WWCMA October Meeting - Cost of Depression in the Workplace


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October meeting, Cost of Depression in the Workplace: What Employers Need to Know about Depression in the Workplace, and Practical Solution, which was presented by the Massachusetts Workplace Mental Health Initiative; a Department of Public Health sponsored program. We had some great insights and discussions prompted by our panel of experts Valerie Dickerson Cordero, Ph.D., Program Manager, Families for Depression Awareness; Bruce Cedars, Ed.D., Founder/Owner, CMG Associates; and Sara Herman, BS, Program Coordinator, Screening for Mental Health.

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  • Bruce
  • John’s story represents the story of many men and many people with depression; Fortunately for John and his family he got the help he needed. Today’s presentation will draw on many of the issues raised by John. John is an example of “Overt Depression” John’s Story. John was surprised by the changes in his life and outlook. The changes came on slowly and became progressively worse. He lost all interest in the things he loved to do. He suffered from very low energy. On many days it became a major effort to get out of bed and get to work. On some days he hit the alarm and just went back to sleep, at times forgetting to call and say that he was not able to come in to work. He lost interest in his fish. His large aquarium tanks that he usually kept pristine turned green from algae and lack of attention. His wife Michelle grew increasingly concerned about John and his behavior. Eventually she was able to get him in to see his primary care doctor. John said nothing to his doctor about depression. He talked about his physical symptoms. John was started on medication and quickly began to improve. He regained interest in the things that had been important to him.
  • Symptoms of Depression… Think SIGECAPS S leep (increased or decreased) I nterest (decreased) G uilt (increased) E nergy (decreased) C oncentration (decreased) A ppetite (increased or decreased) P sychomotor (increased or decreased) S uicidal thinking (increased)
  • Ray also struggled with depression but it’s presentation was very different and more “covert”. Ray’s story.
  • One of the reasons why men may have such lower rates of depression as compared to women is that they are less likely to seek help. In focus groups conducted by the National Institute of Mental Health (NIMH) men reported that they perceived depression as a woman’s issue and that if they were to admit that they were depressed they’d face negative consequences such as being stigmatized by family, friends, and co-workers or employers. Men who are depressed may report more physical symptoms and instead of getting help may…
  • One of the reasons why men may have such lower rates of depression as compared to women is that they are less likely to seek help. In focus groups conducted by the National Institute of Mental Health (NIMH) men reported that they perceived depression as a woman’s issue and that if they were to admit that they were depressed they’d face negative consequences such as being stigmatized by family, friends, and co-workers or employers. Men who are depressed may report more physical symptoms and instead of getting help may…
  • The large majority of American adults who abuse alcohol don’t believe they need treatment 7.4 million Americans 21-64 with alcohol dependency, only 1.2 percent said they would benefit from treatment. Untreated alcohol dependence disorder, (more serious) only 7.8 percent recognized they needed treatment .
  • Bruce
  • Julie
  • WWCMA October Meeting - Cost of Depression in the Workplace

    1. 1. Cost of Mental Health Disorders and Practical Solutions October 18, 2011 Bruce Cedar, CMG Associates Sara Herman, Screening for Mental Health Valerie Dickerson-Codero, Families for Depression Awareness
    2. 2. Massachusetts Workplace Mental Health Initiative Screening for Mental Health, Inc Massachusetts Department of Public Health CMG Associates Families for Depression Awareness
    3. 3. Mission and History of the Massachusetts Workplace Mental Health Initiative <ul><li>The Goal of the WMHI is to increase awareness by MA employers and companies about the benefits of good employee mental health, to train employees about recognizing signs of stress and depression, and to provide intervention via screening </li></ul><ul><li>The MA WMHI is a workplace collaboration, funded by MDPH, formed in 2007 in response to the growing financial and emotional toll that untreated mental illness has on Massachusetts communities </li></ul><ul><li>Background of MA WMHI </li></ul>
