Uber and Lyft disrupted the taxi industry; Instacart disrupted the grocery industry; Airbnb disrupted the hotel industry.
Well-funded tech-based disruptors abound and have changed the face of traditional industries all around us. It’s no wonder entrepreneurs look high and low for opportunities to think differently and be the first to upend new industries and become Silicon Valley’s latest “unicorn.” And it’s no wonder many entrepreneurs look to technology as their first intervention. It’s a tempting prospect – make an up-front investment in technology to empower an engine for an all-important scale and spend heavily to take it to market: one essentially fixed-cost solution that can yield higher and higher margins the more people buy into the dream.
But what if there are some industries in need of a different kind of disruption? Industries in dire need of improvements, but for whom a technology-only solution would move the needle in the wrong direction and lead to worse outcomes?
Mental health is that industry. Well before the pandemic, mental health and substance misuse disorders were sharply on the rise. The stresses of the pandemic and mounting societal traumas have thrown gasoline onto an already raging fire.
The National Alliance for Mental Illness (NAMI) estimates that 21 percent of U.S. adults have a diagnosable mental health issue.
Data from the Centers for Disease Control (CDC) suggested that the number may now be as high as 40 percent.
At a time when the need for mental health providers is at record highs, the wait for new appointments is longer than it’s ever been. According to a 2021 New York Times survey of 1,320 mental health professionals, nearly one in three clinicians said it could take up to three months to get an appointment, and in some cases, they didn’t have room to accept new patients. There is a dire need for access to mental health services.
Many company employees have had an often-underutilized secret weapon for decades to help with this problem: Employee Assistance Programs (EAPs). The term EAP Itself carries baggage and stigma, and in some cases, that’s for a good reason.
EAP, with its genesis in the early 1980s, was a brilliant premise: if employers provide easy access to a knowledgeable, central point of contact that can be consulted for any emotional health or high-sensitivity work-life services need, like legal or financial issues, then employees can efficiently get the care and solutions they need to get their personal lives on track and subsequently “bring their best selves to work.” For the company, the return on investment of this prospect was abundantly clear, resulting in decreases in absenteeism and “presenteeism” (decreased productivity by a distracted employee), as well as a clear decrease in healthcare costs by enabling early intervention on mental health issues before they evolve into or exacerbate physical health issues.
Unfortunately, with the rise of managed care and other market forces, many players in the EAP industry experienced a “race to the bottom” beginning in the 1990s. Entry-level call centers replaced expert clinicians within EAPs, services were outsourced to the lowest bidder, and some health plans even began offering free “tack-on” EAPs as a loss leader to help sell their core insurance products. Instead of reaching experts who truly facilitate provider appointments, these bargain EAPs handed participants a list akin to an insurance directory, leaving them the burden of securing an appointment.
This friction yielded a predictable vicious cycle: frustrated participants abandoned efforts to get the help they needed, company decision-makers took minimal steps to promote a program they weren’t proud of, and EAP became the “forgotten benefit” for many companies. Few die-hard workplace mental health solutions providers held true to the original EAP vision. Sadly, at the same time, many joined the commoditization trend, offering a low-quality, very low-cost product that they counted on being underutilized to eke out a profit margin.
Now, we face record demand for mental health resources, a clear and compelling business case for employers to provide these services to their employees, and a broad field of solutions providers. Most of them have allowed themselves to be gutted over the past two decades. The market is (and has been) ripe for disruption.
“Technology disruptors” now abound in this space. Their central premise is that digital care solutions can solve many emotional health issues, minimizing the need for expensive and hard-to-find expert clinicians. Their efficacy claims are bold but do not stand up to scrutiny in credible peer-reviewed journals. If a mobile app or online portal can be made incredibly elegant and user-friendly, they reason, then people will be compelled to use it regularly and manage their mental health needs in “self-service” ways. And when more severe clinical conditions emerge, self-serve provider booking tools can circumvent the need for expensive human-led assessment, in-the-moment support, and follow-up. These “disruptors” have become household names overnight thanks to venture capital-backed marketing budgets that flood the market with celebrity endorsements and myriad flashy content.
There is another disruptor taking a different approach:
BHS, a 40-year mental health solutions veteran.
Despite market forces commoditizing most competitors in the space, BHS has held firm to its premise that it is humans who heal humans. They believe that every emotional well-being intervention, from sub-clinical to emergent, benefits from the close involvement of an expert clinician who assesses each member, guides them to the proper care, and follows up to ensure no one falls through the cracks.
A 2019 study in JAMA Psychiatry compared the efficacy of various treatment modalities, including group sessions, individual sessions, telephone, and “guided self-help,” meaning self-led tools with support and follow-up by a human clinician. All forms of human-led or even human-guided interventions were between three and five times more efficacious than “unguided self-help,” such as the app-based resources and cCBT modules that some tech disruptors are hoping to convince customers are game-changing innovations.
A January 2022 study synthesizing 14 meta-analyses of 145 randomized control trials looking at mobile phone-based mental health interventions failed to find “convincing evidence” that any app intervention significantly helped with people’s anxiety, depression, smoking or drinking, thoughts of suicide, or feelings of well-being. Scientific consensus agrees that human involvement leads to better outcomes.
BHS has doubled down on this premise with its brand of disruption that uses technology for convenience and support but emphasizes the human connection at every step by launching a product called Guide+Thrive.
Guide+Thrive is a concierge mental health solution that acts as the front door to mental health resources and all other company benefits members can access to improve their health and well-being. Staffed by master’s level clinicians, the solution can be structured with options to completely replace a poor-performing EAP or sit on top of an existing EAP and help companies extract more value from it by ensuring provider appointments are facilitated and that the member is satisfied with the match.
When a company implements Guide+Thrive, a deep culture dive is completed to understand the context within which each member is calling and what resources are available. Guide+Thrive solves the critical access issue by putting members in contact with clinicians – even allowing pre-scheduling meetings with a concierge of their choice via the mobile app. Should further care with an outside provider be warranted, they facilitate the appointment for the member.
Guide+Thrive has disrupted the industry by solving the access problem in a practical, high-quality way that prioritizes human connection at the expense of scalability, not because it will help BHS achieve a billion-dollar valuation, but because this is the evidence-based approach proven to help people in need.
Professional services firms have been early Guide+Thrive adopters, including nearly half of the Am Law 25 firms, for whom the well-being and performance of high-value talent are mission-critical. These organizations understand that the brand of disruption that is of value to them is the one that serves and relieves the burden for members at challenging times rather than running toward a digital “mental health self-checkout lane.”
And the proof that Guide+Thrive works? At a time when the industry average utilization rate of EAP services is 1-3%, Guide+Thrive’s utilization rate across all customers is 13.2%. Our version of disruption drives people to use and re-use our services and tell their peers.
Guide+Thrive is the real disruptor that the mental health industry needs.
Want to put our disruptive solution to work for your company? Contact us today