By the time the Behavioral Health Education Center of Nebraska closed the second round of American Rescue Plan Act (ARPA) funding on April 10, 2023, it had received 137 applications requesting almost $22 million in funding, vastly outweighing the $3.3 million in available funds.
While funds are being deployed to help train more behavioral health professionals, employers and organizations are stepping up to meet residents in the present.
Some may not know that laws have been passed in the last 10-plus years to ensure access to behavioral health, which includes mental health care and substance use disorders.
With the enactment of the Affordable Care Act in 2010, insurers became federally required to offer coverage for mental health and substance use disorders. The Mental Health Parity and Addiction Equity Act of 2008 requires that insurers provide behavioral health services at the same cost as other physician services.
Ron Rowe, chief revenue officer at Blue Cross Blue Shield of Nebraska (BCBSNE), said with BCBSNE most employer-sponsored plans include office visits with no copays, something that Leah Vetter, Gallagher area president, said is becoming more popular.
“Over the past year we’ve seen a lot of employers start to decrease the cost of copays, or make the cost of out-of-network providers the same as in-network providers,” she said.
Of note, in Gallagher’s 2022 U.S. Benefits Strategy & Benchmarking Survey, 58% of Nebraska employers reported offering telephonic mental health counseling, either as part of insurance or as a standalone service.
Eighty-six percent offer an employee assistance program (EAP). EAPs typically include a limited number of counseling sessions for free for employees or family members.
Some companies, such as those with large numbers of remote employees spread out over the country, cannot offer some EAP services.
To that end, BCBSNE Chief Medical Officer Dr. Josette Gordon-Simet noted that BCBSNE employees and customers have access to BCBSNE’s nurse case managers.
“Nurse care managers are behavioral health nurses by experience,” she said. “They are also available for members to have confidential discussions around what other support services they may need.”
The challenge, however, comes back to a lack of providers. One initiative gaining momentum is training individuals on how to identify if someone is going through a mental health challenge, and how to address the challenge with kindness and resources.
The National Council for Wellbeing, which has trained and certified 2.9 million individuals in Mental Health First Aid (MHFA), administers the internationally recognized training.
In May 2022 the United Way of the Midlands (UWM) received a $25,000 grant from The Molina Healthcare Charitable Foundation to support its Mental Health First Aid initiative.
Matt Wallen, SVP of community impact and analytics, said the need became obvious after conversations with the community.
“As a community organization, we said it’s incumbent on us to step up and do what we can to help support the community,” he said.
UWM, which works with over 600 corporate partners and 40,000 donors, decided it could have the most impact by bringing awareness to the training Region 6 Behavioral Health was already offering. Internally, Wallen said all UWM staff members have been trained.
“On any given day, anybody can be going through something,” Wallen said. “I would say as an employee, it’s comfortable to know that everybody has training and understands how to help if I’m handling a difficult situation.”
The training is free, and organizations and individuals can sign up online or by calling UWM’s 2-1-1 helpline.
Organizations such as Scoular and BCBSNE have participated in such training, with employees from all levels participating. Other organizations, such as Nebraska Methodist, Best Care EAP, and Children’s Hospital have created their own mental well-being training.
“The beauty of [peer support training] is there’ll be more support on an ongoing basis throughout the entire health system,” said Jean Faber, Best Care EAP corporate director.
Laurie Willburn, Children’s VP of total rewards & people strategies, said that just about 10% of its employees volunteered for training and are easily identified by their badge.
Monitoring how employees are engaging with various initiatives through surveys and data can help employers determine the gaps.
For example, BCBSNE HR Operations Director Molly Billings said that during COVID-19 the onsite fitness center wasn’t getting much use. Even as things have stabilized the usage remains average due to a hybrid work schedule.
Seeing this BCBSNE promoted two apps to engage with employees and encourage mental health through exercise. Vitality for tracking goals, and Well Beats offers a variety of exercise classes as well as nutrition and mindfulness advice.
BCBSNE also shares how it utilizes these apps with its corporate partners who can then elect to share the apps with their employees.
For Children’s Hospital & Medical Center and Methodist Hospital, it became apparent the medical staff needed a space to decompress after difficult situations. This meant creating relaxation rooms for employees that include items such as aromatherapy and meditation music.
In another effort to further support frontline workers, community leaders Diane Duren and Drew Collier donated funds that allowed Children’s to bring on a chief morale officer – Howie, a service dog.
“In pediatric hospitals, service dogs are not uncommon; we have two service dogs that serve our kiddos,” Willburn said. “Howie is unique
in that he is a service dog for our workforce and is solely dedicated to our team.”
Create a Waterfall
When it comes to communicating resources and benefits, employers need to consider what their employees’ schedules are.
For example, Willburn noted that nurses on the patient floor aren’t going to be checking their email, and therefore might not see a wellness newsletter.
With that thinking in mind, Children’s will launch a quarterly magazine in May that will be mailed to employees’ homes. The first issue of Thrive will feature one provider’s mental health journey in line with Mental Health Awareness Month.
“Physicians are not necessarily known for raising their hands and saying, ‘I’m in trouble here. I need some help,’” Willburn said.
“There’s even a misperception that if they say ‘I’m in trouble, and I need some help,’ their medical license may be at jeopardy. There’s just a lot of stigma around it and we’re trying to get rid of that stigma.”
Lori Thomas, director of workplace culture and wellbeing for The Wellbeing Partners, said sharing and incorporating positive messages like this is important to reducing stigma. Another example is Scoular providing employees a mental health day or a lifestyle spending account.
“We hosted some virtual forums and co-workers actually spoke about specific stories about either their or their loved one’s personal struggles,” said Kelli Eickhoff, SVP, chief human resources officer. “It was really impactful, and, actually, people are still talking about it a year later.”
Making sure intentional language and messaging are carried out at all levels of management will help foster a psychologically safe environment for employees.
“A lot of times you’ll see the C Suite or the executive leadership have a plan laid out but for whatever reason that information isn’t being communicated all the way down,” Thomas said. “So, instead of being a waterfall, it’s like a trickle.”
Thomas said a good place to start is by providing training to all managers, whether it be mental health first aid, emotional intelligence, conflict management or something else.
In recognition of Mental Health Awareness Month in May, The Wellbeing Partners is making its Mental Health Toolkit available online for everyone. The kit includes sample policies, graphics, action steps and data and can be found at thewellbeingpartners.com.