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How can we remove the largest barrier to behavioral care in the workplace?

katherine switz
Moderator

founder
@the stability network

jacqui brady

director of hr
@general assembly

julia bernstein

vp strategy & development
@beacon health options

kelsey meyer

ceo
@influence & co

andrew sekel, phd

managing partner
@marketplace funds

Katherine Switz:
Hi, good afternoon. Thanks for joining us. I know this is the hard time, after lunch, so we’ll keep you energized, and engaged. It’s great to be here for this opening access panel. What I thought we’d do first, is just let each of our panelists say a quick word about who they are, and what brought them there. Then, we’ll just do about 40 minutes of moderated discussion. Then, of course, leave time for Q and A. Let me ask you Kelsey, to start.

Kelsey Meyer:
Great, my name is Kelsey Meyer. I am the cofounder of a marketing company called Influence and Co. And, I think I’m here because about a year ago, our company implemented a mental health policy for the first time. We wrote an article on Harvard Business Review, kind of documenting our experience, and what we learned, that other companies could learn from.

Katherine Switz:
Andy?

Andy Sekel:
Hi, I’m Andy Sekel, trained as a clinical psychologist. I practiced for about 15 years, became an entrepreneur, and started three healthcare companies that I sold to fortune 500 companies. After a number of different things, wound up at United, and was the CEO of United Behavioral Health or Optum Health, as it’s known now, and covering 50 million people in the United States.

Jacqui Brady:
Hi, I’m Jacqui Brady, I’m director of HR at General Assembling. We’re a global training company looking to close the 21st century skill gap. Partnering with tons of global corporations, in order to help upskill their talent, and I’m here because we’re pretty lucky not to have a ton of stigma within our environment. And part of that, is from a really early stage, we implemented a lot of resources around behavioral health for our staff.

Katherine Switz:
Before I start with the first question, I just wanted to say that I live with Bipolar One disorder and was at GE and McKenzie in a series of non-profit roles, really trying to balance this question of, how do I access care? How do I get the right level of care, the right type of care? I think Andrew mentioned this morning, the difficulty of getting away for a weekly therapist appointment. Different difficulties in getting other kinds of accommodations, so bring that to the panel, as well.

But let me just start with Andy. Tell us your thoughts about access, and what you think the biggest challenges are?

Andy Sekel:
Sure. We talk, I’ve heard a number of different times, the notion that only 3% of people, that have an EAP benefit access care, but I don’t think we’ve talked very much about, why is it 3% instead of 15%, or 12%? And I think it’s both the companies, that don’t sufficiently promote. That don’t really kind of demonstrate inside of their culture that they want people to use the EAP, or the mental health benefit. Some of the companies I’ve worked with as an advisor now, we promote mental health capabilities once a quarter in the companies and really try to do a marketing program that starts chipping away at stigma, and lets people know that the benefit is there and there for them to use.

I think the other part of it is us as providers. You know, we’re the only part of the health care system that still practices like we were in 1890s. We want people to come to us … I’m not talking about digital, I’m talking about traditional. We want people to show up at our office, we want them to stay for 50 minutes, whether they need to or not. And we want them to do it weekly. And there’s no other part of healthcare that still practices of the mode of the 1890s. And I think the issue is that it makes it very difficult. Most people can’t wait for two to three weeks. We all know as clinicians that the time to see someone is when they are in crisis, and the face that we postpone that and then are not very customer friendly makes it difficult for people to have good access.

I think digital behavioral health care companies are breaking that down in a way that’s really effective that actually focuses on the customer. And some of our customers, the people who work on campus-based companies, it’s just impossible for them to leave on a regular scheduled basis. So, I’ve talked to Warren about this … My prediction is if we come back here and sit in this auditorium 10 yeas from now, that half of outpatient digital, half of outpatient mental health services will be digital versus office based.

Katherine Switz:
I think it serves an interesting question about whether uptake is limited because people don’t have exposure once they have access to the technology, like Talkspace, I assume, the uptake then is much higher because there is such a hunger for it.

