How to Measure the ROI of Mental Health Programmes at Work

The ROI of mental health programmes is the net financial gain an employer gets from workplace mental health support, divided by what the support costs. Published estimates are positive: Deloitte UK puts the average return at £4.70 for every £1 spent, and WHO links each US$1 invested in treating depression and anxiety to a US$4 return.

Those headline numbers are useful for a board slide, but they are averages from other people's data. This guide explains what the evidence actually says, the formula to use, which data to collect in your own organisation, and a worked example you can adapt. The example uses invented figures and is labelled as illustrative throughout.

What does the evidence say about the ROI of mental health programmes?

Three bodies of evidence are cited most often, and each measures something slightly different. Knowing the difference stops you from overpromising to your CFO.

Deloitte UK: £4.70 for every £1

Deloitte's 2024 report on mental health and employers estimated that poor mental health costs UK employers £51 billion a year, with presenteeism (working while unwell and below full capacity) the largest share at about £24 billion. Based on a review of 26 sources published since 2011, Deloitte found an average return of £4.70 in improved productivity for every £1 invested in employee mental health support. The Deloitte press release also notes that early, organisation-wide interventions such as culture change and education tend to show higher returns than in-depth support delivered once someone is already struggling.

WHO and The Lancet Psychiatry: US$4 for every US$1

A WHO-led study published in The Lancet Psychiatry in 2016 estimated that scaling up treatment for depression and anxiety across 36 countries would cost US$147 billion between 2016 and 2030, and that every US$1 invested would return US$4 in better health and ability to work. This is a national, health-system estimate rather than an employer study, so treat it as context, not as a forecast for one company. The source is the WHO announcement of the fourfold return.

Australia: at least 2.3 times the outlay

A return on investment analysis by PwC for Beyond Blue (report dated May 2014) found that each dollar spent on successfully implementing an appropriate workplace mental health action returned on average $2.30, mainly through lower absenteeism, presenteeism and compensation claims. The word "successfully" matters: programmes that are poorly launched or barely used do not deliver this.

A note of caution from a large trial

Not every workplace health initiative pays back. A randomised trial across 160 BJ's Wholesale Club sites in the United States, published in JAMA in 2019, found that a general wellness programme improved some self-reported behaviours but did not reduce absenteeism or health care spending over 18 months (Song and Baicker, JAMA). The lesson is that design, targeting and measurement decide the result, not the label on the programme.

Why does the cost of poor mental health matter in Asia Pacific?

ROI starts with the size of the problem you are trying to reduce. Globally, WHO and the ILO estimate that 12 billion working days are lost every year to depression and anxiety, at a cost of nearly US$1 trillion in lost productivity, according to their 2022 joint call for action.

Regional data points in the same direction:

• Singapore: a Duke-NUS and Institute of Mental Health study published in BMC Psychiatry in 2023 estimated that lost productivity from anxiety and depression costs about S$15.7 billion a year, or 2.9% of GDP. Affected respondents missed an extra 17.7 days of work a year and were 40% less productive while at work.
• Malaysia: a Relate Mental Health Malaysia white paper estimated that workplace mental health issues cost the economy RM14.46 billion in 2018, about 1% of GDP. Presenteeism accounted for RM9.84 billion, absenteeism RM3.28 billion and staff turnover RM1.34 billion.
• Australia: the PwC and Beyond Blue analysis put the annual cost of mental health conditions to Australian workplaces at more than $10.9 billion.

In both the Singapore and Malaysia figures, presenteeism outweighs absence. That is the single most important point for your model: if you only count sick days, you will understate both the cost and the return.

What is the formula for calculating mental health programme ROI?

Use the standard ROI formula, and keep it separate from the benefit-cost ratio that most published studies report.

• ROI (%) = (Total financial benefits minus Total programme costs) divided by Total programme costs, multiplied by 100.
• Benefit-cost ratio = Total financial benefits divided by Total programme costs.

Deloitte's £4.70 per £1 is a benefit-cost ratio. Expressed as ROI, it is a net gain of £3.70 per £1, or 370%. Mixing the two is the most common error in HR business cases, and finance teams notice it.

What counts as a cost?

• Provider fees for your EAP, coaching, therapy and training.
• Internal time: HR administration, manager training hours and employee time spent in workshops.
• Launch and communication costs.
• Any backfill or overtime needed while people attend training.

What counts as a benefit?

• Reduced absence days linked to mental health, valued at daily employment cost.
• Reduced presenteeism, valued as recovered productive time.
• Fewer regrettable resignations, valued at your own replacement cost per hire.
• Lower claims, such as medical or disability claims where you hold the data.

How do you calculate ROI step by step?

Follow these steps in order. Each one produces a number you can defend in a finance review.

