Supporting Mental Health in the Workplace with Christina Mainelli & Heather Lavallee

In this episode we have not one, but two CEOs who join the podcast to talk about a topic that’s very important to both of them: mental health in the workplace. Joining for the discussion is Voya’s own CEO, Heather Lavallee and Christina Mainelli, CEO at Quartet Health. At Quartet Health, Christina and her team are on a mission to improve the lives of people with mental health conditions with technology and services that reach people who need care to connect them to the right care, track the quality of their care, and support their care journeys. Tune in to hear from both Heather and Christina who discuss opportunities for employers to support their workforce as this important conversation unfolds. 

Bill Harmon is a registered representative of Voya Financial Partners, LLC (member SIPC). 

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Transcript

Speaker 1: 0:01

You are listening to the Hire Through Retire podcast with Voya's Bill Harmon tackling all things from 401ks to HSAs and everything in between. We are talking to the best and brightest in the industry to bring you the latest in benefits, savings and investment trends in the workplace. Come along with us on our journey to help all Americans become well-planned, well-invested, and well protected.

Speaker 2: 0:25

Welcome back to the Hire through entire podcast. I'm your host, bill Harmon, and I'm really happy to be back with everyone today. And we have a very special episode. We have not one but two CEOs. We're here to talk about a topic that's very important to them and really to all of us, and that is mental health in the workplace. First we have Christina Minnelli, who is the c e o at Quartet Health. At Quartet Health. Christina and her team are on a mission to improve the lives of people with mental health conditions, with technology and services that reach people who need care to connect them to the right care, track the quality of their care and support their care journeys. So Christine, thank you so much for joining us.

Speaker 3: 1:07

Hi Bill. Thanks for having me on this show. I am super excited for today's discussion.

Speaker 2: 1:12

It's gonna be a great one. And to introduce our second c e o, really this guest really needs no introduction here because she used to co-host this podcast and that's our very own Heather Lava who recently became Voya's new c e o at the beginning of this year. So Heather, so glad to have you back.

Speaker 4: 1:29

Hey Bill, thanks. It's so great to be here with you and I could not, uh, think of a better topic and a better guest to be on than Christina Minelli and really focus in on just this unbelievably important topic around mental health that is a global issue.

Speaker 2: 1:43

Thank you so much and you know, really happy to have you both here. Big topic. Let's dig right into it. If we could start with you, Christina, can you start by sharing a bit more about Quartet Health? And if you don't mind sharing, could you talk about how you first got involved in the company and then your passion on the topic of mental health support?

Speaker 3: 2:02

Absolutely. Thanks Bill. Um, so for those of you in the audience that don't know of us, quartet is one of the largest tech enabled mental health provider groups in the country. And we focus on speed to quality behavioral healthcare for all through three primary offerings. First, we've got a tech platform that matches patients to broad networks of mental health providers, including in-person and virtual care. Second, we work with mental health providers or clinicians to help ensure they're delivering quality care and they're rewarded for it. And we call this value-based care. And third, we deliver care directly to patients or consumers or employees through our medical group, which is made up of over 300 psychiatrists, nurses and therapists. Just to give you a sense of size, we're contracted to serve over 21 million members across 33 states. We've got over 20,000 providers on our tech platform and our medical group delivered over 500,000 patient visits last year alone. As for me, I've got two decades in the healthcare industry and I've worked in physical health, which is like medical health. I've worked in behavioral health, so mental health and addiction, and also in social care, which is around social determinants of health, where we talk about housing, transportation, employment. I've held leadership roles in all of these types of companies and including at health insurers, providers and healthcare tech companies. All of that said, my true passion really lies in mental health and for many reasons, largely due to the sheer number of individuals that struggle with mental health and addiction, including some of my dearest friends, um, and close family members. So I joined Quartet to help drive the mission of speed to quality behavioral healthcare for all.

Speaker 2: 3:51

Well, first of all, thank you so much for what you do. This is a huge topic, um, and, and just getting bigger and we're, I'm so happy we're talking about it not just on the podcast, but even beyond that. So Heather, taking this further, um, to the topic of the workplace, recent industry data shows that workers with fair or poor mental health experienced four times the absenteeism, which leads to a national cost of 322 billion turnover and lost productivity. So it's clear that mental health has certainly become pivotable when it comes to benefits, particularly over the past several years to help really address burnout given both the workplace and at home needs that employees have today. So from your perspective, what trends have you seen companies establish or really lean in when it comes to mental health benefits?

