Beyond Benefits: Building Personalized Mental Health Support at Work

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Text: Wednesdays with Woodward (registered trademark) Webinar Series.

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JOAN WOODWARD: Hello, everyone, and welcome. Welcome to Wednesdays with Woodward. I'm Joan Woodward, President of the Travelers Institute.

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Before we get started, as always, I'd like to share our disclaimer about today's program. I'd

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Text: About Travelers Institute (registered trademark) Webinars. The Wednesdays with Woodward (registered trademark) educational webinar series is presented by the Travelers Institute, the public policy division of Travelers. This program is offered for informational and educational purposes only. You should consult with your financial, legal, insurance or other advisors about any practices suggested by this program. Please note that this session is being recorded and may be used as Travelers deems appropriate.

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also like to thank our program partners, the Master’s of FinTech Program at UConn, the CBIA, the MetroHartford Alliance, the Independent Insurance Agents & Brokers or the Big I, NAAIA, the National African American Insurance Association. So, thank you all for partnering and your tremendous support of the Travelers Institute.

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Logos: Travelers Institute (registered trademark). Travelers. Master’s in Financial Technology (FinTech) Program at the University of Connecticut School of Business. CBIA. Big I (registered trademark), Independent Insurance Agents and Brokers of America. NAAIA, National African American Insurance Association. Metro Hartford Alliance. Text: Beyond Benefits. Building Personalized Mental Health Support at Work.

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OK, let's get started, everyone. So earlier this year, you probably remember we launched our new educational platform called Forces at Work, where we aim to help today's leaders navigate the shifting dynamics of the modern workplace. As part of that initiative, we've been looking at worker mental health, well-being and how employers can help support employees.

Earlier this year, at our Forces at Work symposium at the New York Stock Exchange, we heard from former U.S. Surgeon General Dr. Jerome Adams, who told us that the state of mental health in America has profound impacts on businesses, our workforce and the economy, for sure.

According to the National Institutes of Health, anxiety disorders affect 40 million U.S. adults, and depression affects 17 million, while direct costs for treating mental health conditions totaled $210 billion a year. Dr. Adams told us that many of those costs are shouldered by employers, and untreated mental health conditions cost them even more by affecting productivity, decision-making and employee turnover.

Clearly, it seems that employers have a direct interest in the mental well-being of their workforce. How can employers play a proactive role in improving mental well-being? That's what we're going to talk about today. What strategies can organizations of any size implement today to improve mental well-being among their workers? So, we're so thrilled to bring this webinar to you to explore all these questions with two fantastic experts in their field.

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Today's Speakers. April Koh, Co-Founder and CEO, Spring Health. Greg Landmark, Senior Vice President, Total Rewards and People Analytics, Travelers.

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First, we have April Koh. She is the CEO and Co-Founder of Spring Health, a comprehensive mental health benefit for employers and health plans. April is one of the few female CEOs and one of the youngest leading a unicorn company. Woo-hoo! And that is a company valued at more than $1 billion.

April, we're so thrilled that you were able to join us today. And you got your idea from this company while in college, I'm told. But I'm going to let her tell you about that story and what inspired her.

But after graduating, April and her co-founder, Adam Chekroud, launched Spring Health, a mental health technology company that uses AI to connect patients with tailored care. I'll let her tell you more about how all of this works, but she was named one of the 15 Most Powerful Women in Startups by Fortune Magazine and is an honoree at Marie Claire's Power List, Forbes 30 under 30, and Crain's 40 under 40. So we're thrilled to have you with us today, April. Welcome. Thank you for joining us.

Also joining us today is my colleague and friend Greg Landmark. He is the Senior Vice President of Total Rewards and People Analytics at Travelers. He's been with us for more than 25 years, leading Total Rewards, including compensation and benefits, for over 20 years.

In 2024, it was Greg's idea to bring Spring Health to Travelers, along with our CEO, Alan Schnitzer. And today, our 30,000 employees have access to mental health care benefits. He's going to tell us more about that. But before joining Travelers, Greg worked as an Actuarial Consultant at Hewitt and an HR Strategies Consultant with Deloitte.

All right, so let's get into it. First, I want to talk about the landscape and the scope of mental health problems in the United States. Let me set the scene for everyone here. As I mentioned at the top, mental health challenges impact us every day. We published a white paper at the Travelers Institute earlier this year called "Investing in Mental Well-Being-- A Guide For Employers," which highlights statistics on the mental health crisis in the United States. We're putting a link right now in the chat.

But let me just tick off a few of these statistics and findings. Twenty-three percent of U.S. adults experience symptoms that would meet the criteria for diagnosable mental disorder. When it comes to the workplace, 83% of U.S. workers report daily work-related stress, and almost 3% of working adults age 18 to 64 experience psychological distress, according to the NIH.

This rate was 78% higher for individuals working evening or night shifts, and 100% higher for those in anticipated losing their jobs in the next 12 months. So I just wanted to share-- add this to this all. Back in September, we heard from Lindsay Jurist-Rosner-- she's Co-Founder of Wellthy-- about the stress of the juggle. That is the stress for 53 million workers who do double or triple duty as caregivers, taking care of children, parents and/or ill spouses.

So that's a lot to unpack here. First, I want to go to you, April. I think you're the expert in talking about this, given your history of building this company. I think to some extent, we all feel these statistics are sobering. So what are the headlines right now in mental health, and what are the macro trends that you and your company are seeing?

APRIL KOH: Yeah. Thank you so much for having me, Joan and Greg. It's a delight to be here. Yeah, unfortunately, Joan, the data shows that things are getting worse and not better.

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A person sits with their elbows resting on their knees and their hands clasped in front of them. Text: This is a pivotal time for workplace mental health. Key statistics. 65% of employees say they are as stressed or more stressed than they were five years ago. 21% decline in global employee engagement, with managers experiencing the largest drop. 52.1% of U. S. adults with a mental illness received treatment. 48.7% of U. S. adults have used LLMs for psychological support in the last year. Footnote: Sources. Forrester (Spring Health), Gallup, SAMHSA, American Psychological Association.

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A new global study actually showed-- it involved 150,000 adults across 29 countries. And it showed that 50% of people, so one out of two people, will face a mental health condition in their lifetime.

And on average, if you adjust for age, the annual U.S. suicide rate increased by 30% between 2000 and 2020. And unfortunately, the macro trends in mental health are getting worse for younger generations. There is an acute mental-- youth mental health crisis going on, with suicide being the second leading cause of death among 10- to 14-year-olds.

So mental health issues are getting more and more prevalent, but most people don't actually get the care that they need. So as you see up here, only about half of U.S. adults with a mental illness receive treatment. And it takes, on average, an astonishing 11 years to get care that's effective for you. And unfortunately, the failure rate of the first treatment is very high. And even if people get the access to the care that they need, the care doesn't actually work for them. And it's because usually, the care is poorly personalized to the individual. So the care is not right for the person.

And so people have to try a bunch of different treatments, different programs, providers, until they kind of randomly find something that works for them. So that's the status quo.

But a few things give me hope. So, especially after COVID, I think boardrooms started to realize the correlation between employee well-being and employee performance and productivity. And so instead of just being kind of something that benefits departments were prioritizing or health plans were prioritizing this, or HR was prioritizing, generally, employee well-being and mental health became a priority for boardrooms and C-suites.

And so you're seeing significant investment in employee mental health over the past-- or increased investment over the past 10 years in solutions like Spring Health. And I can get into what Spring Health does in just a second. But what we've shown is that with high-quality easy care or easy-to-access care, most people do find recovery and most people do feel better after receiving care from Spring. So that gives me hope.

JOAN WOODWARD: April, thank you so much for that overview. And so, Greg, I want to go to you, because mental health is a topic that some people don't want to discuss. It’s no longer a topic that we can afford it for at work. So let's talk to about how our current mental health crisis impacting businesses and what does this mean for employees as well. So employer and employees to you, Greg.

GREG LANDMARK: Thank you, everybody, for joining our discussion. I'll build on what April said. I mean, it's an important business issue for sure. Like we've been tracking medical trends and things like that. And there has been increase in mental health claims inside a medical plan. So it was a topic there.

And we saw that. And a lot of companies build wellness programs, initially probably physical and financial wellness. Then we realize the importance of mental wellness and the impact it has on the company and what happens there. But also, like you said, the impact on employees.

And we want employees to succeed at work and in life. And when there's-- like the statistics say, so many people are impacted by mental health. And for people to be successful at work and to be able to be productive and to thrive in their work environment, we need to support mental health for sure.

JOAN WOODWARD: OK. So April, back to you. I want to go-- we teased earlier about how you started this kind of back in your dorm room at Yale, and now you've built it into a company that has, what, 13,000 mental health consultants and over 1,500 people working at your corporate headquarters. So share your story of how you founded this, how did this idea come to you, and how were you so successful so early in your career.

APRIL KOH: Yeah. So I started Spring Health almost a decade ago in my dorm room at Yale. And I was in my last year of my undergrad. And I had kind of gone through this 10-year journey with my own mental health. I had gone through extensive trial and error to find something that would work for me and my mental health issues.

And I really went through program after program, provider after provider. And every time something wouldn't work, I would just feel this profound hopelessness that nothing would ever work for me. And thankfully, I did find recovery. I did get better.

But coming out of that journey, I was just so struck by how hard it was to understand what I was struggling with, to understand my options and then ultimately to get access to the care that was right for me. And I was so struck by how much of mental health care felt like a total guessing game.

And so I thought, this has to be a lot better. Everything else in my life was becoming digital or already digital. And everything else in my life felt much more data driven. Mental health just felt like completely left behind and completely analog.

So I looked for innovations and technologies that were emerging to address this problem. And I came across this paper that a Yale scientist had written in one of the world's top medical journals. And it was authored by a gentleman named Dr. Adam Chekroud. And he was this kind of up-and-coming Yale scientist.

And he proved through this paper for the first time that machine learning could actually outperform the average psychiatrist in matching people to the right treatment for them. And I was-- I read the paper and I thought, this is the future of care. It's going to be data-driven. There won't be any more guessing. And science and technology will allow us to much more precisely care for individuals.

And so I reached out to the author of that paper cold. I just looked him up on the university directory. And I said, if I had had this science and this technology when I had gone through my own journey, it might have changed my life. And I want the opportunity to bring this research and this technology to the hands of real people and really make a difference. Like, would you consider starting a business with me to scale the technology?

And we became fast friends. And he also was very passionate about bringing his work outside of the bounds of academia. And so that was like 10 years ago. And that's how we got started with this vision around science, around bringing a data-driven approach, which we call Precision Mental Healthcare, to mental health and really revolutionizing the way mental health care was delivered.

