Nearly every employee knows their employer offers mental health benefits, but awareness alone isn’t translating into care, according to a new survey from Segal that suggests employers should focus less on promoting benefits and more on making them easier and more affordable to use.

The survey found that 99% of workers are aware of their mental health benefits and trust the information their employer or health plan provides about them. Yet only 38% said using those benefits feels normal at their workplace, while nearly half (48%) said mental health benefits exist, but people simply don’t talk about them.

Cost also remains a significant concern. More than two-thirds of respondents said they worry at least moderately about the cost of receiving mental healthcare if they needed it, and 35% identified lower out-of-pocket costs or clearer upfront cost estimates as the single change most likely to encourage them to use their mental health benefits. Another 19% said having a list of in-network therapists accepting new patients would make the biggest difference.

Nearly 7 in 10 respondents said either they or a family member has used their employer-sponsored mental health benefits. Among those who sought care, almost half described the experience as positive, with respondents citing supportive care, easy scheduling and the convenience of virtual therapy. Still, some reported difficulty finding in-network providers, high out-of-pocket costs, restrictive coverage limits and administrative challenges.

The survey also found employees remain divided over when mental health benefits should be used. Just over half (52%) said benefits are appropriate for everyday mental wellness, while one-third said they should be reserved for more serious mental health challenges and 15% believed they should only be used during a crisis.

Stress continues to be widespread across the workforce, with 72% of respondents identifying work as a major source of stress over the past year, followed by financial concerns (64%), mental health symptoms such as anxiety or depression (52%) and family or caregiving responsibilities (51%). When asked what most harms mental health at work, respondents most frequently pointed to unmanageable workloads and unrealistic deadlines, followed by toxic workplace cultures, low pay and job insecurity, and poor manager behavior.

Segal said employers can increase engagement with existing mental health benefits by reducing financial and logistical barriers, clearly communicating what services are covered and what they cost, expanding flexible access to care, reassuring employees about confidentiality and addressing workplace conditions that contribute to stress in the first place.