Speaker 4: 4:42

Yeah, well Bill, you, you, you tee that up well in terms of talking about the issue and the prevalence and if you kind of take it back to a topic, we've talked a lot about, uh, the pandemic and when we think about in the first year of the pandemic, the global prevalence of anxiety and depression increased by massive 25%. I don't think that has gone away, right? If anything, it has continued to exacerbate for families all around the globe. This is not just an issue here in the States. At the same time, when we think about it, there still is a stigma that exists around mental health issues and that often comes just from a lack of understanding or fear. So really the way to combat it is we've gotta take the stigma around mental health issues outta the equation and we've gotta let individuals and family members feel more comfortable talking about it. You know, I know it's something for us in Voya as I've talked about, family members that have struggled. It's amazing, you know, in, in a public forum. It's amazing how much that opened the doors for others to share some of the situation that they're going through. And I think that's one of the first steps. And when we think about it from a benefit perspective, cuz we spend so much time with employers and looking at their overall benefit programs, we're seeing an increase in making, uh, employee assistance programs available for workers and their family members. Um, we're also seeing a increase in counseling, and I'm sure this is something Christina's gonna spend a little bit more time talking about as well as specialists, right? We, we know that the increase of stress, anxiety, elder care, financial care being caregivers, substance use and recovery, the list goes on and on. And so the more we can lean in on those benefits, remove the stigma, and then finally communicate to our employees, use opportunities, town halls, other uh, communication vehicles as a way to acknowledge the issue. Even things like awareness month to bring it to the attention of their employees. And I think if employers can lean in on those three issues, we can collectively make a dent in helping what has really become quite a serious issue, uh, globally.

Speaker 2: 6:51

Thanks Heather. And I think you're so right. As long as you can have an environment where people are much more comfortable addressing with peers, looking for help and all of that. And, and we are starting to see that more, but we've got a long way to go.

Speaker 3: 7:05

Employee assistance programs typically have one to 3% utilization. So one to 3%, that's good cuz it's not very expensive for the employer, but that's bad because they're not being utilized. So the question kind of for an employer to think about is why are my employees not using this, this resource given all the information that we just put out there around the prevalence of these mental health issues? And is it because there's a lack of awareness? Is it because there's an issue of stigma? Is it an issue because the program doesn't work? Well, that's something I would look to employers to kind of reflect on and think about why isn't my program being utilized? Because the issue certainly exists

Speaker 2: 7:47

If we just talked about the giant need and then there's a program, there's a mismatch. You've mentioned something that was really interesting about helping individuals, helping companies find providers and solutions that can help support their mental health needs. I gotta imagine if you're an individual and you're really struggling and you want to, I mean, taking that first step is, shouldn't be difficult, but I oftentimes it is. So can you speak to some of the challenges that you've seen for both individuals or employers when it comes to finding care and really what led you to go ahead and solve for that?

Speaker 3: 8:19

Absolutely. But let me back up just a moment cause I want to, um, elaborate more on the size of this problem. Cause I think it's important to understand how, to Heather's point post pandemic, we're seeing the numbers play out even more so than what she stated. So think about mental illness in two categories, right? There's kind of any mental illness that's actually a term which affects about 23% of the US adult population, or one in four today. And this would include individuals with depression, anxiety, eating disorders. Then there's severe mental illness. So bucket two, which affects about 6% of the population. And this could include the same categories that I just mentioned, but this is a scenario where it's become so acute that it causes functional impairment, eg, I can't go to work, right? And includes diagnoses like bipolar, schizophrenia, P T S D and addiction. So s m i, we call it serious mental illness is a 300 billion problem each year in our country. And an individual. So one employee with serious mental illness may cost their employer or health plan around$40,000 a year in treatment. Often these are individuals with a comorbid diagnosis. So maybe diabetes or congestive heart failure or C O P D. But again, you know, I share the impact and the number because A, there's someone struggling in your community, which is most important, and b, there's a tremendous cost. And a lot of this is avoidable. And I'd be remiss if I did not speak about adolescence, which would be the children of many of your employers. 49.5% of individuals age 13 to 18 had a mental health issue last year, 22% of adolescents had a severe mental illness. And it's worth noting that suicide is now the second leading cause of death for adolescence and the first for individuals age 14 and 15. I mean, it's just shocking, you know, it, it just gives me pause whenever I think about these numbers. So let's move on to the question though. What are the challenges in finding care? Because often these situations escalate to the point that I've just described because individuals didn't have care or weren't matched to the right care. So first challenge is mental health issues often present themselves in the primary care setting. So you're going to see your primary care doc. These clinicians often know which patients may be struggling with mental health or substance use issues, however, they often lack tools, resources, or quite frankly, the time to connect a patient to care. You know, telling someone call the 800 number on the back of your card doesn't feel good, right? So one of the important elements in getting a patient to care really is it's timeliness. So it's making that connection at that point in time, getting that referral over to avoid what we call a drop-off rate. Because often if you just get a card and a number, you walk away and either A, it doesn't happen, or b, if it happens there can be a real, um, speed to care issue. So timeliness, right? You've heard these stories about individuals waiting 10, 12 weeks and months to get to an appointment. So first issue is really, these are often presented in the primary care setting and they're not pulled through. Second is, uh, you know, access is the primary issue. So it's not just getting an appointment, but it's getting an appointment with a clinician that's a good fit for the patient or the employee. And that means different things to different people. It could be site of care. Do you want a virtual appointment or do you want to see someone in person, the type of clinician that's needed? Do you need a pediatric psychiatrist? Do you need an addiction specialist? And is this clinician culturally competent or a good fit for you? And that may mean that it's a good fit around race, gender, sexual orientation, religion. So this matching is often very difficult even if you can get an appointment. So look, our company was founded on the premise of connecting individuals to mental healthcare from the primary care setting. And we do it f few, a few things. Our tech platform allows you to connect to care through an automated referral. There's a matching algorithm that helps to match needs and preferences to the right kind of provider. And then we have a broad supply of clinicians across the country that we can connect patients to, whether it's in-person, virtual, a specialist, and in fact we provide care ourselves so we can connect to our own clinicians. So the result in which is what we, what we hope for all is speed to care. That's a great match so that you can see a provider within days, not weeks or months

