Engineering Mental Health: Building a Strategy from the Ground Up

Learn how employers can build a comprehensive mental health strategy for the workforce based on three pillars.

July 18, 2023

This Guide informs the development and execution of a comprehensive mental health strategy built on three pillars: 1) Organizational factors that impact employee mental health; 2) Initiatives to promote mental health; and 3) Benefits and programs to treat mental health conditions and substance use disorders.

Supporting workforce mental health has been a priority for large employers for years, but never more so than during the COVID-19 pandemic, as employees and their families experienced myriad challenges impacting their emotional well-being. Now, although the acute crisis of the pandemic is behind us, numerous and serious mental health challenges remain, creating an imperative for employers to transform their support of mental health into a cohesive and comprehensive strategy – one that assists every employee, from those who are thriving to those with mental health conditions and substance use disorders and everyone in between.

A comprehensive mental health strategy is good for employees and for business. Extensive research documents the significant challenges related to poor mental health. According to a Milliman study of commercially insured adults in the U.S., claims for those with mental health conditions cost twice as much as those for individuals without them, even though direct spending on mental health care accounted for less than 5% of costs.1 Worldwide, depression is the leading cause of poor health and disability according to the World Economic Forum.2 And employees experiencing stress are more likely to miss work, become disengaged and leave jobs.3,4 What’s more, life expectancy is either stagnating or declining depending on the country, which is in part attributed to “deaths of despair”-- overdoses, suicides and alcohol-related liver disease.5 Thus, there’s a burning platform to prevent and treat mental health and substance use disorders, and there are many opportunities for employers to make a positive impact on employees’ lives through the development of a cohesive mental health strategy that attends to the spectrum of employee needs.

There is growing agreement among major health-focused entities, including the World Health Organization, the U.S. Surgeon General’s Office, and leading voices in mental health, including the team behind the Mental Health at Work Index™, that creating a comprehensive strategy must involve assessing and addressing multiple factors, or “pillars,” in concert to best support workforce mental health.* While different organizations may use their own terminology, these pillars typically include:

  • 1 | Organizational factors that impact employee mental health;
  • 2 | Initiatives to promote mental health; and
  • 3 | Benefits and programs to treat mental health conditions and substance use disorders.

This Business Group on Health resource is for employers – those in executive leadership roles, as well as those responsible for health benefits and employee well-being, and their health industry partners. The resource informs the development and execution of a mental health strategy built on the three pillars above. It covers:

  • An in-depth review of the three pillars, including the benefits of focusing on each;
  • The role that benefits and well-being leaders have in advancing each pillar, including actionable solutions for implementation; and
  • Areas of opportunity for measurement, integration and accountability within and across each of the three pillars.

A Note on Terminology

There are varying terminology used to refer to mental health, including behavioral health, brain health, mind health, emotional health, mental fitness, etc. This resource uses the words: “mental health” “mental health conditions” and “substance use disorders.” Mental health may be more recognizable than other terms, as it’s more commonly used by organizations around the world and is intended to refer to a continuum, from thriving to crisis. Naming substance use disorders separately is intentional and seeks to ensure they are part of the conversation when creating a comprehensive mental health strategy.


*Business Group on Health is a Founding Corporate Council member of Mental Health at Work Index™ - an assessment tool for employers. The Business Group wishes to acknowledge its participation as a Founding Corporate Council member. Our participation influenced the development of certain aspects found in this resource.

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