And in the early days, we really worked on the algorithms and the R&D. And then a few years in, we started to look for a business model that would help us scale this and bring it to real humans. And we found this incredible opportunity with employers because what we found was that organizations, and this was even pre-COVID, organizations were really starting to urgently look for alternatives to their employee assistance programs because they were realizing their EAPs were failing employees in delivering really long wait times or providers that weren't necessarily a good fit. And they were really struggling with their mental health programs.

And especially the younger generations and millennials were starting to come into the workforce and starting to say, we need better and-- we need better support for our mental health care. And so HR departments were urgently looking for new solutions.

And so that's where Spring came in. And we really took off. We found this really strong demand from employers early on. And then COVID happened, which really started to elevate the conversation around mental health in the workplace, especially in boardrooms.

And so now we're the scaled organization. We cover over 20 million lives and give them access to the highest quality of mental health care possible. And that includes self-guided resources, like meditation and mindfulness exercises, AI, includes coaching, therapy, both virtual and in-person. And as you mentioned, we have over 13,000 global providers who are supporting these employees and their family members.

JOAN WOODWARD: That's really wonderful. And thank you for that background. It's just fascinating how life is all about fate, who you meet and the connections. And so, first of all, thank you for creating such an amazing company, especially our employees are benefiting. And I know many, many thousands and hundreds of thousands are benefiting from your vision. So thank you for that.

I want to dig deeper into the effects of the economy and what the untreated mental health conditions might cost employers, productivity, decision-making and employee turnover, which is a big thing. So, Greg, first, I feel like the business case writes itself for employers to care about employee mental well-being. So why don't you tell me what should employer-- why should employers care about the state of mental health in America?

And again, what are some things that we've done about it? We're going to get into later how we connected with Spring Health. But why should employers care? And maybe even speak to the small mom-and-pop smaller businesses versus the large companies who maybe already get it.

GREG LANDMARK: No, great question. And the statistics tell it, but your workforce is probably dealing with things that you don't see. It's not always visible, but it has such an impact on how people come to work or how people help productivity, the way they interact with people, the way that they thrive at work. And so we should care from a productivity standpoint, but we should also care from taking care of our workforce and helping serve overall well-being of our employees.

And I think that combination, the return on supporting people's mental health is so powerful because it, again, it helps people be more productive, but it makes a connection to people and to the company. And when you can support someone's mental health, I mean, it's life-changing. I mean, April told her story and think about doing that person by person throughout your organization and the impact it has on lives, I think, is incredible. A business case is so strong.

And April said it earlier. It's more of a-- and Joan, you said it as well. Our CEO saw that awhile back and made the comment to me about, hey, this is something that we need to lean into and strongly support because he and our leadership team saw the value of having-- supporting the mental health of our workforce. And I'll share more specific stories and stats later. But I'm really excited about the impact it's had at Travelers.

JOAN WOODWARD: All right. And April, same question to you, the business case. So you're talking to the CEO, who maybe doesn't get it and doesn't understand why it's important to think about this as a topic for employees. What do you tell them?

APRIL KOH: I mean, it's like what Greg said. There are so many-- there are a few major reasons why CEOs should care about this. I mean, the first main reason is that mental health issues are a significant cost driver for organizations from even when you strip away, like productivity and all that stuff. And just look at health care costs, It's a significant driver.

So unfortunately, health care costs are increasing at an unsustainable rate across the board, globally, but especially within the U.S. And the burden for employers to bear is increasing in an unsustainable way as well. Costs have increased 8% to 9% in 2025 alone. And so a lot of employers, a lot of organizations are really struggling to control this spend and contain this spend.

And mental health contributes significantly to it, both directly and indirectly. And if you look at your claims data, you won't see mental health claims necessarily rise to the top of the list. But what you will see are physical-- the cost of physical conditions explode because of underlying behavioral health issues. So if you take someone with a physical, chronic condition like a diabetes or asthma, and if that person, a person that has that chronic condition with depression and a person who has that chronic condition without depression, the difference is meaningful. So with depression, the costs go up 2 to 6x.

And this makes a lot of sense, because if you're depressed, you're struggling maybe to get out of bed, you're struggling to adhere to your care plan, you're struggling to take your medications, you're struggling to go to your doctor's office and have those routine visits. That means that the chances that you escalate and go to the ER or get hospitalized for chronic condition, the chances of that goes up. And so your costs start to increase significantly. And that’s-- those are the costs that employers are bearing today.

So if you're able to successfully treat the underlying behavioral health conditions, you can curb that physical spend significantly. And that's what we've shown across all of our customers. So what we've shown is that for every dollar an employer invests in Spring, they get $2 back from health care savings alone.

And then when you layer in the productivity savings-- so when I say productivity savings, I'm talking reduced sick days, I'm talking reduced turnover, things like that-- you actually get $4 back for every dollar that you invest in Spring. And that's because someone who engages with Spring, they're 22% less likely to turn over and they have 12% fewer sick days. And these are things that we're able to quantify and measure through our data.

So employers should care because of the impact to the bottom line. And then also, employers should care because managers actually impact someone's mental health just as much as their spouses impact their mental health. So actually, the impact of managers on someone's mental health is very, very high relative to other people in their lives. Actually, the impact of managers on someone's mental health is higher than their doctor or their therapist.

