iPMI Magazine's CEO, Christopher Knight, speaks with Simon Miller, Senior Director of Customer Proposition at Aetna International.
They deep dive into how COVID-19 has impacted the mental health agenda, what employers can do to ensure a thriving workplace, and how apps and coaching via text can build positive coping mechanisms.
Hi Simon. Can you tell us a bit about how you first got started in health insurance and have you’ve seen it change over time?
I’ve been in product, proposition and innovation roles in health insurance for the past 15 years – the last two with Aetna International having come from a UK domestic PMI provider. It’s been a fascinating journey as product development has moved way beyond treatment benefit limits to answering wider everyday customer health needs. We’ve also seen a big shift in taking a proactive holistic approach to health – emotional, mental and physical – as well as a focus on keeping people healthy rather than intervening when someone becomes sick.
COVID-19 has clearly had a big impact on people’s mental health. What does that mean for employers who want to put in place robust support?
The pandemic has really shone a spotlight on the importance of workplace culture, mental health and well-being. Everyone has mental health, whether it’s poor or flourishing, and people can be at different stages of this complex journey. Our focus often falls on those who are unwell first. However, many people are not at that stage and may never reach it, if supported early enough. So, companies need to look for ways that their employees can approach positive mental fitness in the same way they’d approach physical fitness – prioritising well-being because it helps you achieve a well-balanced lifestyle and positive mindset, not because you’re ill or at risk.
Previously, we’ve seen the cost of well-being driving the agenda, through metrics like lost productivity, absenteeism and presenteeism. But, in my opinion, it’s time for a change in rhetoric. While these are important measures, they tend to focus on the negative and the few in that space that are struggling or at crisis point. Instead, wouldn’t it be exciting to see a shift in focus to measuring the positive impacts of a well-executed well-being strategy across a workforce? One where we hold ourselves to account on more holistic measures like sense of purpose, energy, connectedness, happiness and gratitude? Businesses could then validate the impact of the initiative back to harder measures like staff retention, job satisfaction and even, dare I say, health insurance claims and outcomes. In the future, we might even start to see the positive mental well-being of a workforce featuring in annual reports and influencing share price – a prospective that excites me.
What’s the role of a health insurer in achieving this in your view?
It’s about supporting both the employer and the employees, making sure the employer is aware of what’s available and helping to drive engagement. Sometimes employers aren’t aware of the full range of services available to them – from education and training to toolkits and apps for employees – so the first thing I’d recommend is a conversation with your insurer to make certain you’re tapping into everything your cover offers.
At Aetna International, for example, our focus is on empowering the member. We recognise different well-being needs and preferences, and ensure these feed into straightforward customer journeys that triage and navigate to appropriate onward support. In practice, this could be self-help tools, virtual primary care, other therapeutics via phone or video, or specialist in-person treatment. We’re also seeing apps gaining in popularity. People are familiar with the format, they’re convenient to access when and where needed, and they’re a straightforward point of entry for self-care support.
Where does your recent launch of the Wysa app fit into this?
Wysa is like having a mental well-being buddy in your pocket. It’s an app that uses conversational language to enable people to openly but anonymously share thoughts and feelings in a safe place, via text, on their terms, at any time of the day. The AI-driven chat function is really clever, having been programmed by therapists. It learns from you, so people can reflect on their thoughts and feelings and be guided to appropriate next steps, from self-help resources to coaching with a professional.
It's a great example of how digital tech can effectively bridge a spectrum of need and build positive coping mechanisms – not everybody is ready to speak to a stranger or commit to a structured counselling programme. It’s secure, confidential and solves the practical issue of having private conversations when private space may be hard to come by. So it’s a very accessible front door to enhance everyday positive emotional and mental health, and we see it as a key tool to support early engagement.
Does Aetna provide this approach to their own staff?
Yes, I’m pleased to say we’ve made sure we are walking the walk with our own staff. We’ve taken note of findings from our recent report, The Digital Health Dilemma, which highlighted how tech can be a double-edged sword when it comes to well-being, and looked to both digital and non-digital solutions for our employees.
For example, in terms of using tech solutions, we made sure everyone could access our virtual primary health care service, vHealth, so that they could talk to a GP without having to visit one physically. We also provided Wysa, which quickly became an invaluable tool for employees to deal with everyday anxieties associated with change, uncertainty, and the personal challenges associated with working and schooling from home.
To improve social connectedness, we’ve undertaken a very successful webinar series called ‘Let’s Get talking’, involving bi-weekly remote get-together sessions across our regions to pause, reflect, connect and share. These have been facilitated by our partner Rob Stephenson, a mental health campaigner and founder of Form. This is a simple but effective tool we’ve used to ask ourselves ‘How are you today?’ and get a regular temperature check across our teams. We’ve all taken a lot of inspiration and learning from Rob, from each other and from our guest speakers who’ve shared their personal mental wellbeing challenges – from CEOs to Olympic athletes.
In addition, we’ve recognised the need to provide further mental health training for managers, to equip them with the skills and confidence to have insightful, empathetic conversations with their teams. We want to be sure they can spot the early signals of distress and, if appropriate, navigate their staff to the right resources and support available to them.
What signs have you seen that show how COVID-19 has impacted mental health?
We’ve seen significantly increased demand for our services. Our Employee Assistance Programme, for example, has seen a huge increase in calls – a lot of which have been for ‘in-the-moment’ and crisis support. Concerns about job security, finances and the health of loved ones have been very high on the agenda. In fact, I think it has brought to the fore the need to support our members in looking after others – particularly if people are living overseas and away from social support networks amidst the restrictions.
We’ve also seen a significant increase in the utilisation of vHealth, which has been there not only to support access to primary care for those with or without symptoms, but also for those needing mental health support or requiring diagnosis, medication and onward specialist referrals. And we’ve seen much higher engagement in our health and well-being content and member offers such as the partner apps we promote to support self-care for Mind and Body.
Some of this might be due to need or limitations in access to existing physical support services. But I think some of it is also because people have had a bit more time to prioritise their health and explore what they have available to them. If there is a silver lining to the pandemic, it might just be that we’ve seen the start of a tipping point to people giving their holistic health the importance it deserves.
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