The 2025 EBRI Employer Mental Health Survey is based on a survey of about 400 employers of 500 or more employees conducted in February and March 2025. All respondents had held an employee benefits decision-making role for at least six months. The survey sought to better understand the breadth and depth of the mental health benefits being offered, changes in benefits offered, views of employer responsibilities regarding worker physical and mental health, and perceived challenges and opportunities regarding worker engagement, among other topics. Poor mental health in the work force is widely understood to result in lower productivity, higher turnover, and higher health care costs for employers.
Figure Figure 10 14 Figure 3 Figure 6 Figure 12 To what ext What en t sp do ecif you ic be enliev hanc e em emen ploy ts ers are can you im copro nsid ve ering men ? tal health What mental health benefits does your company currently offer? Do you measure employee satisfaction with any of the following? The Emplo 3. Menta yee Benefit l Health What Re Best Pract ch sallen earch ge Institu ices s do :te is a p Emplo you fa riv yers ce ate, n in wer en on e colle parti courag san, a cting in so nd g me n em onpr d pl ata from th oy ofit ee resea enga eir h rch i ge ealth p nsti men tute b t lans reg ased in ardin g Employers Lack Visi care bilit access y Into Employee Mental Health B and quality without govern enef men itt Use interv ention? 80% Key Findings (Select all that apply) W ashingt pr on actice , D.C., s widely that fo seen as p cuses on h romo ealth, tin wg savin ith acc men ess gs, ret to tal q ireme ualit healt nt y m h , an ben ental h d econo efit ealth s? mic sec care, in urity clud issues. ing acc EBRI d ess to p oes n roviot ders (6 lobby 3 100% October 10, 2025 Quality of men 73% tal health care Access to mental health care Employee Assistance Programs (EAPs): Confidential services offering short-term and does n percent), ot take p tele olhealth icy Overal positio (6 l sati 9 sfns ac per ti. ocent), Th n wie work th hea in lth tegratio c o are f EBRI plann with is made p primary care (47 ossible by p fuerce ndi 37% ng nt), fro crisis m its mem suppor bers t servi and ces (46 72% Prior research has shown that when employees utilize mental health benefits, the correlation with positive counseling, resources, and referrals for mental health issues. 70% Coverage 90% Rates for Mental Health High, Substance Use Disorder Coverage Lags sponsors, wh percent), ich i and nclu de a bro EAPs (60 ad r percent) ange of(Fig publ ur ic and e 8). private organizations. For more information, visit business outcomes like presenteeism and productivity is dr amatic. Another study found employers with complete Therapy anS d ti C g oma uns earoun ling Cod m veraen ge:ta Inls h urea anc lth e coverage for individual or group therapy 43% 62% sessions with licensed mental health professionals. 3 www .ebri.org. This study wasO su veral pp l ex or pe ted rienby ce wi a g th crant arrier from Path Forward. 80% 44% and transparent claims access are much more engaged with improving health quality across a range of areas. 58% The surv 60 Tele % heey f alth Seound rvices: A m ccesental s to virtua he l mealth ntal heacov lth careerage , allowing was employene es to arly connecun t iversal among large employers, with 97 percent of 2025 EBRI Employer Figure Menta 8 l Health Survey 73% with providers from home or other convenient locations. 70% surveyed plans offering mental health services but only 67 percent covering substance use treatment (Figure 2). Lack of awareness Which of availab lof e ben th O efi Oe ts P cfo ost f llo or pr w es in crg iption in drugs formation do you receive from your health 36% 47% Our survey found low rates of employers tracking whether their employees were using mental health care, with Crisis Intervention Services51% : Immediate support options, such as hotlines or on-site crisis 51% 40% counseling for urgent mental health needs. 