Mental Health Awareness:
Information and Resources for Employers
Clare Miller, Director
Partnership for Workplace Mental Health
What’s the Partnership?
An American Psychiatric Foundation educational program in
collaboration with employers and the American Psychiatric
Association.
Mission
To advance effective employer approaches to mental health.
www.WorkplaceMentalHealth.org
What Does the Partnership Do?
• Promotes the business case for quality mental health care,
including early recognition, access to care and effective
treatment.
• Delivers educational materials to employer health care
purchasers
• Provides a forum for employers to explore mental health
issues, share innovative solutions and take action.
Workplace Mental Health
• Private employers finance ~50% of U.S. health care system.
• Employers concerned about high health care costs; low quality
(although direct mental health costs remain minimal, and in
fact should increase).
• “Brain-based economy” = increased attention to workplace
mental health.
• Mental illnesses affect people during their prime working
years.
• In any given year, 1 in 5 adults experience a diagnosable
mental illness or substance use disorder.
– Only 13.2% receive treatment, and
– Privately-insured populations have even lower treatment rate:
5.5%.
SAMHSA 2004/NCQA 2002/Watson Wyatt Staying at Work Survey/
Sederer LI et al: Integrating Care for Medical and Mental Illnesses. Preventing Chronic Disease, April 2006
Mental Illness Impacts
Business’ Bottom Line
Cost of Mental Illness to Employers
• Lost Productivity
• Overall Healthcare Costs
• Comorbidity with other diseases
• Disability
Cost of Mental Illness to Employers
Absenteeism and Lost Productivity
• More workers are absent from work because of stress and
anxiety than because of physical illness or injury. 2
• More days of work loss and work impairment are caused by
mental illness than many other chronic conditions such as
diabetes, asthma, and arthritis.1
• Employees with depression cost employers $44 billion per
year in lost productive time.2
• Mental illness and substance abuse annually cost employers
in indirect costs an estimated $80 to $100 billion.3
Overall Healthcare Costs
• Individuals who are depressed but not receiving care for the
condition consume two to four times the healthcare
resources of other enrollees.3
1Stewart WF et al: Cost of Lost Productive Work Time Among U.S. Workers with Depression. JAMA, June 18, 2003.
2 Marlowe JF: Depression’s Surprising Toll on Worker Productivity, Employee Benefits Journal, March 2002.
3 An Employer’s Guide to Behavioral Health Services, National Business Group on Health, December 2005 .
Cost of Mental Illness to Employers
Comorbidity with other diseases
•
Individuals with depression are about twice as likely to
develop coronary artery disease, twice as likely to have a
stroke, and more than four times as likely to die within six
months from a myocardial infarction.1
Disability
•
•
Mental illness short-term disability claims are growing by
10% annually and can account for 30% or more of the
corporate disability experience for the typical employer. 2
53% of employers surveyed by Watson Wyatt found that
return to work is more difficult following a psychiatric
disability than after physical disability.3
1 Sederer LI et al: Integrating Care for Medical and Mental Illnesses. Preventing Chronic Disease, April 2006.
2 Marlowe JF: Depression’s Surprising Toll on Worker Productivity, Employee Benefits Journal, March 2002.
3 Watson Wyatt Staying at Work Survey, 1998.
Depression Is Prevalent and Causes Significant
Work Impairment
Major
Depression
16.5
14.6
Asthma
Reason
709
Arthritis
12.6
Blood
pressure
12.4
438
504
484
7.9
Panic
395
7.2
Substance
0
5
166
10
15
20
Population (%)
Kessler RC, et al. J Occup Environ Med. 2001; 43:218-225.
0
200
400
600
800
Days Impaired per 1000 Employees
Depression and Chronic Medical Illness
Medical Condition
Percent With Depression
52%
Chronic Pain
MI
40%
Stroke
40%
45%
Asthma
Diabetes
27%
Pincus HA. J Clin Psychiatry. 2001;62 Suppl 6:5-9; Schatzberg AF. J Clin Psychiatry. 2004;65
Suppl 12;3-4.
The Good News: the Business
Case for Quality Treatment
Treatment Works
• Major depression can be treated successfully with
antidepressant medications and psychotherapy in 65 to 80
percent of all cases - a success rate that exceeds many
current common medical treatments for non-psychiatric
illnesses.
• Eighty percent of those treated for a mental illness reported
“high levels of work efficacy and satisfaction.”
• Seventy-five percent of patients who are depressed show
significant improvements after CBT treatment.
• Nearly 86 percent of employees who were treated for
depression with antidepressant medications reported that
their work performance improved.
Am J Psychiatry 150:10, October 1993
Therapy in America 2004
The University of Michigan Depression Center
Psychopharmacology Bulletin
Treatment Saves Money
• One Fortune 500 company achieved a 1.7:1 return on
investment by conducting a depression screening program.
• When aggressive care management interventions for
behavioral health issues were instituted at one Fortune
500 company, outpatient costs went down by $400,000 the
first year and by $500,000 the next.
• Open access to mental health results in lower psychiatric
disability claims and productivity losses compared to
restrictive plans.
A Mentally Healthy Workplace: It’s Good for Business
The Bottom Line
• Mental illness is very prevalent in working
populations – but few receive treatment.
• Mental illness is frequently comorbid with other
health conditions
• Treatment works and is cost effective.
• Treating mental illnesses improves outcomes for
coexisting illnesses.
• There is a clear business case for tackling
workplace mental health.
Tools to Help Employers Take Action
Information for Employers
•Partnership E-Updates on timely and relevant topics
•Dynamic web site with useful content
•Parity resource portal
•Business case for quality mental health
•Tool kits for employers on depression and anxiety
•Depression cost calculator
•Alcohol cost calculator
www.workplacementalhealth.org
Depression Calculator
• Free Online Tool translates research
findings about prevalence and cost for
specific company.
• Users customize for industry type,
location, number of employees, etc.
• Used to make business case within
company for action.
• Uses business language – ROI- it’s not
about doing the “right thing,” it’s the
economically smart thing.
Research Works
New series focused on translating research to action
• Specific workplace question answered with research,
action steps and corporate case examples
• Employee Personal Financial Distress and How
Employers Can Help
Mental HealthWorks
Free quarterly newsletter for business
• Research summaries, corporate examples
• Latest issue :
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Overview of parity legislation
Houston Texans experience with parity
New research on AD/HD and workplace
Employer Innovations Online
•
A web-based, searchable database that profiles employers’
innovative programs and practices for addressing mental
health at the workplace.
•
Actual practices of leading companies in key areas including:
o
o
o
o
o
Employee Assistance Programs
Disability/Case Management
Integration/Partnerships
Benefit design
Pharmacy Benefits
•
Why/How Employer Addressed Mental Health
•
Results – outcomes on employee health and ROI
Information for Employees
• HealthyMinds.org, consumer web site about mental health
and mental illnesses and effective treatments.
• Tip Sheets – Back to School, Winter Blues, etc.
• Let’s Talk Facts brochures for distribution to employees
and families (print & online):
Anxiety Disorders
Bipolar Disorder
Choosing a Psychiatrist
Childhood Disorders
Depression
Domestic Violence
Eating Disorders
Phobias
Posttraumatic Stress Disorder
Teen Suicide
What is Mental Illness?
So What Can Employers Do?
•
Use purchasing power to leverage the system and demand
quality. Ask questions!
•
Ensure access to quality treatment.
•
Provide coverage to mental health equal to
medical/surgical benefits.
•
Align incentives to change care-seeking behavior and
encourage treatment.
•
Provide education at the workplace about mental illnesses,
their impact on work, and the importance of seeking
treatment.
Special Focus
Research Works:
Employee Personal Financial Distress
and How Employers Can Help
Employee Personal Financial Distress
and How Employers Can Help
• One in every 4 American workers reports feeling seriously
distressed by their personal financial situation.
• Almost two-thirds (61%) of Americans report having ‘serious
financial problems.’
–
–
–
–
–
–
paying for gas (44%),
getting a good-paying job or a raise (29%),
paying for health care and health insurance (28%),
paying rent or mortgage (19%),
paying for food (18%),
problems with credit card debt or other personal debt (18%),
and
– losing money in the stock market (16%).
April 2008 survey by Kaiser Family Foundation
Employee Personal Financial Distress
and How Employers Can Help
• A survey found that most Americans are stressed and
anxious about their financial future.
• The study reports that about 8 in 10 people identify money
(81%) and the economy (80%) as significant sources of
stress in their lives.
• Other sources of stress include work (67%), family health
problems (67%), housing costs (62%), relationships (62%),
personal health concerns (61%), job stability (56%), and
personal safety (48%).
American Psychological Association survey in 2008.
Health and Work Consequence of
Employee Financial Distress
• Workers with financial distress report poorer overall health.
• Distressed workers reported spending time on the job
dealing with or worrying about money problems.
– 13 percent on the job dealing with money matters
• Record high utilization of employee assistance programs and
outpatient mental health services.
– EAP providers survey found dramatic increase in requests for
financial services from employees (up 88% since past year) and
for help with laid-off employees and downsizing (up 60%).
– Five to ten percent increase in hospital admissions for
psychiatric and substance abuse services related to financial
problems and accompanying symptoms, such as depression and
anxiety.
Employer Action Steps
• Communicate with employees.
– Frequent communication from management to employees
on issues of company viability in general and employee job
stability in particular.
– Good communication with supervisors is essential so
workers know what is expected of them.
• Provide Prevention and Treatment Services
– Personal Financial Education
– Credit Counseling and Debt Management
– Employee Assistance Programs (also positioned to provide
brief psychological counseling and stress management
support).
Employee Personal Financial Distress
and How Employers Can Help
• Case Examples
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–
–
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Home Depot
IBM
Pepsi Bottling Group
USAA
• Resources
DPN Call To Action
• Navigators, in coordination with One-Stop Business
Services staff, can share this information and free
resources with:
– Employers, including:
• Marketing and outreach activities (e.g., the Business
Case)
– Employment organizations, including:
• Chamber of Commerce, Rotary, Better Business Bureau
– Employer related activities, including:
• Job/Career Fairs
• Employer Forums
– Interagency Committees and Partner Agencies
DPN Call To Action
• Review Mental Health Resource Guide
• Tailor the MH Resource guide to fit your individual
workforce area(s)
• Follow and build upon suggestions provided
within the MH Resource Guide
Contact Us
Clare Miller
Director
1000 Wilson Blvd., Ste. 1825
Arlington, VA 22209
P: 703-907-8673
cmiller@psych.org
www.WorkplaceMentalHealth.
org
Miranda Kennedy
Training Coordinator
National Disability Institute
P: (720) 890-3990
mkennedy@ndi-inc.org
www.dpnavigator.net
www.ndi-inc.org