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December 29
14:18 2021


The need becomes more obvious; how will benefit plans respond?

By Thomas A. McCoy, CLU

One lasting effect of the pandemic, a positive one, is that both employers and employees are becoming more aware of the importance of employee mental health. Support for employees’ mental health is looking more and more like the next universal need in employee benefits plans.

Although certain demographic groups have been especially vulnerable to mental stress during the pandemic, mental health needs transcend age, gender, job functions and income levels. These needs were present before the pandemic and will continue after it ends. The pandemic has simply kick-started the mental health conversation.

Jolee Crosby, head of global L&H underwriting and medical reinsurance for Swiss Re, says it is a “good sign” that consumers’ concern about mental health is on the rise. According to Swiss Re research, almost half (44%) of consumers were already concerned about the issue before the pandemic; now an additional 23% are even more concerned.

“Insurance companies—our clients—are also concerned, so there’s a much better chance of taking action to address the problem.”

One reason for insurers, brokers and plan sponsors to be concerned is the effect that employee mental health has on physical health conditions, which are covered under workplace benefits.

“Mental well-being can have a positive or negative effect on other clinical factors,” says Crosby. “Healthcare professionals call this the ‘mind-heart-body connection.’ For example, if someone is not getting enough sleep, they may be prone to eat more because they are looking for energy, which can lead to weight gain.

“In recent meta-analyses, research shows that social isolation and loneliness were linked to a 50% greater risk of cardiovascular events.”

Mental well-being is one of six lifestyle factors Swiss Re has been researching to better understand its connection to health and well-being. Swiss Re refers to these factors as “The Big Six” and has been exploring how lifestyle factors, in conjunction with traditional clinical factors, such as BMI (body mass index) or blood pressure, can lead to more precise, personalized risk assessment for insurers and better health outcomes for policyholders at the same time.

The pandemic has made it more difficult to determine where work stress leaves and home/life stress begins. Still, studies that measure the mental pressures experienced by workers are shedding light on the need for greater attention to mental health in the workplace. In research conducted by The Hartford in early- and mid-2021, a majority of workers (61%) said they were experiencing burnout in their jobs.

Adele Spallone, head of clinical operations for workers compensation and disability at The Hartford, describes the phenomenon of burnout this way: “People feel exhausted; they feel less capable at work; they’re having trouble socializing; they may be experiencing sleep disturbance; they’re becoming more irritable.”

Spallone, who is also a licensed behavioral health clinician, continues, “We know for a fact that when people are burned out and don’t address the problem, it can lead to more work absences and unhealthy coping mechanisms, and ultimately, injury or illness.

“Burnout can lead to anxiety or depression, not necessarily a chronic condition, but it can be an acute situation. People can learn to work through it, develop coping skills and rebalance their life activities to take care of themselves in a better way.”

In a survey by The Hartford in March 2020, just before the pandemic escalated in the United States, 20% of U.S. workers reported that they struggled with depression or anxiety most days or a few days a week; by February of 2021, the number had risen to 27%.

Another hazard of burnout is that it’s closely tied to attrition. The Hartford’s mid-2021 survey found that among workers who said they were “extremely likely” to look for a new job in the next six months, 55% said they “always feel burned out,” and another 16% said they “often feel burned out.”

Spallone says, “Our survey shows that the workers reporting burnout and looking for a new job are specifically looking for a more flexible schedule, a better workplace culture, and remote work options. Some may have gotten used to working at home and now have some trepidation about going back to a workplace. Because employers are more open to remote work options, workers have additional opportunities for career growth and promotion that weren’t available before.”

More than two-thirds (68%) of women workers reported feeling burned out, compared to 52% of male workers in The Hartford’s most recent survey. This marked an increase in the disparity between women and men experiencing burnout compared to the early 2021 results (66% and 57%).

“Other research has shown that working mothers have really been grappling with the double shift of integrating household responsibilities with remote work,” Spallone notes.

On the worker age scale, younger workers were the most likely to report that they experience feelings of depression or anxiety. More than half (52%) of the Gen Z/Younger Millennials group said they have these feelings, compared to 38% of Older Millennials, 26% of Gen Xers and 10% of Baby Boomers.

A recent MetLife study sheds light on the special mental health challenges faced by managers within an organization. It found that managers who have had a mental health condition themselves over the past 12 months are more likely than those without such a condition to say it is hard to spot signs of stress, burnout or lower mental health among their reports (37% vs. 21%).

“It’s so important for managers to prioritize their own well-being during this challenging time—both for the sake of their direct reports and themselves,” says Missy Plohr-Memming, senior vice president, Group Benefits at MetLife.

Workers surveyed for the MetLife study rated “flexibility” as one of the top qualities in a supportive manager. Yet, 56% of managers surveyed said they have struggled with flexibility over the past 12 months.

Managers who are caregivers outside the workplace are more prone to mental health struggles, the study showed. Close to two-thirds (63%) of managers who are caregivers experienced a mental health difficulty over the past 12 months, compared to 46% of non-caregivers. This includes having to take time off for mental health (17%), suffering from a mental health condition (26%) or having severe sleep difficulties (30%).

