Accessing mental health care is easier said than done

It’s one thing to have insurance that covers mental health services; but it’s another thing to access those services.

That was among the takeaways from the Employee Benefit Research Institute 2025 Employee Mental Health Survey. The survey results were reviewed as part of EBRI’s Virtual Policy Forum this week.

Treatment for mental health disorders in people under age 65 has continued to increase since the COVID-19 pandemic, said Tami Simon of the EBRI Board of Trustees. The percentage of those in the under-65 group who sought treatment inched upward to 15.5% in 2023 from 14.1% in 2021.

This increase, she said, “signals the direction of this trend and its impact on worker productivity and benefit costs.”

Anxiety is driving the increase, she said, with 6.8% of the under-65 population diagnosed with anxiety disorder in 2023. Other disorders impacting this age group included major depressive disorder (3.9%), attention deficit hyperactivity disorder (2.7%), substance abuse disorders (1.5%), and bipolar and manic disorders (0.6%).

More than 20% of those ages 18-44 were treated for a mental health or substance abuse disorder, she said, and slightly more than 10% of that age group sought help for anxiety disorder.

“This paints a troubling picture for the workforce,” she said.

Having trouble accessing mental health care

The 2025 EBRI Employee Mental Health Survey examined about 3,000 workers between the ages of 20 and 74 who were covered under an employer-based health plan from their own employer or their spouse’s or parent’s employer.

The survey found 27% of those who are covered under an employer-based plan reported they or someone in their family has a mental health condition. Anxiety was reported by 17% of respondents, followed by major depressive disorder (11%) and ADHD (8%).

Those who have a mental health condition were twice as likely as those without one to have trouble obtaining medical treatment or tests a doctor believed necessary. More than 30% of those who said they or someone on their health plan had a mental health condition said they had trouble accessing care, compared with 15% of those who did not have anyone with a mental health condition on their plan.

The main reason for not being able to obtain care a doctor believed necessary is that their health plan would not approve, cover or pay for the care, the survey found. Other reasons frequently cited by respondents included their doctor not accepting their insurance and being unable to afford the care.

“We found many households have more than one member affected by mental health disorders,” said Paul Fronstin, EBRI director of health benefits research. “Stressors extend beyond the workers and employers see spillover effects in terms of productivity, absenteeism.”

Network adequacy seems to be a barrier to employees and their families receiving care, he added. Cost and a shortage of mental health care workers also contribute to difficulties in accessing care.

Insurance is no guarantee

“Having insurance is not a guarantee for mental health care access,” said Anna Bobb, executive director of Path Forward. “We’re still having trouble getting mental health care. People are struggling but it’s not for lack of trying.

The key in getting help for mental health is to seek that help early on, she said.

“To get access to care, we need to treat mental illness the same way we treat other chronic illnesses such as heart disease. We must take an early intervention approach to mental illness.”

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Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].