New survey shines a spotlight on mental health concerns among organizations that care for others
May 2021 | Specialty Care
89% of nonprofit organizations said they openly discuss the importance of mental health
About 1 in 3 specialty care organizations reported that mental health concerns were increasing at their organization
Between 2003 and 2015, more than 2% of nearly 50,000 deaths among adults 55 and older were suicides associated with long-term care facilities
Employees and volunteers of specialty care organizations — defined in this article as mental health programs, residential programs, senior living communities, and similar human services operations — are asked to provide aid to those in need, often in fast-paced and sometimes stressful environments.
This stress was undoubtedly magnified by the COVID-19 pandemic, when one lapse in protocols or judgment could cause significant harm to individuals that specialty care organizations serve (e.g., residents or community members). For individuals to whom specialty care organizations provide aid, COVID-19 has had an isolating effect, as many were not allowed to see family members and loved ones due to pandemic-related policies. Put simply: Specialty care organizations faced difficult pandemic-related challenges and didn’t have the policies or procedures in place to address them.
As a result, mental health has been a key area of focus for specialty care organizations in recent times, as indicated by Nationwide’s Agent Authority research. According to this research — which surveyed 400 middle-market nonprofit and health business owners — 89% of nonprofit organizations said they openly discuss the importance of mental health. Furthermore, the majority of respondents felt they have created a safe environment for employees and volunteers to speak with leadership or take time off if they were experiencing mental health issues.
Still, according to the survey data, nonprofit organizations believed they could be doing a better job of prioritizing the well-being and mental health of employees, volunteers, and people they serve. Only a little more than half of respondents offer employees and volunteers access to mental health workshops, assistance programs, support groups, and similar services. This is concerning, as about 1 in 3 specialty care organizations reported that mental health concerns were increasing at their organization.
With May being Mental Health Awareness Month, there’s no better time to put a spotlight on mental health concerns in specialty care and to review ways that organizations can support their employees, volunteers, and individuals they serve.
For organizations to appropriately address mental health concerns, it’s important to first understand what mental health refers to. In general, an individual’s mental health includes how they think, feel, and act, and includes their emotional and social well-being.1 While mental health includes mental illness, the two aren’t interchangeable. Specifically, an individual — whether they be an employee, volunteer, or individual they serve — can go through a period of poor mental health but not necessarily have a diagnosable mental illness.2 Additionally, a person’s mental health can change over time depending on factors affecting their work or personal lives.3
In specialty care settings, mental health concerns can manifest themselves in various ways. For employees and volunteers, mental health issues can be compounded by heavy workloads, periods of high stress or issues regarding work-life balance.
These are top-of-mind concerns for specialty care organizations as — according to Nationwide’s Agent Authority research — the majority of nonprofit business owners saw a negative impact from COVID-19 in 2020, with the total cost of operations being the most affected aspect of their business. This was followed by total revenue, employee or volunteer head count, and access to supplies.
The survey also found that some specialty care operations were not prepared for the greater demands of individuals they serve due to the pandemic. In fact, about 22% of organizations didn’t have the necessary resources or channels in place to maintain partnerships. Furthermore, 21% of nonprofit organizations did not have a contingency plan in place to maintain operations through the economic uncertainty caused by the pandemic.
In other words, COVID-19 created unprecedented challenges for specialty care organizations as well as their employees and volunteers. Organizations had to establish new COVID-19 protocols to keep workers and the individuals they serve safe, while employees and volunteers were tasked with providing a high level of care, often with limited resources. Even though nursing is one of the fastest-growing professions in the country,4 the demand for nurses and nurse aides continues to outpace the supply. In fact, an estimated 27 million individuals will need long-term care by 2050.5 In the short term, the population of individuals ages 65 and older is expected to grow from around 13% in 2010 to over 20% by 20306 — and over a million new workers will be needed by 2025.7
COVID-19 also has had an impact on the mental well-being of the individuals these organizations serve. Throughout the pandemic, specialty care organizations were forced to restrict visitation to their facilities. This meant that individuals were quarantined to their rooms and weren’t allowed to engage in social activities. In some cases, individuals with pre-existing mental illnesses (e.g., depression or bipolar disorder) had decreased access to their mental health providers, compounding mental health concerns.
If left unaddressed, mental health concerns can lead to employee and volunteer burnout, time away from work, the worsening of one’s mental state, chronic physical health issues, suicide, and substance abuse issues. In fact, suicide and substance abuse issues are already prevalent in specialty care settings. Between 2003 and 2015, more than 2% of nearly 50,000 deaths among adults 55 and older were suicides associated with long-term care facilities (specifically among adults living in or transitioning to residential long-term care).8
Thankfully, there are several steps that specialty care organizations can take to address mental health concerns among employees, volunteers and clients.
To provide support for mental health caregivers, organizations need to be proactive. The following are just a few strategies that employers should consider to make mental health a priority:
Mental health concerns, domestic abuse and trauma can all have a devastating impact on an individual’s total health. This is particularly true if these issues are left unaddressed.
Historically, in health care settings, these types of concerns have been treated independently of physical injuries. This creates situations in which general practitioners and specialty care providers work in silos. As a result, those seeking care are often less likely to receive holistic treatment for both their physical and mental health concerns during a given visit.
To address these gaps in care, physicians, psychiatrists, nurses, social workers and other care providers have advocated for integrated care. Put simply, integrated care is a growing, worldwide health care trend that focuses on providing coordinated care. It’s intended to blend behavioral health services with general or specialty medical services, ensuring that individuals get the care they need regardless of how they seek treatment. What makes integrated health care unique is that it allows for the sharing of information among team members, which helps organizations create a comprehensive treatment plan to address the biological, psychological and social needs of the individual.
An integrated care approach has the potential to:
As a result, an integrated care model can help specialty care organizations better address mental health concerns among clients, employees and employers.
It’s worth noting that through telemedicine, the prospect of moving to an integrated care model is made easier. That’s because telemedicine can easily connect an employee with general or specialty care quickly through the same health care delivery system. Many individuals are already benefiting from this concept using teletherapy.
In a general sense, teletherapy refers to the use of technology that connects therapists with their clients. Teletherapy can involve therapy sessions completed over the phone, group chats for group-based therapy or videoconferencing for individuals or couples. It’s just one example of how, through telemedicine, individuals aren’t restricted to one type of care. Instead, they have access to both primary and specialty care at their convenience and through an integrated channel.
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Nationwide commissioned Edelman Intelligence to conduct a 20-minute quantitative online survey among a sample of 200 U.S. middle market healthcare business owners and 200 U.S. middle market nonprofit business owners between January 5 – January 14 to explore the challenges facing business owners and the actions they’ve taken as a result of COVID-19, understand their outlook for the economy and their organizations in 2021, and gauge their experience working with insurance agents and buying or renewing insurance policies. For the purposes of this survey, middle market healthcare and nonprofit business owners were defined as anyone who self-reported as being a sole or part owner/decision-maker of a healthcare or nonprofit company with 25-500 employees or $10M-$500M in revenue or 20+ fleet vehicles. As a member of CASRO in good standing, Edelman Intelligence conducts all research in accordance with Market Research Standards and Guidelines.