Mental health claims have become one of the fastest-growing cost pressures in group benefits, and the cost is increasingly falling on employer-sponsored plans because public healthcare systems are not absorbing the demand, according to Denis Guay, president of global benefits at HUB International.
"73% of employers saw an increase in mental health claims in 2025," Guay said. "Inpatient behavioral health claims are up nearly 80% in recent years."
He said mental health has become a leading cause of short-term disability claims in most countries, while musculoskeletal conditions remain the top driver of long-term disability.
The clinical trajectory is pointing in one direction. Dr. Kryijztoff Novotnaj, chief medical officer for employee benefits at HUB International, said the global population is headed toward more than half a billion people living with anxiety, representing an estimated $16 trillion in economic cost.
"For most of the global markets, the public systems barely cover mental health sufficiently," Novotnaj said. "And the supply of mental health providers worldwide falls short of that global demand."
He said the gap between what public systems cover and what employees actually need is wider in mental health than in almost any other area of healthcare. When the public system does not absorb the demand, it defaults to whichever layer the employer is funding.
"Failure almost always defaults to the supplemental or the ancillary layer of your coverage, which could be your EAP or your behavioral health rider, or even your disability coverage," he said.
Novotnaj described it as the most clear-cut example of a risk that public systems are not built to catch.
"This is the clearest example from the public health perspective of a risk when the social system doesn't catch the need of the demand of the population that you serve," he said.
The pressure is not distributed evenly. Novotnaj said the Nordic countries – Norway, Sweden and Finland – along with the Baltic states and Denmark carry some of the highest rates of mental health burden in the world. Even in those markets, where public healthcare is traditionally strong, the systems are overloaded.
"The public systems in those countries are so overloaded that the private supplemental use of benefits is climbing at an exponential clip," he said.
Guay said the pattern extends beyond mental health. Public healthcare systems globally are struggling to keep pace with demand across dental, vision and broader medical services, pushing more utilization into employer-funded private plans.
"Social systems do not always adequately cover things like dental, vision and mental health," he said.
He said the result is a structural shift in what employer-sponsored plans are expected to carry. What was once a supplemental layer is becoming, in many markets, the primary route to timely care.
The financial case for investing in mental health coverage is well documented. Guay said employers that have built effective behavioral health programs are seeing a measurable return.
"Investing in effective behavioral health has proven to be a 4 to 1 return on investment for employers," he said.
But he said the level of investment in mental health coverage has not kept pace with the scale of the claims problem.
Novotnaj said the broader pattern is consistent across clinical risk areas – the fastest-growing costs are landing on the layers employers are funding, not the public system.
Mental health is driving claims volume, disability duration and plan costs simultaneously, and the public system is not offering a backstop. Carriers and brokers writing group benefits are already seeing it in renewals – the gap between the scale of the problem and the level of investment in most plans has not closed.
