WWCMA October Meeting - Cost of Depression in the Workplace
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Transcript of WWCMA October Meeting - Cost of Depression in the Workplace
Cost of Mental Health Disorders Cost of Mental Health Disorders and Practical Solutions and Practical Solutions
October 18, 2011October 18, 2011
Bruce Cedar, CMG Associates
Sara Herman, Screening for Mental Health
Valerie Dickerson-Codero, Families for Depression Awareness
Massachusetts Workplace Massachusetts Workplace Mental Health InitiativeMental Health Initiative
Screening for Mental Health, IncScreening for Mental Health, IncMassachusetts Department of Public HealthMassachusetts Department of Public Health
CMG AssociatesCMG AssociatesFamilies for Depression AwarenessFamilies for Depression Awareness
Mission and History of the Massachusetts Mission and History of the Massachusetts Workplace Mental Health InitiativeWorkplace Mental Health Initiative
The GoalThe Goal of the WMHI is to increase awareness by MA of the WMHI is to increase awareness by MA employers and companies about the benefits of good employers and companies about the benefits of good employee mental health, to train employees about employee mental health, to train employees about recognizing signs of stress and depression, and to recognizing signs of stress and depression, and to provide intervention via screeningprovide intervention via screeningThe MA WMHI is a workplace collaboration, funded by The MA WMHI is a workplace collaboration, funded by MDPH, formed in 2007 in response to the growing MDPH, formed in 2007 in response to the growing financial and emotional toll that untreated mental illness financial and emotional toll that untreated mental illness has on Massachusetts communitieshas on Massachusetts communitiesBackground of MA WMHI Background of MA WMHI
Members of the CoalitionMembers of the CoalitionMass Department of Public HealthMass Department of Public Health– Funds coalitionFunds coalition– Helps support development of coalition materials and planningHelps support development of coalition materials and planning
Screening for Mental Health, IncScreening for Mental Health, Inc– A national non profit dedicated to promoting the improvement of mental A national non profit dedicated to promoting the improvement of mental
health by providing the public with education, screening, and treatment health by providing the public with education, screening, and treatment
resources.resources. www.mentalhealthscreening.org www.mentalhealthscreening.org CMG AssociatesCMG Associates– CMG Associates is a team of psychologists, organizational CMG Associates is a team of psychologists, organizational
consultants and social workers dedicated to helping you keep consultants and social workers dedicated to helping you keep your workplace healthy your workplace healthy www.cmgassociates.comwww.cmgassociates.com
Families for Depression AwarenessFamilies for Depression Awareness– A national nonprofit organization helping families recognize and cope A national nonprofit organization helping families recognize and cope
with depressive disorders to get people well and prevent suicides. with depressive disorders to get people well and prevent suicides. www.familyaware.org www.familyaware.org
Are any of these concerns for your Are any of these concerns for your company? company?
• Rising costs?Rising costs?
• Decreasing productivity?Decreasing productivity?
• Incidents of evident drug/alcohol abuse, theft, Incidents of evident drug/alcohol abuse, theft, family violence impacting the workplace, family violence impacting the workplace, suicide, etc.?suicide, etc.?
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AgendaAgenda
• DepressionDepression• Cost to EmployersCost to Employers• Best PracticesBest Practices• Practical SolutionsPractical Solutions
DepressionBruce Cedar, CMG AssociatesBruce Cedar, CMG Associates
Why Address Mental Health in the Workplace?Why Address Mental Health in the Workplace?
How does depression affect organizations?How does depression affect organizations?
Depression is number one cause of disability in US, and it ranks among top Depression is number one cause of disability in US, and it ranks among top three workplace problems addressed by Employment Assistance Programs. three workplace problems addressed by Employment Assistance Programs.
Depression tends to affect people in their prime working years and may last a Depression tends to affect people in their prime working years and may last a lifetime if untreated. lifetime if untreated.
More often than not, a depressed employee will not seek treatment because More often than not, a depressed employee will not seek treatment because they fear the affect it will have on their job and they are concerned about they fear the affect it will have on their job and they are concerned about confidentiality. confidentiality.
Approximately 225 million workdays are lost annually due to productivity decline Approximately 225 million workdays are lost annually due to productivity decline related to depression. This amounts to more days of work loss and work related to depression. This amounts to more days of work loss and work impairment than many other chronic conditions such as diabetes, asthma, and impairment than many other chronic conditions such as diabetes, asthma, and arthritis. arthritis.
"Sustaining Productivity: Addressing the economic burden of workplace depression," "Sustaining Productivity: Addressing the economic burden of workplace depression,"
A Special Supplement to Advancing Suicide PreventionA Special Supplement to Advancing Suicide Prevention, 2007., 2007.
