Statistics show about one in four U.S. adults suffer from a diagnosed mental disorder. Many others go undiagnosed and struggle quietly on a daily basis.
That reality doesn’t disappear when people clock in. Business Group on Health data shows 73% of employers are seeing an increase in employees seeking services to treat mental health and substance use disorders, making mental healthcare a top cost-driver on employer health plans.
Employers must navigate the associated soft costs, too. For example, poor mental health impacts a person’s ability to be present at work, which in turn can lead to presenteeism and absenteeism. There’s been a 300% increase in mental health leave of absences since 2019.
This burden weighs heavily on employers and labor organizations who want to do the right thing by their organization and team members. As a result, many look to mental health services for employers to address this growing concern.
The challenge is that since the pandemic and subsequent rise of mental health concerns, the market for mental health has become so oversaturated with different care and access types making it hard to navigate for employers and their people.
The answer? An integrated mental health approach. This seamless path forward embeds mental healthcare within primary care, where it works as part of a connected whole.
What is integrated care in mental health?
Integrated mental healthcare connects mental health support with primary care to create a more coordinated, streamlined experience for patients. Instead of sending individuals to navigate separate systems on their own, care teams work together to identify needs early, align treatment, and support follow-through.
This approach reduces friction in accessing care and helps ensure mental health is addressed as part of overall health—not as a separate issue to manage later. For employers, it means fewer gaps in care, better engagement, and more consistent outcomes across their population.
Why integrated mental health matters
Mental health conditions and symptoms have huge overlap with chronic health conditions like diabetes, heart disease, COPD, and asthma, and can even cause them to worsen. The problem is that the traditional medical system treats the conditions separately. That disconnect creates barriers to appropriate care.
Up to 75% of primary care visits include a mental health need. The standard response is often for a primary care physician to give a referral to a mental health provider, but that’s usually as far as it goes.
Anyone who has received a referral to a specialty provider has felt the confusion and frustration of figuring out how to navigate the care system. Often, this leads to a patient not following up on the referral at all.
If an individual does follow up on the referral, there’s still a disconnect between the primary care provider and mental health provider. Clinical context doesn’t travel with the patient.
Without integrated primary care and mental healthcare solutions, such as LiveBetter by Marathon Health, in which both providers are working together on your behalf, it becomes very difficult to make meaningful progress on your mental health.
For example, a mental health provider may not know if the patient tells their primary care provider that their medication isn't working or they're not sleeping. The primary doctor doesn’t know if the patient has seen their therapist.
Logistically, integrating mental health and primary care calls for a sharing of records, providers in conversation with each other, and warm handoffs for referrals. I’ve seen the real impact this makes in terms of continuity of care and notable health improvements.
What employers should look for in an integrated mental health strategy
Before you begin evaluating solutions, it’s important to understand your unique population’s needs. Data tells a story. Start by analyzing claims to see where you should focus—you might notice a rise in depression treatment or psychiatric medications prescribed. Those trends can dictate next steps.
In addition, talk to your people leaders about where they see gaps in people’s abilities to find mental healthcare. Is it for their children? To support caregiving stress? For relationship support? For example, certain industries may have higher exposure to repeated trauma, like first responders.
Beyond your workplace and industry specifics, I recommend employers consider the following when evaluating solutions.
Access and ease of use
The average national wait time to speak to a mental health provider is six weeks. When someone struggles to function because of their mental health and finally seeks care, the last thing they need is to be put on hold.
A mental health benefit should be easy to use. That means no confusing steps, long wait times, or chains of phone calls just to get started. It should be easy for users to find out:
- Is this provider accepting new patients?
- Are there available appointment times within the hours I need?
- How many appointments are covered?
- How much will an appointment cost me?
- What am I paying for, and how will I know if it’s working?
- Are there any providers available who I will connect with culturally?
Ensuring ease and access also requires considering your employee population. For example, if you have a workforce that never checks their email and shares phones across family systems, the likelihood of them engaging with a virtual mental health solution is low. That doesn’t mean it’s a bad channel, but that it’s not the right channel for your company.
For large, varied workforces, consider solutions that offer different models of care to meet employees where they are, like a hybrid approach of onsite and virtual support with quick access.
Effective, evidence-based care
With the oversaturation of the mental health market, benefits leaders often think offering more access will reduce the mental health concerns their teams are experiencing. But that’s not the full picture.
In some areas of the country, we see an abundance of providers, but people continue to struggle with mental health. It comes down to the quality of the services.
The more you can probe into capabilities around evidence and outcomes-based mental healthcare, the better equipped you’ll be to choose the right option for the people you're trying to help.
Providing access to effective and quality care often means the care should be integrated, giving employees a trusted one-stop shop for all their medical, mental, and physical needs. The goal is for patients to leave appointments feeling heard and not like they need to see five more specialists to feel better.
Quality you can measure
Many large virtual mental health platforms and EAPs see low levels of engagement. If people aren’t using the benefit, your company isn’t seeing the returns.
Ask vendors for engagement metrics, and learn how that engagement is measured. For many point solutions, vendors report on the number of people who access the benefit, but there’s no qualitative data provided on whether users continue to meet a provider or make measurable improvements.
Push vendors to demonstrate value beyond the number of people trying the solution once. Some metrics to consider include:
- Time to first appointment
- Return on investment
- Changes in GAD-7 and PHQ-9 screening scores
- Treatment plan goal completion
- Number of referrals given and number of referrals completed (in traditional healthcare settings, it’s common to see about 50% of referrals from medical to mental health drop)
- True engagement (3+ appointments)
Changing the conversation
Mental health isn't a separate, secret struggle that only certain people face. It exists on a spectrum, and most of us land somewhere in the middle on any given day. Very few people move through life without a mental health history, family stress, trauma, or significant life events. That's not failure. That's being human.
The goal of integrated mental health support isn't to achieve some narrow definition of “normal.” It's to help people function better in their daily lives. That includes managing work-life balance, navigating relationships, processing stress, and showing up more fully at work and at home.
When leaders, managers, and colleagues talk openly about stress and mental well-being, it signals to employees that this is a safe topic. Paired with the right integrated care solution, culture change creates a meaningful path forward.
The more we can talk about mental health as part of whole health, the more we chip away at the stigma that keeps people from seeking care in the first place.
Download our eBook, Measuring the ROI of advanced primary care, to learn how those engaging with Marathon’s advanced primary care see 42% lower spend on anxiety and 12% lower spend on depression.
About Grand Strides
Marathon Health’s Grand Strides series brings our clinical community together for candid conversations with trailblazers in healthcare. These sessions are designed to spark new thinking, share actionable insights, and inspire our teams as we navigate the evolving landscape of care. Looking for more healthcare optimism? Read the recap from Grand Strides with Dr. Amy Abernethy.