Addressing Depression in the Workplace

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1 Addressing Depression in the Workplace There is a cost connection between mental health and productivity. For employers: Doing nothing = Ever-increasing costs 1

2 Impairment & Disability Depression is the leading cause of disability worldwide. Approximately 80% of persons with depression reported some level of functional impairment because of their depression. 27% reported serious difficulties in work and home life. The World Health Organization (2008). The Global Burden of Disease: 2004 Update. Pratt LA, Brody DJ. Depression in the United States household population, National Center for Health Statistics: NCHS Data Brief No. 7; Available from: What depression feels like Deep feelings of sadness Loss of interest in work or social activities Lack of concentration, slowed thoughts and difficulty thinking Forgetfulness and trouble remembering Trouble making decisions Trouble sleeping or sleeping too much Feelings of worthlessness or experiencing inappropriate guilt Energy loss or increased fatigue Irritability, anger or tearfulness Weight or appetite changes How it looks to co-workers Withdrawal from team, isolates oneself Indifference Putting things off, missed deadlines, accidents on the job Seems "scattered" or absentminded Procrastination, indecisiveness, slowed productivity Late to work, can't get going in the a.m., afternoon fatigue, accidents on the job Unsure of abilities, lack of confidence Low motivation, detached Inappropriate reactions, strained relationships with co-workers or clients Change in appearance 2

3 A Closer Look at Loss in Productivity Depression is estimated to cause 400 MILLION lost workdays each year In a 3-month period, employees with depression miss an average of 4.8 WORKDAYS and suffer 11.5 days of REDUCED PRODUCTIVITY Merikangas KR, Ames M, Cui L, et al. The Impact of Comorbidity of Mental and Physical Conditions on Role Disability in the U.S. Adult Household Population. Archives of General Psychiatry. 2007;64(10): PubMed doi: /archpsyc health care resources consumed by employees with depression compared to those without Employees Employees with depression 3

4 Economic Impact of Depression $210.5B in 2010 Absence $23.3B Presenteeism $78.6B Direct medical costs $100 B Suicide- related costs $8.6B Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). Journal of Clinical Psychiatry, 76, doi: /JCP.14m09298 Look Beneath the Surface Medical Mental health/substance use disorders Pharmacy Disability Presenteeism and lost productivity Absenteeism Unrealized output Stress on team members Overtime to cover sick-day absences Overstaffing Temporary workers Recruitment Hiring costs Retraining 4

5 Is Stigma Still an Issue? Increasing number of people believe the cause of mental illness to be neurobiological. Increasing number of people supportive of professional treatment general medical doctor, psychiatrist, mental hospital, and/or prescription medications. Neurobiological Alcohol dependence 38% 47% Major depression 54% 67% Schizophrenia 76% 86% General med doctor Alcohol dependence 74% 89% Major depression 78% 91% Schizophrenia 72% 87% Bernice A. Pescosolido, Ph.D. et al. "A Disease Like Any Other"? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence. American Journal of Psychiatry,

6 Acceptance of cause of illness and support for professional treatment did nothing to change prejudice and discrimination, and in some cases, made it worse. Stigma Measure (Social Distance) Major Depression Alcohol Dependence Schizophrenia Unwilling to 1996 (%) 2006 (%) 1996 (%) 2006 (%) 1996 (%) 2006 (%) Work closely with Have as a neighbor Socialize with Make friends with Have marry into family Bernice A. Pescosolido, Ph.D. et al. "A Disease Like Any Other"? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence. American Journal of Psychiatry, People do not seek help on their own because: They don t know they re depressed They don t want to admit they re depressed They are afraid it will adversely affect their work status They are embarrassed They feel alone They don t know where to seek help 6

7 With treatment, 80% of individuals will fully recover. 86% of employees treated for depression report improved work performance. Early intervention results in decreased disability and avoids more costly levels of care. As employers, you are in a powerful position to help. Take a step in the Right Direction. 15 Offering a Solution: The Right Direction Initiative 7

8 Depression awareness initiative for the workplace. Collaboration with Employers Health (Ohio employer coalition). Goal: increase awareness about depression, reduce stigma and encourage people who need help to seek it. How: provide employers turnkey materials for worksite education to increase employee help-seeking behaviors. Designed with direct feedback from employers (focus groups) to ensure the initiative met the needs identified. Seeks to raise awareness about depression in the workplace, while reducing stigma and encouraging employee/employer dialogue. Contains tools/resources for easy implementation (not your typical mental health campaign). \ Take a step in the right direction toward information and help. 8

9 Message is Simple Depression can make you feel alone and lost in the woods. There are many paths toward help. The key is to take a step in the right direction toward information and help. 9

10 & It s FREE Support for Employers: Material Assets Field Guide with business case and FAQs Guidance on how to plan and implement the initiative Documents to guide discussions with EAPs and other vendors Newsletter, intranet content for ease of use PPT decks to secure alignment with C-suite to educate & support managers 10

