Tailoring Behavioral Health Services for Your Population

The importance of behavioral health benefits

A Kaiser Family Foundation survey found over half of American adults have experienced a serious behavioral health-related disruption in their family.  According to the latest data available from the National Institute of Mental Health (NIMN), 21 percent of all adults in the United States have a mental illness. The NIMH also reports that younger adults and adults of two or more races experience higher rates of mental illness than other groups.

Since the beginning of the COVID-19 pandemic and the opioid crisis, patients and their families have sought treatment for mental health and SUDs more frequently. Consequently, the behavioral health industry has seen a dramatic uptick in demand that it’s having difficulty meeting.

Despite rising demand for care, mental health and SUDs remain undertreated. In particular, young adults and men are less likely to receive treatment. Given that more than half of those with an SUD work full time, undertreatment is a concern for organizations.

The long-term impact of untreated (or undertreated) behavioral health conditions within a population are significant. Behavioral health affects absenteeism, accident rates and morale. Additionally, it affects quality of life and health plan costs. For example, people with depression are at greater risk of developing cardiac disease than those without depression and individuals living with mental illness experience up to double the cardiometabolic disease risk of the general population.

The current landscape of behavioral health solutions

Today, plan sponsors face a complex and rapidly evolving behavioral health landscape.

Traditional behavioral health networks often struggle with limited provider availability, inconsistent quality and difficult navigation, which can discourage individuals from seeking care. Increasingly, we are seeing networks attempt to improve access by cobbling together a hodgepodge of point solutions or stitching together large networks accessed through multiple directories. Also, “ghost networks” — in which providers listed in a network aren’t taking new patients or are no longer in business — create added frustration when your people try to find care.

In response, many organizations are reassessing how networks, employee assistance programs (EAPs) and supplemental solutions work together to meet population needs.

To determine what works best for your population, we recommend reviewing your people’s needs, plan utilization trends, and the cost and quality of vendor solutions.  Comprehensive behavioral health benefits may require integrating multiple types of programs.

Six best practices for designing behavioral health benefits that meet the needs of your population

To ensure mental health and substance use benefits deliver real value to your people and their families, take a population‑driven, access‑focused approach grounded in data and sustainability.

We suggest following six steps:

1. Start with your population‑specific data

Review claims, utilization management and EAP data to identify coverage gaps, underserved groups and areas where spending is disproportionately high. Low utilization can be a more meaningful warning sign than high costs and should prompt deeper evaluation.

2. Design for access, not just coverage

The provider network should offer real availability, reasonable wait times and clear navigation. Add targeted performance guarantees to keep the vendor on task and to ensure that they deliver on promises made. Ghost networks, fragmented vendor arrangements and complex digital pathways can discourage engagement and reduce the value of otherwise robust benefits.

3. Match solutions to defined needs

Different populations require different approaches — such as early intervention, specialty care, pediatric expertise or substance use treatment. Tailoring may require integrating multiple solutions rather than relying on a single program.

4. Balance innovation with sustainability

Cutting-edge EAPs and standalone services can improve engagement and outcomes, but pricing models, budgeting volatility and legal considerations must be carefully evaluated to ensure long‑term viability.

5. Offer both virtual and in-person care options

Virtual care expands access and supports outcome tracking, but it cannot fully replace in‑person relationships or clinical judgment. Maintain in‑person options and recognize that preferences vary across individuals and conditions.

6. Plan for compliance and communication

All solutions should be reviewed for compliance with Mental Health Parity and Addiction Equity Act requirements and launched with a clear, stigma-addressing engagement strategy to drive awareness and sustained utilization.

How to drive meaningful use of behavioral health benefits

When evaluating the needs of your population against potential behavioral health solutions, we recommend prioritizing the gaps that affect a large percentage of your people and/or areas of high spending.

Additionally, effective behavioral health benefits rarely operate as simply as “plug and play.” They require a thoughtful engagement strategy that includes vendor-facilitated orientations and demonstrations of technology platforms, endorsements from peers and leadership, and clear communications designed to build awareness and increase usage of your solutions.

Ensuring your people understand what’s available to them, how your solutions work and that others have had good experiences with your benefits can mean the difference between meeting and exceeding benchmark engagement levels.

See all of our insights on mental health issues.