Speaker 2: 13:09

As well as in, I'd love how you talked about that cultural match. But boy, I will tell you those stats that you said are staggering. And I imagine our listeners are gonna go back and rewind, what did she say? Is it really? And when you brought in the adolescence, if if that's happening within the family, it's affecting the entire family. So as much as that's that individual, but the whole family's really affected by that. And so another question for you, Christina. I mean, I was reading a recent study from Pew Research Center that found that nearly 40% of employees want their employees to discuss mental health in the workplace. And this is especially true in the younger generations. However, there still remains this barrier when it comes to trust between employees and employers specifically to the topic of mental health. And Heather, this kind of speaks to what you were talking about earlier with the stigma. My question, Christina, is this, what advice would you then have for employers looking to implement solutions into their workforce and where can they seek support?

Speaker 3: 14:10

Yeah, thanks for that question, bill. I think you know, a couple, kind of a couple themes here. One is awareness, which Heather brought up, right? Like make sure your employees are aware of your mental health benefits, your e a P programs. Sometimes you start an e a p employee assistance program, and then you still might need more care. So you should be able to move into your mental health benefit, which is often part of the health benefit. The core health benefit include mention of these resources in your onboarding program. Emphasize the privacy and security, um, and the anonymity of these programs. But don't forget to bring them back up when there's other even events, uh, market events. Um, let's say there's a shooting, you know, people, you, there's lots of things that trigger employees to have a, a situation where they mean need access to mental health resources and they may not think of their E A P or their, you know, benefit program. I'd say second, from an, from an employer perspective, find great partners, vet your solutions that you're working with, make sure they support what we call speed to care. 10 week wait for an appointment is not acceptable. Develop service agreements with these partners, um, ensure they can meet that speed to care. And then look the next, um, place we go in behavioral healthcare is quality. We're so focused on access, just get me an appointment. But start to ask about quality. Are there outcomes with your program? That's really what you need is speed and quality. And finally, I would say, um, and Heather touched on this, but lead by example, nearly 60% of people with mental health conditions never talk about it at work. I would argue it's probably gotta be bigger than that, but it's important to train managers. So if you have training programs, you know, in how to have these conversations and foster this culture of, uh, where this is mental health is de-stigmatized. And look, a recent example in the news is what the US government, you might have seen, there's a number of senators that have started to come forward with their personal challenges around mental health and addiction. And they're actually leveraging this as a platform to reduce stigma and for policy change. So I think it was Senator Tina Smith who's on the Senate Health Committee is actually brought forward her experience with, um, mental health, others with substance use to increase access to mental health in rural areas. So you can see where, you know, leading by example, Ken A helped to destigmatize, but b also helped to solve the more systemic issues that exist.

Speaker 2: 16:47

Those are great examples of that. Thank you so much, Heather. One of the things I remember you talking about during the pandemic was the concept of leading with empathy. And I think one of the silver linings of going through covid as a company was that we all had the opportunity to be more empathetic. What are some of the biggest changes you've made yourself or that have been altered as a result, particularly when it comes to supporting behavioral, uh, health in the workplace?

