Don't hide your head in the sand, ID depression early
Your involvement is 'crucial'
Depression is not as visible as a back injury — but it is without question a significant drain on workforce productivity — both absenteeism and presenteeism. According to Garson M. Caruso, MD, MPH, FACOEM, co-director of the American College of Occupational and Environmental Medicine (ACOEM) Depression in the Workplace project, "The occupational health nurse is crucial to improvement of management of depression in the working population."
A new position statement from the ACOEM says that only half of depressed workers are receiving any treatment at all. Of these, less than half receive care that is consistent with current treatment guidelines from organizations such as the American Psychiatric Association.
ACOEM estimates the cost of depression at $36 billion in lost productivity per year. The position statement, Depression in the Working Population, notes that unlike conditions such as cardiovascular disease or hypertension, depression often strikes very early in a worker's career, creating a disease burden that may last for decades in the workplace. The statement calls for a new approach of screening programs and early treatment.
Caruso stresses that businesses can achieve a positive return on investment by creating programs to intervene and treat depression at its early stages. "There is a general under-recognition and under-acceptance of the existence and effects of depressive illness by third party payers and others," says Caruso.
Many employers still fail to realize the actual costs of depression in their workplace, or the return on investment of enhanced depression care for workers, says Caruso. "This was one of the reasons that ACOEM decided to take a lead role in exploring and addressing this issue," says Caruso.
Depression in the working population is an under-recognized source of both direct and indirect costs to business, notes Carson. "We are still in the early stages of defining the full benefits of increased corporate investment in enhanced depression care," says Caruso. "However, evidence is beginning to demonstrate significant effects."
One analysis suggested that approximately $100 to $400 in additional outreach and care management costs could result in an annual increase in $1800 of work value.1
"In addition to lack of recognition, other factors such as the stigma associated with mental illness continue to impede the recognition of and effective intervention in depressive illness," adds Carson.
Worst mistake: Avoiding it
Caruso says that the worst mistake that senior management can make is to avoid addressing the issue of workplace depression at all, whether out of ignorance, or fear, or concern over cost.
"The second major mistake is taking a piecemeal or 'silo' approach to the problem, in which each relevant department follows its own isolated policy and practice without integration with other stakeholders," says Caruso.
For occupational health, says Caruso, "potential areas of involvement include prevention, early identification, and disease and disability management."
Reference
- Wang PS, Simon GE, Kessler RC. Making the business case for enhanced depression care: The National Institute of Mental Health-Harvard work outcomes research and cost-effectiveness study. J Occup Environ Med 2008; 50(4):468-475.
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