- Mental health disparities affect workplaces. Gaps in care and poor health outcomes disproportionately impact certain employee groups.
- Bias and stigma impede care. External and cultural factors affect subpopulations' mental health and access to effective treatment.
- How employers can offer support. Provide targeted, culturally competent benefits, taking employee feedback into account.
This is part two of a two-part series examining health disparities and the workplace. Part one explores physical health.
Fostering improved employee mental health is a growing priority for businesses, but hampering such efforts are circumstances contributing to mental health challenges — and the ability to obtain care among various employee populations. Data show that disparities (such as inadequate care and worse outcomes) occur based on employees’ race, ethnicity, gender, sexual orientation, socioeconomic status, geographic location and other factors.
Read: 5 Health Benefits Trends Come into Focus for 2024
A January report from Morgan Health examined data from three nationally representative surveys — the National Health Interview Survey, the National Study on Drug Use and Health, and the National Vital Statistics System — and found these key disparities in employee mental health:
- LGBTQ+ individuals reported higher rates of psychological distress and substance abuse.
- Asian employees were four times less likely than whites to seek treatment for depression, perhaps pointing to a stigma in this community about receiving care.
- Lower-income individuals reported higher prevalence of psychological distress and substance abuse.
- People of color reported lower rates of mental health issues and similar or lower rates of substance abuse compared to white employees. (But some fear these data may under-report the demand for mental health care among this community, as explored below.)
Why Gaps in Mental Health Care Exist
Gaps in mental health care can be caused by a number of factors, including bias and social determinants of health. Cultural stigma may make some groups of employees reluctant to seek treatment, as well as “a lack of representation in providers that someone can find easily who may share a lived experience and looks like them,” said Katie Scott, principal, Health Equity Center of Excellence at MercerWELL. She noted that finding a provider of the same gender, sexual orientation, race or ethnicity, age or religious affiliation can increase trust and lead to better treatment outcomes.
Financial concerns also can be a factor, prompting some individuals to view physical health care as “necessary” and mental health care as “optional,” said Erin Terkoski Young, director of health, equity and well-being at WTW.
LGBTQ+ Mental Health Challenges
In 2023, 66% of LGBTQ+ employees reported that in the previous year they worked while mentally unwell, and 57% said they feel stressed in everyday life, according to research from Mercer.
Some of the pressures faced by those in the LGBTQ+ community include discrimination, stigma and the stress of coming out, said Kathleen Schulz, global innovation leader, organizational well-being at Gallagher. She added that quality of care can vary based on the availability of providers — especially those who, as Scott mentioned, understand the needs of the employee.
Young added that these experiences are also affected by geography. “That includes the political or social climate of a state or region, its general acceptance of LGBTQ+ individuals and the social risks they may encounter in areas that are less accepting, such as hate crimes, violence, and state or local laws,” she said.
Factors Influencing BIPOC Mental Health
Schulz and Scott said individuals of color are less likely to receive mental health services when they have a diagnosis.
And the data may not adequately reflect the demand for mental health care among this community, some believe.
“I absolutely think mental illness is under-reported in communities of color,” said Vikki Walton, health equity leader at Mercer's Health Equity Center of Excellence. “Having under-utilized mental health services does not imply the absence of mental health issues.”
For example:
- Native American and indigenous populations experience higher rates of untreated mental health issues and substance use disorder.
- Black and Hispanic individuals are more likely to experience postpartum depression but less likely to receive care.
- Suicide rates are disproportionately increasing among populations of color.
“Socio-political movements or stressors can contribute to peaks and valleys of mental health exacerbation,” Young said, referencing the 2020 death of George Floyd and heightened hate crimes against Asians as examples.
Steps Employers Can Take
Experts interviewed for this article offer a variety of tips employers can pursue to ensure effective mental health treatment for all employees.
- Ensure leaders and managers create a good environment. The U.S. Surgeon General recognizes toxic workplaces as a health risk and reports that 84% of employees say their working conditions have contributed to at least one mental health challenge.
- To address the workplace environment, start with company leaders. “Most managers underestimate how much their behavior is influencing the mental health of their teams,” Schulz said. “Create an action plan with managers. Hold them accountable.”
- Provide managers with training. Only 43% of companies feel their managers are equipped to respond to their employees' mental health needs, highlighting the importance of additional training, according to data from Gallagher.
To help employees receive the care they need, make sure managers understand disparities facing different groups in their workforce and are trained to thoughtfully share information with them about available mental health resources.
Managers and company leaders also can help reduce the stigma of getting help. Schulz said: “It goes a long way when a leader within an organization says, 'Hey, I struggle, too.'”
- Set up employee resource groups. These teams can foster open discussions, help the organization learn what employees need and offer mental health champions who can share resources.
- Tweak insurance plans. Making sure your insurance includes culturally diverse and competent providers can help all employees feel more comfortable when seeking care.
- Develop tailored benefit guides. Develop and share documents that provide information and resources suited for LGBTQ+ individuals, BIPOC employees, women, veterans or other subpopulations.
- Help manage expenses. Share price transparency data tools and offer financial incentives for employees who access substance abuse treatment programs.
The High Cost of Not Meeting Mental Health Needs
At least one-fifth of the U.S. population is affected by mental illness. Untreated mental health can be a “health care cost multiplier” when taking into account comorbid complications and reduced productivity and engagement, Young said.
Responding to these issues boosts recruitment and retention, Scott added: “[Addressing disparities] is, ultimately, a cost to employers, but having employees that feel connected and feel like their employer cares about them — especially considering the changing demographics of the workforce, with different generations and diversity of race and ethnicity — is hugely important.”
Editor’s Note: Additional Content
For more information and resources related to this article see the pages below, which offer quick access to all WorldatWork content on these topics:
