Depression in the Workplace Railway Health & Wellbeing Conference
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Depression in the Workplace Dr Paul Litchfield OBE OStJ FRCP FFOM Chief Medical Officer BT Group plc Railway Health & Wellbeing Conference London – 20 October 2014 Mental illness is part of a chronic disease epidemic Mental Ill Health (OECD) Lifetime up to 50% affected 20% at any one time Common in all age groups Fastest growing disability 3% - 4% of EU GDP Depression (EC) Half the MH disease burden 86% in working age adults 1 in 2 cases unrecognised Knowledge based economy Presenteeism & Absenteeism A business issue! Cumulative lost global output 2011-2030 by disease (Bloom et al., 2011) By 2020 mental illness will be the No. 2 cause of disability worldwide - WHO © British Telecommunications plc Depression is much more than sadness A range of disorders of varying severity - often associated with Anxiety Predisposing Factors Genetics / Environment / Biochemistry Precipitating Factors Adverse Life Events / Bereavement / Physical Illness Perpetuating Factors Social Support / Financial Pressures / Embitterment Impact: Low Mood Low Energy Low Self-Esteem © British Telecommunications plc Poor Appetite Weight Loss Fatigue Poor Concentration Hopelessness Guilt Presenteeism & Extended Absence Insomnia Indecisiveness Suicidal Thoughts Depression impacts on business regardless of cause Work is not normally the main precipitating factor People’s perception may be different Business Focussed Approach: • Address perceptions as well as reality - don’t medicalise issues • Maintain active line management – disengagement is negligent! • Focus on practical employment matters – they make a difference © British Telecommunications plc Developing a workplace mental health framework Primary Engagement Promote Good Health Secondary Intervention Support when Health at Risk Tertiary Resolution Managing Health Issues © British Telecommunications plc Shift in focus with maturity From framework to Mental Health action grid Education & Training Monitoring & Assessment Products & Services Primary Engagement General awareness training of issues and stigma avoidance Risk assessment to control psycho-social hazards Agile working to help balance work and home commitments Secondary Intervention Training of managers to recognise signs of distress and signpost sources of help Stress audits to identify at risk workers or business units Provision of confidential employee assistance programme Tertiary Resolution Guidance on rehabilitation and return to work adjustments Access to occupational health to assess work fitness and adjustments Access to cognitive behavioural therapy services Good Work – Good Health: Guidelines for the European Telecommunications Industry © British Telecommunications plc From action grid to Mental Health Toolkit • Promoting good mental health Positive Mentality Managing Pressure Management Competencies Achieving the Balance • Support when mental health at risk STREAM Resilience training Health & Wellbeing Passport Employee Assistance Programme • Managing mental health issues Open Minds – Head First Occupational Health Service Managing Mental Health CBT Service © British Telecommunications plc Making resources accessible © British Telecommunications plc Feedback through management information © British Telecommunications plc Keeping people in employment © British Telecommunications plc Keeping people in productive employment Average Clinical Outcome Data Pre Post 16.00 13.44 14.00 Mental Health Service* 12.20 Score 12.00 10.00 8.00 6.00 4.04 3.67 4.00 • Company funded therapy 2.00 0.00 PHQ GAD Measure • Major health improvement Work Status Pre/Post Psychological Intervention Referral Discharge 700 632 • Major work improvement 600 Cases 500 400 300 274 245 177 200 100 9 55 * Economic evaluation underway 0 Off Work Restricted Duties Work Status © British Telecommunications plc Full Duties Making the investment • Depression is a business issue • Interventions need structure • Managers need help to understand it • Most interventions are low key • The economic cost of failure is high • The human cost can be far higher http://targetdepression.com/#intro © British Telecommunications plc paul.litchfield@bt.com © British Telecommunications plc
