As an employer, the youth mental health crisis in America is likely affecting your workforce more than you realize. A recent study shows 71 percent of parents said their child’s mental health or emotional wellbeing made it much more difficult to cope with the stresses of work.¹ Considering two out of every five workers are parents with a child under age 18,² youth mental health can have major ramifications for the wellbeing of your employees and the productivity of your business.

Mental health by the numbers:

• The number one condition affecting the health of children and adults across the U.S. is major depressive disorder, according to the recently updated Blue Cross Blue Shield Health Index³
• One in six children has a diagnosable behavioral health condition⁴
• 53 percent of working parents have missed work at least once a month for their children’s mental health⁵
• It is common for there to be a delay of up to 10 years between the onset of mental health symptoms and intervention⁶
• 50 percent of mental health conditions begin before adulthood with 14.5 years being the peak age of onset⁷
• For youths of color who need treatment for major depressive episodes, almost two-thirds don’t receive care, revealing racial disparities in access⁸

According to mental health practitioner and educator Sheila Robinson-Kiss, MSW, LCSW, access to behavioral health services goes hand in hand with job performance. “We lose 550 million workdays every year, not because people can’t come in and do the work, but because they are so overwhelmed by the stress of life and they say, ‘I just don’t have anything else to offer,’” says Robinson-Kiss. She continues, “Additionally, 72 percent of employees want their employer to champion mental health and wellness as a top priority. It is so important that, of that group, 70 percent shared they would be willing to take a cut in pay if it meant having a more consistent, mentally balanced life.” 

With mental health and productivity so entangled, employers simply can’t afford not to talk about this issue.

Stigma in the workplace

Because stigma drives silence, it’s critical to take action to overcome it to help employees and their families get the care they need. Even in the most progressive workplaces, many employees are hesitant to share concerns about mental health. 45 percent of parents affected by their children’s mental health felt they could potentially lose their job and 43 percent felt they wouldn’t be considered for promotions if their child’s mental health concerns interfered with work.⁵ Twenty-three percent of parents felt comfortable talking to an HR representative about a child's mental health; even fewer felt comfortable talking with their supervisor about their child’s mental health.⁹

Employers have an opportunity to address stigma head-on and help set the tone for a workplace where employees feel supported. 

Some steps to consider: 

• Leverage talking points and information on topics such as burnout, caregiving, stigma, and everyday stressors in the Manager’s Handbook and Employee Talk Paths toolkit 
• Remind leadership to be outspoken about your organization’s commitment to battling damaging mental health stigmas
• Allow employees flexibility to address mental health needs and assure them their jobs are safe if they need time off
• Prioritize access and equity – help your workforce find resources in their communities 
• Promote covered care options and other available resources
• Consider programs Blue Cross offers to help destigmatize mental health among youth and encourage employees who are struggling to seek care
• Provide emergency education and resources such as the Suicide and Crisis Lifeline – call or text 988
   

Removing barriers to care

The U.S. average ratio of child and adolescent psychiatrists to children is only 14 per 100,000.¹⁰ 
With 90 percent of children receiving regular medical care from a pedicatrician,¹⁰ primary care is first line of defense in addressing mental health care for adolescents. 

Pediatricians are trained to evaluate and diagnose behavioral health conditions in children. They provide referrals to behavioral health providers and medication management when appropriate. Currently between 70 and 80 percent of youth mental health prescriptions are written by pediatricians and general practitioners.¹¹

Promoting primary care — for youth and adults — is the first step to helping employees get the mental health care their families need. 

Virtual options
Virtual solutions not only offer greater access, but the added convenience and lower cost options are appealing. Many providers – and some of the nation’s school districts – offer virtual appointments with mental health professionals to reach more students.  

Blue Cross and Blue Shield of Minnesota has several virtual care options that are available with certain plans: 

• Learn to Live* is an online cognitive behavioral therapy (CBT) program for and adults and youth ages 13 and older. This program starts with an online assessment to identify conditions such as anxiety or depression, and then virtual courses provide skills and tools to better manage specific conditions. 
• Doctor On Demand^®*  provides online visits for all ages with a licensed psychologist or board-certified psychiatrist using the video feature on a phone, tablet or computer. Mental health professionals are available by appointment to help with depression, social anxiety, addiction, relationship issues, trauma and loss, and workplace stress.
• Employee Assistance Program (EAP) offers online counseling available by appointment for youth ages 13 and older and adults. Confidential, short-term assistance navigating life events and reaching personal goals through a holistic approach that focuses on all aspects of wellbeing. 

Navigation support
Blue Cross offers several programs designed to make navigating the health care system easier for specific conditions. Resources include access to specialists and/or licensed professionals to get members support and treatment that meets their unique needs, such as:

• Autism  
• Eating disorders
• Substance use and opioid addiction
• Peer Support Specialist benefit (Available January 1, 2024)

Awareness and training

As part of our strategy to address the national mental health crisis,¹² Blue Cross and Blue Shield of Minnesota is investing in programs and initiatives to raise awareness in the workplace and the community.

In the local community, Blue Cross has pledged $600,000 over three years to establish the operational structure and advance the growth of the Blue Cross and Blue Shield of Minnesota Center for Rural Behavioral Health at Minnesota State University, Mankato. The partnership will allow the Center to develop and implement best practices for strengthening behavioral health capabilities in non-metropolitan areas, with a focus on research, workforce development and continuing education, and customized training.

Nationally, we’ve joined forces with the Blue Cross Blue Shield Association and other Blue plans to invest more than $10 million over the next four years to combat the youth mental health crisis in the United States. Through this funding, the Boys & Girls Clubs of America (BGCA) will implement trauma-informed behavioral health practices into more than 5,000 clubs and train more than 48,000 BGCA staff members to better support the emotional and mental wellbeing of 3.6 million children.
 

Advancing the conversation

Blue Cross is committed to be part of the solution to the mental health crisis through continued dialogue, education and collaboration. Together, we can bring this often-silent burden into the open and create solutions to get everyone timely access to the high-quality mental health care they need and deserve.

Additional resources

• Suicide and Crisis Lifeline: Call or text 988
• National Alliance on Mental Illness (NAMI): 1-800-950-NAMI (6264) or text “HelpLine” to 62640
• Crisis Text Line: Text “HOME” to 741741
• Veterans Crisis Line: Call 988 then Press 1, chat live, or text 838255