John’s Story
What Depression Looks LikeWhat Depression Looks Like
What depression feels like to the employee
What depression looks like to the employer/ co-workers, clients
Slowed thoughts Poor quality work
Lack of concentration Procrastination, accidents on the job
Reduced interest, low motivation
Presenteeism
Self-medication Missed deadlinesAbsenteeism
In Men, Irritability, angerIn Women, Crying, upsetIn both, over-reaction
Poor relationships with co-workers, boss, clients; low morale in workplace
Can’t get going in the a.m. Late to work
Aches and pains Trips to the doctor, increased health ins costs
Ray’s StoryRay’s Story
Men & DepressionMen & Depression
Men are less likely to seek help than Men are less likely to seek help than women due to:women due to:
– Gender-role socializationGender-role socializationBelief that help seeking is a “female trait” –Belief that help seeking is a “female trait” –antithetical to masculine gender roleantithetical to masculine gender role
– Social Costs to Help-SeekingSocial Costs to Help-SeekingIncompetence, Dependence and Inferiority which Incompetence, Dependence and Inferiority which result in a perceived loss of power and control for result in a perceived loss of power and control for the person seeking helpthe person seeking help
– Fear of being stigmatized Fear of being stigmatized by family/friends/colleaguesby family/friends/colleagues
Cochran SV, Rabinowitz FE. Men and Depression: clinical and empirical perspectives. San Diego: Academic Press, 2000.
Men & DepressionMen & Depression
* Robbins and Reiger (1991) ** Kessler, McGonagle, Zhao, et al. (1994)
Abusing alcohol and drugs
Hand in HandHand in Hand
The federal government estimates that, 8.9 percent of full-time workers – 12.7 million people - have drinking problems. Substance Abuse and Mental Health Services Administration
Mental Health Disorders are Mental Health Disorders are TreatableTreatable
80% of people with depression get well!Illness is invisible when treated.
• Nearly 86% of employees treated for depression report improved Nearly 86% of employees treated for depression report improved work performance.1work performance.1
• 80% of those treated for mental illness report “high levels of work 80% of those treated for mental illness report “high levels of work efficacy and satisfaction.”2efficacy and satisfaction.”2
• Treatment of depression results about a 40-60% reduction in Treatment of depression results about a 40-60% reduction in absenteeism/presenteeism.3absenteeism/presenteeism.3
1 Finkelstein SN et al: Improvement in Subjective Work Performance after Treatment of Chronic Depression: Psychopharmacology 1 Finkelstein SN et al: Improvement in Subjective Work Performance after Treatment of Chronic Depression: Psychopharmacology Bulletin, vol. 32, 1996, pp. 33-40.Bulletin, vol. 32, 1996, pp. 33-40.
2 Therapy in America 2004: Poll Shows Mental Health Treatment Goes Mainstream. Therapy in America 2004: Poll Shows Mental Health Treatment Goes Mainstream. 3 Dunlop, DD Am J Pub Health 2005. Wang, PS Am J Psych 2004. Simon, GE Gen Hosp Psych 2000. Claxton, AJ JOEM, 1999. 3 Dunlop, DD Am J Pub Health 2005. Wang, PS Am J Psych 2004. Simon, GE Gen Hosp Psych 2000. Claxton, AJ JOEM, 1999.
Cost to Employers
Why address mental health in Why address mental health in workplace?workplace?
• Lower costsLower costs• Disability leave, sick days, health careDisability leave, sick days, health care• Average depressed employee loses 32 Average depressed employee loses 32
workdays per year* workdays per year* • Disability leave: 7-20% are psychiatricDisability leave: 7-20% are psychiatric
• Increase productivityIncrease productivity
* archives of psychiatry, Oct. 2007* archives of psychiatry, Oct. 2007
Costs of mental health disorders in Costs of mental health disorders in the U.S. workplacethe U.S. workplace
• Depression #1 cause of disability in U.S.*Depression #1 cause of disability in U.S.*• Mental illness and substance use disorders Mental illness and substance use disorders
annually for employers: $80 to $100 billion in annually for employers: $80 to $100 billion in indirect costs alone.**indirect costs alone.**
• 32 workdays/year lost per depressed 32 workdays/year lost per depressed employeeemployee
• 225 million work days lost/yr225 million work days lost/yr• Depression worsens other health conditionsDepression worsens other health conditions
• Even greater costs***Even greater costs***
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1 NIH 2007 2 Finch, R. A. & Phillips, K. (2005); 3 Katon, et. al. (2010)
Impact to the WorkplaceImpact to the Workplace
MedicalMedicalMental health/substance abuseMental health/substance abuse
PharmacyPharmacyDisabilityDisability
Presenteeism and lost productivityPresenteeism and lost productivityAbsenteeismAbsenteeism
Overtime to cover sick-day Overtime to cover sick-day absencesabsences
Unrealized outputUnrealized outputOverstaffing Overstaffing
Temporary workersTemporary workersStress on team membersStress on team members
RecruitmentRecruitmentHiring costsHiring costs
RetrainingRetraining
Depression and WellnessDepression and WellnessTypical wellness programs include weight loss, exercise, Typical wellness programs include weight loss, exercise,
smoking cessation.smoking cessation.Root cause can be depression.Root cause can be depression.