And so employers have such tremendous impacts on someone's well-being and mental health. And so employers should care because they're part of the equation in that way. And so it's no longer just like an HR initiative to take care of employee mental health. I really believe it's a business imperative that all CEOs should care about.

JOAN WOODWARD: I really love kind of talking about the dollars because you have to connect it back to productivity, the business bottom line, in addition to, of course, taking care of each other. But I want to talk about how we got here, April. So maybe there's some historical factors that you've identified that have contributed to the current state of where we are and how can we effectively address these long-standing issues.

APRIL KOH: Yeah. There are a few macro trends that are happening that I think are all coming together and resulting in this mental health crisis that we're confronted with. And I think, one, the rise of hybrid work has really started to blur the lines between work and life.

And people are, for lack of a better terms, like always on. And so the risk of burning out has significantly increased. There's this always-on culture that is impacting our ability to rest effectively and recover effectively from our hard work.

There's also this loneliness epidemic that's been brought on by this hybrid work, a culture that's emerged especially because of COVID. And there's also this correlation between social media and anxiety, especially among our youth. So Jonathan Haidt actually writes about this extensively and talks about this. And I would highly recommend his book.

But especially for the digital natives, who are entering the workforce, and the younger generations, who are making up our workforce, they've kind of grown up with this new world of omnipresent social media and the anxiety that comes from that. And then there are other macro trends that are impacting our mental health, like climate anxiety is something that especially impacts our younger generations. There's a lot of geopolitical anxiety, financial stress because of the economy.

And then there's actually anxiety rooted in the pace of change in today's world. And something that we've uncovered in our data, interestingly, is a lot of feelings of shame regarding-- related to someone's inability to adopt these new tools and technologies as quickly as they think that their peers are. So there's a lot of job-related anxiety as well.

And so there are a lot of factors contributing to this increased or this elevated mental health risk that employees face today. And so I think that we fix this-- we can't fix it all. But I think that organizations can do two major things. One is make sure that the mental health care that you offer is high quality and accessible and personalized, so that's kind of where we play at Spring.

And then the second way that organizations can support their workforce is where we or we can help also is really building a culture of mental health. And in order to build a culture of mental health, you need to talk about mental health and destigmatize mental health, but also you need to have, clear, high-quality management. People often underestimate the role of good management in a workforce's mental health.

And so there's no silver bullet that can solve all of these big problems. But on a fundamental level, one, you need to make sure you have a great strong mental health benefit. And then two, you need to make sure that your culture sets your employees up for success.

JOAN WOODWARD: That's wonderful. I really love everything you said about practical steps and tips that employers can take. Greg, I want to talk to you just for a moment about how organizations can then support our employees while maintaining performance standards and meeting your company's corporate goals. So performance standards, company goals also come into play here. Well, it's a balancing act.

GREG LANDMARK: No, absolutely. So I think there's a concept of still having-- always having the high expectations but then providing great support for people to achieve those expectations. And I think that's often built into the ways companies perform, like they have great tech support to help people reach their expectations.

But I think to set high expectations, that also means providing good mental health support. So how do we make sure people are thriving mentally as they're approaching their work and their jobs and stuff?

And there's a lot of factors that come into play, like April just went through. You think about each workforce and the challenges that each individual brings to work and to think about-- we still have high expectations. We want people to thrive and work hard and do all the right things, but we want to do-- them to do that with a healthy mind.

JOAN WOODWARD: And so, Greg, why did you feel it was important to bring this to Travelers? And what has been the impact now here?

GREG LANDMARK: Yeah, no, it's a great question. So it's interesting, as I was mentioning before, we were seeing, as April said, the increase in the health trends of mental health claims and things like that. And then our CEO had brought up the need to provide more mental health support.

And some of the things that we talked about before, we had an EAP program where we would have about 3,000 cases a year, where we would give out a referral, but we wouldn't know how many people would see that person. And we heard a lot of anecdotal feedback that say it might take a month to be able to see a therapist.

And we didn't know necessarily if they were getting to the right level of therapy, which I know that's April and Adam-- was the origin of their organization and stuff like that. And then COVID came along, and we-- and there was more emphasis at corporate-- a lot of companies. And it was that case at Travelers, too.

And so we knew it was important to do more and to be better, but not just to provide the benefit, but try to be a leader in this space and try to do-- have an impact that would impact our employees and impact our business. And so that was a lot of the driver.

The other piece of the driver, and you talk about corporate goals, and Joan, as you know, we have a stated purpose that says we take care of our customers, our communities and each other. And part of taking care of each other is supporting people's mental health.

And so we felt like, it was important to do this at another level. And I'm thrilled to say what we've accomplished since we've leaned into this more for sure. And I can share some stats, or I can wait till a little further on, but I'm so excited about what has been accomplished so far.

JOAN WOODWARD: OK, and let's talk a little bit about the history and the stigma associated with this mental health condition in America, why a lot of people don't seek help they need and why it's a taboo topic in a lot of workplaces. And again, the older generations maybe did never talk about this. And how do we end that stigma associated with this so people can seek help? Greg, to you first. And then, April, I want to get your thoughts as well.

GREG LANDMARK: No, absolutely, absolutely. That's one of the biggest hurdles to overcome early on changing like company culture kind of changing people's minds on this. And it's interesting that it depends on your background, maybe your generation, all those types of things, what your views are on mental health and the importance of mental health and stuff like that.

