The access crisis in behavioral health is only getting worse. Roughly 137 million Americans live in mental health professional shortage areas, and even outside those behavioral health deserts, the demand for mental health services far exceeds capacity.

Nationally, the average wait time for a psychiatry appointment is 67 days, and it's often much longer for specialty care such as perinatal or youth and adolescent psychiatry. More than half of all psychologists aren't accepting new patients, and one-third don't accept insurance of any kind. The predictable result? More than 20% of adults and 40% of young people with mental health issues don't receive the support they need.

Though their efforts are often overlooked in the national conversation on mental health, a key group of stakeholders is stepping up to close this gap: employers. U.S. employers, which provide health insurance to more than 160 million Americans, have a vested interest in the mental health of the workforce — and, thanks to advances in virtual care and other technology, they have more tools at their disposal than ever before to support employees.

By partnering with national virtual care providers, employers are significantly expanding the pool of high-quality mental health professionals available to their workforce, helping to overcome geographic supply-and-demand mismatches and connect people to care in a fraction of the time it would take to see a brick-and-mortar provider.

Increasingly, employers are also integrating virtual behavioral health with other forms of virtual care, creating holistic solutions that support overall well-being. As these efforts continue to scale with new technology (AI included), innovative employer-led approaches are a growing catalyst in addressing the nation's mental health crisis.

Removing barriers to care

Access isn't a challenge only in rural areas. Nearly 40% of behavioral health deserts are located in metro areas, and even in big cities without official provider shortages, visiting a therapist or psychiatrist in person can still mean sitting in traffic for 2 hours or more. For many people, that translates into taking a half-day off work and incurring indirect costs (such as gas money or child care) on top of any out-of-pocket expenses for the appointment itself.

These barriers are especially pronounced for hourly and part-time workers. These employees tend to have lower incomes and lack access to employer-sponsored health plans, and many juggle caregiving responsibilities at home. Not surprisingly, they are also disproportionately likely to report high levels of stress and mental health challenges.

Employers are uniquely positioned to address these multilayered economic and logistical barriers. And yet, with healthcare spending for large private employers projected to rise by 9% this year, many organizations are simply not in a financial position to extend traditional health insurance coverage to their entire workforce.

Recognizing the scale and economic implications of the mental health crisis, forward-thinking employers are responding by investing in low-touch, high-impact virtual care solutions that allow employees to access support at a time and place that's convenient for them, with minimal disruption to their work or personal life. And because affordability remains a major deterrent to behavioral health utilization, many employers have also waived or reduced copays to encourage the use of cost-effective, high-value services.

McDonald's illustrates how this creative, outside-the-box approach can expand access to mental health support. The fast-food chain, which employs roughly 800,000 people in the U.S., has partnered with Included Health (where I lead the behavioral health practice) to offer every restaurant employee up to 10 virtual visits (either behavioral health or urgent care) per year at no cost to them. Because the program is not insurance-based, its flexibility extends to part-time workers and other restaurant crew members, regardless of their full- or part-time status or their enrollment in McDonald's insurance plans.

Notably, McDonald's went a step further by extending the program to employees' entire households, including spouses, children, parents, and even grandparents. This reflects the reality that employees' mental health is closely intertwined with the well-being of their loved ones, and that mental health challenges often play out within family and household dynamics.

The program has already had a meaningful impact on individuals and families. In 2024, the second year of the program, 100% of those who engaged with virtual behavioral health reported reduced depression symptoms, and 83% reported reduced anxiety (as measured by PHQ-9 and GAD-7 scores, respectively).

Integrating mental and physical health

Just as the mental health of families and households is intertwined, so too are physical and mental health. Behavioral health issues can lead to physical problems, and vice versa. Despite this well-known connection, delivering truly integrated behavioral and medical care has been a long-standing challenge in U.S. healthcare.

Here again, large employers are helping to fill the gap with integrated models that combine behavioral health with virtual urgent care and primary care. Integrated virtual care creates an additive, amplifying effect that improves both physical and mental health. It allows care teams to flag emerging issues, ensure important concerns aren't missed, and guide people to the right mix of medical and behavioral health care. 

Walmart, the nation's largest private employer, has been a leader in this approach. For the past decade, Walmart has partnered with Included Health to offer no- or low-cost virtual therapy and psychiatry to Walmart associates. In 2020, we began piloting $0-copay virtual primary care with integrated therapy and psychiatry. At the time, 180,000 Walmart associates lived in behavioral health deserts, and roughly half did not have a primary care provider.

Results from the three-year pilot highlight both the scale of unmet need and the impact of integrated virtual care. Thirty-seven percent of employees who had a virtual visit with a primary care provider went on to have at least one visit with a therapist or psychiatrist. Among those who did receive behavioral health care, depression symptoms improved by an average of 40%. Use of integrated virtual care was also associated with a 38% reduction in inpatient hospital costs and an 11% reduction in the total cost of care.

The power of technology

As a psychiatrist with 20 years of experience spanning brick-and-mortar facilities and digital health, I've witnessed the access barriers firsthand and understand how difficult it is to deliver truly integrated care in either space. Despite sustained effort and investment, traditional providers and standalone behavioral health point solutions have failed to solve the national mental health access crisis or deliver integrated care at scale.

Employers deserve recognition for their investments in workforce mental health, and for their commitment to using technology to address access challenges in novel, employee-centered ways. As these tools continue to evolve, innovations such as AI-powered healthcare assistants, proactive outreach, and personalized follow-up will make it possible to scale high-quality integrated behavioral health care to more people, more efficiently

For clinicians and employers alike, the need to expand access to mental health care isn't going away any time soon. What's changed is that we now have the tools — and the partnerships — to meet people where they are, close gaps in care, and make meaningful progress against a crisis that has gone on far too long.

Cheryl Baggeroer, MD, is a board-licensed psychiatrist and the senior director of behavioral health at Included Health, a personalized all-in-one healthcare company.