Andy Sekel:
Yeah, I think the statistics you saw that [Orem 00:05:00] presented earlier … About the number of people who stay in care, they get care quickly, that have effective outcomes, is because, partly because of the immediacy of it. And then we all know we don’t learn in 50 minute segments once a week. We learn new skills by small, incremental pieces. And so I think the way Talkspace and other digital companies break down that structure, that literally is the same in the 1890s, is why it’s become so effective.

Katherine Switz:
And I think that issue of stigma and of convenience, how you get away for that appointment, and of course cost at some level as well. Is there anything, Kelsey or Jacqui, you want to that as we think about some of the barriers to people accessing care?

Kelsey Meyer:
I think that stigma in my organization was definitely the biggest one. And we say that because as soon as we started having conversations and kind of breaking down that stigma, people started coming up. And it started with … We were at a company retreat and we did … I don’t know if anyone here has ever done this exercise? It’s called a lifeline exercise, but you plot highs and lows from your own life on a chart, and then present it to the group.

And I did this with my own life, and presented to the group the history of mental illness in my family, and just talked very open about it, as if I was speaking about someone in my family having cancer, breaking their bones a lot. And after that, about 10 people from our 70-person company came up to me and said, “I’m really glad you brought that up because there has been something I’ve been scared to talk about.” And just me being open about that immediately broke down those barriers. So I think that stigma really is a huge part of it.

Jacqui Brady:
The stigma doesn’t come up as much in my organization, I think part of that is because our average age is 30. And our CEO is pretty open about it, and about the support he needs as a founder and a first-time CEO, which is very supportive for our organization. When we were a company of under 50, we put into place a telehealth or a teledoc option for staff, so that they can … You know, they don’t have to physically leave the office or leave their apartment. So, even if they’re sick and too sick to get to a doctor, they can have that conversation or get a prescription from home.

And people love it. It is something that we touch upon in new-hire onboarding, and talk about some of the use cases for it, including behavioral health. We just switched to Doctor on Demand two months ago. Within the first month 25% of our population enrolled, and half them have engaged in the service more than once. So it’s just really exciting to see that data, as like a baseline to start out and then figure out how it can continue to grow it.

Katherine Switz:
That’s great. And there are other areas that you’re focused on as well, just besides just Doctor on Demand. Do you want to just talk about the whole suite of offerings that you have at this point?

Jacqui Brady:
Sure. So, it’s kid of two-fold within GI. On our consumers side business we have students who take full-time classes with us, so we want to think about their wellness, their mental health as well. So, we have a company called Ginger io, very similar texting you can … Students love it. They love to have that support, particularly because oftentimes students don’t have access to healthcare. If they’ve left their job to work with us for 10-12 weeks in order to upscale or pivot their careers. I would say on top of really rich medical suite of benefits, thinking about how both in-network and out-of-network is covered.

We also have our gym stipends. We’ll cover things like flu shots. Kind of your traditional stuff. But really our goal is to empower staff to talk about what they want and what they’re looking for. So in our New York office we have yoga twice a week. We have individuals who lead their own medication on a daily basis. And they just reserve a room and do it on their own. So, it’s not necessarily about the HR team implementing everything. It’s about empowering our staff to talk about what they want and what would help them be a more productive employee.

Katherine Switz:
I think it’s amazing the whole message that you send with all of those offerings. It seems like you create an environment where people feel that they can access services. That they can ask for services. Do you just want to talk a little bit about the culture that you feel you’ve created through all of this.

Jacqui Brady:
Sure. Again, it’s a really flexible work environment. It’s honestly not uncommon for someone to reach out to their manager and say, “Hey, we like push back our one-on-one because I have a meeting with my therapist tomorrow morning, and I’ll be in after.”

So we’re lucky in that sense. It’s also … I forgot what I was gonna say. Not only is the value, the business value in General Assembly is to really focus on our talent, but we have to make sure that we do that internally as well, so we really have to practice what we preach.