11 Field Guide Getting Started Get company leadership and managers on board Talk with your vendors about the initiative Create a calendar Rollout Engage front line managers Spread the Word Measuring Success Planning and evaluation guide Sustaining Success Long term integration Ongoing calendar Support for Employees: Material Assets Website: RightDirectionforMe.com Patient Health Questionnaire 9 questions version (PHQ-9) screening tool Signs and symptoms, getting help How depression feels & how it looks to coworkers Materials Library 11 different Posters, 3 Intranet articles, 4 Logos, 2 Pocket cards Promotional items Tips to manage stress pocket cards Bear-shaped stress balls 11

12 PHQ (2 and 9-question versions). Tool preferred by primary care and MH professionals. Keys to DSM symptoms, assesses severity. Includes symptoms that affect work performance. Research supports its use in measurement-based care. Employee Awareness Posters 12

13 Evaluation : Evaluation : 13

14 Who is using it. and what are they doing???? 14

15 Happy Celebration 15

16 Employer Case Study: Kent State University 16

17 Widespread Launch Tactics Educational Sessions IMPACT Solutions provided 36 education and training sessions across all campuses that reached more than 400 managers and employees. Employee Events Right Direction and IMPACT Solutions included in 10 enrollment fairs serving 800 people and at an employee appreciation event attended by 1,600 employees. Customized Materials KSU customized, displayed and distributed Right Direction materials: posters, flyers, coasters and newsletters, which were cobranded with IMPACT Solutions. Ongoing Communication Outreach included monthly management update, wellness newsletter articles, and monthly wellness s featuring Right Direction and IMPACT Solutions branding. Widespread Launch Tactics: Posters 17

18 Widespread Launch Tactics: Website Widespread Launch Tactics: IMPACT on the Web 18

19 Widespread Launch Tactics: Newsletter Measuring the Success of Right Direction Aside from employee interest in participating in the initiative, KSU has seen success by implementing Right Direction, including: An increase in traffic to the EAP website surrounding mental health issues. A 10 percent increase in web hits with mental health information. An increase in the number of people calling into the KSU EAP with mental health as their primary claim (15 percent to percent in first year post launch). An increase in EAP utilization rates (percentage of EAP utilization over a six month period went from percent in year one to percent six months post launch). 19

20 KSU Data Findings P1 = 12 months pre-right Direction (July 2013 June 2014) P2 = 12 months post-right Direction (July 2014 June 2015) Total paid represents all costs, including those for claims unrelated to depression, for members with depression. Criteria=1 inpatient or 2 outpatient claims to identify member with depression. # of Members Members per 1000 Office Visits per 1000 Diseases P1 P2 P1 P2 P1 P2 Major Depression $18, $17, ER Visits per 1000 Admission per 1000 P1 P2 P1 P2 Disease Type Acute & Episodic The Bottom Line Total Paid PMPY P1 P2 P1 P2 $ 3,116, $ 2,041, $ 13, $ 8, Total Paid Reduction = $1,074,900 PMPY Reduction = $4,

21 Employer Case Study: Zappos! Zappos! takes a step in the Right Direction 21

22 About Zappos Founded Employees Corporate headquarters in Las Vegas 22

23 Raise awareness about depression in the workplace Promote early recognition of symptoms and reducing the stigma surrounding depression and mental illness Depression one of top three presenting issues for EAP Targeted Audience No traditional managers Targeted entire population since any employee can transition in a leadership position throughout their career 23

24 Tactics Launched in Q Ongoing communication via s, presence at wellness fair and open enrollment, new hire benefits orientation reaching all 1,500 employees Integrated with stress management program Extensive Materials Library makes it easy to promote and maintain momentum after launch 24

25 In 2015, Zappos launched a 6-month Breaking up with Stress program. 25

26 Integration with EAP Employees have unlimited access to EAP for such issues as child and elder care, education, government assistance, relocation, personal convenience, financial experts, licensed attorneys and more! On-site Seminars and Educational Workshops focused on mental health Come say hello to Jeanine in the café today from 1:30-4:00pm! Today is the first day Jeanine, our counselor provided by ComPsych, will be onsite as part of our Breaking Up With Stress pilot program. *Find below, her schedule for the 6-month period as well as her contact information and location. On-site Work-Life Specialist helped promote this resource On-Site Education Stress: a way of life or fact of life? The confident you Learning to relax Balancing work and life 26

27 Measuring Success EAP utilization, STD claims, and Rx claims were looked at before/after but were not drivers or measures for success. Before the program in Q1, EAP utilization was at 81 EEs. In Q3, utilization jumped to 204. Utilization in Antidepressants during the 6-month period spiked in comparison to the prior three months. No significant change as related to short term disability Consistency, persistence, and momentum are keys to success 27

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