And so I think one of the biggest things that's happened at Travelers, and I'm so grateful for it, is leadership may-- took a big step towards this. And this is our CEO and the full leadership team at Travelers leans into this. And as you know, our CEO talks on his quarterly all-employee calls. He has-- on October, he talks about benefits each year.

And for a number of years, he has a “shatter the stigma” slide. And he puts it up there and from his chair says, we need to shatter the stigma. And from that, from his role, and then from all the senior leaders’ role, supportive mental health, I think it's so important.

And then I guess the second thing about it, it's not even just saying it, but leaders sharing their stories, sharing their stories about the challenges that they have and how it impacts them, that allows their employees and others to have the psychological safety, I guess, to share that more. And so I'm thrilled with the impact that those things have had at Travelers and in breaking the stigma.

And we're not all the way there. I still think there's more to do, but we've come such a long way in the last couple of years.

JOAN WOODWARD: April, same question to you.

APRIL KOH: I mean, I just want to echo what Greg was saying about the role of leaders in breaking that stigma. I think that when leaders even just talk about the importance of mental health in the workplace, that moves the needle. But what moves the needle the most is when leaders themselves get vulnerable about their own journeys, because stigma really stems from this belief that people won't-- will think, I can't be successful if I have a mental health issue or if I struggle with my mental health.

And the reality is leaders struggle with their mental health all the time. And they also have family members who are struggling as well. And so the more we can normalize mental health issues just on par with physical issues and their impact to our ability to bring our whole selves to work, I think, the more we can break the stigma.

And what we see at Spring is the difference between organizations that have leaders announce the benefit and talk about why the benefit is so important versus those organizations that don't do that is profound in terms of engagement. So the leaders who talk about it really get their organizations to engage. And they have really high participation in Spring Health.

And then those organizations who don't have that kind of top-down launch or announcement or elevation of the benefit, they don't see as much participation. And so I do see even just on a quantitative level leadership just has such an impact on engagement, utilization and ultimately breaking the stigma within organizations.

JOAN WOODWARD: I love that and just having your CEO or the head of your company talk about it, just put it up on the slide, as Greg says, make it an important initiative within your benefits open enrollment, right, is also important. April, to you, want to talk about we see a lot in our construction business that some industries struggle with this more and certainly one of the most effective approaches you've seen for creating these psychological safe workspaces for industries that maybe are historically high and having trouble dealing with this issue.

APRIL KOH: Yes. So, one of the things that we started to notice at Spring was industries with a heavy male population, middle-aged male population, to be specific, were really struggling to get high engagement. And so a few years ago, we did this whole study at Spring to really fully understand how to best engage men specifically in mental health care.

And we came up with this acronym that I think is helpful for a lot of our customers and a lot of the organizations that we work with. And the acronym is MEN. And it stands for Medicalize, Externalize and Normalize. And it basically speaks to how you can talk about mental health care in a way that doesn't alienate the male workforce, but-- especially the frontline workforce, but really engages them and gets them to come to the table.

So medicalize, it really refers to stress manifesting as physical symptoms. So don't let your physical symptoms go untreated. Talking about stress as a medical issue tends to resonate more. Externalize, it refers really to life, money, work, family, it's stressful. It's not your fault. It's like the things around you that are causing your stress.

And then normalize is referring to stress is common. Everyone struggles with stress sometimes, so you don't need to hide from it. So leaning into those themes in our communications and our engagement tactics for the male populations have proven to work really well for us.

And then generally, when you're talking about psychologically safe workforces, I think, ultimately, what is most important is training your managers. You need to train your managers to recognize early warning signs.

And the data shows that 60% of crises are prevented when intervention starts at the manager level. And managers don't need to be mental health professionals, but they do need to know the basics of what to say, what not to say, and then how to refer someone into mental health care. So I think manager trainings are really, really important.

JOAN WOODWARD: OK. The moment we've all been waiting for, getting into actually how Spring Health works, and maybe a lot of people don't understand how AI can tailor care. And so, first, April, to you, exactly how does Spring Health work. And then to Greg, to you, what are some of the success stories that we've seen at Travelers? I know you're going to give us a very large number of people who've taken advantage and use Spring Health at the company, which we're thrilled to see. But first to you, April. How are you using AI to tailor this care?

APRIL KOH: Yeah. So it's actually quite simple. We partner with organizations like Travelers, and we first create a custom engagement plan for our customers. So we say, OK, based on your culture, based on the communication channels that work best for you, how do we announce this benefit? And then how do we make sure to grow and scale awareness around this benefit for employees?

And so that engagement plan might include a home mailer. It might include an email or a series of emails. It might include an announcement at all hands. It might include webinars. But it's really a custom engagement plan. So you might hear about Spring from a number-- through a number of channels.

So let's just say that you get an email from Spring, saying, you now have access to this benefit. You have a certain number of sessions sponsored by your employer, coaching or therapy sessions, et cetera. So then you sign up for the benefit.

And you take a very brief assessment. And the assessment changes based on your responses. And it's really meant to understand your situation and your preferences very thoroughly, so that we can precisely match you to care and support that is appropriate for you.

So if you're someone who is just dealing with mild work-related stress and you don't necessarily need clinical care, but you want to talk a hard-- you want to talk through a hard issue with someone like a coach. Then we connect you to a coach, and we actually pair you to the right coach for you.

If you're someone who is struggling with a clinical issue that needs a therapist, a licensed clinician, then we not only pair you-- we not only recommend that you see a therapist, but we also pair you to the right therapist for you based on your preferences and based on what you're struggling with. And you can see these providers same day, next day, guaranteed. And you can see these providers virtually or in person. So you can engage with them via video, or you can go in person to see them.

And then you also are paired with a care navigator, who you can reach out to and interact with on an unlimited basis. And they're really there to make sure your mental health journey is as successful as possible and as personalized as possible to you.
So if you need help sifting through the provider choices, then the care navigator, who is also a licensed clinician, they can also help you sift through the provider and make the right recommendation for you. So that's how Spring works. It's very easy. And we track your progress over time. And ultimately, we hold ourselves accountable to either your recovery or just, in general, your thriving.

JOAN WOODWARD: Wonderful. All right, Greg, to you, tell us about all these wonderful success stories that I know I've heard about at the company here at Travelers.

GREG LANDMARK: Oh, thank you, Joan. I'm so excited to do that. And thank you, April, for the great partnership here, because what's happened in the less than two years has really been incredible. And maybe I just start with a couple of things, like the-- I think Spring has a goal of removing all barriers to mental health. And then when we think about the way that their tools work and how it's impacted our employees.

Finding the right level of care for a person, I think, is important. So I think completing that-- the short, customized survey is important. And then I think when it's kind of shocking to employees when they do this, and either on the app or on their screen or on their computer, they'll say, here's a few therapists are available at these times for you, like today or tomorrow. And it's like-- for people, who've been through this to say, like tomorrow, I can see somebody that's like lined up for my needs in person or virtually is such a great experience, start out and stuff like that.

So that's what's happened. That's what people are doing. And then they're getting that level of care. And then that builds a culture. So when that happens to somebody, they're talking to other people about it. And it builds, and then we're communicating.

So I mentioned earlier that we used to get about 3,000 cases a year where we do 3,000 referrals. Now in less than two years, we just crossed 50,000 appointments completed in less than two years. So what's amazing about-- that's a number of things.

So one of the things that's amazing about that is the fact that we know that the appointments were completed. Because of Spring Health's great technology, they are able to have the providers, but then they can tell back to us and say, did the person complete the appointment? And so we know that they did that. It's all private. We don't know who it was, but we know the appointments were completed and all of those types of things.

So it allows us to better measure the impact. So when April talked earlier about that there's at least a 2x value on the medical savings, we've seen that and even more like in our population. So that's been great. So that 50,000 number is so important to me.

But then also important is the people improving, how quickly people improve from whatever diagnoses they have. We've seen great statistics around that. And then also like the level of care, we offer something called Specialty Care with Spring Health, too. That goes after more intensive needs like substance abuse or trauma or eating disorders. We've seen huge impacts on the lives of our employees.

So it's culture changing. And it's impacting people's lives. It's helping with the relationship with employees. It helps retain great talent. It helps people thrive at work and at home. And so we're excited about what's been accomplished.

JOAN WOODWARD: That's wonderful, Greg. It really is wonderful to hear. And that's dependents and employees when you say the 50,000-person number. So that's most exciting, too. So Greg, just to you for a minute, what are the most common barriers you see in actually rolling out these initiatives? And how can a leadership team overcome them quickly? Well, what are some strategies that you've employed, we've employed?

GREG LANDMARK: Yeah, yeah. So I think the one is like it's not just a HR topic or it's not just a benefits topic. I think one of the barriers is getting like leadership buy-in and company buy-in and getting managers involved and stuff, too. And so I think that's one barrier that happens.

I think the other barrier is, what is the experience that you're going to provide to employees? If they have a great experience, then it'll continue and it'll build and it'll grow. But if it's difficult and they can't find a provider and things don't go well, then I think that becomes a barrier as well.

And so I think that plus always continuing to educate people on mental health and things like that, because there is the stigma and there's different levels of mental health needs and things like that. And meeting people where they're at with the right level of service, I think, is important, too.

Those are a few of the barriers, like getting that support, understanding the ROI. And the ROI is bigger than just the mental health costs. It's all the other things that April mentioned as well. So those are a few things I would highlight.

JOAN WOODWARD: OK, great. I'm going to skip a little bit down kind of our pre-questions, because I want to get to a slide that we had in our Travelers Institute, "Investing in Mental Well-Being-- A Guide for Employers." We have five actionable steps if we can put that slide up.

And I want to ask both of you to comment on these steps.

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Five actionable steps managers can take to support their employees' mental well-being. From Travelers Institute's "Investing in Mental Well-Being, A Guide for Employers." 1, Open Communication. Foster open communication about mental health. Normalize conversations about stress, burnout and seeking help. 2, Active Listening. Practice active listening skills to create a safe space for employees to express their concerns. 3, Recognize Signs of Distress. Train managers to recognize common signs of mental health struggles, such as changes in mood, productivity or behavior. 4, Regular Check-Ins. Schedule regular one-on-one meetings to discuss workload, goals and overall well-being. 5, Lead by Example. Demonstrate healthy work habits by taking breaks, respecting boundaries and maintaining a positive attitude.

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And in the meantime, my audience members can submit your questions in the Q&A function. We have a lot of questions coming in, actually a lot on the same topic. So we're going to hit a lot of topics with the question-and-answer session.

But April, to you, first. Let's talk about these five actionable steps that we're seeing on the screen right now and what your thoughts are on them.

