Therapy, at work? Companies are bringing clinicians directly to their employees

Employee needs are changing. With increased demand for mental healthcare, firms are bringing therapists to workers in corporate offices.

Your therapist’s office may soon be down the hall from your own. 

As companies adjust to post-pandemic ways of working, many firms have spent the past few years updating their benefits suites to respond to workers’ changing priories. While employees are still asking for generous paid time off and retirement schemes, they’re also asking for holistic benefits, including mental-health resources.

To meet this need, some companies have introduced access to digital tools, such as meditation apps or online therapy portals. But others have gone a step further to differentiate themselves. Large global employers – including Comcast, Delta Airlines and Shaw Industries Group – are now offering on-site therapy in their corporate offices and worksites. These programmes enable employees to discreetly schedule a session with a licensed clinical therapist during the workday, often at no cost.

It may be unconventional – but companies say this resource is popular with employees, especially amid a dearth of mental-health professionals and prohibitive costs that otherwise keep them from accessing care.

Therapists who are working are overloaded. In 2022, 60% of psychologists in the US reported having no openings for new patients following the pandemic, according to the American Psychological Association (APA), and 38% say they maintain a waitlist. Even for people who can find a clinician with new-patient availability, they may not have the ability to schedule an appointment unless they have flexible work arrangements.

These factors, along with high costs in many countries, can keep people from getting the services they need. “Therapy is a really good solution for many people, but it’s very expensive, it’s very inconvenient, and it’s very hard to find a therapist that your insurance covers [in the US],” says Jen Porter, interim CEO at Mindshare Partners, a California-based non-profit organisation that advocates for workplace mental health.

It was once unheard of to discuss matters of mental health in the workplace, much less attend an hour-long therapy session in the office. Yet the stigma around mental health at work is abating, and many workers expect mental health benefits as part of the employment deal. Mary Beth Ryan, who advises clients on behavioural health services at consulting firm Mercer, says workers are more comfortable than in the past asking for mental healthcare and talking about their mental states, especially younger ones.

As a result, she has seen a steady climb in the number of employers offering on-site therapy. “We’ve seen employers respond by thinking about how to offer an on-site counsellor as a way to reduce certain barriers to care,” she says, “whether that’s barriers around location, availability in a certain geographic location, or finances.”

Employees are seizing the opportunity. In the US, on-site healthcare provider Premise Health, which places on-site therapists at host companies, has 94 clinical therapists working on-site or at a near-site offices. Visits for the services have increased nearly six-fold since 2020. In 2023, the company booked 35,000 visits across 65 clients. 

Some of these programmes originated pre-pandemic, but have grown in the years since.

Delta added its first on-site therapists in 2019. It started with nine, and now have 20 therapists across 15 sites in the US, and in cities including Tokyo, London, Paris, Amsterdam and São Paulo. Some are stationed at airports. Should a troubling incident occur during a flight – a belligerent passenger or a medical emergency – flight attendants could walk off the plane and see a therapist in the attendant’s lounge. The company has recently added licensed social workers at two hubs to connect workers to community resources on domestic abuse and financial struggles. In some cases, it has also made on-site therapists available outside the 9-to-5, so employees can schedule a session before or after their shifts.

Global on-site therapy provider Lyra says employee utilisation is high. This is especially the case in India, where there is fewer than one therapist for every 100,000 people, and workers may struggle to find a way to attend sessions. “Travel outside of the office can be difficult. There are certain cities where it takes three hours to get five miles across the city, so in-person care can be very challenging,” says Alethea Varra, the company’s VP of clinical care. She adds that the office is more convenient for some workers, since they may have trouble finding privacy for a virtual appointment at home.

On-site therapists are not directly employed by the companies they serve, but rather employed by healthcare providers or employee assistance programmes (EAPs). They are charged with following the same privacy laws and ethical codes any therapist in a private office would be, and don’t share conversations with managers or the company.

Clinicians also understand privacy concerns about seeking on-site mental health services amid stigma. Employers offering talk therapy on site are encouraged by providers to set up their offices in out-of-the-way places, so walking in isn’t an announcement to their colleagues that they’re having a session.

Premise Health sets up brick-and-mortar multi-purpose clinics at company campuses, where talking therapy is one of many services offered. Employees might be visiting for a flu shot, or they might be reporting for a 50-minute session to talk about their divorce. Because all services are in the same building, employees can maintain their privacy.

Marriage and family therapist Brad Smallwood, 44, spent three years, from 2017 to 2020, as an on-site therapist at the San Francisco headquarters of tech company Square. His office was down a hallway, out of the way, so appointments could be discreet. Smallwood says his work was confidential. Although he was embedded in the company, he followed the same ethical protocol any therapist would. He wouldn’t acknowledge clients at the coffee machine or lunch tables unless they did first.

To begin, workers thought Smallwood was there to talk exclusively about work matters. “There was a misunderstanding that my role was to somehow make them more effective, to perform better at work,” he says. “I was really clear from the outset that I’m a marriage and family therapist. Their participation in therapy has absolutely no bearing on work performance.”

Once employees became comfortable with in-office therapy, he says were able to talk openly about their concerns: anxiety, depression, substance use, loss of loved ones, divorce. Smallwood said his schedule filled quickly.

Despite being privately employed, some clinicians are woven into the company culture for the benefit of their patients. They are often asked by companies to join activities outside therapy sessions. “Mental health interventions, including therapy, are more effective when they’re tailored to cultural contexts,” says Porter, of Mindshare Partners. 

Alyson Smith, Delta’s managing director of health and wellness, estimates that roughly 60% of therapists’ time is spent in one-on-one sessions, while the remaining 40% is spent “walking around, checking on people, going to team meetings where they’ll come in and do a 10-minute healthy mind debrief or meditation – just to get their face and their names out there so that they’re a recognised source of confidence and stability”.

Being immersed in the working environment makes for better care, says Smallwood. Coming from a similar background as clients helps, too. “We pay attention to the demographics of the company to make sure that people have support from providers who may be representative of them and have some of the shared experience from more of a culturally responsive care aspect,” says Lyra’s Varra.

Media company Comcast added a full-time English–Spanish bilingual therapist in March 2023 at its Telemundo offices in Miami, Florida. When workers have a place they can easily access care, from a therapist they can relate to, people get more comfortable talking about mental health, says Dorothea Scattaglia, the company’s senior director of emotional wellbeing.

Many mental-health experts and corporate leaders hope these employee programmes will encourage workers to get the help they need.

“Our employees, just like everybody else in the country, are struggling to get access to providers, so we are making it as easy as possible,” says Scattaglia. “There’s still a little bit of a stigma surrounding mental health, but that breaks down the barriers – just having somebody they’re familiar with that is the entry point to other services and programmes.”

If this approach succeeds, both parties stand to benefit. Not only can workers get the access they need, but employers may also retain happier, healthier employees. US-based flooring manufacturer Shaw Industries Group added on-site therapists through Premise in January 2020.

Rachel Bolden, who leads employee health and wellness at Shaw, says having on-site care is part of the company’s retention strategy. “We wanted to take care of [employees] in a way that it’s not just at work,” she says, “but that also takes care of them at home.”