Anyone who’s ever run a marathon or completed an endurance race or trek knows the last few miles are the hardest, both physically and mentally. For most Canadians, the ongoing coronavirus pandemic has been a marathon of sorts and, although we appear to be getting closer to the end, the finish line keeps moving.
While many Canadians have been spared the physical symptoms of the coronavirus, few have escaped at least some deterioration in their mental health. In fact, nearly half (46 per cent) of Canadians said they feel the need for mental-health support, according to the April LifeWorks Inc. mental-health index report.
Canadians generally access quality health care to treat physical issues, but the level of government-funded mental-health treatment is, in my opinion, completely inadequate. Free public access to mental-health treatment is largely limited to psychiatrists, which tend to require a referral from a family doctor and often have very long wait times for treatment. Also, there’s often little to no access to mental-health care in many communities across Canada. And while there tends to be ample free mental-health resources and help for those in crisis, access to longer-term treatment can be in short supply.
Fortunately, most employers offer some mental-health support to their employees and eligible dependants to supplement the government-funded options. Employer-sponsored programs and benefits to treat mental-health issues may include employee assistance programs, virtual health services and coverage for prescription drugs and mental-health practitioners under an extended health-care plan.
Employer-sponsored coverage for mental-health practitioners is typically limited to a maximum of about $500 to $1,000 per person per year for psychologists and social worker services, which tends to only cover about two to five treatment sessions. While there’s been an emerging trend over the past several years for some progressive employers to increase these maximums to as much as $5,000 or $10,000 per year, most employers have left this coverage unchanged until now.
Since the onset of the pandemic, many employers are revisiting the mental-health programs offered to their employees and dependants and there’s numerous options for employers to enhance this support. Many employers are considering increasing the annual maximum for psychologists and/or social workers. Additionally, some employers are looking at and expanding the list of mental-health practitioners covered under a benefits plan to include psychotherapists, psychoanalysts, clinical counsellors and marriage/family therapists.
Increasing the annual coverage maximum for psychologists and social workers is a relatively simple plan change for employers that have the means to make this investment, but expanding the list of covered practitioners can be more challenging. For insurers to adjudicate claims for mental-health practitioners with the same diligence they apply to other types of claims, the practitioner generally must meet two criteria: the first is they must be regulated by a provincial governing body and, secondly, they must be eligible for the medical expense tax credit.
While psychologists and social workers meet these criteria in most provinces and territories, some other types of mental-health therapists and counsellors don’t, which can make it difficult for insurers to validate the practitioners’ credentials and establish reasonable and customary limitations. Insurers may be able to expand coverage to include certain additional therapists and counsellors in some provinces, but national employers that want to add coverage for multiple practitioners across all provinces can be tricky.
Each insurer is taking a slightly different approach, so employers are best advised to discuss any plans to expand the list of covered mental-health practitioners with advisors and insurers to determine what’s feasible. Employers thinking of beefing up mental-health offerings should also first ensure there aren’t limitations like not being able to provide coverage for specific practitioners in certain provinces or not being able to apply reasonable and customary limitations.
The completion of this pandemic marathon won’t be a definitive line and it’s likely not going to be anytime soon, although there are real signs of improvement on the horizon. Many employees are mentally fatigued and are going to need support well into the foreseeable future. Employers that want healthy and productive employees should review mental-health strategies and make necessary program adjustments to help better support employees mental well-being.