APRIL KOH: Yeah. I mean, these are-- this represents the blueprint for managers and how to best support employee mental well-being. So I'll go through each of them really quickly. So open communication, so normalizing the conversation around stress and burnout. Talking about your personal experience with stress and burnout, that can really start to open the dialogue.

Active listening, so not only hearing what people have to say, but also kind of seeing and observing more closely and your employee's behavior to look for signs for stress and burnout. So actively listening to understand changes in their mood, their energy, their engagement, recognizing signs of distress, which is related.

Regular check-ins, so proactively bringing up the conversation around someone's well-being, someone's balance between their work and life. And also, leading by example, so really demonstrating healthy habits.

Like, for example, what I do is I talk a lot about recovery at Spring. So just like high-performing athletes really build in deliberate recovery in their schedules and in their training programs, we do the same at Spring. And whenever I go on PTO or whenever I take some rest or recovery for myself, I'm very vocal about it, and I celebrate it for myself so that I can normalize that culture of rest and recovery in a high-performance environment for the rest of my team.

JOAN WOODWARD: All right, Greg, do you want to speak to a few of these that really stand out to you?

GREG LANDMARK: Yeah. I'll just mention a couple of them. And I'll start with what you said earlier, Joan, and April said it, too. The relationship between the manager and their team is so important. So that's-- as far as mental health is concerned, that relationship is really, really critical.

So like the open communication, I think that includes managers being aware of the support structure that's available and really listening. So I'm not going to go through all them, but listening, I think is really important.

And then that maybe I would just highlight the leading by example. Like April said, being like celebrating when a person needs to take PTO or they're taking PTO and what they're doing but also sharing the mental health challenges leaders have or managers have with their employees, too. So it opens up that dialogue.

I think that if a person has a hurt ankle, they'll show that physically and they'll say that. But if they have a mental health challenge, I think it's OK for managers to share that, too, and whatever-- however they're working with that, so that employees see that. And I think those are important. I think these steps are, again, the relationship between the manager and employee is so important. So thanks for sharing this.

JOAN WOODWARD: OK, great. I asked everyone to fill out a survey. Please fill out a survey about today's session. We're going to drop that in the chat. We're going to get to a lot of your questions as many as we can. But first, I want to get to April. Looking ahead, what are your bright spots in your mind regarding the future of mental health in the workplace and the country?

I mean, are people really recognizing this is an area of focus for managers and employees? And what steps can managers, employees, CEOs take to get to where maybe Travelers is in this journey? What are some bright spots do you see? Then we're getting to all of our audience questions.

APRIL KOH: Yes, yes, yes. Well, I'm really optimistic about the future of mental health in the workplace. I think that what we see is more and more CEOs and boards investing in this because they see the science and the data really correlating mental and emotional well-being with performance. And so I do think that cultures are being transformed to put mental health front and center.

Something else that gives me a lot of optimism, and I think is a bright spot, is how mental health care is really transforming in the age of AI. And I think, what I like to say is that everything's kind of shifted from being episodic to continuous in our lives, and mental health is going through that revolution right now.

Mental health care as-- mental health care generally hasn't really changed over the past century. The modality of talk therapy has kind of stayed more or less the same. But now with generative AI, there's the potential to really transform the way mental health care looks like and make it a lot more continuous and accessible for people.

And people are already engaging with AIs to-- for emotional support and mental support. And what we're doing at Spring is really trying to bring AI to mental health care in a really ethical and responsible way to ensure that the AI tools that people engage in for their mental health are safe and effective for their mental health.

So we've been doing a lot of work to integrate these new technologies into our program and our solution, and it's making care a lot more accessible, so that people don't have to wait two weeks to see their therapist for the next time. They can get, in the moment, support when they need it.

So I'm really excited about that. We have a lot of work to do to make sure that these technologies are adopted responsibly and ethically. But I do think that it's going to be a good thing for the industry and for people.

JOAN WOODWARD: Wonderful. Well, thank you for all you're doing, of course. And thank you, Greg, for bringing this to Travelers. It's been life changing, I know, for a lot of people. All right. Audience questions, one of my favorite parts of our show.

First, we have a reporter from PropertyCasualty360. Elana Jefferson asks, what are the best practices for managing employees with mental health challenges? And especially she wants to talk about the legal considerations of that challenge. So maybe to any of you who want to answer that.

APRIL KOH: I can start and then maybe Greg--

GREG LANDMARK: Sure, I'll go answer the question. April, you go first.

APRIL KOH: OK, sounds good. I mean, manager trainings, as I mentioned earlier, are just so, so important. So, you have to train managers to recognize the signs of distress and to respond appropriately. And you have to remind managers that it's not their role to diagnose these issues, but really to notice, not label, and then route people to the right resources for them.

And there are some technical pieces of information that managers need to know. They need to know their obligations. They need to partner with HR and legal to understand ADA, FMLA and confidentiality requirements.

But in general, managers need to be trained to really understand how to foster cultures of mental health within their teams. And I think the thing that's tactically most helpful for managers is talk track, specific talk tracks that they can practice with and ultimately utilize. Never underestimate like boilerplate templates that they can start to work with, because sometimes managers fear even broaching the conversation because they don't know the right words to say. Greg, what are your thoughts on--

GREG LANDMARK: And I agree with everything that April said. And the things I would add are just a couple of things. The importance of it, this is real-- I mean, these are real things that people are dealing with. So the importance of having the procedures in place and the manager trainings because, in some cases, these are really important topics.

