ approaches to mental-health benefits, said Blomeley. While he noted many offer employee assistance programs, these aren’t well-promoted — and hence not well-used — and employees hit their annual maximum within a few therapy sessions.
Employers may also only cover a small number of mental-health professionals, which these professionals have identified as a pain point in research conducted by Green Shield Canada. A certain provider may have an approach that’s the best fit for an employee’s mental-health challenges, but may not be covered by their benefits plan. Blomeley also expressed concern that many organizations don’t have a mental-health strategy.
The issue will only become more challenging in the coming years as Canadians deal with the mental-health fall-out from the coronavirus pandemic, he said, noting the insurer expects mental health-related visits to double as a direct result. According to data cited during the presentation, three in 10 Canadians have been diagnosed with anxiety or depression since the onset of the pandemic.
Green Shield Canada’s’s own book of business points to the scope of the challenge, with a 103 per cent increase in mental-health claimants and a 140 per cent increase in claims in the last two years, as well as a 125 per cent increase in the counselling spend since 2018.
Blomeley said he sees an opportunity for private digital solutions that use data analytics and artificial intelligence to track the effectiveness of treatment, which treat mental health as a chronic issue and focus on medium- or long-term interventions rather than the traditional EAP’s short-term focus.
These apps have been able to leverage a marketplace model to scale effectively, he said, noting the model relies on a network of hundreds or thousands of clinicians and uses a matching algorithm to pair patients in need with a counsellor based on their symptoms and needs. “We’re seeing more and more of this in the Canadian market and it’s up to plan sponsors, in my opinion, to really push the envelope in terms of giving [a shot to] organizations that are doing this kind of work.”
Research has found 75 per cent of patients prefer psychotherapy to mental-health medications, something that’s supported by these types of apps, said Blomeley. “People actually do want therapy, it’s just a challenge to get [access].”
Digital solutions also reduce the friction plan members often face while searching for help, he said, by offering them the broadest range of services in one place — including telemedicine and digital pharmacy — and the ability to switch between treatment paths as their needs change. These apps also offer clear and simple system navigation.
They also make therapy more accessible to underrepresented groups and people who may have been traditionally reticent to seek therapy, he added. According to Green Shield Canada research, more men and ethnic minorities are engaging with digital-based mental-health supports.
While Blomeley acknowledged some employees would prefer face-to-face interaction with a mental-health professional, “digital enablement should be a part of any strategy right now.” However, he stressed the importance of making sure a digital mental-health vendor can demonstrate their ability to reduce symptomology.
Going forward, he expects to see digital mental-health supports, telemedicine and digital pharmacy become the three core components of employers’ mental-health strategies. “We’ve got to remove some of the fragmentation in terms of somebody’s ability to get that treatment or preventative care. They shouldn’t have to stick with one path; there should be the ability to pivot depending on their particular needs.”