SilverCloud Health Survey: U.S. Employees Are Not OK Right Now, And They’re Hiding It

55% show symptoms of mental health distress, and they’re asking employers for empathy over money

BOSTON (Sept. 20, 2021) — U.S. employees are not OK. When asked, “how are you,” 84% don’t always mean it when they say “good” or “fine.” More than one-third (37%) mean it less than half the time, according to SilverCloud Health’s 2021 Employee Mental Health and Wellbeing Checkup, released today.

The employee insights paint a picture of a population that is hiding how they’re truly doing, and reveal opportunities for employers to take specific employee- requested actions to support the people whose performance drives their business outcomes, and whose wellbeing is the concern of any executive a team. More than half of employees surveyed had symptoms indicating mental health support would improve their wellbeing and productivity.

“I find the requests for company empathy particularly poignant,” said psychologist Jorge E. Palacios, MD, PhD., Senior Digital Health Scientist at SilverCloud, of employee responses to the question of what employers could do to help. “The global pandemic has helped more people recognize that mental health is a continuum: we can be functional, but still not OK. This recognition that there’s opportunity to help people improve mental health metrics even at the lower-acuity end of the spectrum – and that there’s economic value in doing so – is a wake-up call for employers who may not have recognized, or had the incentive to address, such needs.”

The findings of the research, which surveyed 2,141 employed Americans and analyzed their responses by the severity of their mental health symptoms, showed:

Some employees need a lot of help. A lot of employees need some help.

Respondents each answered a questionnaire used in clinical settings to identify symptoms of anxiety and depression:

  • About two-thirds of employees have clinically-measurable mental health symptoms.
  • 1 in 10 has severe symptoms.
  • 55% of employees are languishing on the spectrum in a state of mild to moderate distress.

Where an employee lands on this spectrum directly affects their productivity at work—with severely distressed people self-reporting they are twice as unproductive (almost 4 hours each workday) as people without mental health distress (up to 2 hours each workday). Those in the middle reported over 3.25 of unproductive work hours per day.

The survey also found that an employee’s mental health correlates with flight risk. Employees with any mental distress are 3.4 times as likely to have quit a job because of mental health. Notably, managers were more likely than non-managers to have considered quitting a job because of mental health (34% vs. 25%). Managers were also more likely than non-managers to have taken a day off during Covid-19 because they weren’t mentally present (47% vs. 34%).

Employees cited the workplace as both the cause of – and potential provider of relief from – mental health distress.

About 9% of respondents said they don’t have a go-to coping mechanism to feel better when they’re outside of work. That number doubles to 18% when people were asked if they had a coping mechanism while at work. Importantly, employees offered solutions, noting in free responses what they wished their employer would do to help them cope with negative feelings and other mental health needs while at work.

  • Nearly 20% of responses suggested employers could help just by being more human and acknowledging that it’s ok to not always be ok – a compelling finding as stigma about discussing individual mental health needs evolves and acceptance of the need for change slowly enters workplaces.
  • 37% called for physical or mental space from work, including quiet places to take breaks.
  • 32% explicitly requested mental health resources such as counseling or mental health insurance coverage.

Each of these were considerably more frequently noted than benefits like food or a gym (10%) or financial compensation (7%).

How employers can put employee feedback to work

Clinical research studies have proven that deploying mental health programs, including internet-based Cognitive Behavioral Therapy, can help individuals reduce their levels of anxiety or depression and better manage stress.

In reducing the severity of their mental health symptoms, an average employee could gain improvements in productivity and medical costs of:

  • 12% by improving from the mild/moderate symptoms population.
  • 19-21% by improving from the moderate-severe/severe population.

Employers who can nurture mental wellbeing across the entire company, therefore, will also be nurturing productivity.

“The large number of people with measurable mental health needs isn’t surprising, given what the world has been through, but it’s jarring to juxtapose the scope of need against employees’ intents to hide those needs, particularly alongside their calls for specific areas of support from employers,” said Michael Anselmo, Vice President of Healthcare Economics for SilverCloud Health. “These survey findings suggest employers have an opportunity to measurably impact a fairly large portion of their employee population, and their bottom lines, by making mental health resources more accessible.”


SilverCloud Health’s 2021 Employee Mental Health and Wellbeing Checkup queried 2,141 employed Americans about their mental health status, ability to cope with distress, and thoughts on what employers could do to help. A standard questionnaire used by clinicians to flag symptoms of anxiety and depression established where each respondent stands on a continuum from “no distress” to mild, moderate and severe distress, allowing data to be analyzed along a continuum of mental health needs. Data were collected in July 2021. Respondents ranged in age from 18 to 99 and all self-identified as being employed either full- or part-time. Census-balancing was applied to ensure representative distribution among geography, age and gender. The margin of error was +/- 2.161%.

About SilverCloud Health

SilverCloud Health is the world’s leading digital mental health company, enabling providers, health plans and employers to deliver clinically validated digital health/therapeutic care that improves outcomes, increases access and scale while reducing costs. The company’s multi-award-winning digital mental health platform is a result of over 18 years of clinical research with leading academic institutions. Today, SilverCloud is being used by over 500 organizations globally to meet their populations’ mental health needs. Global experts have deeply validated the platform through full randomized control trials and real-world data from over half a million SilverCloud users. The platform continues to lead the industry with its effectiveness, engagement and range of clinical programs that encompasses the spectrum of mental health needs. Learn more at

SilverCloud Health was recently acquired by Amwell® (NYSE: AMWL), a leading global telehealth platform that connects and enables providers, insurers, patients, and innovators to deliver greater access to more affordable, higher quality care. The acquisition provides SilverCloud with an opportunity to expand its delivery of proven behavioral healthcare capabilities to further advance the reach and impact of care teams around the globe. To learn more visit: