POSTED: September 30 2020
EXCLUSIVE INTERVIEW: Simon Miller, Senior Director of Proposition, Aetna International

EXCLUSIVE INTERVIEW: Simon Miller, Senior Director of Proposition, Aetna International

advo’s Advocate magazine caught up with Simon Miller, Senior Director of Proposition at Aetna International, to talk about the mental health challenges faced in the wake of COVID-19, what employers can do, and how the latest apps can help build resilience and positive coping mechanisms.


Q. Firstly Simon, can you tell us a little bit about you and your role at Aetna International?

Sure. A marketer by profession, I’ve been in product, proposition and innovation roles in health insurance for the past 15 years – the last two with Aetna International having come from a UK domestic PMI provider. It’s been a fascinating journey as product development has moved way beyond just treatment benefit limits to finding ways that actively manage everyday health care needs – mental, emotional and physical.

Q. What’s driven that change in health insurance?

There’s been a conscious shift in mindset to a proactive, preventative and personalised approach rather than just stepping in when someone is already sick. It’s a move we’ve been championing at Aetna International and it’s particularly important when it comes to mental health, where there can be hidden costs to both employers and insurers that a reactive approach may never fully account for. If we don’t engage early enough with a member, for example, then we might not associate an underlying mental health issue with a claim for co-morbidities. The knock-on impact for an employer could be a potentially delayed return to work. Equally, if we don’t take a holistic view of a member’s health at point of claim, then we may miss the opportunity to support someone with the emotional impact that diagnosis, treatment and rehabilitation can often have. So, engaging early and supporting holistically means a much better outcome for patient, employer and insurer.

Q. What do you see as the biggest challenges to earlier mental health intervention?

I think a lot of employers and providers are either over reliant on a ‘one-size-fits-all’ approach to mental well-being support or, at the other end of the spectrum, are providing a suite of solutions that leaves an employee potentially confused and disengaged.

Our research tells us that members want four things: a clear understanding of their mental health and well-being cover, an understanding of how that might be relevant to them in their situation, ease of access and continuous support. This might not sound like especially shrewd insight but when you take a step back and put yourself in the customer’s shoes, it quickly becomes apparent that there is still a lot of opportunity to improve. It’s one of the reasons we’ve recently refreshed our Aetna Well-being proposition, which includes a wide range of support services – from self-care to remote and physical care from a professional. By splitting our apps and offers into straightforward categories, including body, mind and living and working abroad, the relevant resources and tools are much easier to navigate, understand and use.

Q. Where does your recent launch of the Wysa app fit into this?

Wysa is a simple, scalable digital solution that’s like having a mental well-being buddy in your pocket. It’s an app that uses conversational language to enable people to openly but anonymously share thoughts and feelings in a safe place, via text, on their terms, at any time of the day. The AI-driven chat function is really clever, having been programmed by therapists. It learns from you, then guides you onward towards self-help resources to build mental positivity and resilience. If needed, it also provides access to qualified human coaches who can have a 1:1 conversation to help address specific issues and goals through text, chat and online journaling.

One of the things I really like is, Wysa understands, as valuable as Employee Assistance Programmes and other therapeutics are, that not everybody is ready to speak to a stranger or commit to a structured counselling programme – particularly younger digitally native workforces. Wysa is secure, confidential and provides a very accessible front door to support a wider population with everyday mental health support. We see it as a key tool to drive wider early engagement in emotional and mental well-being.

Q. What about the dichotomy of providing digital solutions to overcome what are often digitally induced anxieties?

You’re right. There is no doubt that screen-time can be unhealthy – both physically and mentally – and our recent report The Digital Health Dilemma highlighted some of these challenges. For example, tech can contribute to an unhealthy ‘always-on’ mindset. 70% of respondents admitted to checking their phones first thing in the morning for work-related messages, whilst nearly two-thirds do the same thing right before going to bed.

On the flip-side, there is significant evidence to show that digital tools can drive social connectivity as well as help deliver well-being support for those that might not otherwise engage in traditional channels. And amidst Covid-19 physical restrictions, an essential aspect of providing remote care. So it’s vital that companies provide a range of solutions to meet the needs and preferences of employees, with appropriate triage, guidance and navigation to the right solution at the right time.


Q. In your opinion, what’s involved in achieving a ‘thriving’ dynamic in the workplace?

First and foremost, it has to be about culture. It’s incumbent on executive teams to lead the way, encouraging employees to help foster change by openly contributing to a workplace that prioritises wellness. I think it’s also about changing the rhetoric. Too much focus has been on driving the agenda through looking at the cost of poor well-being indicators such as lost productivity, absenteeism and presenteeism. These are important measures, but they tend to focus on the negative and the few in that space that are struggling or at crisis point.

Personally, I’d like to see a shift in focus to measuring the positive impacts of a well-executed well-being strategy across a workforce. One where we hold ourselves to account on more holistic measures like sense of purpose, energy, connectedness, happiness and gratitude. As well as absenteeism and the like, businesses could then validate the impact of the initiative back to harder measures such as employee engagement results and even, dare I say, health insurance claims and outcomes. Wouldn’t it be great if we could look to the future and start to see the positive mental well-being of a workforce featuring in annual reports and influencing company KPIs?

Q. How is Aetna International approaching mental health challenges for their members?

Our focus is about empowering members and supporting them wherever they are with their mental health journey. It’s also about supporting people to take everyday steps to develop positive mental fitness in the same way you might approach physical fitness – prioritising well-being because it helps you achieve a well-balanced lifestyle and positive mindset, not just because you’re ill or at risk.

Of course, individuals have very different well-being needs and preferences, so we need to take into account personalisation, accessibility and convenience. We also want to ensure frictionless customer journeys with escalation to appropriate onward support, if necessary. Wysa is a great example of this in motion. It helps with the everyday anxieties associated with change and uncertainty as well as any personal challenges. But it also solves the practical issue of having private conversations when private space may be hard to come by, builds positive coping mechanisms, and effectively bridges a spectrum of need by directing into our onward clinical support if needed.

Q. Does Aetna International take this approach with their own staff?

Yes, I’m pleased to say we’ve made sure we are walking the talk with our own staff, with both digital and non-digital solutions. For example, as well as Wysa, we broadened access to our virtual primary care service, vHealth, to make sure employees’ physical health was taken care of.

We’ve also undertaken a very successful webinar initiative called ‘Let’s Get Talking’ across our regions, using an interactive online platform. This has allowed people to virtually gather on tables of six, listen to presenters, and then easily hop around to speak to colleagues on other tables. It has been a good opportunity to pause, reflect, connect and share. And we recognised the need to provide mental health training for managers to equip them with the skills and confidence to have insightful conversations with their teams, spot the early signals of distress and if appropriate, navigate their staff to the right resources and support available to them.

In truth, nothing could have prepared us for the impact of COVID-19 or the resulting mass migration to working from home. But we’ve viewed it as an opportunity to take a fresh look at how best to support our workforce and ensure they have access to the support they need, when they need it.


You can find out more about Aetna International and how they support clients by speaking to your advo account manager or by visiting their website here.