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Mental Health for All: The Missing Middle and Beyond


Mental health is more than simply the absence of mental illness. Despite the fact that 83% of people will experience mental health issues by middle age, it’s a topic that has long been misunderstood and stigmatized. These issues range from temporary periods of overwhelming stress to more serious, chronic conditions.

Poor mental wellbeing is as bad for companies as it is for employees. From low productivity to absenteeism to higher healthcare costs, a failure to support employee mental health can come with a big price tag.

  • 200 million workdays are lost due to mental health conditions each year
  • Employees experiencing mental distress utilize an additional $3,000 in healthcare services each year
  • Depression alone costs employers $44 billion in lost workplace productivity

The ‘missing middle’

While 90% of businesses added mental health programs over the last few years, just 25% of employees feel their employer provides adequate mental health support and 85% say that work actually makes them feel worse. There is a disconnect between what employees need and what organizations are offering.

Unfortunately, many of these benefits investments are too narrow in scope, focusing only on one end of the mental health continuum. This has created a ‘missing middle’ – the significant portion of the working population that is struggling with their mental health but doesn’t have an easy pathway to care.

Mindfulness and meditation apps are great for those looking to cope with everyday stressors but lack the science-based techniques used in therapy. EAPs and bolt-on therapist networks can help those needing more in-depth support but aren’t the best option for employees who are simply looking to maintain their mental wellbeing.

Furthermore, mental health isn’t a constant. Each individual exists on a spectrum of mental wellness on which they move back and forth throughout life. Mental health is also a highly individual experience. Providing effective, accessible mental health resources across this continuum addresses the urgent need to support the ‘missing middle,’ meeting the needs of all individuals at all points on their unique journey.

With the stigma and shame some associate with face-to-face treatment, long wait times, high co-pays, or limited insurance coverage, it’s no surprise that more than half of individuals struggling with their mental health aren’t seeking treatment. A preference for self-help options is one of the most cited reasons given for not seeking care.

Jennifer Gendron - CCO, Koa Health

“Everyone has mental health, and where you’re at on a continuum—from building tools for resilience to talking to someone about difficult feelings or more acute treatment—that can continuously be changing and evolving depending on your stage in life and the circumstances around you. But no one is exempt from hard things. So, as part of taking care of your people, you must consider how you can make the right kind of support easily accessible when they need it most.”

– Jennifer Gendron, Chief Commercial Officer, Koa Health

Full-spectrum mental health support

At Koa Health, we’re on a mission to deliver mental health for everyone, and we aim to be a true partner in creating a holistic culture of mental health. This not only means providing accessible, personalized support that adapts to users’ unique circumstances while breaking down barriers to care—we’re also helping users and clients gain a better understanding of mental health and care modalities.

Koa Foundations is an evidence-based app grounded in cognitive behavioral science, mindfulness, meditation and positive psychology, that teaches users the ‘why’ behind the content, deepening their understanding of their own mental wellbeing. The library of science-based content—curated by our team of skilled psychologists—is designed to help users deal with stress, poor sleep, worry, anxious thoughts, low self-esteem and more. With our digital-first, self-help approach, we’re reaching individuals across the care spectrum—including the large portion of employees that fall within the ‘missing middle.’ In other words, we’re helping people who need more than deep breathing exercises and guided meditations, but don’t need such acute care, while still being clinically sound.

Health starts with behaviors, rooted in daily small habits. Learning the ‘why’ behind the behaviors—whether it’s a maladaptive behavior that one is trying to break or a healthy habit that one is hoping to establish—can make change and growth easier to achieve. Since success breeds success, this empowers users to continue on the path towards resilience and improved mental wellbeing.

An ethical approach to mental health

Mental health for all means offering approachable, inclusive, trustworthy support that meets users’ ever-changing needs in a way that they understand. Ethics is intrinsic to issues of health and healthy behaviors, especially when providing trusted, evidence-based advice on what to do. At Koa Health, our ethical principles are at the core of everything we do. We’ve invested over 10,000 working hours and more than $1 million in our comprehensive ethics strategy.

To keep us accountable, Koa Health has publicly committed to a set of ethical principles and undergoes an annual external audit to ensure our products and services effectively use non-gendered and non-biased language (aiming for a reading age of 11) and images. This enables us to build truly inclusive and approachable mental health programs for all users, wherever they are on their mental wellbeing journey.

We’re not here to just work around the problems, we’re here to re-invent the playbook. We’re solving the functional mental health needs of the largest part of the population, but doing it in a way that contributes to holistic improvements in the global comprehensive care system and the de-stigmatization of mental health challenges.

Koa Health
Koa Health

Koa Health is the leading global provider offering evidence-based, personalized, integrated solutions and services that deliver mental health for everyone. Available to more than 3 million users worldwide, Koa Health addresses a vast spectrum of mental health needs – from improving wellbeing to supporting treatment for the most prolific disorders. Backed by investors such as Telefónica, a consortium advised by Ancora Finance Group, Wellington Partners Life Sciences, and MTIP, Koa Health leverages deep clinical expertise, research and technology to deliver effective and accessible care that adapts to users’ unique circumstances, leading to lasting behavior change and positive health outcomes. Koa Health partners with employers, health plans, health systems and providers around the world with its headquarters in the Netherlands and operations in Boston, London and Barcelona.

Koa Health was a 2022 WELCOA Summit Sponsor and are a proud partner of the WELCOA Premier Provider Network. To learn more visit their Vendor Profile.