Employee Preference and Use of Employee Mental Health Programs: Mixed Methods Study

Mental health issues represent a prevalent challenge for employees and their employers, leading to substantial impacts on individuals, society, and the economy. Different employee mental health programs (EMHPs) can support employees in preventing and treating mental health issues. However, the impact of such EMHPs depends largely on the use behavior of employees.

This study aimed to gain deeper insights into employees' attitude and use behavior regarding EMHPs by investigating (1) employee preference and intention to use EMHPs, (2) factors that predict use, and (3) key facilitators and barriers influencing use.

An exploratory sequential mixed methods approach was applied, including a scoping review, qualitative interviews, and a quantitative web-based survey. Semistructured qualitative interviews were conducted with 15 employees to gain insights into EMHPs from the employee perspective and inform the creation of a web-based questionnaire. The quantitative web-based survey was conducted to collect representative primary data on employees' perspectives on different EMHPs using 7-point Likert scales. The collected quantitative data were analyzed through descriptive and inferential statistics, including repeated measures ANOVAs and chi-square tests.

The final sample of the web-based survey consisted of 1134 participants and was representative across several sociodemographic characteristics. Analysis of the sample revealed that when given the choice, employees preferred digital (n=666, 58.73%) and self-intervention (n=590, 52.03%) EMHPs. Employees were most likely to use EMHPs focused on prevention (mean 4.89, SD 1.61). Intention to use EMHPs was predicted by age (young: mean 4.59, SD 1.2; old: mean 4.19, SD 1.4; P<.001; Cohen d=0.32), education (academic degree: mean 4.68, SD 1.24; no academic degree: mean 4.26, SD 1.32; P<.001; Cohen d=0.32), and mostly by company culture (positive company culture: mean 4.61, SD 1.27; negative company culture: mean 3.99, SD 1.27; P<.001; Cohen d=0.49). Cost coverage (n=345, 30.42%) and ease of use (n=337, 29.72%) were critical facilitators of use.

Employers can have a positive contribution to employee mental health by starting to offer EMHPs, preferably digital self-intervention programs for prevention; creating and maintaining the right work environment and culture; and ensuring cost coverage for the EMHP.