Ep#492 Transforming Workplace Mental Health: Stephen Sokoler

Speaker 1: 0:00

Pretty much everybody agrees that mental health care is a serious challenge. The question is how can we shift the way companies prioritize mental health? We'll find out on this episode of Shift Shapers.

Speaker 2: 0:13

Change either energizes or paralyzes. The choice is yours. This is the Shift Shapers podcast, bringing the employee benefits industry interviews with individuals and companies who are shaping the industry shifts. And now here's your host, david Saltzman.

Speaker 1: 0:35

And we've asked Stephen Sokolor, founder and CEO at Journey, to join us. Stephen, welcome to the podcast. Thanks for having me, David. Happy Friday the same to you. Tell us a little bit about your background. We always ask that question because the way people get to be doing what they're doing today in our industry is particularly interesting and rarely a straight line.

Speaker 3: 0:55

Yeah for sure. I mean. I think if someone had told me I'd be in the mental health space a decade or two ago, I certainly would have laughed. I certainly would have laughed, but grew up in Queens middle-class family, was always entrepreneurial, started random businesses here and there a snow removal business, a soda business and when I graduated from college, I ended up working at this company called the Award Group, which was helping organizations celebrate and inspire their employees, so we designed awards and recognition programs. I ended up running one division, which I then purchased a few years later in a management buyout Fast forward financial crisis 2008.

Speaker 3: 1:31

Ended up consolidating the industry, so rolled up a couple of small companies in the space, along with a few others, and then expanded to London, Sydney, Hong Kong and Montreal.

Speaker 3: 1:41

And the reason this is relevant is I moved to Sydney to open our office there and it was the first time I had lived outside of New York and I very serendipitously found meditation through Buddhism and it was super helpful for me and ended up moving back to New York A few years later, sold the company. Had no idea what I wanted to do, but when I looked I realized I really wanted to do something that made a difference in the world and I wanted to build another business and both of those were interesting, sort of the head and the heart and I thought there was an opportunity to bring meditation to people in a really simple, approachable, secular, science-based way, and so we started out in meditation. That was in 2015. Happy to tell you the whole journey on how we got to where we are today, but expanded basically from meditation into a whole host of subclinical practices, then added a clinical element and, yeah, I've just continued to evolve over the last nine plus years. That's awesome.

Speaker 1: 2:37

So, from your perspective today, can you outline the scope of the problem?

Speaker 3: 2:44

How much time do we have?

Speaker 1: 2:47

About 25 minutes, so be as brief as you can, but go be thorough.

Speaker 3: 2:50

Yeah, I think there's a number of things and this certainly won't be exhaustive, but for one there's a stigma. So if you were to show up at work with a broken arm or a broken hand, nobody would ask you any questions. Everyone understands it. If you were to say I'm depressed or I'm having anxiety, one just the ability to share, that would be something that's really not allowed or culturally normal in many workplaces today. So that's number one and number two we don't know how to respond to that. Managers don't know, Employers don't know, Colleagues don't know. So there's a big stigma.

Speaker 3: 3:22

The other is when you do reach out for care, there's a shortage of therapists here in the States. I mean, the pandemic was obviously devastating for many, many reasons globally. One of the pros, one of the silver linings, is that it shined a light on mental health, and so more people are saying, hey, actually the way I'm living is not working for me, and so they reached out, but they're coming into a system that just doesn't have the supply needed. And then the third thing is most of the providers in the space, whether that's the traditional healthcare companies or a lot of the employee assistance programs, they don't provide access to care in a way that meets people where they are. So the average EAP, which is my world, takes three weeks on average for somebody to get care. So imagine, David, you're looking for care and we're in the end of May and they're saying, oh, we have help for you in mid-June, mid to late June. That just doesn't work right. So I think that's just a small sampling of some of the problems.

Speaker 1: 4:19

So how do you start squaring that circle? If you've got I mean, in my day job we do mental health parity analysis we know what the network paucity is how do you start trying to resolve for both of those variables, the need versus the lack of providers available, Right?

