Although the economic burden of depression is staggering, most companies are just scratching the surface with this costly health issue. A recent flurry of e-mails going back and forth between the members of the Milwaukee Well City Steering Committee evoked a concern that depression be kept in the forefront of worksite wellness efforts. Milwaukee Well City is part of a national initiative, Well City USA, sponsored by Wellness Councils of America, to create a healthier workforce by engaging the business community in improving the health and well-being of the workforce. The e-mail discussion centered around the recently introduced Wisconsin Assembly Bill 235, which provides tax credits for companies who offer workplace wellness programs. While the bill addresses stress management intervention as an essential component of a wellness program it makes no mention specifically of depression or mental health. There is concern that we are not adequately addressing depression, and the cost and bottom line effect of this illness on the workplace.
Despite the fact that the annual cost of depression is significantly more than that of hypertension or back problems, and comparable to that of diabetes or heart disease, most employers remain unresponsive. Well-established research and dozens of intervention studies demonstrate the highly successful treatment options. The success rate for treating depression with medication, psychotherapy, or a combination of both is more than 80 percent, and most people who seek treatment get relief within weeks.
Still, nearly two of three people with depression never reach out for help. Lack of awareness, stigma, and under-diagnosis in primary care settings prevent many people from getting appropriate care.
Depression tends to affect people in their prime working years, is more prevalent among women, and may last a lifetime if untreated. Often times, a depressed employee will not seek treatment because they fear the affect it will have on their job and they are concerned about confidentiality. Many employees are also unaware they have depression or they fear their insurance is inadequate to cover costs.
Know The Facts
(from the National Mental Health Association):
• Depression ranks among the top three workplace problems for employee assistance professionals, following family crisis and stress.
• Three percent of total short-term disability days are due to depressive disorders.
• In a study of First Chicago Corporations, depressive disorders accounted for more than half of all medical plan dollars paid for mental health problems. The amount for treatment of these claims was close to the amount spent on treatment for heart disease.
• Almost one-third of costs for depression are for treatment and more than two thirds are costs related to absenteeism and lost productivity at work.
• Almost 15 percent of those suffering from severe depression will commit suicide.
Best practices for employers
So why aren’t businesses including depression in their wellness programs? Most employers want to do the right thing but may fear doing something wrong, thus they end up doing nothing at all. But even if employers fear doing the wrong thing, they should still make an effort, not only for their employees but also for their business. In a 2004 survey by the University of Michigan Depression Center, managers and employees said they believed the following would be effective workplace practices for depression. The company should:
• Ensure that employees have appropriate access to outpatient care and a broad continuum of services, settings, and providers.
• Provide information to employees to help them understand the health care system and the benefits available to them for treatment of depression.
• Provide information to employees on symptoms of depression and the importance of seeking care.
• Have employee screening or early detection mechanisms for depression.
• Have guidelines for job accommodations, including time to participate in therapy and other mental health programs, for those with depression.
• Have supervisor training to help them identify, manage, and assist employees with depression.
• Have a return-to-work plan for employees who have been absent due to depression.
Clinical depression has become one of America’s most costly illnesses. Left untreated, depression is as costly as heart disease or AIDS to the US economy, costing over $43.7 billion in absenteeism from work, lost productivity and direct treatment costs. With early recognition, intervention, and support, most employees can overcome clinical depression and remain healthy, productive employees.
