Product Solutions
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  • November 2023
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Product Trends Around the World 3Q 2023

RGA Market Intelligence

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In Brief

RGA provides quarterly updates on global product developments, which can be made available upon request.

This issue explores how insurers worldwide are developing products to meet the growing need for mental health solutions.

View the 3Q 2023 digital newsletter.

Some alarming statistics from this report include:

  • 1 in 8 in the world live with a mental disorder
  • Half the world’s population lives in countries where there is just one psychiatrist to service 200,000 people
  • Countries dedicate less than 2% of their health budget to mental health
  • Two thirds of low-income countries do not include mental healthcare in their national insurance schemes

We are living in an age where every day seems to present another new threat to our mental health, from economic downturns to the cost-of-living crisis, a catastrophic pandemic, humanitarian emergencies, displacement, wars in Ukraine and now Israel, and climate change.

This issue of Product Trends will look at what insurers are doing in mental health, provide some examples of recent product offerings, and suggest ways in which insurers could continue to help and support people suffering from mental health issues.

Mental health: a growing concern

Major insurers now regularly conduct surveys on the state of their country’s mental health. This happens in regions around the world, including the Americas, Europe, and Asia. The AXA Study of Mind Health and Wellbeing2 is one global example. The study surveyed 30,000 people across 16 countries. The AXA Mind Health Index assesses individuals’ mental health by asking them a series of questions. People were ranked in four mind health bands, from flourishing at the top, through getting by and languishing, to struggling at the bottom. One third of the respondents reported they were just getting by.

This survey found that people often turn to family and friends for help, rather than healthcare professionals. The experience of COVID-19 appears to have made some people more mentally resilient and perhaps has helped to mitigate the stigma associated with mental illness. Attitudes toward mental health are slowly changing, and large multinationals are realizing that taking care of their employees’ health could now give them a competitive edge.

The Mind Health Index, based on the 10 skills needed to flourish, helps assess mental wellbeing. The 10 skills include emotional intelligence, self-acceptance, connectedness, pride in achievement, meaning and purpose, challenge response, resilience, self-confidence, close relationships, and physical health behaviors (nutrition, exercise, sleep, smoking, alcohol, Me-Time).

The Geneva Association in February published a report, “Promoting Peace of Mind: Mental Health and Insurance."3 The report looked at how life and health insurers are addressing mental health.

In Asia, the FWD Group’s international mental health survey interviewed more than 10,000 people across 16 international markets. It included the nine markets where FWD operates: Cambodia, Hong Kong, Indonesia, Japan, Malaysia, the Philippines, Singapore, Thailand, and Vietnam.

Noteworthy findings of the survey include the following: 65% of people in Asia believe mental health will be one of the most critical issues in the coming year; 31% of respondents in Asia believe renaming “mental health” can help people to open up; and 40% of respondents in Asia say the cost of treatment is the biggest impediment to seeking outside help for mental healthcare. The survey also found that people in Asia are interested in insurance options for mental health: 76% of people want to explore insurance to assist them in dealing with mental health challenges.

A woman leads a brainstorming session
RGA's 2023 Global Mental Health Survey provides insights into insurers' current offerings and initiatives related to mental health and a unique view of where the industry may be headed.

How can insurers help?

Since the COVID-19 pandemic, the number of people requiring mental health support has increased. Insurers play a role in informing and educating the public on the issue of mental health. Insurers can partner with schools, community organizations, and employers to invest in partnerships, programs, and initiatives to support children, youth, and families to improve mental health literacy.

Insurers also can offer donations to support communities in times of crisis, such as during the COVID-19 pandemic and after an incident such as the Louisville, Kentucky, shooting in April of this year. Through their foundation arms, insurers have provided grants to community organizations, including youth-focused programs.  These programs help to destigmatize the subject of mental health among young people and to normalize discussions through inclusive workshops.

The Healthy View, Healthy YOU! Active Minds program promotes mental health awareness and education for young adults. Funding received from a large insurer will enable the organization to launch a pilot program in 50 school districts to better serve youth mental health at the middle school level. Another program, Project SUCCESS (Schools Using Coordinated Community Efforts to Strengthen Students), embeds a specially trained student assistance counsellor in each school to provide students with easy access to services. This approach allows for early identification and intervention for alcohol and other drug use-related risk factors, such as drinking at an early age, poor academic performance, tardiness, absenteeism, and other behaviour problems.