60% plan/TPA/mental health services provider regarding its mental health The 20 50% 25 EBRI Employer Mental Health Survey is based on a survey of about 400 employers of 500 or more just 22 percent of employers tracking employee utilization data. Said another way, nearly four out of five Endnotes Wellness Programs: Initiatives focused on overall well-being, including stress care services? OOP cost of physical health care 44% Figure 2 em ployers may be missing one of the most impactful tools at their disposal to track the effectiveness of 68%their employees conducted in February and March 2025. All respondents had held an employee benefits decision- 50% management workshops, mindfulness sessions, and resilience training. Complexity of benefits 44% 39% Did any of the health plans cover any of the services listed? me ntal health benefits: clai Access to prms ovide analy rs sis of mental health utilization trends (Figure 5). making role for at least six months.40% The survey sought to better understand the breadth and d63% epth of the mental 40% Mental Health Days: Paid or unpaid leave s pecifically designated for mental health 40% 54% purposes, allowing employees to take time off as needed. O 34% OP cost for mental/behavioral health care 42% 1 health benefits being offered, changes in benefits offered, views of employer responsibilities regarding worker Access to mental health services that address diverse cultural backgrounds and unique employee needs. Telehealth options 69% 30% Workplace Mental Health Training: Programs for managers and employees to raise 30% 48% Limited resources or budget awareness and promote understanding of mental health issues. 33% physical and mental health, and perceived challenges and opportunities regarding worker engagement, among 23% 30% Figure 5 2 Comprehensive coverage 53% Ease of getting an appointment with physical health care provider 60% 100% A financial therapist is a professional 97% who merges mental health pr 19% inciples with financial counseling to help individuals and other Pto eerpi Sucs. pport P Po rogror am mental h s: Initiatives that ealth i connect empl n oth yeee s wwork ith trained fo peerce is widely rs for support understood to result in lower productivity, higher 20% 32% Receives Utilization Data from Health Plan/Third-Party Administrator and sharing experiences related to mental health. couples understand and change their emotional and psychological relationship with money, addressing issues like financial Employee assistance programs (EAPs) 60% turnover, and higher health care costs for employers. Ease of getting an appointment with mental/behavioral health care (TPA)/Mental Health Services Provider 10% Stigma ReductCo ion nfi Cade mpa nign tias li:ty E fc foo rtnc s to erns create an open and supportive environment 7% stress, 20 de %bt, overspending, and communication conflicts. 40% 61% 17% provider around mental health, reducing stigma and encouraging help-seeking behavior. 3% Crisis support 1% 46% 0% 0% Health and Wellness Incentives: Programs that encourage participation in mental health 3 About the Sample 60% Employers with complete and transparent access to claims data can see how their health care spending is being utilized, activities, such La asr g ge e ym m xte embe nt rships, meditaCo tionns clas ide sersa , bl ore e wellx nte esnt s challenges. Moderate extent Slight extent Not at all Quality of physical health care received 80% Preventive services 66% 47% 10% Cultural barriers down to the details of individual procedures, medications, and provider costs. 33% Cultural Competency Resources: Access to mental health services that address diverse 26% cultural backgrou Mo ndsni ators nd u, niqu 22% e employee needs. Integration with primary care 47% The survey sample represents a broad cross section of the U.S. work force. Of employers surveyed, more than Quality of mental/behavioral health care received 68% 67% Employers See Challenges and Opportunities to Lead on Improving Mental Health Benefits Self-Care Resources: Access to tools, apps, or platforms that promote self-care, such as 0% 47% one-half of those sur Cultu vey ral ced om pe described tency themselves as being in 26% blue-collar industries — like construction or utilities guided meditations, mental health assessments, or educational materials. Urgent care Barr for ps iers to yc h ac iat cre yss Additional mental health services Additional substance use services Wellness workshops 24% 0% 10% 20% 30% 40% 50% 60% 70% 80% (10 percent); Long-term Ther ma apy Onu ptions facturin : Coverage g or s(2 upp1 percent) ort for ongoing ment ; or al healt wh h trol eatesa ment le trad for e, transportation, or warehousing (5 percent) — or 60% Wellness programs 33% 65% Eighty-five percent of employers surveyed said that they were interested in enhancing their mental health benefits chronic conditions. frontline industries — like retail trade (10 percent), health care and social assistance (11 percent), or Conclusion (Fig ure 11). But they reported challenges in encouraging their employees to engage with mental health care. Confidentiality and privacy Other (please specify): 45% 0% Employee out-of-pocket costs 27% accommodation or food services (4 percent) (Figure 1). 