• 50% to 80% of those with a mental illness smoke.50% to 80% of those with a mental illness smoke.1
• 45% of people with asthma and 27 % of people with diabetes 45% of people with asthma and 27 % of people with diabetes have co-occurring depression.have co-occurring depression.2
• 17% to 27% of those hospitalized with cardiovascular 17% to 27% of those hospitalized with cardiovascular disease have depression.disease have depression.3
• Many of those who are obese have depression, there Many of those who are obese have depression, there appears to be a cortisol abnormality. If someone is appears to be a cortisol abnormality. If someone is overweight, then experience stress, weight will usually overweight, then experience stress, weight will usually increase.increase.4
1Smoking Cessation Leadership Center; 2Schatzberg AF. J Clin Psychiatry. 2004;3Depression and Cardiovascular Disease, Science Daily, 10/17/2007; 4psychcentral.com, Biological Link to Obesity and Depression, Rick Nauert, 6/12/2009
ExamineExamine Your CostsYour Costs
• Go to www.depressioncalculator.com• A tool that uses an algorithm established in clinical
research to estimate costs of depression
• Get the following costs from your providers:• Days missed due to absenteeism• % of disability cases that are due to psychiatric causes• Annual disability costs• Utilization of Employee Assistance Program (EAP)
Best PracticesValerie Dickerson-Codero, Families for Depression Valerie Dickerson-Codero, Families for Depression
AwarenessAwareness
Care Team: Peer Assistance CommitteeCare Team: Peer Assistance Committee Interested employees (crewmembers) are trained to listen to employees by phone or in person and
provide emotional support, and help them make use of JetBlue's employee assistance program (EAP) and benefits.
Trained on depression by Family Speakers who tell personal stories from Families for Depression Awareness.
225 peer assistants. Health Risk Assessment (HRA)Health Risk Assessment (HRA) Available to all employees and their families over 18. Gather detailed stats and provide more
specialized health programs to person.Disease Management ProgramDisease Management Program Disease Management Program for diabetes/ asthma/back pain/ heart, if depression also present,
then provide with treating clinician.NurselinesNurselines 24/7 telephone line for self care and advice (e.g., if person has depression, can discuss medication,
treatment options)EAP UsageEAP Usage 10.6% in 2010 compared to 3-4% average, attributed to ongoing reminder communications and
Peer Assistance Committee referrals
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Culture of Caring and Safety
~13,000 employees
GoalGoal• Manage health care costs through better health management. Personal Health PortalsPersonal Health Portals• WebMD/Ingenix partnership. Provide employees with their health care records and
health and wellness programs. EMC able to analyze aggregate data on top employee health issues, prescription drug usage, results of programs.
Targeted Wellness ProgramsTargeted Wellness Programs• Based on data of depression and antidepressant prescriptions, realized need for
depression workshop, sleep disorders, etc.On site Counseling: United Behavioral HealthOn site Counseling: United Behavioral Health• Counselors next to EMC locations, get free visits and better access to clinicians• Telepsychiatry is next step so that people can do counseling virtually, saves time,
money.Clinical Study Partnerships/Pilot ProgramsClinical Study Partnerships/Pilot Programs
• Tufts Medical Center Workplace Depression Study: 6-8 mo NIMH study. For employees 45 or older and depressed, receive online health coach.
• Partners Health Care SmartBeat hypertension program pilot, 70% of participants saw a decline in blood pressure
Training Article, Boston Globe “Targeting Untreated Depression in the Workplace: Training Article, Boston Globe “Targeting Untreated Depression in the Workplace: • http://www.boston.com/yourtown/news/waltham/2010/11/waltham_group_targeting_untrea.html
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EMC is an IT company behind online banking, health records, data storage, sharing, transferring.