Katherine Switz:
And Kelsey, are some of the things Jacqui talked about things of your plan? Or how does your approach differ?

Kelsey Meyer:
Absolutely. A lot of similar things in our plan, but one thing I think about the implementation of the plan that’s really important to remember is thinking about how you roll this out. Because at first, honesty, my gut was … Okay we put this great mental health policy together that we had a mental health consultant and a woman that had bipolar disorder come in and help us create it, so that we could get her perspective. But my first gut was okay, let’s just send an email out to the team. And the woman who runs our HR said, “You know what, I don’t think this is an ’email the team’ type of thing.”

She really coached me in a different direction, and said we need to have a whole team meeting and talk about why we’re doing this and really, have you explaining to the team that we want them to take advantage of this policy. That it’s not just a policy that we put in our handbooks, that we can say check mark, we have it. But really talk about it.

So we had about a half-day mental health workshop and we talked through the policy. We had this woman, [Sara Jo Cofferd 00:11:06], talk and tell her story. And we really just kind of explained the why behind it and talked the team through how they could take advantage of the different things in the policy. And I think that was really, really important to not just having the policy, but how you roll it out.

Katherine Switz:
And do you feel that that effected utilization? That people are using the services more because of that environment?

Kelsey Meyer:
Absolutely. And another thing that I’ll just touch on that we did, before we had that workshop was went through a training with all our managers. Because what I was nervous about is, in this policy we say that if you need a reasonable accommodation for a mental illness that you are struggling with, reach out to HR or your direct support, if that’s the person you have a closer relationship with.

And I got nervous that well, what if they reach out to their manager and here she doesn’t know what to do? So we first went through training with our managers, talked to them about … Here’s what you can say. Here is what you’re not responsible for. So, don’t try to take all of this on you, and here’s all the resources that we have. And we also have a very young team, so a lot of new managers. And I think that was really important. To make sure that they felt well equipped. That they could direct people on their team towards the right resources.

Katherine Switz:
That’s great. Now Andy, do you want to add to either of those?

Andy Sekel:
Yeah, well, I think in addition on the provider’s side we have to be able to assure the clients we search that we are providing evidence-based care. I think we need to move away from the notion that psychotherapy is a science and an art, and be much more focused on the science. I think part of the barrier is sometimes people hear about things that psychotherapists occasionally do that are “novel approaches,” but are not evidence-based, and they are reluctant to engage with individuals like that.

So, I think to the extent that we can move more and more to evidence-based practice and coach people in evidence-based practice so that they get the best results with their patients. I think that will also reduce the barriers for people accessing care.

Katherine Switz:
And it seems again it’s like again this question of are people not accessing it because it’s not available, or once it’s available, are they not utilizing it? And it just is exciting and inspiring to hear you guys talk about these programs and policies and approaches that you put in place. That you are seeing positive impact. The question I get all the time from companies is … Okay, we’re a company, what should we do? We want to improve “workplace mental health,” what do we do? I don’t know if each of you could just give the three bullets that you would tell a CEO on that.

Kelsey Meyer:
Yeah. The first I would say is create the mental health policy, and have an actual documented policy, so that when someone first comes to HR or a manager on a team, it’s not a shock, we don’t know what to do with this. Because that’s not going to make a person feel supported. But it’s a … Great. Here’s the plan we have. Here’s how we can help you. And then the second thing is to remember that there are a lot of small things that you can do that can make a big impact on your employees’ mental health.

A really easy example is once we rolled out this policy, we had a woman on our team who came to me and she said, “Hey. I don’t want to get into all of the details, but I suffer from PTSD, and I can’t sit with my back to the door. It’s a trigger for me, and it’s really unhealthy for me.” She said, “We just did a desk draft,” … We do once a quarter where we choose names out of a hat and choose where to sit … “So we just did a desk draft and I’m seated with my back behind the door. Can we change it?”

I said, absolutely. And from now on, you’re going to get one of the first slots in desk draft to make sure that you get the spot that you want. That was so simple, but I think that if we wouldn’t have had this policy in place, where we said we had these reasonable accommodations, she might have just been nervous of how to bring that up. So I think remember that it’s not always huge things that you have to do. It can be very simple.

Katherine Switz:
But having created that environment where she was willing to say something is so powerful. That’s amazing.

Andy Sekel:
I think it’s really important if you’re going to change culture, especially in larger companies to continue to promote the kind of activities you’re talking about. To have senior management talk about the value of people getting help. To even share stories about having a friend or knowing someone that has gotten help and how effective help can be. I think assurance that people are going to have access to a network where they get evidence-based care is important. And I think especially when you think about companies up in this area that often operate off of large campuses, no matter how many therapists are seven, eight minutes away, it doesn’t really matter.

Because in those companies, you can’t just walk out typically during the middle of the day. So, having multiple ways you can access care, whether that’s digital, whether that’s video, where that’s AI, whether it’s in person makes a huge difference and allows people to make choices, just like we make choices about all sorts of other things in our life. We might go to Target and buy something, we might to Amazon and buy something. We have those choices.

And to be able to access care within the number of different choices makes a huge difference in terms of not only reducing stigma, but increasing access. Access is a structural problem. And part of it is we as therapists, as clinicians, have created that. Not on purpose, the world has changed, it doesn’t operate like the late 1800s or early 1900s. People don’t work in the same way. Travel inside of cities is not that easy. So, we have to adapt in order to be successful. And I think in that adaptation we can offer some really interesting things like Talkspace, like other digital companies, and really have a positive impact on people that are suffering, but are reluctant to get help in the traditional models that are available to most of them.

Jacqui Brady:
I’d probably take a step back from what Kelsey talked about and say first you need to talk to your employees. I think we think we know what they want, but we really have no idea. So, talk to them. If that’s the type of open culture to have that conversation in a really large setting. Maybe you have to start it really small, and start it with one individual who you know may be really comfortable having that type of conversation.

They can encourage others to come to HR, their managers to talk about it, and then you can start in smaller groups and try to brainstorm what people are looking for. And then, test a couple of things out. Just because something doesn’t work, that doesn’t mean that people don’t’ want it. I may have just been poor execution on rolling something out. The other approach that we’ve taken internally with HR, not just when it comes to wellness, but with everything, because we’re such a lean team and having been a startup and cool in the text space we didn’t want to throw policies down people’s throats and have waited quite a long time to formalize things. But really we just approach everything with the mindset of plan and build for the 99% of people who are looking to do the right thing.

There’s always that one person who’s gonna do what they’re gonna do, and just treat that individual like a one-off, but don’t create something with that intent. So when we’re thinking about supporting our staff and someone brings up a concern that they have or an accommodation that they need, whether or not it would be a formalized medical accommodation, it’s what is the right thing to do for this person. Like as a human, how can I be really empathetic? Which, is one of our work values. And how can I just make this a better situation for them, which in turn is a better situation for the team and the broader organization.

Katherine Switz:
That’s great. And I think that’s such a amazing starting point to then build that culture, have that communication, open discussion. And it seems like form your perspectives, what to do is somewhat clearer than the question, “How do we incentivize more companies?” We were talking earlier about you start with small and mid-size companies and then ideally grow into some of the larger companies over time. But how would you make the case to a CEO considering whether the should adopt a new policy or listen deeply to their employees?

Kelsey Meyer:
Yeah, that’s kind of hard for me to answer, because I think similar to what Jacqui said, my mind just goes to … Well, these are people. Treat them with respect and treat them with empathy and that would naturally lead you to creating a policy like this. But, if other people, that’s not what would cause them to take action, then I think that … When she spoke this morning … When [Lori 00:20:00] spoke this morning, she made a great business case. She talked about the money that is lost to absenteeism. She talked about the money that is slot to people having to pay more for health insurance premiums. So, I think that can be the other case, is the financial case.

