Benefits plans tend to support employees dealing with either mild or severe mental-health symptoms, but an entire middle category of plan members lack a treatment option geared toward their moderate symptoms.
As such, plan sponsors should think about matching services with severity when they’re considering which mental-health programs to incorporate into their benefits plans, said Rochelle Hildebrand, national director of operations for outpatient services at EHN Canada, during Benefits Canada’s 2022 Tech Insights conference in mid-April.
Plan members with mild mental-health symptoms are typically still functioning well in the workplace and their symptoms are usually triggered by a specific situation, she said, noting these employees have many treatment options available to them, such as individual counselling, internet-based cognitive behavioural therapy and peer support groups.
Meanwhile, people with very severe symptoms may already be on disability leave or are having very low functioning at work due to their chronic mental-health condition. Those employees will benefit from a residential treatment or partial hospitalization program.
But employees with moderate symptoms aren’t served well by either of these categories, said Hildebrand. These plan members suffer from lower functioning at work and outside of work, leading to absenteeism, presenteeism and increased sick days.
“They’re having more frequent and intense mental-health episodes,” she said, noting plan members in this group may have already attempted to access their employee assistance program or iCBT through their benefits plan, but “it’s just not enough to treat their moderate mental-health concern.”
Hildebrand said plan members often benefit from a combination of individual and group therapy in what’s called an intensive outpatient program. These programs are primarily used to treat patients with mild or moderate mental-health challenges. They’re a very common treatment option in the U.S. and have also been used effectively as a step-down program to help transition people who were previously attending residential programs and improve their outcomes, said Hildebrand.
EHN Canada offers intensive outpatient programs for substance use, workplace trauma and mood and anxiety disorders, all in an online setting. The company’s program involves eight weeks of intensive therapy at nine hours of therapy per week, followed by 10 months of aftercare. The program takes an evidence-based approach, using CBT, dialectic behavioural therapy, behavioural activation therapy and acceptance and commitment therapy.
“These therapeutic approaches are typically used in-person but have translated very well to an online session and are really based in increasing skills and mental-health coping strategies,” she said.
During the intensive therapy, plan members receive eight hours of psycho-education and skills groups plus an hour of individual therapy each week, as well as 12 hours of programming for their loved ones. The program is facilitated through EHN’s online Wagon platform and its app, contains customized goals, daily check-in questions that are customized to each program and coping tools based on the skills being learned in treatment. In the aftercare phase, employees receive an hour of group therapy per week.
EHN’s intensive outpatient program has significantly improved outcomes for patients. Referencing data from its substance use stream, Hildebrand said the program had resulted in an average decrease of 66 per cent in symptoms. She said patients starting the program in moderately high distress end the intensive portion with moderate distress and continue to decrease through aftercare. Scores for critical symptoms such as suicidal ideation, aggression and self-harm dropped by an average of 54 per cent.
The program supports people through their focus on skills-based programming that helps them increase their functioning at home and productivity at work, reducing their symptoms in the workplace. They’re able to track their progress with an outcome measurement tool that informs long-term support recommendations. Hildebrand also pointed out that the online format is accessible and convenient for plan members and complies with privacy and health legislation.
EHN’s outpatient program can also maximize plan sponsors’ return on investment in its benefits plan by reducing the number of employees needing to take disability leave.
“If we can support clients before they go on short- or long-term disability, we can get them while they’re at that moderate phase of their mental-health concern and treat them and support them. Ideally, we’re going to see less clients taking leaves of absence from work.”
Read more coverage from the 2022 Tech Insights conference.