September 30, 2021
There is little doubt in 2021 that mental health care is incredibly important the world over. Regional variation in delivery capabilities and cultural norms makes global approaches to employer mental health care very difficult. Many vendors claim to provide services with “global capabilities,” but employers have much to consider when it comes to assessing these companies, whether they deliver employee assistance programs (EAPs) or other mental health services.
Employers should keep the following points in mind when assessing these vendors:
Assess Your Global Mental Health Providers’ Global Capacity
Employers need to deeply assess what a global mental health provider means when they say they have global capabilities.
What is meant by “global capabilities” varies widely. For example, some mental health providers with global capabilities can deliver multilingual care in 100+ countries around the world, whereas others may offer English-only services in the U.S. and Canada. As global need for mental health services has increased, much of which can be delivered virtually, mental health vendor companies with apps may say they have global capacity because their app can be used anywhere with an internet connection (available to about 60% of the world) but this is no guarantee that it will address local needs. It is important for employers to do an analysis of their workforce to determine if a vendor’s capabilities will fill their gaps and address mental health care needs in both a country-by-country and regional perspective.
Consider Whether Services are Delivered In-House or Subcontracted
Whether a global mental health provider delivers services in house or through subcontracted vendors matters, and employers need to consider what is important to them.
Employers should pay attention to whether a global mental health vendor is delivering services through their own employees or if these services are being contracted out to regional providers. Services that are subcontracted out to regional providers may be more culturally appropriate or tailored to a region’s sensitivities but gives employers less control over the structure of the contract and terms of services.
See if Provider Language Capabilities Match the Needs of Your Employees
The language capability (and cultural accuracy) of a vendor in a country may not match the needs of your employees based on dialect or other cultural nuances.
Make sure that mental health providers have language capabilities that meet the needs of your employees, which may not be only the official country language. Capability to deliver services in French is probably more important if you have a facility in Quebec than if you have one in Manitoba, and the location of your facilities in India will dictate whether you need to make sure services are available in Bengali, Punjabi, Tamil, Hindi or other languages. Additionally, employers should ask vendors how their services are translated into local languages; ideally, translations should take into account the context of a country or region’s common language use rather than literal translations that might not resonate from one country to another.
Determine Your Top Mental Health Priorities to Support Your Employees
Because there is a wide variation in virtual health strategies among mental health strategies among health care providers, employer should think about what is necessary for their employees as they consider vendor partners.
Most global providers offer virtual care, but employers are behooved to push for outcomes data – beyond engagement – from their vendors to get a sense of whether their services are providing equivalent value. As employers assess countries where they need mental health coverage, it is essential to learn what the cultural norms are for using virtual services before assuming that virtual care will increase meaningful access. Virtual care is commonplace in 2021, but exactly what that means for a given mental health provider will vary. This is not a “check-the-box” situation, and cultural norms will further impact the level of utilization and value of virtual care.
Employers should ask mental health providers if they have the ability to deliver live and virtual therapy through an app. Apps may also include asynchronous tools for people to use outside of the standard therapy visit. Both modalities may be helpful to your employees, but require different measures to access their efficacy.
Artificial Intelligence (AI)
AI is sometimes used for intake triage and identification of services or providers most helpful to a new or current user, but capabilities are advancing quickly. During regular check-ins, employers and their mental health provider partners should discuss advances in their capabilities, including in AI.
Outcomes for Virtual Care Versus In-Person Visits
Virtual care is a newer modality of care than in-person visits, so longitudinal data is less robust regarding its effectiveness compared to in-person care. Employers need to push for outcomes data on whether in-person or virtual care is more effective. For the time-being, the jury is still out on which achieves better outcomes. Given more long-term experience with in-person care, some employers may be more comfortable steering employees to this option first.
Dig in to How Vendors Transition Employees to Local Mental Health Supports
Transitions from vendor provider services to mental health supports outside the bounds of mental health vendors are difficult in many parts of the world, which is why mental health providers mostly rely on local clinicians to facilitate referrals.
Employers need to push their partners to become more sophisticated in how they use and leverage technology, communications, and relationships to improve the patient experience, especially as it relates to transitions of care. Global mental health care providers generally rely on local clinicians to make referrals to services outside the provider company, which can improve speed but reduce influence and oversight by the global provider vendor. This may be appropriate and even necessary, but improvements should be considered and pushed for in the future. Employers should be aware that transitions to appropriate local supports are likely to be smoother in North America and Western Europe than in the rest of the globe.
Decide the Number of Mental Health Visits You Cover Based on What You Are Trying to Accomplish
The number of visits to cover through a global mental health provider should take into account what an employer is trying to accomplish through its partnership and what the vendor’s approach to care includes.
Several criteria will influence the number of visits employers will cover through a mental health provider: what they perceive is necessary to best support their employees across the regions in which they operate, what a vendor recommends may be needed to achieve positive outcomes, and costs, among others. This will be different for any given employer, though during the pandemic, the average number of visits covered by large employers has increased given the greater need for support.