Andy Sekel:
I think about it in the comment Seth made earlier today and that companies look at data. And they say well, this another year where EAP, which is a part, but not all of behavioral health benefits, is again at 3%. Or behavioral health part on the medical side was 7% and we know that probably, 15 or 20% of our population should have accessed it. And kind of my response it … You know, we’re continuing to do the same thing.

And we’re not gonna get a different result. And so I used to have several customers of Fortune 100 companies in this area, and we’d have these annual meetings where we’d talk about these percentages, and it doesn’t change … I used to then get more people on a network within five minutes driving time to these campuses, and the next year we’d come back and then nothing had changed. And the answer is, it isn’t about that. It’s about the structure.

And so my response to larger companies is, if you want it to be different, let us innovate. Let us do some things differently, so that you can get the result that you want. Coming back after two decades of kind of beating the same drum that we’re not getting the results that we want, and then demanding a structure that’s exactly like the one ht previous 19 years, it probably isn’t gonna change. So, it’s possible to change it and these digital companies are demonstrations of that possibility. But unless we embed them in companies, in their benefits, and learn how to adapt the benefits to cover this intervention, then we’re just going to have this discussion over and over again.

And the frustration isn’t that we’re having the same conversation, the frustration is that there are people in need that aren’t getting care. In smaller companies it’s easier to sit down and have those discussions. When you have 20, 30, 40 thousand employees and they’re all over the United States and in other parts of the world, these discussions become more difficult. And so if you want it, my salutation to large companies, if you want to change, then we have to collaborate to bring a different kind of system into place.

Katherine Switz:
That makes sense. And the with that change, with that new system, you’ll see the results that people are looking for, but aren’t saying that they have. And I think so interesting as well there’s the payer roll. I mean there’s the corporate roll, but I just want to make sure I’m drawing sort of the unique role that the payer can play as well, where that sort of power lies in that relationship.

Andy Sekel:
Well, large companies, like Fortune 100 companies, are self insured. And so they dictate to how people think about payers what they want. So I’ve worked at United Healthcare, I’ve worked at Optum, and we were restricted, or mandated by those large companies by how they wanted to use their benefit dollars. And so the payer is an administrator.

The payer plays claims, and those a lot of … You can think about it as back office things, but the payer doesn’t actually build the structure of the benefit. Each company builds its structure. So, if you have the opportunity, build. And this is what happened to organizations like Teledoc and all the telehealth companies, is eventually large employers said, we want them. And then payers included them. But it really, the customer is really the company, and the payer is the administrator in most cases.

Jacqui Brady:
So, having a telehealth option really early on helped give us the ability two years ago to move from a fully insured to a self insured plan, which for our population and our demographic made a lot of sense economically. When we implemented a new telehealth option in earlier this year, the intent and the pitch to our CFO, was for individuals on our healthcare coverage and their dependents, they should be able to leverage this at no cost to them. So it is an individual’s economic advantage to go to this telehealth option first. We then pay, because it’s not a PEPM, it’s per usage. And then that claim is also not hitting our health insurance. So there’s an extra dividend ROI there, which I mean for any CFO is a pretty quick to get an, “Okay, keep going.”

Andy Sekel:
Yeah, and those kinds of interventions, especially telehealth, reduce emergency rooms and urgent clinic visits, which are incredibly expensive. So the most expensive way you can get healthcare in this country is to show up at an emergency room. The second most expensive way is to show up at an urgent care clinic. And so when you have that kind of capability, it really does pay for itself. And that’s what companies finally started realizing. Why these telehealth companies have taken off.

Because they save a lot of money, they save a lot of inappropriate access to emergency rooms. And it’s not just about health. If you’re a patient in mental health system and you have a crisis in the middle of the night, and it’s really a bad enough crisis, chances are you’re gonna wind up in an emergency room. And an emergency room is either going to send you to the psychiatric hospital or medicate you or dig up your therapist or do something that just keeps this revolving door going.

Or, you could get on Talkspace and text and have an interaction with someone and say, “I have an urgent need,” and actually get a response about how to start managing it. And so these interventions, these innovations like in a lot of places, once they’ve proven out, tend to really save a lot of money.

