‘Micro-Losses’ and Mental Health: How Telehealth and Digital Apps May Help Us Close the Wellness Gap

By: | May 16, 2021

Terri L. Rhodes is CEO of the Disability Management Employer Coalition. Terri was an Absence and Disability Management Consultant for Mercer, and also served as Director of Absence and Disability for Health Net and Corporate IDM Program Manager for Abbott Laboratories.

I have written a lot over the years about mental health, and I’m proud to say that DMEC is one of the pioneers in promoting and helping employers recognize its impact in the workplace.

I’m also happy to report that as we recognize Mental Health Awareness Month this year, employers and the larger society have a new level of understanding and recognition regarding the impact of mental health. Perhaps even more important, we seem to be on the cusp of widespread awareness. We have found that there is no separate and distinct “mental health,” just as there is no separate “physical health.”

There is simply health and wellbeing.

But before we think all is well, I read some startling statistics from a recent survey conducted by Unmind and Welcoa. The survey indicated that:

  • 90% of employers recognize employees are experiencing burnout.
  • Almost 40% of employees say their mental health has been impacted by COVID-19.
  • 65% of employers feel their businesses will be negatively impacted by mental health issues and business performance over the next 12 months because of COVID-19.
  • Many companies are failing to develop a mental health strategy because of lack of senior leadership buy-in and budget.

Traditionally, employers turned to their employee assistance programs (EAPs) for support, but during the pandemic, they fell short.

While usage was up, it became evident they were not equipped to deal with the unique and increased needs experienced during the pandemic. One size does not fit all. Many EAPs have included legal, financial and elder and childcare options, but there is a utilization problem, and we are not addressing the access issues in this country.

This is where digital apps have somewhat closed the gap. Today, there are more than 380,000 health apps available through Apple and Android stores, and around 20,000 of them address mental health, according to the European Connected Health Alliance.

The stresses produced by the pandemic, including among those fortunate enough to be able to work from home, have spared few workers.

One size does not fit all. Many EAPs have included legal, financial and elder and childcare options, but there is a utilization problem, and we are not addressing the access issues in this country.

While the virus has forced people into isolation, nearly all the symptoms associated with isolation have been shared. This includes stress, depression and anxiety. Employees up and down the ladder have also shared the responses they have used to address these issues — increased alcohol and other drug use, unhealthy eating habits, overwork, etc.

As time goes on, we’ll see the full costs of these sub-optimal coping mechanisms.

The upside of these across-the-board stresses is a more broadly understood need for resources to address mental health issues and the life events that drive them.

Relaxed work-from-home rules, online yoga and other programs, subsidies for children’s camps and other activities, and telehealth and EAP promotion are just some of the initiatives employers have implemented during the pandemic. Many large employers have announced these and other changes and benefits are here to stay.

The second major factor driving greater mental health awareness is that which drives so much change — generational turnover.

In a study conducted by The Standard, it stood out that the younger generations in the workforce are reporting mental health issues (59% of millennials and 71% of Gen Z). This sends a strong message that we need to get ahead of this.

Millennials and Gen Zers — those born between 1981 and 2015 — are more open about acknowledging and discussing their own mental health struggles. This is reflected in the high numbers of people in these generations who will tell researchers about their issues.

A June 2020 survey of U.S. adults conducted by the Centers for Disease Control and Prevention showed:

  • 40% are struggling with mental health or substance abuse.
  • 13% started or increased substance abuse.
  • 31% report anxiety/depression symptoms.
  • 26% reported trauma/stressor-related disorder symptoms.
  • 11% seriously considered suicide, including 25.5% of adults 18-25.

Many of these issues stem from “micro-losses,” such as school and graduation cancelations, isolation, financial insecurity and an unstable job market.

Yet younger generations are not convinced employers want to help them address their issues. A survey by Businessolver shows that 76% of millennials and 73% of Gen Zers believe companies view those with mental health issues as a burden.

This is part of an “empathy gap” that has grown during the pandemic. In 2020, 84% of Gen Zers saw their employers as empathetic, but that number fell to 68% in 2021.

Here are a couple of easy and cost-effective ways employers can help.


According to Businessolver, only 29% of HR professionals say their companies provide access to online mental health services or clinics.

This means there is a tremendous opportunity for employers to expand access to these services, delivered in the way many and perhaps most employees are most comfortable using them.

Telephonic and video counseling and therapy are private and convenient. They can reduce the time employees take off work. Even more, their relative ease of use enables preventive care. Over time, this has the potential to substantially reduce absence and disability and its costs.

States generally require people to work with mental health providers licensed in their states. Some state governments are considering changes to these laws. That and other reforms to increase supply and access would make remote mental health services even more attractive to employers and employees.

But even without these changes, telehealth’s potential benefits far outweigh its costs.


The pandemic has seen an explosion in mental health-related applications employees can download to phones and laptops.

More are being added every week. These include mindfulness exercises, stress relief, meditation and, most significantly, apps that connect employees to therapists. These apps often provide free assessments, enable users to connect with a therapist at any time, and allow them to easily change therapists to find the right fit.

These apps, as potentially helpful as they are, do present challenges.

They are usually not designed for serious mental illness, but rather, for the more common issues — stress, anxiety, insomnia, etc.— many employees experience. There are potential privacy concerns, and currently there’s no real way to measure outcomes and quality.

All of which argues for greater employer involvement in this burgeoning industry. Especially if they are directly or through insurance, indirectly reimbursing costs, employers can help influence the direction this sector takes.

The pandemic has brought about many changes. But, even more, it accelerated those already underway.

This includes how we view and address mental health.

More and more individuals are acknowledging their struggle with mental health, which means we need to be thinking about how to address mental health before it becomes the second pandemic. As we start to bring our workforce back to the office, employers have a unique opportunity to advance this pandemic-induced change and reap the benefits of a healthy workforce. &

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