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New Survey: Mental Health Benefits Are Nearly Universal. But Are They Working?

WASHINGTON, DC, Oct. 14, 2025 (GLOBE NEWSWIRE) -- Nearly all large employers (97%) now offer mental health coverage, and a growing majority (67%) include substance use disorder treatment, marking clear signs of progress in addressing employee wellbeing. But a new national survey finds that the next challenge is accountability. Fewer than half of employers are measuring whether these benefits are delivering timely, effective care.

The 2025 Employee Benefit Research Institute (EBRI) Employer Survey suggests that while a good number of employers now cover mental health care, the majority lack visibility into whether their benefits are used, if their networks are accessible, or if plans are delivering value to their employees. Poor mental health in the work force is widely understood to result in lower productivity, higher turnover, and higher health care costs for employers.

The findings follow EBRI’s 2025 Employee Mental Health Survey, which found that employees reporting mental health conditions are twice as likely as those without to report unmet mental health care needs, a stark reminder that even those with employer-sponsored insurance struggle to get effective mental health care. 

More than half of employers surveyed came from blue-collar and frontline industries like manufacturing, food service, or retail. Five years after the start of the COVID-19 pandemic, amidst today’s economic uncertainty, these heartland sectors remain under strain. This status check on mental health benefits provides an important barometer of employer practices that can have an outsized influence on the wellbeing of workers and communities nationwide.

Specific findings from the survey of healthcare benefit decision makers indicate:

  • Employee Utilization Tracking Remains Rare: Just 22% of employers monitor whether employees are actively using their behavioral health benefits despite research showing that active utilization of benefits is correlated far more closely than just access to higher productivity and better business outcomes.
  • Coverage is Mixed: Coverage for some clinical services is modestly high, such as telehealth (73 %) and counseling and therapy (62%). Other services were covered by fewer than half of employers surveyed, like ongoing treatment for chronic conditions (33 %) and culturally competent care (26%). All of these approaches are widely seen as highly effective when provided by qualified professionals, especially when paired with ongoing measurement of outcomes.
  • Substance Use Treatment Coverage Lags, especially in Telehealth: Nearly all large employers (97%) now offer mental health coverage, and a growing majority (67%) include substance use disorder treatment. While 96% of employer plans likewise offer virtual access for mental health care, only 58% offer telehealth for substance use services, signaling an area for improvement.
  • Employers Are Missing the Opportunity to Track Network Adequacy: Fewer than one-half of employers collect or receive information from their health plan vendors on industry-standard network adequacy performance measures like provider-to-enrollee ratios (47%), geographic standards (e.g., maximum drive time/travel distance from a beneficiary’s home/workplace) (44%), or appointment waiting times (48%). Moreover, only 31% of employers collect or receive information on out-of-network use, even though affordability remains one of the biggest barriers to mental health care access.

“Complete and transparent access to claims data enables employers to design benefit programs that truly meet the needs of their employees and their families,” said Margaret Faso, policy director with the National Alliance of Healthcare Purchaser Coalitions. “This study reinforces the importance for employers to continue efforts to achieve transparency to better support the health and wellbeing needs of their workforce.”

The National Alliance of Healthcare Purchaser Coalitions recently released a study that showed employers with complete and transparent claims access are much more engaged with improving health quality across a range of areas.

Together, the surveys make a compelling case for employers to be more proactive in ensuring their benefits are effective in treating workers’ mental health needs.

“Our survey revealed meaningful positives – like the widespread availability of mental health coverage and ongoing use of telehealth,” said Paul Fronstin, the director of health benefits research at the Employee Benefit Research Institute. “The data also suggest large employers can play a much greater role in encouraging accountability systems that achieve timely, cost-effective, high-quality care.”

Information for the 2025 EBRI Employer Mental Health Survey was collected from a 15-minute online survey of 410 full-time benefits decision makers conducted in February and March 2025.

Roughly 165 million Americans rely on employer-based insurance.

For more information or to request an interview, contact:
Juliana Keeping
Director of External Affairs, Path Forward Coalition
juliana@pathforwardcoalition.org
(202) 743-5536

About

The Employee Benefit Research Institute (EBRI)  is a non-profit, independent and unbiased resource organization that provides the most authoritative and objective information about critical issues relating to employee benefit programs in the United States. The organization also coordinates activities for the Center for Research on Health Benefits Innovation, Financial Wellbeing Research Center, Retirement Security Research Center and produces a variety of leading industry surveys during the year.

The National Alliance of Healthcare Purchaser Coalitions (National Alliance) is a nonprofit, whose members represent public and private sectors, nonprofits, and labor unions that provide health benefits to over 90 million Americans—more than half of the employer-sponsored insurance market—spending over $850 billion annually.

Path Forward is a coalition of health care purchasers, clinician associations, health systems, philanthropists, and health-related nonprofits united by one goal: ensuring equitable access to quality mental health and substance use care.

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Juliana Keeping
Path Forward
202-743-5536
juliana@pathforwardcoalition.org
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