This is an exclusive BHB+ story
Mental health support is one of the top benefits millennials and Generation Z seek from their employers, yet only 20% are employed by companies that offer it.
Even among those that do offer mental health benefits, how and what they offer is shifting. Traditional employee assistance programs (EAPs) – a mainstay in mental health benefit offerings – are changing, too, industry professionals told Behavioral Health Business.
Traditional EAPs were set up to help employees navigate substance use disorders (SUDs) and crisis needs, but low usage and stigma prevented a more proactive, preventative approach, Becky Minton, head of therapies at Unmind, told BHB.
“The future of EAPs, or how modern EAPs are evolving, is kind of a whole organizational approach focused more on prevention,” Minton said. “They are for the whole workforce spectrum: for the 1% who might be in crisis, but also the 24% who need the mental health support, therapy and coaching, as well as 75% who could really benefit from preventative tools to help their mental well-being at work.”
Unmind is a London-based digital mental health company that provides EAPs, therapy, coaching, a crisis hotline and a mood tracker.
At large corporations, a new benefit trend is gaining steam. Since COVID-19 fueled renewed attention on mental health benefits, some companies with deep pockets have implemented on-site therapy and mental health care for their employees as an adjunct component to the EAPs already offered.
Telecommunications giant AT&T began offering care through on-site psychologists at its company health and wellness center in Dallas in 2020. Today, it averages nine therapy visits per day and provides services to more than 400 unique behavioral health patients.
“The benefit is that this staff works on our campus full-time, so they are available to our employees throughout their workday,” Matt Phillips, assistant vice president of benefits for AT&T, told BHB. “For our employees at our Dallas HQ, they are able to schedule appointments to see someone fairly quickly and can have the same level of professional service they would if they were to go to a doctor’s office off campus. This is a huge plus when you think about how some therapists have much longer wait times to see new patients.”
Delta Air Lines has a similar offering for employees in addition to its EAP. As a company with an always-on 24/7 global operation, it was important to offer a robust EAP and flexible services, a spokesperson told BHB.
“Delta has thoughtfully invested in quality mental health resources that are accessible and designed to meet our employees where they are. Taking care of mental health is just as important as physical health,” Natalie Duggan, manager of global communications, HR and wellness for Delta Air Lines, said. “Delta’s EAP offers access to care that can flex with our workforce’s schedules, work environments and technological capabilities.”
The future of mental health benefits
A growing demand for nearly instant access to mental health support, in-house mental health care and more flexible EAP options aims to meet the needs of a changing workforce.
Yet, both models still have their own limitations.
EAPs generally come with only a handful of visits, which may not be enough to address the extent of an individual’s mental health needs. Meanwhile, in-house models may be stigmatizing to use on-site due to concerns about privacy or retaliation.
What matters most for future mental health benefit models is about how they are embedded and promoted within an organization, Minton explained.
“Think about it as a whole organizational approach,” Minton said, “When it’s launched in an organization, there are lots of positive stories, and encouraging everybody in the organization to engage with it, to sign up to the platform, to see all of the tools available on there, and kind of promoting it as this kind of preventative tool. We’ve seen higher engagement utilization rates with that approach. We’ve also done some work with leaders of organizations to encourage them to talk about their own mental health, and that encourages employees to think about that and use the platform.”
There will always be a place for an EAP model, Minton said, and these options will increasingly be digital and accessible via apps and other technologies as a supplement to overall care, she predicts.
AT&T views its on-site model as a “complement to our EAP program to provide that extra flexibility of care,” Phillips said, but the company also offers virtual and external therapy through a partnership with Lyra Health. The on-site therapists are there, he explained, to add “a personal touch and flexible solution that meets employees where they are.”
“Through our onsite health center, we’ve taken additional steps of anonymity where all of our employees use the same waiting room,” Phillips said. “So, whether an employee is getting an annual exam with a physician or receiving care from a therapist, there’s no way of knowing who is seeking what service in our center, unless that employee chooses to disclose. We are also purposeful at confronting the stigma of mental health head-on, and offering onsite therapy is one way that we can visibly show that employees can bring their full selves to work, even if they are struggling emotionally.”
Since launching its on-site therapy and health care services, AT&T has also conducted a blinded cohort financial analysis to determine whether on-site care management drives value from a health plan perspective. So far? They’ve found it “does add meaningful value to the financial effectiveness of the plan,” Phillips said.
Demand for on-site behavioral health services is also growing, he said. This year so far, AT&T’s on-site location has had 1,634 visits in its behavioral health service line, compared to 1,511 visits in all of 2024.
“From data, we’ve seen that 88% of visits occur in person, so there is certainly a growing need for on-site flexibility, and we’re exploring ways that we can expand this offering to more employees,” Phillips said.
The rising demand for mental health benefits is also being felt by EAPs, prompting virtual health provider Teladoc (NYSE: TDOC) to launch its own EAP, Wellbound, just a few months ago.
EAPs used to be a “check box” for many employers, Matthew Sopcich, senior vice president of mental health solutions at Teladoc Health, told BHB. Now, though, “it’s not enough to just check the box,” he said.
“Employers are expecting EAPs to demonstrate that people are using it, to demonstrate that the people who use it are getting better as a result of it, and to be able to show how that is impacting the productivity of the workforce,” Sopcich said. “So I think there’s just a very different set of expectations.”
EAPs that truly meet the needs of both employers and their workforce today need to be digital-first, equipped with an array of services and supports and increasingly show measurable results, Dr. Russell DuBois, vice president of clinical quality, operations and innovation at BetterHelp, the virtual therapy arm of Teladoc Health, added.
“As behavioral health care costs rise on the employer side, there’s been an increasing emphasis on making sure that we’re able to demonstrate the impact that we’re making on employees,” DuBois told BHB. “So, measuring outcomes and being much more front and center, not just focusing on top of the funnel access, but following that route to ensure that our programs are actually making a measurable impact on the lives of employees.”
Even if a number of large companies do take the path AT&T has and build their own on-site supports, EAPs will continue to be a mainstay and “a practical option from an economic standpoint,” Sopcich said.
But for companies that can afford to invest in on-site care, Phillips recommends it.
“It’s scalable, but it depends on the company’s size and resources,” Phillips said. “Larger companies may find it easier to implement with the investment and space required, but even smaller organizations can explore hybrid models that could combine on-site, near-site, and/or virtual care that meet their required guidelines. There’s a possibility and hope that this trend will grow as more people find themselves in the office more often.”
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