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Understanding the Mental Health Continuum and Its Relevance in the Workplace

Nine out of 10 employers have expanded mental health benefits in the last year, but upward of three-quarters of the workforce believes their mental health is not well supported.

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Even before the pandemic, there was a growing divide between the demand for mental health care and the existing system to support it. Fast forward nearly two years later, and we’re dealing with a tidal wave of increasing mental health challenges. Organizations everywhere are rising to the challenge, but they’re not quite there yet.

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Nine out of 10 employers have expanded mental health benefits in the last year, but upward of three-quarters of the workforce believes their mental health is not well supported. Telehealth and digital solutions are on the rise, but out of more than 20,000 mental health apps in the marketplace, only 6 percent of app companies that claim to have an evidence-based framework have actually published said evidence.  

So, what can we do now to make headway on a complex and fragmented problem?

Mental Health Is a Continuum

The reality is that mental wellness is much more than the absence of mental illness. According to the National Alliance on Mental Illness, one in five American adults experience mental illness, with one in 20 experiencing serious mental illness, which can be defined based on a group of specific diagnoses. 

Those who have not yet identified their need for help or potentially have subclinical symptoms need a better entry point to mental health support that is highly accessible and easy to use. With the average delay between diagnosing symptoms and receiving treatment being 11 years, it’s safe to say there is still progress to be made with this important issue. 

Innately, each and every one of us has what we all call “mental health,” and this will fluctuate in response to our current and past life circumstances. So, while mental health fluctuates, the traditional resources and advice we are given is often only done in a binary state where one is either mentally healthy or mentally ill with few resources for supporting those in between.  

Why Mental Health Is a Continuum

While doctors and organizations continue to try and figure out how to catch up to our 11-year delay, what we know now is that mental illness is a continuum that ranges between a state of mental wellness to acute illness. It’s a spectrum, and understanding where activities such as yoga or guided exercises fit versus therapy and in-person treatment is crucial to overcoming the barriers to proper mental health.  

Let’s break down the spectrum in more detail; with mental wellness starting on one end, we find exercises such as mindfulness and meditation help patients cope with stressors. As we move  along the continuum, we then arrive at the period of pre-diagnosis, in which we learn that those mindfulness activities aren’t enough, and we move into the area where people are experiencing symptoms that require more clinical involvement. On the far right of the continuum, we see patients beginning to receive face-to-face services and treatments, usually customized to their needs and the stage of their mental health. 

The truth is, most of the population will fall somewhere in between, and it will fluctuate every day. For many, mental health can’t be unpacked strictly at home. It can slowly creep into your other hobbies, relationships and even your place of work. 

Mental Wellness Needs to Be Sustained in the Workplace

The reality is that mental health is much more than just the absence of mental illness, and it’s much more than just a box checked on your employee benefits package. Consider topics around our physical health; if we encounter a brief illness or sustain an injury, we have the ability to do and try things that will heal us or make us feel better. Now look at that in the light of our mental wellness. 

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Mental wellness cannot be packaged into five neat containers and presented to a workforce of 500+ people who are all battling different stressors. It’s not always about people having an “off day” at work. According to a Mental Health America survey, 85 percent of workers say the workplace negatively impacts their mental state. What we find is that those who aren’t experiencing symptoms or situations that need clinical treatment are falling through the gaps of access to care. 

In the United States, most people receive their health insurance through their employer. Most of those employers use health-benefits administrators to run their plan, including contracting for access to behavioral health providers. And investment is on the rise, with the average employer budget for employee well-being programs sitting at $6 million in 2021. 

We need to enlist and enact more benefit support for all the individuals who find themselves floating on the continuum. What’s beneficial about this moment in time, and the increased investment toward digital mental health care that’s come about as a result of it, is that advances in technology are helping provide more accessible care to the wider population. Every day new approaches to health care are being developed to help arm us with the right support mechanisms for our current state of mind, creating a greater opportunity for more people to receive the care they need. 

And while technology has helped address the problem within access to care, only 24 in 100 employees need mental wellness support that includes counseling or therapy. Yet, only one out of 100 employees have serious mental health needs that might result in needing more intense services. 

Where We Go From Here

First and foremost, we need to close the gaps in access to care, especially around mental health. Beyond the economic and financial gaps, we need to provide more personalized solutions that can be affordable and effective in the home, the workplace or wherever people need support. Doctors and employers have been investing in and focusing on these siloed areas of mental wellness instead of looking at the whole spectrum, where everyone is floating. 

The silver lining of this growing awareness of mental health is that there are a ton of offerings out there, but very few of them are based on scientific evidence. It’s critical that there is clinical rigor to your programs to ensure they will actually help your people. And those who haven’t yet identified their need for help need an entry point to mental health support that is easy to use, non-threatening and discreet.

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App-based interventions that utilize the ongoing digital revolution across the health care industry will help to support the symptoms of mental disorders. The efficiency and efficacy of app-based care is on the rise for researchers, and we’re going to see an influx in this space when it comes to understanding the mental health continuum and equipping doctors and employers with the right tools. 

There’s still a lot of work to be done, but painting a clearer picture of our mental wellness is the first step needed to better manage this problem.

Oliver Harrison is the CEO and founder of Koa Health.

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