Growing Mental Health Needs Drive Costs Globally, Requiring Employers to Push for Value

The confluence of rising costs, health burden and employee focus highlight the need for comprehensive strategies that drive greater value for mental health benefits. 

Mental health is top of mind for both employers and their employees. A 2024 Ipsos survey of over 23,000 people across 31 countries found that mental health was respondents’ top health concern. Likewise, expanding mental health services and offerings is multinational employers’ top global initiative in 2025, according to Business Group on Health’s 2025 Employer Health Care Strategy Survey. Over half of employer respondents said that mental health would feature in their global health care strategy to a great extent.

This focus makes sense given that, for the first time in the Business Group’s annual survey, mental health appeared in the top five conditions driving employer health care costs. At the same time, mental health also has a tremendous impact on employee well-being, resilience, engagement and productivity. More than one in eight people in the world live with a mental illness, and depression remains a top driver of time away from work worldwide. The confluence of rising costs, health burden and employee focus highlight the need for comprehensive strategies that drive greater value for employers.

Rising Costs Put Pressure on Employers to Drive Value in Their Mental Health Strategy

Cost trends are predicted to grow in 2025 faster than ever in the past decade, requiring employers to push for greater value across their benefits globally. Increasing mental health costs, on the surface, likely means that people who need services are getting them, which is positive. But employers must seek ways to drive greater value in their mental health strategy to provide high-quality mental health support sustainably.

Employers are taking many actions to increase the impact of their mental health resources across the globe:

  • Focusing on deploying culturally relevant, language-specific programs that adhere to the norms, nuances, religions and regulations of a given country or region so communications resonate and drive meaningful action by employees. What works in Japan may not work in China and elsewhere.
  • Targeting anti-stigma efforts in particular countries where it may be most prevalent.
  • Proactively addressing workplace dynamics and policies that can prevent burnout, anxiety and loneliness, all of which contribute to downstream mental health conditions and employee attrition. Examples include flexible workplace arrangements, expanded bereavement leave, leadership communications and manager training.
  • Looking to virtual care and emerging technologies to expand access to culturally relevant care at scale.

Increasing Burdens Require Employers to Expand Their Strategy and Demand More of Partners

For years, employee assistance programs (EAPs) have been the backbone of mental health strategy globally, but expectations about their performance and capabilities have increased significantly. Low utilization of EAPs remains a serious barrier to success, with significant variation across countries. Decades of experience show that it’s no easy challenge to address, but employers and their EAP partners can no longer accept utilization rates that are too low and too variable across countries.

Recent Business Group forums bringing together global employers have held conversations across a broad range of topics that point to the complexity of a strong mental health strategy.

Themes have included:

  • The importance of psychological safety within the workplace, which is not achieved through benefits and programs alone but through cultural change;
  • A need for focusing on elements of mental health that may not have been priorities historically, including suicidality, substance use disorder and neurodiversity;
  • The need for leadership’s participation in mental health initiatives that reduce stigma, especially in countries where use of mental health care is very rare; and
  • The need for a debate about the role of employers in employee mental health. In some countries, employees may balk at their employers being involved in mental health at all. Given these concerns, keeping an open mind about how to best support employees is key.

The Business Group’s Engineering Mental Health: Building a Strategy from the Ground Up digs deeper into how employers can think comprehensively about a mental health strategy. The world isn’t static, attitudes toward mental health are regularly evolving and employers will need to regularly assess what’s working in their mental health strategy, what’s needed and how best to achieve the desired outcomes.