Katherine Switz:
So we’ve talked about the why, the case for why an executive or someone would implement a new mental health policy. We’ve talked about the what. Any final guidance you have for the group before we go to Q and A about how the process has gone? I know your HR article is very much on the process, and you’ve shared that already today. But if there’s anything else, I just want to give you a chance to make any final remarks. Any of you before we move to Q and A.

Kelsey Meyer:
My final would just be constant reminders. I think you kind of alluded to this earlier, that it can’t just be a one email, or even for us one meeting, but this is something that is brought up with every single new employee through their onboarding, and then four items a year at our quarterly all staff meetings. We bring up some exercise, something that has to do with mental health, and then remind people of the resources that we have.

Katherine Switz:
Great.

Andy Sekel:
If you’re here as a Talkspace therapist, you’re on the cutting edge. You’re changing the 50-minute, 1890s model in a way that’s really productive. The reason I think you get good results is because you have frequency of contact, and even if it’s very brief. And I hope you view yourself as a pioneer in the process of changing the mental health system to be much more responsive to the individuals that it tries to serve and ignores fewer individuals because of structure.

Jacqui Brady:
You’re certainly going to have advocates internally for whatever policies or resources you put together. You need find them and you need to encourage them to tell this story. It’s not just about me talking about it, it’s not just about our CEO talking about it, although that helps.

It’s having those individuals that are really high performers, those future leaders of your teams and organizations, the other piece that I’d add is oftentimes thinking about these policies and putting together a practice or a plan of action, it needs to happen before a situation comes up. And luckily, we’ve had a couple of things come up in the past few years, but we’ve already been a little bit of a step ahead of it.

And because of that everyone can kind of exhale, and feel okay about it. But the thought of not having a practice or a policy or some type of support or really thoughtfulness about supporting a staff member … We’ve been a little ahead of the game, and I’m thankful for that, given my position.

Katherine Switz:
And I think my take away from this, which is not what I expected, which is the importance of culture, and listening, and working collaboratively with a group of people, reminding people over time. I think that is such a powerful message for all of us, in whatever small ecosystem we’re in, or a large company. So I think that is just a great point for all of us to remember. So, let’s open it up to Q and A. And I think there’s some microphones, if people have questions.

Audience Member:
Hi, thank you all for speaking with us today. My question si related to this idea of digital health solutions and access, but then going a step beyond access, to also insuring quality. So, I think it’s clear form the conversation that we’re having right now is that digital health solutions are undoubtedly the key to opening up access to behavioral healthcare. But, my question is, how do each of you think about assessing the value of using different digital health solutions? Be that telehealth, online CBT, or other forms of digital technologies to insure quality along with that access.

Katherine Switz:
You want to start with that?

Andy Sekel:
Sure. So, I’m involved with several digital healthcare companies. And I encourage them to do exactly what Talkspace has done, which is do outcome research, and to do it vigorously and to have outside people do that research, and to really collect data, and look at that data to kind of continue to drive improvement. I think we’re gonna get closer and closer to understanding what is the better match between a therapist and an individual that needs help. We’re going to have a better understanding for each therapist. What are they really good at? I practiced for a long time.

I was really good at some things, and I was not that good at some other things. And when I got a little bit older, then starting, I started referring the people that I wasn’t as good at treating. And I think the data that we’re collecting … See, the thing that fascinated me when I met Orin, which was totally different than what he was talking about … Was I said … You know, for the very first time, we’ve opened the box, which was psychotherapy that was always people reporting about what happened, not actually a record of what happened. You might have been in a training facility where someone observed you or it got taped, but it was really rare. So the ability to analyze that data and really understand what helps people get better is I think an incredible gift. And then I think to get to your question directly, I think some people do very good with AI. So they can take courses or work on behavioral therapy or work on a platform that doesn’t have people involved with it and do fine.