2. Network Adequacy: Fewer than one-half of employers collected or received information on industry- Utilization data 22% Common ly reported challenges included lack of awareness of 0% 10% avail20 able b % enefits (4 30% 40%7 percent), 50% 60 stig % ma 70 aro % un 80d % Despite nearly universal coverage of mental health benefits (97 percent), data suggest employers would benefit standard network adequacy performance measures like provider-to-enrollee ratios (47 percent), 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% me from greater ntal h 40%ealthvi (4 sibi 3 percent), lity into their confid em entiality co ployee util ncern ization s (4 d0 ata, p percent), articularly cultu to ral b enco arriers urage (33 earlier int percent)erven , and limited tion and more Ongoing training 15% geographic standards (e.g., maximum drive time/travel distance from a beneficiary’s home/workplace) Figure 1 preventative mental health services. They would also benefit from more rigorous accountability systems to ensure resou rces or budget (33 percent) (Figure 12). (44 percent), or appointment waiting times (48 percent). Moreover, only 31 percent of employers 0% 10% 20% 30% 40% 50% 60% 70% 80% Industry their benefits are always meeting the mark. Employers with complete and transparent claims access will have the Figure 13 Figure 4 collected or received information on out-of-network use, even though affordability remains one of the Employers Reluctant to Own Responsibility in Ensuring Fair Prices, Quality – but Ready to Do Despite these challenges, employers also reported they saw opportunities for improvement. Commonly reported best chance of using industry-standard measures to ensure their employees have the most robust and effective What opportunities do you see for improving Which of the following benefits are included in your mental health Accommodation or food services 4% biggest barriers to mental health care access (Figure 7). opportunities included promoting mental health awareness (51 percent), enhancing communication about More mental h 20%ealth benefits. With greater visibility into their benefits, employers will be empowered to ensure the engagement with mental health benefits? benefits or coverage? Administrative or support services 0% availabl e services (47 percent), and training managers for mental health support (46 percent) (Figure 13). roughly 165 million people in the United States with employer-based insurance can live their happiest, most 80% Agriculture, forestry, fishing, hunting, or mining 0% Fewer th productiv an 1 e li Enhve 0 anc percent s. ed commuof nic emplo ation abouyers b t availabelieve th le services ey should be responsible for ensuring fair prices and 47% quality of 75% Figure 7 A majority of employers surveyed also reported actively considering adding clinical services to their mental mental health care (Figure 9). Rather, they believe federal or state governments and insurance companies should Arts, entertainment, or recreation 1% Do you collect or receive the following information Training for managers on mental health 46% health benefits, like urgent care for psychiatry (51 percent), additional mental health services (73 percent), and ul timately 70% be responsible. But an overwhelming majorit y of employers believe they can, to a large or considerable 0% Construction orw utiith lities respect to access? 10% Does Not Monitor, 78% Mental health care services Substance use treatment additional substance use service (51 percent) (Figure 14). extent, improve mental health care access (78 percent) and quality (70 percent), even without government Data and Methods Incentives for using mental health services 42% Educational services (academic institutions/universities) 4% 62% intervention (Figure 10) Provider-to-enrollee ratios 47% Figure 11 60% Finance, insurance, or real estate 6% Promote mental health awareness 51% Information for this report was collected from a 15-minute online survey of 410 full-time benefits decision Are you interested in enhancing your mental health benefits? Figure 9 Health care or social assistance (hospitals, non-insurance health 11% makers conducted in February G and eograph M icarch 2 standards 025. 