What once meant a few counselling sessions through an employee assistance program (EAP) now extends to a broader mix of practitioners, virtual care and even DNA-based drug matching.Charday Penn/AFP/Getty Images
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Mental health coverage at work is no longer a perk. For young people in the workplace, it has become the price of entry.
A 2024 survey by non-profit health care and insurance organization GreenShield found that one in three Canadians would leave their job for better mental health benefits. Among workers aged 18 to 24, nearly two-thirds said they would walk.
“Younger employees are setting the bar,” says Joe Blomeley, executive vice-president at GreenShield Health. “Five years ago, mental health was treated as a nice-to-have. Today, if you don’t offer it, you’re not going to be competitive.”
That shift has pushed employers and insurers to expand their offerings. What once meant a few counselling sessions through an employee assistance program (EAP) now extends to a broader mix of practitioners, virtual care and even DNA-based drug matching.
Marie-Chantal Côté, senior vice-president, Sun Life Health, says her team started to notice pre-pandemic “significant growth” in long-term disability tied to a mental health condition as the primary cause.
“We saw it clearly in our data and, at the same time, employees and employers were both raising it in conversations,” she says, noting that advocacy work from organizations such as the Centre for Addiction and Mental Health (CAMH) and its “mental health is health” campaign pushed the industry forward.
Ten years ago, most workplace health plans only covered psychologists for mental health. Today, it has expanded to include social workers, nurse practitioners and psychotherapists.
That breadth has been “critical for access,” Ms. Côté says.
Barriers to mental health support
Still, there are barriers to workers receiving the mental health support they need.
Stigma is a big one, Ms. Côté says. She notes that Sun Life expected to see a spike in EAP usage during the pandemic, but that didn’t happen.
“When we asked why, employees told us: A, I don’t know what it is. B, I don’t know how to use it. C, I don’t think I can afford it,” Ms. Côté says. “And all of those assumptions were wrong. It’s paid for by the employer.”
Cost is another concern. The 2023 Commonwealth Fund (CMWF) survey reports that Canadians are more likely than peers in comparable countries to cite affordability as the reason they didn’t get needed mental health services. Fifteen per cent pointed to cost, rising to 34 per cent among those with a prior mental health diagnosis.
Waiting lists are another obstacle preventing people from accessing services. Canadian Institute for Health Information (CIHI) data show that in 2023–24, half of Canadians got community counselling within 25 days, but one in 10 waited almost five months or longer. Access is even more challenging in smaller communities, but insurers are working to close those gaps.
How insurers are stepping up
At Manulife, a partnership with Telus Health now enables employees to book counselling sessions through the Manulife app without incurring upfront costs.
“It took 20 years to kind of remove that need to pay up front and submit for reimbursement,” says Jennifer Foubert, head of product, Manulife Group Benefits.
That same integration allows employees to keep seeing the same counsellor beyond the short-term EAP model.
“It removes the barrier of having to retell your story all over again,” Ms. Foubert says.
Manulife has also broadened the scope of care providers, from psychologists to six practitioner types, including psychoanalysts and clinical social workers. It has embedded internet-based cognitive behavioural therapy into its counselling services, offering a blend of self-guided and therapist-supported options.
“Sometimes folks aren’t ready to participate in face-to-face care,” Ms. Foubert says. “Having a mix of self-guided but therapist-supported therapy creates that space for people to connect with the care they need.”
Employers are also responding with richer coverage. Five years ago, the average workplace mental health account was about $500, barely enough for a few therapy sessions. Today, some companies offer thousands of dollars in annual coverage.
Mr. Blomeley at GreenShield says that a handful of clients now provide up to $10,000 per employee. He adds that virtual care has also become a standard feature, with 90 per cent of GreenShields’ mental health sessions being delivered virtually.
That kind of integration is part of a broader shift to make care more accessible, particularly outside major cities. The CMWF survey found that 82 per cent of Canadian adults who used virtual mental health care were satisfied with their experience. Usage is especially strong where long waits or travel make in-person therapy harder to reach.
The impact of that access goes beyond convenience and into the workplace. Telus Health’s Mental Health Index shows that workers with poor mental health lose an average of 23 working days a year in reduced productivity, more than four times higher than those with good mental health. Employers that invest in support see the reverse effect in the form of stronger retention, reduced absenteeism, and better employee engagement.
“This is about creating workplaces where mental health is recognized as part of overall health,” Ms. Côté says. “The more we have those conversations, the more people will actually use the benefits available to them.