Healthy Blue, a collaboration between health insurers and the innovator EVERFI, is an interactive health and wellness initiative serving select communities in Kansas. The suite of courses brings a prevention strategy to teachers and students, seeking to help students understand mental health and removing the stigma around it. It also aims to teach students how to engage in healthy and safe decision-making around drugs, alcohol, and nutrition.

In Canada, the Canadian Youth Mental Health Insight (CYMHI) Platform, powered by RBC Future Launch, is an ongoing project started in 2022. The online portal enables users to find data and connect insights from community and school prevention programs, youth mental health services, and clinical research studies. It provides access to AI-based functionality to help users navigate mental health services; personalized tools for monitoring mental health, identifying risks, and recommending services; and an interactive atlas of youth mental health service demand and availability to guide providers and policymakers.

In Singapore, the National Mental Health anti-stigma campaign Beyond the Label is now into its third year. This campaign helps to counter the stigma and prejudice attached to mental health and to raise awareness of support options available.

The AIA Healthiest School program in Asia seeks to educate and inspire children across the four pillars of nutrition, physical activity, mental wellbeing, and environmental sustainability. The program will provide teachers with free, downloadable, curriculum-linked resources for students ages 5-16. The program aims to encourage healthy living habits among students by promoting healthy eating, active lifestyles, and mental wellbeing, as well as sustainability.

In the recent RGA Global Mental Health Survey, respondents indicated value added services, protection products, and advocacy as the most valued services insurers could provide in support of mental health.

Peter Farvolden
Meet Dr. Peter Farvolden, RGA’s new mental health consultant and a longtime researcher and clinic head at Toronto's largest mental health teaching hospital.

Group Mental Health Products

The AXA Mind Health Survey found that employees are more likely to flourish at work if they are offered mental health support there. They are also likely to stay longer with the same employer. In the past, employers offered access to employee assistance programs. These offerings now have been expanded to give employees a range of value-added services, which could include internet-delivered cognitive behavioural therapy (iCBT) and bereavement counselling.

Insurers like Vitality already offer iCBT and counselling within services such as Vitality Health’s Talking Therapies network. Their mental health coverage also includes unlimited in-network Talking Therapies, plus further coverage for out-patient, in-patient, and day-patient treatment.

These group offerings have been refined to deliver practical and personalized support for mental health – from prevention to recovery. The services also have been expanded to include the employee’s immediate family and may include family members as young as 16 years. These group offerings can include counselling sessions, virtual consultations, or – if necessary – face-to-face sessions. Some insurers, rather than restricting the number of sessions offered, provide unlimited coverage.

In Australia, the service Mental Health Assist provides a discreet and confidential way to seek mental health support by connecting with a team of leading mental health professionals at Teladoc Health from the comfort of your own home.

In Canada, Sun Life's Mental Health Coach (MHC), provided by CloudMD, is a practical tool designed to tackle this issue head-on. The tool nudges clients who are at risk of developing a mental health issue and recommends a self-assessment. A coach then guides them to the right resources and support before their symptoms worsen.

In South Africa, RGA is running a pilot of a CBT app called Vimbo in conjunction with an insurer’s staff group scheme.
Group offerings may also give employees access to mental health apps. Some recent launches include
Teladoc’s mystrength, which is designed for people over 18 who need structured mental health programs, and Headspace, which recently expanded into the U.K. market.

Sun Life acquired Dialogue in July of this year. Dialogue has a robust suite of virtual healthcare and wellbeing services. Their Mental Health+ service gives access to a multidisciplinary team of psychologists, psychotherapists, and health specialists. The service includes self-led internet-based cognitive behavioural therapy (iCBT) and practitioner-led therapy. Sun Life also offers a range of mental health solutions, which include the Mental Health Strategy Toolkit for employers. 

The Travelers Companies has announced the launch of “Wysa for Return to Work,” an app designed to promote the mental health of injured employees.

Unum’s Help@hand app features unlimited mental health support, with the offering now available to all employees, not just insured employees. Services now include support for mild-to-moderate conditions, along with unlimited bereavement counselling.

In the Americas, Blue Cross is an example of an insurer that has significantly increased its coverage of mental health. Blue Cross partnerships now include Headway; the Alma network, which is made up of more than 13,000 mental health clinicians; Talkiatry; Thriveworks; Refresh Mental Health; and Valera Health, which offer both in-person and virtual treatment with diverse clinicians serving most ages.

Insurers continue to form partnerships with insurtechs, mental health platforms, and apps to refine their coverage of mental health needs. In Asia, the online mental health platform MindWoRx is launching in the Philippines. This platform helps companies assist their employees in overcoming anxiety and depression and handling the day-to-day stress and pressures at work and at home. MindWoRx is an innovative and self-guided behaviour therapy platform with over 150,000 users globally that uses the Cognitive Behaviour Therapy (CBT) approach. The platform includes a web-based Anxiety and Depression Assessment Test, online Mental Recovery & Resiliency Courses, and a Community Support Forum monitored by licensed therapists.

Another solution in Asia is the digital mental health company ThoughtFull, which is partnering with the FWD Group to launch the Mind Strength Support program, a first-in-the-market platform to provide individuals with a convenient and confidential way to access digital solutions to strengthen their mental health. ThoughtFullChat leverages AI-powered technology for seamless and personalized access to mental healthcare solutions. Users can opt to find their best-fit mental health professional for video therapy, daily one-on-one, bite-sized coaching via text and audio messaging, and/or engage with dynamic science-backed content and emotional health trackers. The wide range of tools is available for individuals to utilize at their own pace.

Insurers also have linked up with virtual mental health service providers. AbleTo, Inc offers structured CBT programs tailored to participants’ unique needs for personalized treatment. They also provide Digital CBT, which offers one-on-one motivational coaching access. An example is the Virtual Blue benefits plan, an integrated mental healthcare plan that starts from age 4 and includes access to psychologists, psychiatrists, and licensed clinical social workers (LCSW).

Recent product launches

Cigna Healthcare plan for Seniors is a new, customized health benefits plan aimed at supporting the health and vitality of mobile people age 60 and older. The mental health support offering includes up to 20 face-to-face counselling sessions and access to mindfulness coaches and CBT psychologists.

In the U.K., the recently launched Bupa Family+ offers extensive mental health services, ongoing support for longer-term conditions, and family mental healthcare. It includes the Family Mental Healthline, staffed by trained advisers and mental health nurses. Also in the U.K., a new standalone protection policy, Childshield, provides mental health and wellbeing support 24/7, all year round.

Voya Financial has expanded its critical illness and accident insurance to include coverage for mental health. It will include a benefit for psychological or psychiatric care prescribed by a doctor provided in an eligible facility on an inpatient or outpatient basis after a covered accident.

MetLife, in its collaboration with Empathy, an end-of-life platform, is helping families navigate the experiences associated with loss. MetLife’s Beneficiary Claims Concierge Services now offers employees and their beneficiaries enrolled in life insurance access to Empathy’s bereavement care platform. These benefits, which were made available to all employee policyholders’ beneficiaries, are part of AT&T’s focus on boosting employee wellbeing.

What’s next?

Insurers can help educate children and youth to improve their health literacy and thereby help reduce the fear of social stigma attached to mental illness. They can continue to expand their group offerings to include all members of an employee’s family and consider increasing the number of consultations covered. They also can continue to refine and develop their value-added service offerings in relation to mental health.

In addition, insurers can continue to invest in partnerships with insurtechs and digital mental health platforms so that the range of solutions they offer can include options such as talking therapies and counselling (face-to-face, teletherapy, or hybrid), medications, psychiatry, and inpatient care as needed. They can redesign plans to encompass a wider range of mental health services across key phases of support: prevention, detection, treatment and management, or recovery. Services could include digital tools for early detection of those at risk and to sustain wellbeing. Outpatient treatment options could be expanded to offer counselling (face-to-face, teletherapy, or hybrid).

And, importantly, investment in providing training for professional personnel would be useful to help overcome the severe shortage of qualified mental health specialists across the world.

To learn more about mental health insurance solutions from RGA product development experts, contact us.   

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Meet the Authors & Experts

Diana Bosworth
Diana Bosworth
Senior Research Analyst, Strategic Research


2. AXA publishes its annual study of Mind Health and Wellbeing | AXA
3. Promoting Peace of Mind: Mental health and insurance | The Geneva Association