And so I said the-- I would say, the other thing is having the infrastructure, the resources available. So like our relationship with Spring Health is so valuable, because that's where the manager has to know that's available. So they can tell the employee and then the employee can be speaking with a professional, a therapist about their challenge.

So to accelerate that connection, I think, is best for the manager and best for the employees. And making sure you do that within that framework. And then making very visible your training to managers, to employees about those resources I think is so important.

JOAN WOODWARD: OK, wonderful. I like this question. This is from Adam in New York. How can one create support in a small company, say, 15 to 20 employees and still keep things private? I'm assuming there's a lot of small businesses out there saying, I'd love to do this. It sounds wonderful, but how do I do it? I'm a small employer.

APRIL KOH: So I've noticed a lot of small employers approach this through reimbursing therapy sessions for their employees, which I would discourage because that does lead to confidentiality conflicts. And so I would say, first of all, being a small team is a strength. You can really embed a culture of mental health through the right leadership and the right conversations as leaders.

I think for smaller companies, they should embrace solutions like Spring, cost-effective solutions like Spring to keep it all anonymous and private. But I do see a lot of smaller companies trying to approach this through reimbursements. And I would discourage from that practice. What about you, Greg? Do you have any thoughts on that?

GREG LANDMARK: No, I think I like that you said that can be a strength because at a small employer, you're setting the culture with that group. And so you think about how you approach that. But I would also say make sure you try to, however best you can, through a partnership or what-- however, to maintain that confidentiality and recognize that the importance of the structure that you put around it.

JOAN WOODWARD: OK. Wonderful. Elizabeth from Connecticut asks, how can you ensure an employee who appears to be fragile gets help, especially if they're resistant to it or don't want to talk about it? April, to you, maybe.

APRIL KOH: Yeah. I mean, I would always start with empathy and not pressure. So saying things like, I'm here if you ever want to talk. Also being kind of specific sometimes goes a long way. So maybe if you're noticing a particular behavior, you can bring it up and say, I noticed you don't turn your video on as much as you used to. Is something going on? Just to start the conversation.

And then also, sharing how you've benefited from mental health resources, again, being vulnerable, normalizing, help-seeking, all those things go a long way.

JOAN WOODWARD: OK, wonderful. Vivian from Illinois, how can we better prioritize mental health without compromising performance? So that's another thing I think employers worry about, struggle with. They don't want to compromise performance outcomes, P&Ls. Thoughts?

GREG LANDMARK: Yeah. I mentioned this a little bit earlier, too. I think the idea of saying, hey, we have high expectations, and we want people to thrive and accomplish their goals. So that still can be true. But at the same time, to do that, we're going to help-- we want to support you being as mentally healthy as possible and understand that connection and be confident about both conversations.

Performance is a real conversation, and mental health is an important and correlated conversation, too. I think it's really important to see that-- how they can work together.

JOAN WOODWARD: All right. Terrific. I cannot believe this. The hour has really flown by. I cannot thank you both for joining us. Please promise you'll come back on our program next year or the year after. We love to hear about the innovations going on here. So any closing thoughts from you, April or Greg, before I close our show and tell our viewers about the upcoming programs?

GREG LANDMARK: The one thing I just want to say is, Joan, thank you for giving us a chance to do this. And just the idea of helping people succeed at work and in life, and the importance of mental health, I just appreciate that. And I, April, thank you for the partnership and what we've achieved together.

APRIL KOH: Yeah. I just want to echo that and say, without great employers like Travelers, people wouldn't get the mental health care that they need to thrive. So I think employers and organizations play such a pivotal role, and we're really happy to support them, to support their employees' mental well-being.

JOAN WOODWARD: Wonderful. To both of you, keep doing what you're doing. Clearly, it's a resounding success, especially at our company. So thank you.

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Wednesdays with Woodward (registered trademark) Webinar Series. Take our survey. Link in chat.

(SPEECH)
And to my viewers, thank you so much for joining us. We have one final program for the year, December 10. We're going to be back at Claim University, our incredible claim training organization. And we're going to talk about our Risk Control Lab. And that'll be on December 10.

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Upcoming Webinars. December 10, Live from Travelers Risk Control Labs. Bringing Science to Insurance Risk. January 7, Economic Outlook with U. S. Chamber of Commerce Chief Economist Curtis Dubay. January 21, Real Estate Market Outlook with National Association of Realtors (registered trademark) Chief Economist Lawrence Yun. Register at travelers institute dot org.

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And then to kick off the new year, we have two webinars on the U.S. economy. We're going to do a deep dive on what's going on with U.S. Chamber of Commerce and the National Association of Realtors Chief Economist. And that will be January 7, January 21.

Also, don't forget about our podcast. We are at Apple, Spotify and Google, the Travelers Institute Risk & Resilience podcast.

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Watch at travelers institute dot org. Connect on Linked In at Joan Kois Woodward. Listen to Travelers Institute Risk and Resilience podcast wherever you get your pods.

(SPEECH)
Thank you to all of you for filling out our surveys. I read every single word that you write to me about what's going on and what you want to see on our programming. It's incredibly valuable.

So, thank you so much for your engagement over these many years. Our subscriber list is almost up to 100,000 people. And we're just so thrilled with that. And thank you for joining us. It's been quite a journey over the last five years with you all. So, take care. Happy holidays if I don't see you on December 10. And thanks so much for joining.

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