Speaker 3: 4:36

Well, there's the short-term solution to the long-term solution. So we're doing things at Journey to help bring more therapists into the space. So providing scholarships and other access to underserved communities, high school kids, college kids to be able to say, hey, this is a field that is really attractive, and perhaps you might not be thinking about this right, Because that's one of the things that's going to solve the long-term issues is just having more people available. In the short term, you have to make do with what it is. So how can we get people access to care quickly? How can we make sure that they're getting matched with the right provider? So oftentimes that's another problem Somebody will get a provider that has no experience with that particular person's lifestyle or where they're coming from, and that can turn someone off to the idea of therapy right away. And then there's also the reduction of stigma. So doing things.

Speaker 3: 5:32

One of the things I talk to HR leaders about all the time is the benefits are just the start. The culture has to support mental health. You have to make it safe for people to come in and say I'm not doing well today. I need to take the day. I need to sit out this meeting, right? We have to train managers to know what to look for and how to respond skillfully and how to point people in the right direction.

Speaker 3: 5:53

So I think it's not just that there's a shortage of therapists, it's that people don't really know where to turn and how to get care quickly, and so then issues end up exacerbating because, you know similar to physical health, right? If you're not getting treatment at the start, the longer it goes on, the more likely it is to get worse, right? So, being able to cut things off, which means somebody might not need to be hospitalized, or they might not need eight sessions or 10 sessions with a therapist If we can catch them earlier, perhaps there's more tools available to them. And one of the things that I know you know is we really focus on proactive mental health or preventive mental health. How can we ensure that employees have tools at their fingertips, things like meditation or live coaching classes where they can connect to a community and a coach who can help, you know, build healthy habits and help them create behavior change? That will prevent some of those things from happening. So those are a few of the things we're doing.

Speaker 1: 6:56

You know in my experience, while I agree with you that one of the barriers to using an EAP is that it often takes a long time to get care, I find a lot of employees don't even know what an EAP is. Do you find that in your practice as well?

Speaker 3: 7:18

And how do you get around that? How do you help educate? Yeah, well, yes, we see that all the time, and that's actually not necessarily limited to EAPs. One of the things that we find is employees are going to HR leaders and saying we're starving, we need all of these things, and HR is saying we're putting out this whole buffet, this whole smorgasbord of stuff. How is that possible? And part of it is the methods that HR is using traditionally to bring awareness to the benefits, including EAPs, are just outdated, and so we spend a lot of time up front.

Speaker 3: 7:46

We have a proprietary process called the JEDI Journey, engagement Discovery Interview, where we spend a lot of time with all of the stakeholders that basically the company will allow us to speak with to really understand a 360-degree view of what's happening there. So what are their priorities for this year? Tell us about the demographics, tell us about the employee resource groups, and then from there we build this comprehensive program. That's not simply oh, we put it in the welcome guide, right, you join a company, there's 70 pages of a welcome guide and it's in there. Nor is it buried on the intranet, but it's a living, breathing thing, the. I wouldn't call it a tagline, but one of the things we talk about with the product called Journey of Practical EAP is engage every employee every day. So light, gentle touches and nudges to make sure employees know this is available, know where to go. And I'll say one other thing Traditionally, eaps will measure one thing, which is clinical engagement.

Speaker 3: 8:41

Right, so it'll be. The average EAP is 3% clinical, 5% clinical engagement Okay, which means 95 to 97% of employees are not touching it at all. Well, we look at three different things. Of course we look at clinical. We also look at preventive right, how do we get you to take action before you need clinical? And then we also measure awareness. So most benefits employees are aware. 20% of employees are aware of it. With Journey it's 80%. And that's interesting for a couple reasons. One is, of course, if you're aware of it, you're more likely to use it. The other is it might be something like a fertility benefit or a 401k where maybe this is your first job or maybe you're not ready to start a family yet, but just knowing that you have it is very valuable. It's valuable in terms of retention, it's valuable in terms of peace of mind. So knowing that we're not just engaging employees but also bringing awareness to it makes a big difference for the employee experience.

