The Great Recovery is a series examining how a surge in innovation, outreach, access and attention to equity is improving our mental health system. It is supported by a grant from Wellcome Trust.

A Note About the Art: The images in this story were created by Sarah Graham, a British artist living with bipolar disorder. To learn about her art follow us on Instagram, where we’ll be posting more of Sarah’s work along with a conversation with her about the links between her creative process and her mental health struggles.

When Virginia-based Catherine C. dealt with a family death last year, she would likely have processed her grief on her own, had the company she worked for not offered free therapy as an employee benefit. 

“If I didn’t have this free service available via work, I probably would not have sought out help,” says Catherine, a senior product manager at VideoAmp, a Los Angeles-headquartered advertising measurement company. “Having access to free therapy benefits people like me who don’t have an existing relationship with a therapist and probably would not make it a financial priority before realizing how valuable it is. Without this, I would have had a significantly more difficult time processing my grief.” 

VideoAmp rolled out the service to its then 200-strong workforce in 2020, funding individual virtual therapy sessions for every employee and their dependents via a platform called Modern Health. But it didn’t stop there. The company also brought in a licensed therapist to facilitate group listening sessions both in-person and virtually, and has hosted keynote speakers to share resources around mental health and self care. In the time since, 233 VideoAmp employees have registered with Modern Health –– more than half of the current workforce of 400 people. 

VideoAmp’s worker support offerings may be unusually far-reaching, but the company’s decision to get involved with its employees’ mental health is no longer unheard of. It reflects a changing attitude toward wellbeing and the workplace, as a growing number of companies provide on-site or virtual therapy, days off for mental health, and an environment that encourages discussing such matters among colleagues and with supervisors. In a world where one out of five workers cite lack of mental health support at work as a top factor for resigning, it’s a trend that seems to respond to an urgent need.

But it also raises complex questions. Is work the best place to seek such support? Can employees be expected to comfortably open up to bosses and colleagues? And are companies that  then offer therapy as an employee perk really trying to help, or sometimes compensating for an exploitative work environment?

Employers like VideoAmp are seeing their therapy benefits pay off. Some 42 percent of employees with access to mental health benefits are less likely to leave their company, compared to 27 percent of those without access, according to Mercer’s 2021 survey of 14,000 workers globally. A study of 1,132 employees participating in workplace mental health programs in the US found that mental health benefits can result in as much as 25 percent fewer missed workdays, and fewer overall symptoms of depression and anxiety. For VideoAmp specifically, paying for all employees to access Modern Health’s services and resources is a worthwhile investment — the company has seen a 15 percent uplift in employees’ “rest and recovery” ratings, as measured by its annual engagement survey. 

Yet some 41 percent of US workers still say their employer doesn’t offer any mental health support, according to a survey by FlexJobs in March last year. That corresponds to the results of a survey of 5,000 professionals across the UK and US in September 2021 by HR software platform Beamery. Just 20 percent of respondents said their company offered wellbeing or mental health benefits, and 24 percent felt their employer should have offered more of this over the past 12 months. 53 percent were considering leaving their job in the next year. 

Of the companies that do offer direct mental health support, many are diving in with gusto. Digital marketing agency eComOne, based in Lincoln, UK, introduced a partnership with therapy booking platform Spill to its 20 employees last summer. Employees can book any number of free 50-minute therapy sessions, use the ‘Ask a Therapist’ chat function, and access free mental health resources. If they’d like to see the same therapist on a recurring basis, they can book and pay for it privately. Of the hundreds of companies that use Spill, eComOne is now rated in the top 25 workplaces for “low stress,” “excitement” and “enthusiasm.” 

“We believe it has been an overwhelmingly positive thing for us as a company. Staff feel more supported, their productivity is improved and we have the means to help them indirectly,” says eComOne CEO Richard Hill. “As long as anonymity is maintained, we do not see an issue with providing such a personal service. It can only be a good thing.” 

20 therapy sessions have been booked so far. One was by an eComOne account manager, who was dealing with a death in the family, as well as another family member who’d had a severe mental health breakdown. The account manager sought help through Spill, and after their free session, was referred to another service which led to several more months of therapy.

“My overall mental health felt very much in decline and the circumstances meant that I was unaware of being in a state of shock, as well as experiencing sadness and grief,” says the account manager, who asked to remain anonymous. “Work providing Spill meant I could deal with the problem almost immediately and the one-off session meant I could know where to pursue private therapy.” 

“This signposting and recognition may not have been there without the company providing Spill as an anonymous benefit for us, as I have never engaged with this kind of care before. I feel much more confident, balanced and able to cope because of it.”