Speaker 4: 17:13

Yeah, bill, I, I, I love this question because, you know, oftentimes as companies we're so focused in on, you know, achieving results or delivering for customers, we, it's so important to take that step back and just think about the health of our workforce and not just talk about, uh, you know, before the pandemic, when we were all together, we would often be very much focused in on the work that was getting done. And that's what we discussed in meetings was how are we delivering? And, and so for me, one of the things is the ch the conversation has changed. You know, w we at Voy still embracing the hybrid work environment, and even though we are, are meeting one another in person, the conversations change. Instead of starting with how is that project doing? They start with, how are you, how's your family, right? And when I meet an employee for the first time at the organization, they say, tell me a little bit about you, and not just you as the employee, but about you as the person. Tell me about your family. And it's amazing how much people will say thank you. You actually cared to ask about my family. And, and that really, that really goes a long way. So when I think about things that, that, that apply for me, but as, uh, you know, other employers and folks in our positions is it's so important that we make sure we're, we're supporting our employees with flexibility, with compassion, uh, really leaning in and listening to our employees. One of the other things that continues to be important, and we talk a lot about Ed Voya, about allyship, but it's also about looking out for your colleagues. And, you know, particularly in environment where you still might have some workers that are working remotely and could be by themselves who's looking out for them the same way you think about within a neighborhood, having a neighbor have an eye on, on their neighbors, we need to do that within the workforce and really leaning in and, you know, making sure that our employees are doing well, that they know that they're in an organization that cares for their whole self. That if they have flexibility, you know, maybe they need to step away and care for a loved one, and they need a little bit of flexibility in terms of how they're, how they're delivering. So to me, I think some of those things are, are so critical. And, and lastly is really making sure that we're helping individuals and their families. We talk a lot about, you know, financial wellbeing and financial confidence, but mental health wellbeing is equally as important. You really can't have one without the other. So we need to continue to show compassion, so empathy, and really be good listeners and, and have our eyes for, you know, where people might be in pain and how we as employers can help them.

Speaker 2: 19:45

And thank you so much for those comments, Heather, you, you really have, uh, led by example on that and, and we've seen that permeate, you know, the world went through so much change and to have people just do those check-ins as people are adjusting to the way the world was throughout the pandemic and even beyond it. Heather, Christine, thank you both again for being here. As, as we all know, it's not easy, uh, to ask you to take some time outta your busy days, but as I mentioned at the start of this discussion, this is a really important topic and one that many employers today are talking more and more about. And as, as the needs of today's workforce grow and expand, this really needs to be addressed. So I'd like to wrap up by asking one final question to both of you and Christine, let's start with you. What advice or insight would you offer employers today when it comes to embracing mental health discussions in the workplace? And, you know, really where can they start?

Speaker 3: 20:35

Yeah, it's interesting. I I share much of Heather's thoughts and philosophy on this. Um, and look, I work in a mental health company, so the, the conversation is a little bit more free on the topic because we are, um, so conditioned to talking about mental health. But one of the things I'd say is kind of going back to where I started, which is really thinking about the whole person. So am I taking care of the physical health of my employees, right? You've got your benefits packages, um, and all the traditional things that you think of, am I taking care of their mental health, right? So that's another part of the whole person, if you will. And then social care or their social environment. And this could include things like you mentioned, Heather, their family system, their support system, what is their environment at home. So really, and this is where healthcare is moving, it's towards whole person care, not treating each of these as three legs of a very different stool. So I would encourage employers to think about this as one package for employees and ensure they've got great partners that they can really measure not only speed and access, but quality.

Speaker 2: 21:41

Heather, what are your thoughts?

Speaker 4: 21:42

Yeah, I'll, I'll build on, uh, a lot of Christina's comments. I think, you know, to summarize some of the things we've talked about throughout this discussion is, as an employer show you care, take the stigma out of it and have the conversations and have your leaders role model the discussions. You know, really starting with the empathy and to the point Christina made about the benefits, really recognizing that the broader benefits package, including investments in your workforce more broadly is gonna, is gonna pay off for you, not only in having a talented workforce as well as the overall success of your organization. So this is one of the things we talk about. It's not only good for society and good for your workforce, but it can be good for your business as well.

Speaker 2: 22:27

Boy, that is so true. And if, just think about even days when you're feeling up and you're having a good day, like how much more productive and it kind of permeates around the office and so on, or even just through virtual calls, but those days you're not, you know, it's tough. And if we can all just check in, it can really, really help, um, people with those tough days. And I, I wanna thank you so much. This has been such an incredible conversation. I think we're gonna have listeners that are really gonna lean in and say, okay, maybe you gave me a bit of a roadmap, something I can start with. So, uh, Christina, Heather, thank you again for this great conversation.

Speaker 3: 23:02

Thank you.

Speaker 4: 23:02

Thanks, bill. Great to be here with you again and with Christina.

Speaker 2: 23:05

Thank you also to our listeners. As always, thank you for joining us today. Stay well.

Speaker 1: 23:10

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