Speaker 1: 9:38

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Speaker 1: 10:14

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Speaker 3: 11:10

Yeah, we do a lot of engagement that is separate from HR. So we will go to HR with this really robust plan after we do that, that Jedi, and say you know, companies will often get very excited about launch right, like for for L'Oreal. They're not far from here, they're in Hudson yards. I went over there and we did this big launch. They had a, a very famous women's basketball coach who was outspoken on the topic of mental health and we did that and I said, okay, great, but what are we doing in month two? What are we doing in month five? What are we doing in month seven? Right, how are we keeping this? So it's not people use it and then it tails off, but the opposite, so it builds over time. So they'll sign off on the plan and then from there we'll do things.

Speaker 3: 11:48

So, for example, with Beck and Dickinson, we're going to their employee resource groups and we're showing up there whether it's women's leadership, black excellence, pride, veteran to present resources that are specific for them, because if you're a parent, as you and I were talking about prior to joining this, your needs are a little bit different than if you're a manager or if you're a veteran and perhaps you're multiple right, perhaps you're all three of those. So how are we making sure that a very broad, all-encompassing benefit like an EAP still feels really personal to the employees when they're seeing it? And then of the product itself super inclusive, super diverse and making sure that when you go there as a I'm not going to state your age, but you can feel free as a gentleman at your age of life, right as we talked about before, your needs are going to be different than the Gen Z employee who this is their first job. How do we make sure both of you, when you do get there, say, wow, this is perfect for me.

Speaker 1: 12:47

So the age is 71 and not shy about it. But while since we're talking about numbers, you guys have an awesome downloadable and we'll include a link to it in the show notes because I encourage everybody to go and read it. A lot of fascinating stuff in there and stuff you can use with clients also to help educate. But you talk about six strategies to boost EAP up to 10 times. That's a pretty bold and audacious claim. Can we look at all six of those and talk about them a little bit? The first one is expand coverage.

Speaker 3: 13:17

Yeah, I was going to say, well, if you promise to remind me of what each one of them, I will do that. I'm your genial host and that's what I'm here to do. Yeah, yeah, I mean some of this we talked about. But expanding coverage, we think about the idea that one of our core pillars is that engagement has to be inclusive of all employees. So making sure that we're not leaving any group of employees behind, because oftentimes companies will say, oh, we have good engagement, and then you'll double click on it. It's, oh, it's only the millennial females who are more socially aware of mental health and are more likely to lean in versus hey, we work with Walgreens. It's 250,000 employees. A lot of them are, you know, they've been there for a long time or this is their first job out of high school, right, and they're not necessarily thinking about mental health. How do we make sure we're meeting them where they are? And so enhancing coverage in that way?

Speaker 1: 14:08

The second is flexibility of services or flexible services. You kind of alluded to that a little bit. You spend a lot of time, I think, worrying about meeting people where they are. Talk a little bit about that and why that's critically important for take-up.

Speaker 3: 14:21

So we talked a little bit about the diversity and inclusivity, but one other thing I'll say about flexibility of services, and I know some of the things that I'm going to share are going to overlap into multiple of these things. But one of the things that we pride ourselves on, as I talked about, is meeting people where they are, which not only means the diversity and inclusivity of the providers and the teachers, but also the tools themselves diversity and inclusivity of the providers and the teachers, but also the tools themselves. So we have a mobile app, because a lot of people almost everyone has a smartphone nowadays, but we also have a Zoom app because many of us are spending far too much time on Zoom calls. We have a Teams app because a lot of big organizations run that way. We have a calendar integration.