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For employee benefits supplier MyStaffShop, offering unlimited therapy through a platform called Spectrum.life, which provides workplace wellbeing resources like counseling and coaching, is a way of showing they take their employees’ mental health seriously, and are willing to support them and their families during difficult times. More than three quarters of the company’s 30 staff have used it.

“From a culture perspective, it’s going to highlight the value you place on your people’s wellbeing, and that will foster a sense of belonging,” says communications manager Verity Gough.

“For example, the wife of one of our employees was at a crisis point, as she suffers with her mental health,” continues Gough. “She needed to speak to someone urgently, and was connected with a counselor who was able to help, arranging a further referral to assist with her particular issues. She was given eight counseling sessions after this. Thankfully, she has fully recovered, but the service was invaluable to her and was accessible, quickly triaged and she got the in-the-moment help she needed.”

Helping employees navigate the challenges and tragedies of life is certainly to be commended. But what about when someone is seeking therapy because of their job? 

Workers who reported a toxic workplace were more than three times as likely to experience negative mental health in the workplace, according to the American Psychological Association’s 2023 Work in America Survey. Two thirds of 1,000 US workers surveyed by ResumeLab have experienced work-induced mental health problems in the past two years. And 68 percent have taken time off work as a result, while 59 percent indicated that their poor mental health was getting in the way of their career progression. 

Psychologist Lee Chambers works with a number of large corporations on improving employee wellbeing. He warns that companies can’t just offer therapy as a side benefit, without then addressing how this connects to what’s going on in the business as a whole. He gives the example of a Black employee seeking therapy because of racially driven microaggressions at work — a pointless exercise if the root of the problem isn’t addressed.

“Having access to therapy is great as a principle, but it’s not great if fundamentally their everyday work is damaging them,” says Chambers, who’s based in Preston, UK. “They’re receiving that support, then going back into the workplace and just facing all the things that are ultimately putting them in a place where they’re struggling.” 

Researchers have looked at the effectiveness of employee assistance programs encompassing mental health support, against what they called “the corporate climate for worker psychological health and safety.” They concluded that, while successful in helping individuals with their problems, such programs could have a bigger impact if they could also be connected to improving related issues within the business.

But companies tackling the workplace-related reasons people are seeking therapy isn’t so straightforward. It relies on employees being comfortable making such disclosures — something that’s still fraught with stigma, especially in the workplace — and on the information revealed during private sessions being used ethically and anonymously. 

“Having access to therapy is a bit like the cherry on top of the cake. Companies need to make sure the cakes they are baking are good in the first place, through thoughtful, intentional building of processes, systems and structures to protect and support people,” says Chambers. 

Companies also need to dig deep into how the mental health platforms they partner with treat the data they’re given, how qualified the therapists on the platforms are, how diverse they are to ensure they can reflect the lived experience of the people that turn to them, and how the therapists, in turn, are treated by the platform.

“Some of these digital platforms are quite poor when it comes to data security, and are guilty of funneling personal information to other places because it’s another income stream,” says Chambers.

“Some of the providers in the space have to be aggressively commercial and focus more on hitting targets, because they’ve been heavily funded by investors on the premise they’ll be able to grow quickly. Some have been squeezing therapists (on fees paid) to a point where it won’t be sustainable for them to remain on the platform.”

What’s also not sustainable is offering a workplace therapy program without giving employees the time and autonomy they need to take advantage of it. 

“Telling someone to just exercise, meditate, go to therapy, and all the rest of it is the kind of go-to for better mental health,” says Bex Spiller, who runs wellbeing platform The Anti-Burnout Club. “But when someone is working long hours, coming home and having to deal with ‘home life’ or bringing up kids, or whatever else they might have going on, it just feels impossible to find that time.”

“We work a lot with employees in the National Health System and caring roles who work 12-hour shifts, with very few breaks and certainly not an hour lunch for yoga or meditation.” 

The Goldilocks solution, as some companies have found, has been to enshrine time off for mental health in their policies and practices. For example, California and Michigan-based creative production agency Hook has seven paid annual sick days that are meant to be taken pre-emptively, to avoid serious illnesses, physical or mental, from developing. That’s on top of the set company-wide closures it implemented in 2021, when management made the drastic decision to give their 100-person team the entire month of December off, to ensure everyone had time off to take care of themselves. 

While the downtime was welcome, a subsequent employee poll revealed that most people preferred to divide the break into two, using half of it during the summer. So a year later, the company closed from December 23 to January 8, and then again from July 1 to 9 in 2023. The company-wide closings don’t count as vacation days, which vary from 15 to 25 days annually, depending on employee tenure. 

