Depression hotline allows private self-screening
April 1, 1999 4 minutes read
Depression hotline allows private self-screening
An anonymous telephone hotline that can help workers seek treatment for depression carries a small price tag for employers and a high likelihood that workers needing treatment will go on to get help.
The telephone screening program is offered by the National Mental Illness Screening Project in Wellesley Hills, MA, a nonprofit organization devoted to helping people with undiagnosed, untreated mental illnesses. The project runs screening programs for depression, alcohol, eating disorders, and a variety of other problems. In 1995, limited success with its depression activities led the project to offer the hotline as a way to reach more people who needed help, says Joelle Reizes, assistant director of the project.
"We find that the face-to-face screening for depression was not working for a number of work sites because the anonymity factor is so critical," she says. "We created the telephone screening specifically so it could be put in a workplace and reach people in a way that is completely nonthreatening, completely anonymous, and accessible."
Project provides service for small fee
For a small fee, the project provides the depression hotline service to any employer wanting to offer it to employees. Employers register with the project and are provided with a toll-free telephone number specific to that employer. That particular hotline number is used only by that employer’s work force and includes referral information specific to their local community, employee assistance program, and health insurance program.
The main portion of the depression hotline information is the same for all employers, with a series of 10 questions designed to determine whether the caller has symptoms that indicate a need to seek further help. Callers are asked how certain symptoms apply to them, such as "I get tired for no reason" and "I feel others would be better off if I were dead." The system tells the caller how he or she scored on the screening and recommends where to seek further help if needed.
The anonymity of the system is important because depression still carries a social stigma. The hotline allows people to explore the possibility that they have serious depression without immediately identifying themselves to anyone.
"Once the employers sign up, the employees and their immediate families can take that screening any time they want, from any phone," Reizes says. "If you want to call at 2 a.m. from a pay phone on the corner, you can do that. The system underscores that this really is anonymous and makes it very nonthreatening."
Reizes points out the depression hotline serves as an adjunct to whatever depression screening and treatment already is offered by the employer, not a replacement. The customized depression hotline is a tool for the occupational health provider and employee assistance program publicize that help is available.
"This is in no way a replacement for in-person screening and treatment," she says. "The idea is to help these people who think they might have a problem and steer them toward the treatment that is already waiting on them."
The fee for the program is based on the number of employees served; an employer of 5,000 people or fewer would pay $1,000 per year for the service. Each additional 1,000 workers adds a cost of $100 per year. Participating companies receive weekly reports on how many calls were processed, plus quarterly reports that show the sex, age, and depression scores of callers. There is no information identifying the employee.
For an added fee of 50%, the employer can add alcohol screening to the hotline.
Because the service is anonymous, there is no way to know how many of the callers have symptoms suggesting depression or how many go on to seek help. But Reizes says the project’s experience with other types of depression screening suggests those numbers probably are very high.
"In other screening, we find that most of them calling have mild to moderate depression and are not in treatment," she says. "They’re calling because they already suspect they have a problem. Depression is prevalent in the mid-20s to early 40s, and that’s when most people are working."
The depression hotline has been used successfully by a number of employers across the country, including the State of Michigan, Sprint, Bell South, Levi Strauss, the State of Tennessee, and Texas Instruments. More than 350 companies participate, with a total of 3.5 million employees. The hotline system has processed an estimated 31,000 calls in the past six months.
The city of Boston started using the system in October and had received 155 calls by February.
Though the system is anonymous, asking for no identifying information, it does record some data from the callers. Most of the callers were between 30 and 49, and most callers scored in the mild-to-moderate range for depression symptoms.
Reizes notes that finding is especially good news because it is best to intervene when people have mild-to-moderate depression, rather than waiting until the problem becomes more severe, making it more expensive and difficult to address.
One employer reports that the screening hotline clearly increased the number of workers seeking assistance, and it resulted in major cost savings. Carol Boone, EdD, CEAP, is the employee assistance program coordinator for the State of Tennessee in Nashville.
She says the hotline encouraged many workers to seek help instead of waiting until their depression became worse and resulted in absenteeism or led to their dismissal or resignation. Utilization of Tennessee’s employee assistance program rose by 33% when the hotline was offered, Boone says.
"When you consider the cost of replacing employees who leave the work force due to problems associated with untreated depression, as well as training and supervisory costs for new employees, we estimated a savings of $240,800 in one year," she says.
Sources
For more information, contact:
• National Mental Illness Screening Project, One Washington St., Suite 304, Wellesley Hills, MA 02481. Telephone: (781) 239-0071. Fax: (781) 431-7447.
• National Institute of Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226-1998. Telephone: (800) 35-NIOSH. The entire text of the NIOSH guidelines can be obtained on its Web site at www.cdc.gov/niosh.
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