For millions of workers and their families, employers are a gateway to health care, influencing what benefits are offered, which vendors are selected, which treatments are covered, and how employees access their care. That influence extends far beyond purchasing decisions into areas such as mental health, where parity in coverage (to benefits focused on physical health) is aligning with employer recognition of the impact of mental health on employee wellbeing, organizational culture and engagement, and workplace performance. To meet the moment, health care stakeholders need to engage employers as partners –– together with patients, advocates, and clinical leaders –– so benefit design and coverage policies translate into timely, trusted, and usable mental health care.  

Mental health is becoming a cornerstone of employer health strategies 

Employee experience data highlights the overwhelming need for mental health coverage. According to the 2024 National Alliance on Mental Illness (NAMI) Workplace Mental Health Poll (2024 NAMI poll), half of employees reported feeling burned out because of their job in the past year, and a third said they felt so overwhelmed it affected their ability to work.  

Employer leaders are taking action to reflect this priority by elevating mental health benefits into a core component of employer health strategy. In the 2025 Pulse of the Purchaser Annual Survey from the National Alliance of Healthcare Purchaser Coalitions, most employers say they are currently or are considering integrating behavioral health into primary care, signaling the normalization of mental health as part of employers’ overall benefits strategy. 

Coverage doesn’t always equal access 

Employers often feel the effects of anxiety, depression, and burnout long before it appears in claims data through absenteeism, presenteeism, reduced focus, strained teams, and rising employee demand for support. They also recognize that benefits offered on paper can remain difficult for employees to understand, access or use –– a finding confirmed by the 2024 NAMI poll reporting that the majority of employees say their employer offers mental health coverage, but most either do not know or are unsure how to access their mental health benefits. 

These gaps show why mental health benefits cannot be measured solely by whether coverage exists. Benefits design, workplace culture, and employee communication all shape whether access to mental health services becomes meaningful care. 

Employers need usable pathways to better support employees 

Additionally, while employers are seeking to provide parity coverage aligned to employee demands, vendor complexity and PBM processes create challenges in knowing whether they are on the right path. 

With one-third of employers struggling to get complete claims data, many have limited visibility into whether benefit design and coverage align with employee needs and utilization patterns, and have no way to assess the quality of care and overall cost related to their health care benefits package.  

Employer voices belong at the center of the conversation 

Employers have taken action to incorporate mental health in benefits design, but there is a gap in how to make those benefits practical in addressing rising need, persistent access barriers, and pressure to provide new care options responsibly. The path forward will require stakeholders to engage employers, who bring a distinct perspective to identify where gaps exist, what evidence matters, and how coverage decisions are made. 

As employers take a more active role in mental health access, initiatives like Pulse of the Purchaser Research Institute can help connect employer experience with patient, clinical, and policy perspectives.