Our Take
The survey confirms what HR already knows: benefit expansion without cultural change just creates expensive programs that employees won't use.
Why it matters
Mental health spending is climbing while utilization signals suggest workers still don't trust their employers with disclosure, making ROI measurement nearly impossible.
Do this week
HR leaders: audit your mental health program utilization rates this month so you can identify the gap between spend and actual employee engagement.
Mental health masking rises despite benefit expansion
Rula surveyed over 2,000 U.S. adults and found that 43% avoided telling their manager about mental health challenges (company-reported). The behavioral healthcare provider's annual report identifies mental health "masking" as when individuals hide signs of mental health conditions to blend in at work.
The survey found masking has become a leading indicator of employee turnover, with workers suppressing emotions and creating internal stress that affects job performance. Additionally, 37% of employees reported being unsure what kind of mental healthcare they actually need (company-reported).
"While employers have made strides in reducing mental health stigma in the workplace and expanding wellness benefits, a significant gap remains between the policies in place and a truly healthy work environment," said Lolly Coleman, Rula's director of provider quality and engagement.
Benefit programs miss the disclosure barrier
The data points to a fundamental disconnect between mental health benefit availability and employee willingness to access care through employer-sponsored programs. Companies are expanding wellness benefits while workers continue hiding conditions that affect their performance and retention.
Coleman argues that seeking care requires "social permission" to disclose mental health challenges to managers or peers. Without this cultural shift, even well-funded mental health programs remain underutilized, making it difficult to measure return on investment or justify continued spending.
The survey suggests that reactive, one-size-fits-all benefits are insufficient in today's economic environment where benefits budgets are shrinking. Organizations need data-driven approaches to match employees with appropriate providers rather than simply offering broad access to mental health resources.
Focus on utilization before expansion
HR practitioners should prioritize measuring actual program engagement over benefit breadth. The survey indicates that visibility and normalization of mental health support matter more than the range of available services.
Coleman recommends active marketing of existing resources and streamlined access processes. She also suggests training managers to help with workload management and benefits navigation rather than expecting employees to self-advocate for accommodations.
The report emphasizes workplace flexibility as a key factor: schedule flexibility, personal breaks, and peer connection time can encourage employees to "own their mental health" without formal disclosure requirements. This approach may increase program utilization while reducing the pressure on employees to reveal specific conditions to supervisors.