Even with Employer-Sponsored Insurance, Employees Struggle to Access Mental Health Care

A new national survey conducted by the Employee Benefit Research Institute (EBRI) in partnership with Path Forward reveals a troubling yet unsurprising reality: insurance coverage does not guarantee access to mental health care.

For many, these findings mirror personal experience. Yet, when those experiences are validated by data that confirms how far-reaching the problem is, the weight of the challenge is undeniable.

The results of this survey are based on responses from more than 3,100 workers, between the ages of 20-74 covered by employer-sponsored health insurance.

Key Findings

1.    Mental health needs are widespread.

• More than one in four employees (27%) reported they or a covered family member has a mental health condition.
• These workers were most often between ages 25 and 54, married with children, and employed at smaller firms.
• The most common conditions were anxiety (17%), depression (11%), and ADHD (8%).

2. Having coverage is not enough.

• Employees with a mental health condition were twice as likely as others to report being unable to get medical care, tests, or treatment they believed necessary.
• One in three (33%) struggled to access mental health or behavioral health services; nearly as many (32%) could not get needed prescriptions.
• Those with mental health conditions were nearly 2X as likely to cite doctors not taking insurance as the reason for not accessing care
• Lack of time off and childcare were also factors

3.    High reliance on emergency departments.

• Nearly two-thirds (62%) of employees with a mental health condition reported visiting the ER in the past six months.
• They were 50% more likely than their peers to use emergency care, and four times more likely to visit the ER four or more times in that period.

4.    Employees are engaged but face barriers.

• Far from disengaged, workers with mental health conditions were more likely to research provider quality, compare prices, and discuss treatment options with clinicians.
• The issue is lack of access—not lack of effort.

Why This Matters for Employers and Insurers

For employers, these findings have direct implications for workforce wellbeing, productivity, and retention. Employees who can’t access timely care are more likely to miss work, underperform on the job, and sometimes quit altogether—issues that directly impact their organizations.

For insurers, the data underscores the need to double down even more on network adequacy, integrated models and telehealth. When employees are forced into emergency rooms to address their mental health needs, costs escalate and the outcomes are subpar. 

We can all do better.

What Can Be Done

Mental health conditions are among the most common and costly health challenges facing the U.S. workforce. This survey demonstrates that even employees with insurance are being left behind by a system that, at times, makes care seem impossible to access.

Employers and insurers are in the best position to change the trajectory for the 165 million workers covered by employer-sponsored insurance today: Let’s work together to build a better system for patients and their families.

Read and download the full 2025 EBRI–Path Forward Employee Mental Health Survey below.