“Managers who don’t have the flexibility to work off-site also face special struggles,” Plohr-Memming adds. MetLife’s research found that 58% of on-site managers reported having suffered a mental health condition or difficulty over the past 12 months versus 46% who can work remotely.

“We’ve even seen senior leaders at companies talk openly about being stressed themselves and needing to get away for a vacation.”

—Jolee Crosby

Head, Global L&H Underwriting and Medical Reinsurance

Swiss Re

“Managers also were more likely to have sought help for their stress, burnout or mental health issues, compared to other employees in the prior year,” Plohr-Memming notes (based on January 2021 data from the company’s Employee Benefits Trends Study). “In fact, managers also are more interested than other employees in emerging benefits to support their well-being and work-life balance—including counseling or therapy, digital/virtual relaxation or stress management programs and policies to place boundaries on employees’ working hours, such as organization-wide blackout hours, no meeting days/hours, summer Fridays and mandated time off.”

Crosby adds, “For employers to deal effectively with mental health in the work-place they have to first create a safe environment—one where there is no stigma or fear of retaliation about discus-sing mental health concerns. We’ve come along way, but we still have a long way to go.

“Recently, we’ve even seen senior leaders at companies talk openly about being stressed themselves and needing to get away for a vacation,” she says.

“Employers also need to be sure that employees are aware of the mental health resources they provide,” she continues. “Often the take-up rate by employees for some mental health services is low because employees just don’t know about them. So, it can become hard for the employer to justify the cost of continuing those services.”

“Our survey shows that the workers reporting burnout and looking for a new job are specifically looking for a more flexible schedule, a better workplace culture and remote work options.”

—Adele Spallone

Head, Clinical Operations for Workers Compensation and Disability

The Hartford

In June, Unum launched Unum Behavioral Health, a comprehensive platform that is designed to provide mental health resources in the workplace while improving the take-up rate of these resources. According to the Unum website, “Many behavioral health programs—like the typical EAP—offer access to resources, but are not built to proactively help employees engage and improve.”

Unum’s program strives for greater than 50% employee participation in mandatory elements such as its initial introductory training and self-reflection assessment of an employee’s mental health needs. After taking the initial assessment, employees can follow one of three tracks based on their individual needs—coaching, therapy or a self-guided program for those with low levels of stress. All are delivered digitally.

The therapy program is focused on employees with anxiety or depression disorders, and provides 12 weeks of programming (exercises, content, and more), all with the help of a licensed therapist (via video or chat). Employees with other behavioral health disorders or substance use disorder are referred to an in-network medical provider based on the benefits the employer offers.

“It’s so important for managers to

prioritize their own well-being during this challenging time—both for the sake of their direct reports and themselves.”

—Missy Plohr-Memming

Senior Vice President, Group Benefits


Employers will not see any individualized data about their employees, as all data reported by Unum is anonymous and in aggregate. Employers do see metrics that help them measure their return on investment, including utilization of the various support programs and clinical symptom reduction.

“Our early clients have seen significant engagement with the Unum Behavioral Health platform and with our support pathways,” says Swapnil Prabha, vice president, digital offerings solutions, for Unum. “They can see that the solution has components relevant to everyone, not just those with a diagnosable condition.

“We believe once an employee registers and sets up their account with Unum Behavioral Health solution, they are likely to come back and use the program. They gain peace of mind, feel supported by their employer and see savings in out-of-pocket expenses for treatment.

“Employers investing in a preventative behavioral health program see productivity improvement through reduced absenteeism and presenteeism, reduced healthcare costs and improved employee satisfaction and engagement,” says Prabha.

Crosby says, “We’ve seen different technology being used to help employees understand and cope with a potential mental well-being event. If they are feeling the need for help, there are chatbots or health applications that employers are starting to use as a way to provide real-time, personalized support. Then they can also transition into more one-on-one counseling as needed.”


Recent research by Swiss Re helps identify what type of workers are most interested in mental health support in the workplace. The company surveyed consumers who met two criteria: They view a negative mental health event as being highly

disruptive for them or their family; and they see value in an insurance product covering mental well-being.

“Our clients can see that the solution has components relevant to everyone, not just those with a diagnosable condition.”

—Swapnil Prabha

Vice President, Digital Offerings Solutions


This target group represented 21% of a larger sample of 4,500 consumers ages 25-70 with higher than median incomes in five countries, including the United States. The target group—those interested in mental health support—fell into the following age categories: ages 25-40, 58%; ages 41-55, 32%; ages 56-70, 10%.

The study notes: “When considering their own mental health, 8% of our target segment rate their own health as ‘poor’ or ‘very poor.’ However, almost half (46%) rate their mental health as ‘good’ or ‘very good’—the same proportion as those who are not in the target segment. The study also found that single parents are almost twice as likely to fall into the target group.

The mental challenges everyone has experienced during the pandemic are evidence of the universal need to take care of our mental health. The Swiss Re study results show that even those who consider their mental health to be strong recognize this need and are looking for help.

In an upcoming article, we will discuss further positive ways to address mental health.

For more information:

The Hartford


Swiss Re


The author

Thomas A. McCoy, CLU, is an Indiana-based freelance insurance writer.


About Author

Rough Notes Editor

Rough Notes Editor

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