In making the decision, Hook CEO and co-founder Michael Watts cited research demonstrating a rise in mental health issues in the wake of the pandemic, as well as statistics speaking to employee vacation habits. Two data points stood out: since March 2020, a majority of US employees had shortened, postponed or canceled their vacation time, and over 26 percent of American workers have never taken two weeks of vacation in a row.

“Burnout is both real and avoidable. With fewer colleagues taking time off these days when feeling mentally or physically under the weather, we feel we need to reinforce the fact that our employees’ wellbeing is incredibly important,” says Alison Davis, Hook’s COO.

“Plus, we know that productivity is not a reflection of hours worked. By closing shop for set periods, we’re creating space so each of our team members feels empowered to take time for themselves and their families.”

Rather than prescribing fixed services to support employee mental health, other companies are taking a more flexible approach by offering a stipend for people to spend on something they feel will add to their happiness, or improve a negative situation they might be experiencing. 

For example, five years ago management consultancy Baringa’s UK branch introduced a £300 ($380 USD) Wellbeing Fund, which employees can use on an experience that enhances their personal wellbeing. Director Jody Coleman tapped this fund last year, when his son was 13 months old and still waking frequently throughout the night. The fund covered most of the cost of hiring a child sleep consultant to create a personalized sleep support plan for the Colemans, whose sleep deprivation was having a severe impact both personally and professionally.

“It felt relentless. We were never rested and it made for a tense atmosphere at home and simple things at work become increasingly challenging,” says Coleman. “We had Googled ‘baby sleep advice,’ some of which we had tried, but without success. I honestly don’t know how we would have fixed our issues without help.”

Meanwhile, business expenses platform Pleo launched its Flex Benefits program in February last year. On top of core benefits like annual and sick leave, employees are given a yearly Flex Benefits budget based on their location and remote or office status. For example, a UK employee working remotely has a £2,100 Flex Benefits budget (around $2,500), while an employee in Canada based out of the Quebec office receives a $3,700 Flex Benefits budget (around $2,800). 

Like at Baringa, the budget can be spent on something that will improve an employee’s life, including buying up to 10 additional days of leave. While some employees spend their benefit on yoga, massages, fitness memberships and wellbeing apps, some have chosen tattoos, puppies, climbing courses, a home cleaning service or treatments — both medical and aesthetic. Personal development, like learning a language or taking a course in an activity like surfing or rock climbing, has also been popular.

Pleo’s head of belonging and impact, Jessie Scheepers, says such a flexible approach caters to the five generations of people now active in the labor market. It acknowledges that there isn’t a single objective framework for happiness or wellbeing at work.

“Our employees’ feeling of being valued and to be supported in their mental and physical health has increased since the system was introduced,” says Scheepers. “They are happier and they appreciate the flexible benefits as a newfound freedom. They are more motivated and work more autonomously, are more independent and show more willingness to take on responsibility.”

At all of these companies, the dynamics between employee and employer are evolving well beyond the traditional agreement of “I work, you pay, we go our separate ways.” Allison English, deputy CEO of employee experience consultancy Leesman, believes the employee-employer relationship has become less transactional as the pandemic made work and homelife more intertwined, shifting workers’ expectations.

English cites examples of companies paying their workers’ energy bills and childcare fees, rehousing staff based in Ukraine, and in the US, subsidizing transport and medical costs for employees requiring abortions after the Supreme Court overturned Roe v. Wade. Such definitive actions are raising the bar for other organizations, she argues, who risk losing top talent to those publicly sticking their necks out for their people.

“And a lot of employers, certainly the ones who are more open to that shift, are changing how they’re treating employees and what they’re offering,” says English, “recognizing that they’re more than just a resource and a commodity that can be easily replaced.”

While the cynical observer might see this as little more than smart corporate strategy, “I’d like to think that in most cases, providing therapy comes from a good place where employers believe it’s something that employees need,” says English. Or perhaps it’s a bit of both. “If it helps the employee, it helps the company, then it’s worth investing the money in. It doesn’t seem like therapy is accessible enough to people outside of work, so employers then are filling that gap.”

Despite his pragmatic view on therapy in the workplace, Chambers overall assessment of it is, if done well, it can be part of a more holistic offering and have a greater impact than if somebody were to access therapy on their own, in isolation. It can make the difference between someone getting help with a difficult situation, or left to muddle through it on their own, as VideoAmp’s Catherine relates to. Having free therapy provided through work meant she didn’t have to think about whether she needed it or not, or how to access it.

“When I’m feeling lost, I get the professional-level wisdom that’s specific to exactly who I am, what I want in life, and what I’m going through,” Catherine says. “No meditation app or mindfulness resource alone can match this benefit. I wish everyone I know could have this same opportunity available to them for free.”