Some people need interaction, but prefer texts instead of going to someone’s office. Some people prefer texts, but occasionally would like to see who their therapist … So, I think there’s a continuum of things, and I think if we’re really, really sensitive to understanding what clients want and how they learn, we each have a learning style that’s different. And if we can tease that out and find out what is the best environment that you lean in and get healing, and who are the best people who provide that, and that is data based, and we can make those matches. I think we’ll move the field in a great way. And I think for the first time … I mean, think about this. Since the 1890s, we’ve talked about what happens in therapy sessions. Now we know what happens in therapy sessions, and we have the tools to analyze using natural language protocols. What really happens and what the implications are.

I mean it’s really going to change this whole system and the whole way we provide care in a pretty radical place, and when I said … You guys are at the frontier of it, I mean we really are at the beginning of that process. I mean, we’re 3,4, 5 years into these digital companies accessing that kind of data. And what happens is you know it’s slow, it’s slow, it’s slow, and then you accumulate enough data and you start getting insights and then it tips. And you get lots of insights.

And there’s enough research behind all of these companies by external researchers connected to universities that I think we’re going to hit that tipping point pretty quickly. And I’m gonna make the prediction again, 10 years, come back, half of the mental health outpatient services are not gonna be in an office.

Katherine Switz:
Jacqui, did you want to add to that?

Jacqui Brady:
In addition to collecting that data to know what you’re doing is effective. You need to make sure that people want to continue leveraging the resources you’re providing. NPS is something that General Assembly as a business takes to heart, and we live and breathe by it.

So when we’re looking for partners, we’re making sure they have an NPS and something super similar. And we have access to that feedback in real time, again in addition to individuals on your staff reaching out and saying, this was amazing, I’m so excited we have this. Or, there is the occasional, hey this didn’t meet my expectations.

And then if they’re willing to work with you on it, we can find them other resources, whether that may be someone in house that my have an expertise in how to navigate something or leveraging a broker or something like that. So, keeping the dialogue open, you want to make sure that you have that NPS as well, or at least something so that you know that’s effective and people … they’re happy with what you’re providing.

Katherine Switz:
Did you want to-

Kelsey Meyer:
[inaudible 00:35:06].

Katherine Switz:
Other questions?

Any other final reflections?

Andy Sekel:
Oh, there’s one over here.

Audience Member:
So, I think [inaudible 00:35:31] sorry. My question is gonna try and ask earlier. So I’m here with Emily and Jenny. We’re from a smallish tech company, also average age like 30. Don’t really have an HR department. We are very inspired by your mental health initiatives, and I think that’s at least my big takeaway so far.

So, before we’re able to have an initiative, what would you say is the best way, just generally to approach someone that you suspect might have an issue? Which is kind of hard, because at our young age, it’s like, are you partying too hard? Or do you have something deeper going on? And I know that I’ve been in the situation that I’ve been approached and been like, “Hey you’ve been really low energy. Are you okay?”

And I don’t want to be like, “I have depression.” And so that wasn’t quite right. And I even have trouble figuring out how that even should have been brought up with me. So I’m wondering I’m wondering in your experience what you would say to people in young companies like us.

Andy Sekel:
So I don’t think there’s a universal answer because it all depends on the relationship. Right, if you and I are friends, there are all sorts of things I can say about your energy level, or hey, have you been out drinking too much, that you might not like, but not take offense to. If I’m a coworker that you don’t know very well and I say the same thing, as it comes off very differently.

So I think, my sense has been in companies that we’ve worked with often these kinds of issues come up in performance reviews. And they come up with like, you’re struggling with something, is there anything that we can help you with that’s going on outside of work that would be useful to you? Or is there something in work that we can help you with? I think, I really liked the presentation earlier of like, you have to be ready. People have to be willing to be engaged in that way. And so my suggestion si that if you have a good relationship, then you should say things that are part of your friendship.

