Employers are taking time to reevaluate their benefits offerings in the shadow of a pandemic, and mental health has risen to the forefront.

Listen to HR leaders themselves. A 2021 Verizon Media survey found 87% of HR executives saw mental health as the most significant impact on their workforce in the pandemic's first year. But mental health issues vary from patient to patient. Employees experiencing mental health concerns can exhibit a variety of symptoms and may be impacted by differing circumstances.

Childbirth is one such example, and employers are likely familiar with postpartum depression or other forms of perinatal mood and anxiety disorders, referred to by medical professionals under the shorthand PMADS. Approximately 1 in 5 women are affected by mental health issues either during pregnancy or within the first year post-pregnancy, according to the nonprofit Maternal Mental Health Leadership Alliance, constituting the most common complications of pregnancy and childbirth in the U.S.

Much of the focus on such issues is placed on parents who give birth, even though non birth parents also may exhibit symptoms indicative of conditions such as postpartum depression and anxiety, according to Gina Nebesar, co-founder and chief product officer at family health benefits vendor Ovia Health. The problem is compounded by the fact that little criteria exist for detecting conditions like paternal depression, she told HR Dive.

"There is evolving research on this topic," Nebesar said. "What we're seeing, though, is that we're living in a society where there is not as much emphasis on the father's experience."

A May 2019 article published in the peer-reviewed journal Innovations in Clinical Neuroscience, written by Dr. Jonathan R. Scarff, a psychiatrist with the Behavioral Health Service Line at Kenner Army Health Clinic in Fort Lee, Virginia, details risk factors for postpartum depression, or PPD, in men, including a history of depression in either parent, poverty and hormonal changes. Scarff also wrote that no established criteria exist for the condition, though symptoms may include irritability, restricted emotions and depression.

Additionally, the article noted that PPD occurs in approximately 8% to 10% of fathers. "Recognizing and treating paternal PPD can improve quality of life for the father and the family unit and decrease the risk for emotional and behavioral problems in children," Scarff wrote.

Nebesar said Ovia Health is seeing higher rates of PPD in fathers, however, noting the impact of the pandemic on parents generally. The past two years have seen all parents take on additional responsibilities amid disruptions to family life; "It's a perfect storm that parents are going through," she continued.

Lack of support

Employee benefit plans do not necessarily cover care that could help employees dealing with PPD, Nebesar said. For example, many do not cover childbirth classes or post-delivery checkup visits for parents.

But there have been real impacts to employers. Nebesar said she has heard anecdotally that HR teams have experienced parents arriving at work tired and asking for more support, whether they are birth parents or not.

Employees also may lack access to paid leave, and even those who do have access may not take it. The latter issue may relate to broader societal perceptions about taking leave, particularly paternity leave and adoption leave.

"They feel like there's a stigma if they take advantage of the policies offered to them," Nebesar said, adding that leaders can play a role in encouraging hesitant employees to do so. "If senior male fathers or leaders aren't taking that leave, how is that impacting people in the organization? How is that impacting their willingness to take it?"

Involving leadership is a strategy that has worked in other benefits contexts, said Carolina Valencia, vice president in Gartner's HR practice. Employers may be able to turn to executives who have had emotional struggles following a birth or adoption, or parents at the organization who have gone through the process, to talk about the resources they used and recommend those same resources to other workers.

Culturally, employers also can work to acknowledge the experiences of parents during the pandemic. One potential positive aspect of the pandemic, she said, is that workers saw their co-workers being parents, sometimes directly so during video calls and meetings. "That's something not just to be acknowledged, but also celebrated."

Accessibility is another concern. Valencia said she believes employers may be able to do more to streamline their benefits for parents, like creating step-by-step guides that take employees through the benefits process quickly.

"Make it easy," she said. "A lot of times these programs are not designed with the user in mind."

Sometimes the employee in need of a benefit may be a family member or decision-maker who is not an employee. In that case, employers can seek alternative avenues for alerting this audience.

Manager training is essential

Managers are frequently the initial point of contact for benefits, and parental benefits are no exception, Nebesar said. She spoke of the need for managers to help create an environment in which workers feel psychologically safe and are allowed to be parents first.

Training can help, Nebesar continued, and employers should focus on specific aspects of one-on-one interactions with parents when training managers. One mark of success is ensuring that, when an employee reveals they are expecting a new child, "the first words that come out of a manager's mouth are congratulations," Nebesar said. "Even training from that very initial moment is a great thing."

Internally, Ovia Health has had managers use direct questions in one-on-one meetings with all employees to gauge their status, Nebesar added. They can be as simple as, "How are you feeling about this?" or "How are you feeling this week?"

Such open-ended questions allow parents to expand on their stressors while helping to destigmatize mental health discussions at work, Nebesar said.

The mental health layer

2022 has seen employers experiment with different strategies for breaking down barriers to mental healthcare access. For example, some have redesigned employee assistance programs to increase visit limits, according to a Willis Towers Watson survey conducted in October. Others plan to directly fund employees seeking care.

But mental health goes beyond EAPs and similar programs. "Almost every benefit provided needs to have a mental health component," Nebesar said. "Every single benefit, whether or not it is specifically designed for mental health or other conditions [...] there's often a mental health layer."

That the current environment has been producing higher stress levels among employees serves to bolster the importance of addressing mental health as part of an organization's broader employee value proposition, according to Valencia. That goes beyond the list of benefits an organization offers.

"It's no longer just about what you give them, it's also about how you make them feel," Valencia said. "It's not just providing benefits and well-being support, but making sure employees are aware of what's available to them."