On this episode of the Generous Benefits Podcast Amanda Brummitt talks with William “Billy” Schroeder of Just Mind Counseling about why workplace mental health is now a business and humanity imperative. They discuss the real costs of ignoring mental health, how quality care reduces ER visits and turnover, and what effective employer support looks like—from fast access and experienced clinicians to coordinated care and scalable programs for companies of all sizes.

Practical takeaways include investing in high-quality EAPs or direct contracts, offering timely access to evidence-based care, and creating supportive workplace practices that improve retention, engagement, and overall wellbeing.

And, here are the resources Billy mentioned: 

Spring Health Study (JAMA Network Open, February 2025)

• 1.9x Return on Investment (ROI): For every dollar invested in mental health benefits, employers saw a return of $1.90 in reduced healthcare costs.

• $1,070 Net Savings per Participant: This was the average net savings per employee in the first year after implementing enhanced mental health benefits.

• 30% Gross Cost Reduction: Overall healthcare costs decreased by 30% due to improved mental health support.

• 14% Net Cost Reduction: Even after accounting for the cost of the mental health program, there was a net reduction of 14% in total healthcare expenses.

PubMed Study (2021)

• $1,146 Savings per Adult with Chronic Conditions: Adults with chronic physical conditions who received mental health services experienced a $1,146 reduction in healthcare expenditure compared to those who did not (in 2014 dollars).

• $2,690 Savings with Psychotherapy & Medication: Combining psychotherapy and medication for mental health resulted in even greater savings, averaging $2,690 per person (in 2014 dollars).

Milliman Report (American Psychiatric Association)

• $26-$48 Billion Annual Savings Potential: Effective integration of medical and behavioral healthcare could lead to annual savings in general healthcare costs within this range nationwide.

“Addiction and Mental Health vs. Physical Health: Widening Disparities in Network Use and Provider Reimbursement” (Milliman, 2019)

• This study focuses on reimbursement and network adequacy disparities but also highlights how fragmented care and limited network coverage for mental health/substance use services lead to increased out-of-network utilization and higher overall costs (including emergency department visits).

• Patients often end up in higher-cost settings (e.g., the ER) when they cannot get timely outpatient mental health care.

Kaiser Family Foundation (KFF) (Washington DSHS cites KFF)

• 20% Decline in Medical Costs: Managed mental health treatment was linked to a 20% reduction in overall medical costs for individuals receiving it.

• Medical Cost Offsets: KFF highlights that mental health treatment, especially for those with chronic conditions and depression, can lead to significant medical cost offsets.

American Psychiatric Association (APA)
The Collaborative Care Model & Cost Savings

• The APA’s reports on the Collaborative Care Model (integrating mental health specialists into primary care) show that for every dollar spent on evidence-based behavioral interventions, overall medical costs can be reduced by as much as $2–$4.

• One APA study highlighted that integrating mental health into primary care can significantly reduce ER visits, inpatient stays, and total medical spending for patients with mental health diagnoses.

Peer-Reviewed Studies & Additional Data Points
Journal of the American Medical Association (JAMA) Psychiatry

• Research suggests that effective depression care management can reduce total healthcare costs by up to 20–30% for high-utilizing patients, largely through reductions in hospitalizations and ED visits.

American Journal of Managed Care

• Studies have demonstrated that integrated behavioral health programs produce ROI in the range of 2:1 to 4:1 when factoring in reduced ER admissions and inpatient costs.

National Institute of Mental Health (NIMH)

• Mental illness can aggravate the severity of physical ailments such as heart disease and diabetes, driving up costs. Successful mental health interventions (therapy, medication management) can lessen that burden, indirectly reducing medical expenditures and hospital visits.

Evernorth (Cigna)

• Evernorth research shows that behavioral health treatment can reduce healthcare costs by up to $3,321 per person over 27 months. These savings are due to fewer emergency department visits and inpatient hospital stays.

Sources

• Evernorth Research demonstrates behavioral health care reduces medical costs – https://www.evernorth.com/articles/behavioral-health-care-reduces-medical-costs

• PR Newswire – Spring Health Study Published in JAMA Network Open Demonstrates 1.9x ROI of Employer-Sponsored Behavioral Health Benefits: https://www.prnewswire.com/news-releases/spring-health-study-published-in-jama-network-open-demonstrates-1-9x-roi-of-employer-sponsored-behavioral-health-benefits-302369624.html#:~:text=1.9x%20ROI%3A%20For%20every,earlier%20in%20the%20care%20continuum.

• PMC – Employer-Sponsored Digital Mental Health Program and Health Care Cost Savings: A Matched Group Cohort Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC11800021/

• PubMed – Association of Mental Health Service Use With Healthcare Expenditure Among Adults With Chronic Physical Conditions: https://pubmed.ncbi.nlm.nih.gov/33940945/

• American Psychiatric Association – Economic Impact of Integrated Medical-Behavioral Healthcare: https://www.coloradocoalition.org/sites/default/files/2017-01/milliaman-apa-economicimpactofintegratedmedicalbehavioralhealthcare2014.pdf

• Melek, S., Norris, D., Paulus, J. (2019). “Addiction and mental health vs. physical health: Widening disparities in network use and provider reimbursement.” Milliman 2019 Report (PDF): https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p

• Kaiser Family Foundation – The Business Case for Behavioral Health: https://www.dshs.wa.gov/sites/default/files/rda/reports/research-3-28.pdf

• American Psychiatric Association (APA), “The Collaborative Care Model: An Approach for Integrating Physical and Mental Health Care in Medicaid Health Homes”: https://www.psychiatry.org/psychiatrists/practice/professional-interests/integrated-care/get-paid/medicaid-payment-and-collaborative-care-model

• Katon, W., et al. “Cost-effectiveness of a multicondition collaborative care intervention: a randomized controlled trial.” Archives of General Psychiatry 69.5 (2012): 506-514: https://pubmed.ncbi.nlm.nih.gov/22566583/

• “Return on Investment for Behavioral Health Integration in Primary Care” (AJMC, 2018): https://pmc.ncbi.nlm.nih.gov/articles/PMC11800021/