Speaker 3: 14:59

I don't know about you, but for me, I live and die by my calendar. So having a 10 minute mindful break in there, where every day it sends me a new bite-sized video, keeps it top of mind. There's an email newsletter every day with a bite-sized tip and a bite-sized video. So the idea is there's a Slack app. Like we at Journey, we run on Slack, so it allows us to have the mental health there in just gentle touches, gentle nudges, so that it's there for people, right, and that makes a big difference, because it's not. Oh, I have to remember that it's on the intranet, or I have to go ask Susie in HR. It's just there and just keeps it top of mind.

Speaker 1: 15:36

One of the other ones that you mentioned is cultural competency, and I wonder is that any different than just being culturally aware?

Speaker 3: 15:43

Well, I'll tell you how we think about it. We are in 190 countries and therapy is available in 100 languages. Now people will often ask questions and on our digital platform, it's 27 languages and growing. And this goes to what we were talking about earlier, about you know, the experience being perfect for you and perfect for somebody else, right, who might be logging in from South Africa, or from Jamaica, or from you know Portugal, right? So not just making sure that the language feels right, but having localized content and resources. So not a US lens translated into Russian or to Arabic that wouldn't work but actually creating content in the region. So that's one of the other ways that we think about cultural competency.

Speaker 1: 16:28

One of the reasons that you cite on your website and also in this brochure for a lack of take-up on EAP is confidentiality and trust. So one of the things you recommend is improved confidentiality. How does that manifest itself and how do you get people comfortable with the fact that there is this increased confidentiality?

Speaker 3: 16:49

Yeah. So it's a challenge is the honest answer. Most people don't trust the companies they work for. I don't feel like I'm saying anything controversial here, right? And so One thing we'll try to do is say this is a separate company, we are a separate company. Nothing that you do is shared in a personally identifiable way with your organization, and we have that everywhere, because that's really important to just continue to let people know that. And so it's an I'll call it an uphill battle.

Speaker 3: 17:21

You know, obviously some organizations have great relationships with their employees and there's a massive amount of trust, and others' employees feel like I can't go and say that I'm using, you know, this therapy product, because if I do, they're going to think I'm weak or something's wrong or my job's going to be in jeopardy. So we just want to let people know that. And the other thing that we do is try to de-stigmatize it. So, throughout the platform, it says I use my EAP when dot, dot, dot. And then it says you know, worker personal stress is challenging, I'm having trouble sleeping, I can use some support managing my finances, like trying to make it more approachable versus hey, david, tell me about your relationship with your parents, right? And then you're like wait a minute, I don't, I don't want to go there, right, that's not for me. So different type of introduction of the product to people and say, hey, this is not going to be shared with your employer.

Speaker 1: 18:13

You also talk about using a comprehensive evaluation. Does that happen on intake and how does that actually work?

Speaker 3: 18:18

Yeah, with clinical, we use something called the outcomes rating scale. It's a four-part question that evaluates the person holistically. We also ask a number of questions in the intake process, separate from that, to evaluate how is this person doing? Are they at risk of harming themselves? Are they at risk at harming others? Right, how urgent is this situation? And, of course, the good news is most of the time people are calling in, they just need support and so we're able to get them through that process. But there are those times where people need care in that exact moment. Right, we have to put them on hold and call 911 or we have to do more than that. So asking a number of questions during that intake process. But we report our clinical results to our clients. With an average EAP or traditional EAP, less than 50% of people see clinical improvement. With Journey it's 88%, and the reason is what I had said earlier because we're getting care to people sooner, it's easier to get better results. It's easier to see improvement because it hasn't snowballed into. I'm just at that breaking point, right.

Speaker 1: 19:20

One of the last thing, the last of the six things that you mentioned, is integrating with other benefits, and I think when a lot of people think about EAPs, for reasons you've touched on, they don't really want them integrated, they want them separate. So what does that mean in your universe?

Speaker 3: 19:35

Yeah, well, it goes back to what I said before. Oftentimes big companies will have a ton of point solutions that are really fantastic, that are excellent, but employees don't know about them. And if they do know about it, oftentimes they find out when it's too late. So we build a custom benefits page to showcase all of these other benefits, so the journey can be the front door. And then when employees say, oh, I'm starting a family, I'm aware that I have this family planning benefit, hey, I need legal support, okay, we can do that, but perhaps they have some other support that they offer there.