    4. 4. Members of the Coalition <ul><li>Mass Department of Public Health </li></ul><ul><ul><li>Funds coalition </li></ul></ul><ul><ul><li>Helps support development of coalition materials and planning </li></ul></ul><ul><li>Screening for Mental Health, Inc </li></ul><ul><ul><li>A national non profit dedicated to promoting the improvement of mental health by providing the public with education, screening, and treatment resources. www.mentalhealthscreening.org </li></ul></ul><ul><li>CMG Associates </li></ul><ul><ul><li>CMG Associates is a team of psychologists, organizational consultants and social workers  dedicated to helping you keep your workplace healthy www.cmgassociates.com </li></ul></ul><ul><li>Families for Depression Awareness </li></ul><ul><ul><li>A national nonprofit organization helping families recognize and cope with depressive disorders to get people well and prevent suicides. </li></ul></ul><ul><ul><li>www.familyaware.org </li></ul></ul>
    5. 5. Are any of these concerns for your company? <ul><li>Rising costs? </li></ul><ul><li>Decreasing productivity? </li></ul><ul><li>Incidents of evident drug/alcohol abuse, theft, family violence impacting the workplace, suicide, etc.? </li></ul>
    6. 6. Agenda <ul><li>Depression </li></ul><ul><li>Cost to Employers </li></ul><ul><li>Best Practices </li></ul><ul><li>Practical Solutions </li></ul>
    7. 7. Depression Bruce Cedar, CMG Associates
    8. 8. Why Address Mental Health in the Workplace? <ul><li>How does depression affect organizations? </li></ul><ul><li>Depression is number one cause of disability in US, and it ranks among top three workplace problems addressed by Employment Assistance Programs. </li></ul><ul><li>Depression tends to affect people in their prime working years and may last a lifetime if untreated. </li></ul><ul><li>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 confidentiality. </li></ul><ul><li>Approximately 225 million workdays are lost annually due to productivity decline related to depression.  This amounts to more days of work loss and work impairment than many other chronic conditions such as diabetes, asthma, and arthritis.  </li></ul><ul><li>&quot;Sustaining Productivity: Addressing the economic burden of workplace depression,&quot; </li></ul><ul><li>A Special Supplement to Advancing Suicide Prevention , 2007. </li></ul>
    9. 9. John’s Story
    10. 10. What 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 deadlines Absenteeism In Men, Irritability, anger In Women, Crying, upset In 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
    11. 11. Ray’s Story
    12. 12. Men & Depression <ul><li>Men are less likely to seek help than women due to: </li></ul><ul><ul><li>Gender-role socialization </li></ul></ul><ul><ul><ul><li>Belief that help seeking is a “female trait” –antithetical to masculine gender role </li></ul></ul></ul><ul><ul><li>Social Costs to Help-Seeking </li></ul></ul><ul><ul><ul><li>Incompetence, Dependence and Inferiority which result in a perceived loss of power and control for the person seeking help </li></ul></ul></ul><ul><ul><li>Fear of being stigmatized by family/friends/colleagues </li></ul></ul>Cochran SV, Rabinowitz FE. Men and Depression: clinical and empirical perspectives . San Diego: Academic Press, 2000.
    13. 13. Men & Depression * Robbins and Reiger (1991) ** Kessler, McGonagle, Zhao, et al. (1994)
    14. 14. Abusing alcohol and drugs Hand 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
    15. 15. Mental Health Disorders are Treatable 80% of people with depression get well! Illness is invisible when treated. <ul><li>Nearly 86% of employees treated for depression report improved work performance.1 </li></ul><ul><li>80% of those treated for mental illness report “high levels of work efficacy and satisfaction.”2 </li></ul><ul><li>Treatment of depression results about a 40-60% reduction in absenteeism/presenteeism.3 </li></ul><ul><li>1 Finkelstein SN et al: Improvement in Subjective Work Performance after Treatment of Chronic Depression: Psychopharmacology Bulletin, vol. 32, 1996, pp. 33-40. </li></ul><ul><li>2 Therapy in America 2004: Poll Shows Mental Health Treatment Goes Mainstream. </li></ul><ul><li>3 Dunlop, DD Am J Pub Health 2005. Wang, PS Am J Psych 2004. Simon, GE Gen Hosp Psych 2000. Claxton, AJ JOEM, 1999. </li></ul>
    16. 16. Cost to Employers
    17. 17. Why address mental health in workplace? <ul><li>Lower costs </li></ul><ul><ul><li>Disability leave, sick days, health care </li></ul></ul><ul><ul><li>Average depressed employee loses 32 workdays per year* </li></ul></ul><ul><ul><li>Disability leave: 7-20% are psychiatric </li></ul></ul><ul><li>Increase productivity </li></ul><ul><ul><li>* archives of psychiatry, Oct. 2007 </li></ul></ul>
    18. 18. Costs of mental health disorders in the U.S. workplace <ul><li>Depression #1 cause of disability in U.S.* </li></ul><ul><li>Mental illness and substance use disorders annually for employers: $80 to $100 billion in indirect costs alone.** </li></ul><ul><li>32 workdays/year lost per depressed employee </li></ul><ul><li>225 million work days lost/yr </li></ul><ul><li>Depression worsens other health conditions </li></ul><ul><ul><li>Even greater costs*** </li></ul></ul>1 NIH 2007 2 Finch, R. A. & Phillips, K. (2005); 3 Katon, et. al. (2010)
    19. 19. Impact to the Workplace Medical Mental health/substance abuse Pharmacy Disability Presenteeism and lost productivity Absenteeism Overtime to cover sick-day absences Unrealized output Overstaffing Temporary workers Stress on team members Recruitment Hiring costs Retraining
    20. 20. Depression and Wellness <ul><li>Typical wellness programs include weight loss, exercise, smoking cessation. </li></ul><ul><li>Root cause can be depression. </li></ul><ul><ul><li>50% to 80% of those with a mental illness smoke. 1 </li></ul></ul><ul><ul><li>45% of people with asthma and 27 % of people with diabetes have co-occurring depression. 2 </li></ul></ul><ul><ul><li>17% to 27% of those hospitalized with cardiovascular disease have depression. 3 </li></ul></ul><ul><ul><li>Many of those who are obese have depression, there appears to be a cortisol abnormality. If someone is overweight, then experience stress, weight will usually increase. 4 </li></ul></ul>1 Smoking Cessation Leadership Center; 2 Schatzberg AF. J Clin Psychiatry. 2004; 3 Depression and Cardiovascular Disease, Science Daily, 10/17/2007; 4 psychcentral.com, Biological Link to Obesity and Depression, Rick Nauert, 6/12/2009
    21. 21. Examine Your Costs <ul><li>Go to www.depressioncalculator.com </li></ul><ul><ul><li>A tool that uses an algorithm established in clinical research to estimate costs of depression </li></ul></ul><ul><li>Get the following costs from your providers: </li></ul><ul><ul><li>Days missed due to absenteeism </li></ul></ul><ul><ul><li>% of disability cases that are due to psychiatric causes </li></ul></ul><ul><ul><li>Annual disability costs </li></ul></ul><ul><ul><li>Utilization of Employee Assistance Program (EAP) </li></ul></ul>
    22. 22. Best Practices Valerie Dickerson-Codero, Families for Depression Awareness
    23. 23. <ul><li>Care Team: Peer Assistance Committee </li></ul><ul><ul><li>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. </li></ul></ul><ul><ul><li>Trained on depression by Family Speakers who tell personal stories from Families for Depression Awareness. </li></ul></ul><ul><ul><li>225 peer assistants. </li></ul></ul><ul><ul><li>Health Risk Assessment (HRA) </li></ul></ul><ul><ul><li>Available to all employees and their families over 18. Gather detailed stats and provide more specialized health programs to person. </li></ul></ul><ul><ul><li>Disease Management Program </li></ul></ul><ul><ul><li>Disease Management Program for diabetes/ asthma/back pain/ heart, if depression also present, then provide with treating clinician. </li></ul></ul><ul><ul><li>Nurselines </li></ul></ul><ul><ul><li>24/7 telephone line for self care and advice (e.g., if person has depression, can discuss medication, treatment options) </li></ul></ul><ul><ul><li>EAP Usage </li></ul></ul><ul><ul><li>10.6% in 2010 compared to 3-4% average, attributed to ongoing reminder communications and Peer Assistance Committee referrals </li></ul></ul>Culture of Caring and Safety ~13,000 employees
    24. 24. <ul><ul><li>Goal </li></ul></ul><ul><ul><li>Manage health care costs through better health management. </li></ul></ul><ul><ul><li>Personal Health Portals </li></ul></ul><ul><ul><li>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. </li></ul></ul><ul><ul><li>Targeted Wellness Programs </li></ul></ul><ul><ul><li>Based on data of depression and antidepressant prescriptions, realized need for depression workshop, sleep disorders, etc. </li></ul></ul><ul><ul><li>On site Counseling: United Behavioral Health </li></ul></ul><ul><ul><li>Counselors next to EMC locations, get free visits and better access to clinicians </li></ul></ul><ul><ul><li>Telepsychiatry is next step so that people can do counseling virtually, saves time, money. </li></ul></ul><ul><li>Clinical Study Partnerships/Pilot Programs </li></ul><ul><ul><li>Tufts Medical Center Workplace Depression Study: 6-8 mo NIMH study. For employees 45 or older and depressed, receive online health coach. </li></ul></ul><ul><ul><li>Partners Health Care SmartBeat hypertension program pilot, 70% of participants saw a decline in blood pressure </li></ul></ul><ul><li>Training Article, Boston Globe “Targeting Untreated Depression in the Workplace: </li></ul><ul><ul><li>http://www.boston.com/yourtown/news/waltham/2010/11/waltham_group_targeting_untrea.html </li></ul></ul>EMC is an IT company behind online banking, health records, data storage, sharing, transferring. 25,000 US employees
