Symptom reduction has been the primary, and oftentimes sole focus of mental health care for years. But is that enough? In this conversation, we spoke with Modern Health's Dr. Jessica Watrous, Director of Clinical Research & Scientific Affairs to explore how focusing solely on symptom reduction may overlook certain areas of mental health concerns. We will also look into the role of workplace culture and environment in influencing mental health outcomes and the innovative strategies and solutions that Modern Health provides to support employee mental health beyond traditional methods.

How does focusing solely on symptom reduction in mental health support potentially overlook broader workplace factors contributing to employee well-being?

Symptom reduction is one of our strongest indicators of whether or not mental health treatment works - if we want to know if a specific intervention for depression works, then we have to measure depression and see how those symptoms change as a function of our intervention. 

That being said, symptom reduction alone does leave a gap in our understanding of the impact of mental health concerns. First, most of what we’re doing in healthcare focuses on specific mental health disorders like depression, anxiety, or posttraumatic stress disorder. This is important, and it may leave individuals out who are either experiencing symptoms of these specific concerns or whose distress is showing up in other ways, like relationship problems or difficulty motivating themselves. 

Second, reducing our outcomes only to symptom reduction prevents us from truly providing patient-centered care. For example, maybe I want to go to therapy for treatment of PTSD, but ultimately, it’s not that I want to see my symptoms change; it’s that I want to be able to go to the grocery store without feeling distressed or attend my children’s sporting events without getting overwhelmed. Symptom reduction can help us as practitioners understand if we’re moving toward those goals, but ultimately, we have to incorporate measures that are meaningful to the patient themself. 

And last, mental health concerns aren’t occurring in a vacuum. Even if someone is presenting for depression treatment, only focusing on the reductions in their depression symptoms may not tell us if their functioning is improving in other domains like at work or at home. If we want to deliver holistic care, we have to understand the impact that care is having on all facets of a person’s life. 

To tie this back to the workplace and factors that are important to employers as they’re investing in mental health benefits, symptom reduction is a piece of the puzzle they should be evaluating. Does the solution you’re providing drive meaningful improvements in clinical outcomes should be the first question.  And you can take it a step further: are employees demonstrating meaningful engagement? Can they build skills that help them in their personal and professional lives? Are they engaging in strategies that will set them up for long-term health? In order to answer these questions, we need other data points from multiple modalities of mental health and well-being care and support.

What role do workplace culture and environment play in influencing mental health outcomes for employees, and how can employers address these factors effectively?

Ultimately, we have to acknowledge that, similar to many health domains, individual change, like going to therapy, is a small aspect of improving mental health. Work plays a big role in many of our lives, which means that if things are not good, they can take a toll on us both mentally and physically. 

The US Surgeon General’s report on workplace well-being from a couple of years ago really did a wonderful job of highlighting how the workplace directly impacts our well-being and mental health. The framework from that report really creates an actionable guide for employers to make changes across the pillars (Protection from Harm, Connection and Community, Work-Life Harmony, Mattering at Work, and Opportunity for Growth) that can result in improving employees’ experience at work. 

What are some examples of innovative strategies or programs that Modern Health provides to support employee mental health beyond traditional symptom reduction techniques?

The first thing that I would call out is that our core benefit, which includes access to evidence-based digital content, Circles (our group offering), coaching, and therapy, are already impacting outcomes beyond just symptom reduction. We have peer-reviewed papers that demonstrate that our platform helps members reduce symptoms of depression and anxiety and we have papers on other outcomes. One of our papers demonstrated that after using Modern Health for 3 months, members improve their loneliness. To me, this finding is amazing because loneliness could be as detrimental to people’s health as smoking 15 cigarettes daily! We’ve also presented data that Modern Health members improve their physical activity after engaging in the platform, which is another key health behavior that improves long-term mental and physical health outcomes. 

My team, the Clinical Research team, is focused on examining what other types of outcomes we’re impacting because that helps us know if we are having a holistic impact, and it helps us innovate in the product about areas where we can really optimize our care. This leads to a more direct answer to the question: at Modern Health, we are taking our programs beyond just those that are only focused on symptom reduction. That could look like working with a coach on issues like financial stress or maybe improving health behaviors. It could also look like engaging in one of our Pathways, which are a combination of 1:1 meetings with a Pathways specialist paired with digital content specific to the topic you may be working on. Modern Health Pathways is the first of its kind in the digital mental health industry and the only modality of care that guides members through specialized topics with an evidence-based structure, ongoing 1:1 support from a dedicated Pathway Specialist, self-guided experiences, and topic-specific assessments to measure impact. We have a full set of Pathways that are specific to the workplace, like those for managers, and we have some for parents, too. I’m most excited this year that we’ll be going deeper in how we’re focusing on the intersection between physical and mental health. We already know Modern Health helps members improve their physical activity; now, what would happen for members who sign up for a Pathway specifically focused on improving that key health behavior? 

How can employers measure the success of their mental health initiatives when considering factors beyond symptom reduction, such as employee engagement, productivity, and overall satisfaction?

In my mind, employers should be looking for initiatives that maximize value. What I mean is that you don’t want something that drives a lot of engagement but doesn’t actually move the needle on mental health. You also don’t want something that’s VERY effective at improving mental health, but no one at the organization uses. You’re looking for that sweet spot of something effective that drives high engagement. 

This may mean, when it comes to mental health, making sure that it delivers clinical outcomes like symptom reduction. And then taking a broader look from there at other indicators that are relevant to more of your population. So, can members learn skills that help them manage better? Can they gain a sense of community in the offerings? What about modalities of care that support them in mental health adjacent domains like parenting stress? I think other areas where we can get quantifiable metrics are things like retention (i.e., is retention improving for members that engage in the initiative?) and satisfaction (i.e., do members like the initiative).