25,000 US employees
Summary of Best PracticesSummary of Best Practices
• Assessing your organization’s needsAssessing your organization’s needs• ScreeningScreening• TrainingTraining• Employee communicationsEmployee communications• Improving access to mental health servicesImproving access to mental health services• Inclusive health strategyInclusive health strategy• Are you including mental health in all health strategies (e.g. disease Are you including mental health in all health strategies (e.g. disease
management, wellness programs, disability management)?management, wellness programs, disability management)?
Practical Solutions
How We Help YouHow We Help You
• Customizable, anonymous mental health Customizable, anonymous mental health online screening programonline screening program
• Training for management and employeesTraining for management and employees
• Tools to help you make the case to take Tools to help you make the case to take action (e.g., innovations database)action (e.g., innovations database)
How We Put our Mission Into How We Put our Mission Into ActionAction
The MA WMHI provides:The MA WMHI provides:– Free access to a customizable, anonymous Free access to a customizable, anonymous mental mental
health online screeninghealth online screening program program– Free trainingFree training, conducted at the organization, about , conducted at the organization, about
the financial and human cost of suicide and mental the financial and human cost of suicide and mental health issues in the workplace – also helps health issues in the workplace – also helps employees identify and cope with stressemployees identify and cope with stress
– Consultation to workplacesConsultation to workplaces to help devise the best to help devise the best strategy to adequately support the mental health strategy to adequately support the mental health needs of their unique workplaceneeds of their unique workplace
More details… Mental Health Online More details… Mental Health Online Screening ProgramScreening Program
Each organization is given a unique URL to place on their website where Each organization is given a unique URL to place on their website where employees can go to take anonymous screenings for Depression, Bipolar, employees can go to take anonymous screenings for Depression, Bipolar, Anxiety, PTSD, Alcohol Abuse and Eating Disorders Anxiety, PTSD, Alcohol Abuse and Eating Disorders
Organizations can run utilization reports Organizations can run utilization reports
The Screening is customizable, organizations can customize:The Screening is customizable, organizations can customize:– Welcome messageWelcome message– LogoLogo– Color SchemeColor Scheme– Referral Message (most important, EAP/HR resources can be listed, along with Referral Message (most important, EAP/HR resources can be listed, along with
local community support resources)local community support resources)
All online screening tools are validatedAll online screening tools are validated
Provided by Screening for Mental Health, Inc
• Managing Mental Health Issues in the WorkplaceManaging Mental Health Issues in the Workplace• A program for supervisors and managersA program for supervisors and managers
• QPR Training: (Suicide Prevention Strategy)QPR Training: (Suicide Prevention Strategy)• Question, Persuade, ReferQuestion, Persuade, Refer
• Post-VentionsPost-Ventions• Debriefing and support for the workplace following a suicideDebriefing and support for the workplace following a suicide
Workplace Consultation and TrainingsWorkplace Consultation and Trainings
Coping with Stress WorkshopCoping with Stress WorkshopProvided by Families for Depression AwarenessProvided by Families for Depression Awareness
One-hour, fifteen minutes workshop:One-hour, fifteen minutes workshop:– Employees discuss impact of stress on Employees discuss impact of stress on
their livestheir lives– Shows your commitment to employee Shows your commitment to employee
well-beingwell-being– Tools and techniques for managing Tools and techniques for managing
stressstress– Discuss stress, anxiety, depressionDiscuss stress, anxiety, depression– Helps employees recognize depression Helps employees recognize depression
and anxiety and seek treatmentand anxiety and seek treatment– Employees know where to go for help Employees know where to go for help
Includes Coping with Stress BrochureIncludes Coping with Stress Brochure
Coping with Stress Workshop"We need to have seminars like
this at least on a quarterly basis.""I learned how to cope withstress in ways I hadn't triedbefore. It was a good class.""It was valuable to learn the
difference between stress and depression”
Next Steps…Next Steps…ContactsContacts– Sara HermanSara Herman
Screening for Mental HealthScreening for Mental Health 1 Washington Street, Suite 3041 Washington Street, Suite 304 Wellesley, MA 02481Wellesley, MA 02481 781-591-5233, [email protected], [email protected]– Valerie Dickerson-CoderoValerie Dickerson-Codero Families for Depression AwarenessFamilies for Depression Awareness 395 Totten Pond Road, Suite 404395 Totten Pond Road, Suite 404 Waltham, MA 02451Waltham, MA 02451 781 890-0220, [email protected] 890-0220, [email protected]– Bruce CedarBruce Cedar CMG AssociatesCMG Associates
381 Elliot St., Suite 180L381 Elliot St., Suite 180L Newton, MA 02464 Newton, MA 02464
617 969-7600 [email protected] 969-7600 [email protected]