1. Set the baseline. Pull 12 months of absence, turnover and claims data before launch. Run an anonymised survey to estimate presenteeism and wellbeing, for example with validated tools such as the WHO-5 or PHQ-9.
2. Define your population and time frame. Decide whether you are measuring the whole workforce or a pilot group, and fix the period, usually 12 months.
3. Total the full costs. Include provider fees and internal time, not just the invoice.
4. Measure change after launch. Repeat the same measures at 6 and 12 months, using the same questions and the same population.
5. Convert change into money. Multiply days saved by daily employment cost, and resignations avoided by your replacement cost per hire.
6. Attribute conservatively. Only part of any improvement is due to the programme. Apply an attribution rate, such as 30% to 50%, and state it openly.
7. Calculate ROI and the benefit-cost ratio. Report both, with a low, middle and high scenario.
8. Add the non-financial results. Report wellbeing scores, psychological safety and engagement alongside the money, because these lead the financial results.

What does a worked ROI example look like?

Illustrative example only. The figures below are invented to show the method. They are not ThoughtFull client results or benchmarks. Replace every number with your own data.

Imagine a 1,000-person organisation with an average fully loaded employment cost of US$40,000 a year, or about US$160 per working day across 250 working days.

Costs (illustrative)

• EAP, coaching and therapy provider fees: US$60,000.
• Manager mental health training and workshops: US$20,000.
• Internal time and communication: US$10,000.
• Total cost: US$90,000.

Benefits (illustrative)

• Absence: mental health-related absence falls by 400 days. 400 x US$160 = US$64,000.
• Presenteeism: survey data suggest 1,200 productive days recovered. 1,200 x US$160 = US$192,000.
• Turnover: 5 regrettable resignations avoided at a replacement cost of US$15,000 each = US$75,000.
• Gross benefit: US$331,000.

Apply attribution and calculate

Assume 40% of the improvement is attributable to the programme: US$331,000 x 0.4 = US$132,400. ROI is (US$132,400 minus US$90,000) divided by US$90,000, which is about 47%. The benefit-cost ratio is about 1.47.

Notice how much the result depends on presenteeism and attribution. If you halve the presenteeism estimate, ROI turns slightly negative. That is why you should present a range, and why measurement quality matters more than the headline figure.

Which data sources should HR use to measure ROI?

Most of the data you need already exists. The task is to link it in a way that protects confidentiality.

• HRIS and payroll: absence days by reason code, salary bands and turnover with exit reasons.
• Benefits and insurance: medical claims and disability claims, in aggregate only.
• Provider reporting: anonymised, aggregated trends from your EAP provider, such as presenting issues and changes in assessment scores. ThoughtFull's Insights Dashboard for HR shows aggregated, anonymised trends rather than individual records.
• Pulse and wellbeing surveys: WHO-5, PHQ-2 or PHQ-9 scores and psychological safety measures, run before and after launch.
• Engagement surveys: intent to stay and manager support items.

Never request individual-level clinical data from a provider. Confidentiality drives usage, and usage drives return. Our guide on how to evaluate the success of an EAP covers the reporting you should expect.

How can you improve the ROI of a mental health programme?

The evidence above points to a few practical levers. Deloitte's finding that early, organisation-wide work outperforms late support is the most useful for planning.

• Start with a baseline assessment. An anonymised organisational survey tells you where risk sits. ThoughtFull's Organisational Mental Wellness Assessment takes under seven minutes and is built on PHQ-2, GAD-7 and the Edmondson psychological safety scale.
• Train managers. WHO's 2022 guidelines recommended manager training for the first time, because managers shape workload and early help-seeking.
• Offer low-barrier access. Text-based coaching, online therapy and support in employees' own languages reduce the friction that keeps people from using support.
• Fix the work, not just the worker. Workload, role clarity and behaviour at work are psychosocial risks. Counselling alone will not offset them.
• Measure from day one. You cannot show a return without a baseline.

If you are building the case from scratch, an employee assistance programme with integrated assessment and reporting gives you both the support and the data in one place. See also our guide on how to build a business case for an EAP.

ROI checklist for HR leaders

• Baseline absence, turnover and survey data captured before launch.
• Full costs counted, including internal time.
• Presenteeism measured with a consistent survey method.
• Replacement cost per hire agreed with finance.
• Attribution rate stated and justified.
• ROI and benefit-cost ratio reported separately.
• Low, middle and high scenarios shown.
• Only aggregated, anonymised data used.
• Results reviewed at 6 and 12 months.

What is the next step?

A credible ROI figure is built from your own baseline, not borrowed from a report. If you want help setting up measurement across your teams in Asia Pacific, from anonymised assessment to aggregated reporting, book a demo with ThoughtFull and we will walk you through how organisations such as AIA and Standard Chartered approach workplace mental health support.