44% services) Who do you think should be responsible for ensuring fair prices and Peer support groups 37% Information (including publishing, tele No co, mm 15% unications, 16% 50% quality of mental health care? Mental Health broa Coverag dcasting, and e inf Str ormat ong in Some ion technology) Areas, Weak in Others Percentage of providers accepting new patients 58% All respondents were in Lower out-of-po an cket em costs pl fooy r em ee benefit ployees s decision-making role for at least six months and working at 39% Management of companies and enterprises 0% organizations with 500 or more employees. Respondents were required to: Employers Use Accountability Systems, but Gaps Remain Employers 9% Coverage for some clinical services was Mamod nufactur estly ing high, such as telehealth (73 percent) and counseling and 21% Percentage of providers seeing patients Mo on f bi ul le l-ti ap mp e b s asis 58% 33% 40% therapy (62 percent). Others were covered by fewer than half of employers surveyed, e.g., ongoing treatment for Professional, scientific, or technical services 6% • Offer health insurance to active employees. The gold standard for employer measurement of quality and access is performance measures based on complete Insurance companies Address confidentiality concerns 1 28% 31% Network adequacy and participation for psychiatrists 58% chronic conditions (33 percent) and culturally competent care (26 percent). These approaches are widely seen as and transparent claims data. But emplo Public ad ye mi rs can also nistration tr1% ack performance measures developed from other data 30% highly effective when provided by qualified professionals (Figure 3). sources . Ou • r su Offer mental h rvey found Eealth nc a mod ourag care s e wo erate rk-lervices i n fe umb balancer e or su of em bstan ploy ce use treatmen ers are collecting t th ro thugh ese sort the he ofalth d 40% ata. pl an. Retail trade Advocacy groups 2% 10% Network adequacy and participation for psychologists 57% Waste management or remediation services 0% Employee assistance programs (EAPs) 46% Many employers provide mental health support that goes beyond traditional medical coverage. Not only were the • Have at least moderate influence on their company’s mental health benefits program and selection 1. Employee Satisfaction: A majority of employers were tracking and measuring relevant employee 20% NetwoCo rk ade nsum qua er cgroup y and p s articipation for master's-level providers 37% 6% Wholesale trade, transportation, or warehousing 5% tradi tional satisfactio wellbein of ment n al h g with prog ealth o reg ram ard f s lik fering toe ee ase smp . o lo f g yee assista etting a me nce nt al/beh program avio s (ral EAPs health ) (7 care 2 percent appoi ) an ntme d we nt (6 lln0 ess percent), program and s (5 4 Integration of mental health with other well-being initiatives 28% quality of mental health care rece Other, pleaiv se s ed ( peci6 fy8 percent). 3% A smaller number were tracking and measuring percent ) offered by a number o Wf emplo ait times foyers, r appointh tme ey ntswere also providing more novel offerings, in 48%cluding financial My state government 24% 2 10% • Hold Integ an ex ration ofecutiv mental he e, o alth wi fficer th pr, o imar manager p ry care osition in the areas of h 26% uman resources, compensation, or employee satisfaction with out-of-pocket costs for mental health care (42 percent), even though therapists (62 percent) and mindfulness apps (74 percent) (Figure 4). 0% 5% 10% 15% 20% 25% af fofin rdabili ance. ty remains o Use one o f out-of- f th netwo e bi rk pr gg ov est iderbarriers to s mental health care access (Fig 31% ure 6). The federal government 30% 2% Other, please specify: 0% 0% 0% 10% 20% 30% 40% 50% 60% 70% Yes, 85% • Not be an 0% insurance/benefits b 5% roker 10% , agent, or 15 con % sultant. 20% 25% 30% 35% 0% 10% 20% 30% 40% 50% 60% Financial therapist Meditation or mindfulness apps Other, please specify © 2025, Employee Benefit Research Institute, 901 D St. SW, Suite 802, Washington, DC 20024, 202/659-0670 | ebri.org 10 5 4 6 2 9 8 7 3