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Mental Health Service Use and Equity in a Comprehensive Employer-Sponsored Benefit Program: A Retrospective Cohort
Graham Baum1, Matt Hawrilenko1, Cory Cascalheira1
1Spring Health, New York, New York, USA.
Population Health Management
|February 9, 2026
Summary
A new employer mental health benefit program increased care access and reduced disparities for disadvantaged groups. This scalable intervention improved mental health outcomes equitably across socioeconomic levels.
Area of Science:
- Health Services Research
- Mental Health Services
- Health Equity
Background:
- Geographic and socioeconomic disparities create significant inequities in mental health care access.
- Scalable interventions are crucial for expanding access to affordable and effective mental health treatments.
- Addressing these disparities is a critical priority for improving overall population health.
Purpose of the Study:
- To evaluate the impact of an employer-sponsored mental health benefit program on care utilization and equity.
- To compare mental health service access between program users and traditional health plan users across socioeconomic disadvantage levels.
- To assess the program's effect on care initiation, retention, therapy duration, and clinical outcomes.
Main Methods:
- Retrospective cohort study analyzing medical claims and census-level socioeconomic data.
- Inclusion of 742,658 individuals across 90.9% of US counties eligible for employer-sponsored mental health benefits.
- Comparison of mental health service utilization based on area deprivation index (ADI) for program users versus traditional health plan users.
Main Results:
- The benefit program demonstrated a 36% relative increase in mental health care use compared to the prior year.
- Care initiation, retention, and therapy duration became more equitable among program users across deprivation levels, unlike traditional plan users.
- Program use led to significant reductions in anxiety and depression symptoms with comparable effects across all socioeconomic levels.
Conclusions:
- Employer-sponsored mental health benefit programs can significantly improve equitable access to care.
- These programs show potential in reducing systemic barriers and socioeconomic disparities in mental health service engagement.
- Scalable, real-world interventions like this benefit program offer a promising pathway to achieve health equity in mental health care.
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