Speaker 3: 20:09

And so showcasing that and having it built out so every employee can see what's available for them. So, if I'm a part-time employee or full-time, if I'm union or non-union, and just making sure that everything like we want it to fit hand in glove, so everything you know, a rising tide raises all ships and rather than 10 different point solutions or 20, some companies have even more than that all trying to drive engagement. What if we can consolidate that and let employees know hey, you do have this whole buffet, you know, go and choose as needed. Getting people the right care at the right time basically needed getting people the right care at the right time basically.

Speaker 1: 20:43

How does the increase or does it? How does the increase in EAP utilization translate into ROI for companies? Good question.

Speaker 3: 20:51

Well, the clearest case in terms of hard dollars is in reducing healthcare costs. So it's not surprising to say most big companies are self-insured, which means every time somebody is going to the doctor or going to the hospital, those things become expensive. So we did a clinical study with Humana's chief behavioral scientist, a woman named Dr Susan Bukowski, and that showed that when employees use Journey, they save their employer almost $600 per year in health care costs. So if you think about Journey, it's a couple dollars PEPM, right Depends on the size of the company and all the benefits et cetera but it's in that range, right. So it's $20, $30, $40 per year. You're saving $600 in actual hard costs within the same calendar year.

Speaker 3: 21:38

Now we also had another clinical study that showed absenteeism. This was with Humana showed absenteeism was reduced by 51%. So if you're working one of our clients is Inspire Brands, 70,000 employees across Arby's and Dunkin' Donuts and Buffalo Wild Wings Imagine you're working there and your colleague calls out sick. Right, that's going to impact you. That's going to impact the customer experience. That's going to impact revenue. Right, it's going to be stressful for you. We're giving people tools so they show up to work more often, so they're not burning out. They're not turning over and, to your point about the ROI, they're not hitting the health plan as often, which saves companies money.

Speaker 1: 22:14

That's great. So put on your crystal ball for a minute or look through your crystal ball. Where do you see this in a couple, three years?

Speaker 3: 22:22

Journey or the state of mental health overall.

Speaker 1: 22:24

Well, let's tackle the easy one and say journey.

Speaker 3: 22:29

I really I feel deeply committed and passionate about getting care to people, making access to care easier and simpler and de-stigmatizing this so that one of our like, big, hairy, audacious goal, or BHAG, this, this Jim Collins concept, is um, to make mental health as um, accepted as ubiquitous as physical health by 2030.

Speaker 3: 22:53

So, you know, on one hand, this goes back to the conversation we had off camera about how quick children grow up, right? On one hand, 2030 sounds like it's forever, it's going to be here like this, right, but if we can continue to shift the narrative, that also will help more people get into the space, because there's a lot of people that want to help people, right, there's a lot of people that if they knew that they could have a career in therapy or psychology or psychiatry, would go to that right and so being able to say, hey, this is a very valid path for you, right, seeing more people in your community take that up. And then, of course, on the demand side, right, that's the supply side. On the demand side, just letting people know that these tools are available to them and it's easy to access, because right now, that still remains one of the biggest challenges.

Speaker 1: 23:40

Stephen, if people want to reach out to you or learn more about what you're doing at Journey, what's the best way for them to do that?

Speaker 3: 23:46

The website is journeylive. They can email me. I'm steven S-T-E-P-H-E-N at journeylive. I'm on LinkedIn. I'm sure we have a bunch of other social things that I don't even know about. But yeah, come find us. I love talking about this. Hopefully you can tell I'm super passionate about it. So, yeah, if you're out there and you want to talk about this, I'd love to have a conversation.

Speaker 1: 24:04

That's awesome. Stephen Sokol, our founder and CEO at Journey, thanks for sharing your expertise with the audience today. Thanks, David.

Speaker 2: 24:12

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