Going Beyond Benefits: How Employers Can Assess, Create Wellness Culture

What is wellness culture in the workplace?

The committee’s first priority was to develop a mission statement. Tippett-Stangler described the committee’s goals as a pie with five slices, each slice representing the key areas that the group wanted to tackle. The five areas that the group addressed were:

• Increasing access to mental and behavioral healthcare
• Expanding telebehavioral health
• Expanding measurement-based care
• Expanding the collaborative care model
• Ensuring parity from the payer perspective

However, in the committee’s first meeting, the participants recognized that a key portion of wellness culture was missing from that visual: inclusion.

“Our multi-stakeholder group committee said, ‘Wait a minute, all of those things are important, but we can't even talk about that until we address what we call inclusion—diversity, equity, stigma, belonging,’” Tippett-Stangler recounted.

The committee emerged with a new visual in which equity was central: five slices representing access to care, telebehavioral health, measurement-based care, collaborative care, and parity arranged around the goal of inclusion.

These elements are what set offering mental health benefits apart from building a wellness culture, Tippett-Stangler indicated. A company with a wellness culture will assess why employees are not using mental health benefits, what employers can do to create a safe space for employees to communicate their needs, and will be characterized by inclusion.

Once the committee had established the mission statement, they explored how to turn their vision into an actionable resource. The result was Well Gauge, a free tool that employers can use to both assess their company culture around mental health and behavioral health and to ascertain potential steps toward improving their culture.

How to assess workplace wellness

The first step in solving any problem is understanding what the problem is. Employers who want to create a culture of wellness centered on inclusivity must first be aware of their company’s current culture and its proximity to their wellness culture vision.

One of the key challenges that employers face in assessing wellness culture is distance.

“You see it in survey after survey: the employer thinks they're doing X, Y, and Z and they're offering the moon and the stars, and employees are saying, ‘No, you're not,’ or ‘you're not hitting the things that matter to me,’” Tippett-Stangler explained.

Employers have implemented various solutions to address the mental health crisis, including offering preventive care, employing collaborative care models, and using employee assistance programs.

However, research from organizations like The Hartford and McKinsey has highlighted the disconnect between employer and employee perceptions of wellness culture. In these studies, most employers reported that their companies successfully supported employee wellness, while significant populations of employees voiced that their mental and behavioral health needs remained unmet.

These conclusions indicate that employers may be too distant from the employee experience of the company culture to identify mental and behavioral healthcare barriers.

It is crucial that employers assess the impacts of their programs and benefits and genuinely seek to understand whether these resources are meeting employees’ needs.

Well Gauge walks participants through four areas of wellness culture to provide that feedback. Participants answer questions about how mental health and behavioral health show up in the company’s communication, leadership engagement at all levels, companywide equity efforts, and their endeavors to create an environment of total health.

The survey’s 22 questions provide a temperature check on any organization’s wellness culture. While the NEBGH committee initially designed this tool for benefits managers and senior management, committee members and employers have also administered the survey among employees who are not as involved in benefits decision-making to gauge the broader experience of wellness in the company.

“One of the key things is making sure that mental health is part of the company strategy, that it is something that's talked about in earnings calls, in town halls, and it is really incorporating that language into everyone's thinking,” Tippett-Stangler said. “I have heard from some folks that have completed this survey: ‘we talk a good talk, but we're not walking it yet.’ It's baby steps. But this is a way in which we can raise the flag to say, ‘We need to do a better job in this area.’”

Action steps for improving wellness culture

Insights into a company’s wellness culture are only useful if employers act on them. While Well Gauge users’ initial feedback focused on the tool’s usefulness as an assessment, the survey also offered insight into actionable steps.  

“Take a moment to assess what they are doing as an organization that is meeting the employees' needs, but also what isn't,” Tippett-Stangler said. “Internal surveys to employees are great, but if you don't act on them, they're kind of worthless.”

The survey results are accompanied by a list of follow-up suggestions so employers can integrate wellness culture strategies. Tippett-Stangler highlighted three possible actions.

First, employers can ensure that mental health is incorporated into the company’s agenda, including earnings calls and annual reports. When the topic is featured in these public forums, employees might feel more confident about voicing their mental health needs.

Second, employers can ensure that ongoing training is a part of their policies and procedures. For example, some health insurers have partnered with vendors to offer educational mental health programs for employers. Through such programs, employers learn to identify and address employees’ mental health needs compassionately.

Finally, employers can engage with mental health vendors to pursue health equity. For instance, they might work with a vendor to improve access to culturally competent care. Additionally, they might partner with other organizations to expand access to mental healthcare in mental health deserts. Employers can overlay social determinants of health data over their employee data to understand regional access to care challenges and other social determinants of health barriers.

Tippett-Stangler added that employers do not have to tackle wellness culture formation alone. Health insurers can be a great resource by providing more data.

“The next step is to look at the data with your health plan partners. That can help you define what your strategy going forward should be. Where's the utilization? What are you hearing from the plan side as well as what you are seeing internally?” Tippett-Stangler said.

“From a health plan perspective, they want to offer services, they want to offer programs, expand their network, but are not necessarily sure what it is that people need and want. If you don't step back and assess that, clearly you're offering things that people aren't going to use.”

Health systems can also support employers’ efforts, particularly in expanding access to care and telebehavioral health.

The NEBGH committee is already considering ways to improve the Wellness Gauge. Tippett-Stangler hinted that a Wellness Gauge 2.0 might be on the horizon.

“While this was very rewarding work for sure and it will continue, if I could leave you with one thought it is: having all of the stakeholders represented over many, many months is remarkable because it isn't about finger-pointing, it isn't one sector's fault that the mental health crisis is what it is,” Tippett-Stangler emphasized. “The collaboration was remarkable.”