If you don’t, I would be very tentative. Like, is there something going on and can I help you? And most of us, even when there is, we say no. Right, that’s the socially appropriate thing to do, is, I’m great. Nothing’s every going on with me except wonderful things. And then I think sometimes it’s easier out of context. Right? Its easier to have lunch with that person, talk about a number of other things, and say something to that effect that I noticed you haven’t quite been yourself. Is there anything I can do to help … Sometimes opens up the discussion. Btu I don’t think you should be discouraged, because socially we’re all kind of trained to present a façade that, how are you, great. How’s your life, wonderful. Are you happy, extremely. And so you have to have enough of a relationship tow here someone trusts you to break that down a little bit.

Kelsey Meyer:
And that’s what I was going to add. Starting before there is a problem, of just building trust in those relationships, because I know that’s what has been so great of our company is that we do have a lot of trust between people and their managers. We don’t call the mangers, we call them direct supports. So that when there is an issue, it’s so much of an easier conversation, than if it is a very much, like boss-employee relationship. So working to build that trust form the beginning.

And I absolutely agree that it should never be discouraged, when we had the mental health expert come in and talk to our team, she said, ten seconds of awkwardness for you, in order to potentially help someone for the rest of their life, is worth it. So even if it’s incredibly awkward for you to say, hey you know you normally do this, but this week you’ve been doing this, and your skin is on fire, and you hate yourself for saying it. They might brush you off right then, but it might sink in a week later, and so it’s still worth it to go through that awkwardness.

Jacqui Brady:
And talk about either the impact or the effect that their behavior is having, not what the behavior is, because you can’t make an assumption of why something is happening, but you want to talk obviously the impact. And that may also trigger something internally where they realize, oh this is having an impact or an effect and I didn’t think anyone noticed. Especially if it’s impacting their work or their relationship within the organization.

Andy Sekel:
Thanks for your question, great question.

Katherine Switz:
And sometimes I think it’s just even asking someone, how are you doing? Even something so simple as that and doing it over time so that they build trust that you mean it. But it’s a hard question, so thank you. Any other final questions? I think we’re just about out of time. So, I just want to say a huge thank you to the panelists.

Audience Member:
Can I ask a quick question? I’m an HR and Information and Systems Director for a nonprofit. We’re 500+ employees, but we’re fully insured model. And I was wondering if, the concept of the early intervention model prior to seeking health services, is a kind of interesting one. But you are self funded, so you get to direct what type of tiers of benefits you can provide. How do you see fully funded, insurance providers, or the payees being able to be receptive to those types of programs and actually manage our costs.

So, take into account the impact we’re having with sort of these models, telehealth. Because I’m assuming they are not integrated with a fully insured model, right? So separate. So where is that trend going? So right now, we’re being hit by rising insurance costs based on underwriting metrics or their whatever else they’re assuming, but they’re not retaining an [intermension 00:41:49] models that we’re putting I place.

Andy Sekel:
I think that’s .. you have the pieces, you just haven’t quite clicked them. You have to negotiate with whoever is managing of you. So whoever the insurance company is, and be able to say I’m going to invest in telehealth position capability. And I think it’s gonna, and it will, with the size company you have, reduce access to some other kinds of care that are much more expensive. And you have to start negotiating that ti expect that to be a part of my underwriting for next year.

Because they set a price based in large part on how much you use. So what you have to prevent is them just keeping the savings. So, if you’re negotiating for 1118, then you say, I would really like to do a couple of these innovations, but when you look at my data, at the end of the year, I expect to get the discount for the savings that I’ve created by investing in that and becoming your partner in reducing costs. And if they don’t do it you need to find another insurance company, right? Does that help? Does that answer your question?

Kelsey Meyer:
Yeah, we had it before we were self insured and it was the same conversation, and then the data improved it, by far. Our costs were significantly lowr than other organizations, especially with our demographics, and it was because we had all these tools and resources, so we made sure that either our renewal wouldn’t be as high, or we shouldn’t have renewal happen in the past too. So it was just flat year over yer.

Andy Sekel:
Thanks for your question, great question.

Katherine Switz:
Thank you all very much, and thank you to the panelists.