    25. 25. Summary of Best Practices <ul><li>Assessing your organization’s needs </li></ul><ul><li>Screening </li></ul><ul><li>Training </li></ul><ul><li>Employee communications </li></ul><ul><li>Improving access to mental health services </li></ul><ul><li>Inclusive health strategy </li></ul><ul><li>Are you including mental health in all health strategies (e.g. disease management, wellness programs, disability management)? </li></ul>
    26. 26. Practical Solutions
    27. 27. How We Help You <ul><ul><li>Customizable, anonymous mental health online screening program </li></ul></ul><ul><ul><li>Training for management and employees </li></ul></ul><ul><ul><li>Tools to help you make the case to take action (e.g., innovations database) </li></ul></ul>
    28. 28. How We Put our Mission Into Action <ul><li>The MA WMHI provides: </li></ul><ul><ul><li>Free access to a customizable, anonymous mental health online screening program </li></ul></ul><ul><ul><li>Free training , conducted at the organization, about the financial and human cost of suicide and mental health issues in the workplace – also helps employees identify and cope with stress </li></ul></ul><ul><ul><li>Consultation to workplaces to help devise the best strategy to adequately support the mental health needs of their unique workplace </li></ul></ul>
    29. 29. More details… Mental Health Online Screening Program <ul><li>Each organization is given a unique URL to place on their website where employees can go to take anonymous screenings for Depression, Bipolar, Anxiety, PTSD, Alcohol Abuse and Eating Disorders </li></ul><ul><li>Organizations can run utilization reports </li></ul><ul><li>The Screening is customizable, organizations can customize: </li></ul><ul><ul><li>Welcome message </li></ul></ul><ul><ul><li>Logo </li></ul></ul><ul><ul><li>Color Scheme </li></ul></ul><ul><ul><li>Referral Message (most important, EAP/HR resources can be listed, along with local community support resources) </li></ul></ul><ul><li>All online screening tools are validated </li></ul>Provided by Screening for Mental Health, Inc
    30. 31. <ul><li>Managing Mental Health Issues in the Workplace </li></ul><ul><ul><li>A program for supervisors and managers </li></ul></ul><ul><li>QPR Training: (Suicide Prevention Strategy) </li></ul><ul><ul><li>Question, Persuade, Refer </li></ul></ul><ul><li>Post-Ventions </li></ul><ul><ul><li>Debriefing and support for the workplace following a suicide </li></ul></ul>Workplace Consultation and Trainings
    31. 32. Coping with Stress Workshop Provided by Families for Depression Awareness <ul><li>One-hour, fifteen minutes workshop: </li></ul><ul><ul><li>Employees discuss impact of stress on their lives </li></ul></ul><ul><ul><li>Shows your commitment to employee well-being </li></ul></ul><ul><ul><li>Tools and techniques for managing stress </li></ul></ul><ul><ul><li>Discuss stress, anxiety, depression </li></ul></ul><ul><ul><li>Helps employees recognize depression and anxiety and seek treatment </li></ul></ul><ul><ul><li>Employees know where to go for help </li></ul></ul><ul><li>Includes Coping with Stress Brochure </li></ul>Coping with Stress Workshop &quot;We need to have seminars like this at least on a quarterly basis.&quot; &quot;I learned how to cope with stress in ways I hadn't tried before. It was a good class.&quot; &quot;It was valuable to learn the difference between stress and depression”
    32. 33. Next Steps… <ul><li>Contacts </li></ul><ul><ul><li>Sara Herman </li></ul></ul><ul><ul><li>Screening for Mental Health </li></ul></ul><ul><ul><li>1 Washington Street, Suite 304 </li></ul></ul><ul><ul><li>Wellesley, MA 02481 </li></ul></ul><ul><ul><li>781-591-5233, SHerman@MentalHealthScreening.org </li></ul></ul><ul><ul><li>Valerie Dickerson-Codero </li></ul></ul><ul><ul><li>Families for Depression Awareness </li></ul></ul><ul><ul><li>395 Totten Pond Road, Suite 404 </li></ul></ul><ul><ul><li>Waltham, MA 02451 </li></ul></ul><ul><ul><li>781 890-0220, valerie@FamilyAware.org </li></ul></ul><ul><ul><li>Bruce Cedar </li></ul></ul><ul><ul><li>CMG Associates </li></ul></ul><ul><li>381 Elliot St., Suite 180L Newton, MA 02464 </li></ul><ul><li>617 969-7600 [email_address] </li></ul>