Mental Illness and Addiction:

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1 Mental Illness and Addiction: Impact on the Workforce Presented by Terri White, MSW Commissioner Oklahoma Department of Mental Health and Substance Abuse Services

2 Mental Illness and Addiction: Diseases of the Brain Both mental illness and addiction are real medical conditions, just like diabetes, cancer and heart disease.

3 Mental Illness: A Disease of the Brain The brain scan on the left reflects normal activity; the scan on the right shows a person affected with schizophrenia. Source: PBS.org

4 Mental illness is associated with changes in the brain s structure, chemistry and function, and does indeed have a biological basis. NIH Mental Illness: A Disease of the Brain

5 Addiction: A Disease of the Brain

6 Addiction: A Disease of the Brain

7 Between 700,000 and 950,000 adult Oklahomans are in need of services: Approximately 600,000 Oklahomans report having a mental illness 326,000 Oklahomans ages 12+ are dependent/abuse alcohol or illicit drugs Approximately 195,000 Oklahomans received services in FY15.

8 Prescription Drug Abuse Oklahoma ranks No. 2 nationally (tied with Oregon) for nonmedical use of painkillers for all age groups 12 and older in the past year. SAMHSA Oklahoma ranks No. 4 in the nation for the highest rates of prescribed hydrocodone, oxycodone and other powerful painkillers. CDC In 2013, Oklahoma had the 8th highest unintentional poisoning death rate in the U.S. CDC In Oklahoma, more overdose deaths involve hydrocodone or oxycodone than all illegal drugs and alcohol combined. OSDH Overdose deaths surpass motor vehicle crashes as the leading cause of unintentional death by injury in the state and are the leading cause of death by injury for Oklahomans ages 25 to 64. CDC

9 Mental Prescription Health Matters Drugs Prescription Drug Abuse Prevention: Response Opioid Prescribing Guidelines Prescriber/Dispenser Training Policy Change at State Level Increased Use of the PMP Disposal/Storage Methods Media Campaign Overdose Prevention (Naloxone) First responders Retail pharmacies

10 The Silent Tsunami: Mental Health in the Workplace Mental health issues are a silent tsunami in the workplace, one that could engulf organizations in myriad productivity and profitability problems, as well as legal liabilities, unless mental health is addressed as seriously as are marketing, compensation and strategic plans Psychology Today, Sept. 2012

11 Cost to Businesses Mental health is the leading health reason for work performance loss and second for absenteeism. The 200,000 Oklahoma workers dealing with depression and addiction will cost employers an extra $600 million annually in medical expenses. In 2008, mental health problems were one of the top three leading causes of work disability. Mental illness accounts for 30% of disability costs; that figure is growing by 10% a year. It has been predicted that by 2020, mental health problems (particularly depression) will become the leading cause of work disability. Sources: Governor s Task Force; and American Psychiatric Foundation

12 Cost to Businesses Nearly 75% of all adult illicit drug users are employed, as are most binge/heavy alcohol users. More than 90% of employees say their mental health and personal problems spill over into their professional lives, and have a direct impact on their job performance. Employees' personal problems can result in absenteeism, poor job performance, increased onthe-job accidents, and higher medical benefit costs. Suicide occurs most frequently among those of working age, 25-65, highlighting the critical need for prevention initiatives/intervention training for this group. American Psychiatric Foundation

13 Cost to Businesses Alcohol-Specific Information In the workplace, the costs of alcoholism and alcohol abuse manifest themselves in many different ways. Absenteeism is estimated to be 4 to 8 times greater among alcoholics and alcohol abusers. Other family members of alcoholics also have higher rates of absenteeism. Accidents and on-the-job injuries are far more prevalent among alcoholics and alcohol abusers. (U.S. Office of Personnel Management)

14 Stigma Still Persists While attitudes about mental illness have softened in the past few decades, some stereotypes persist, like the idea that people with depression are weak, unpredictable or even dangerous. Few employers are ready to address these issues, and few employees are willing to risk their careers by admitting that they suffer from mental illness. Many fear being viewed as weak and are concerned about being passed over for opportunities or even losing their jobs. A Monumental Problem Mental illness is the workplace s dirty little secret. Workforce Magazine, Aug. 2014

15 Access to Care Matters Limiting behavioral healthcare services can increase employers non-behavioral direct and indirect healthcare costs. One study found that limiting employersponsored behavioral health services increased the direct medical costs of beneficiaries who used behavioral healthcare services by as much as 37%. Further, the limitation substantially increased the number of sick days taken by employees with behavioral health problems. The study concluded that savings attributed to limiting behavioral health benefits were fully offset by increased use of other medical services and lost workdays. Center for Prevention and Health Services

16 Employee Assistance Programs An EAP is a confidential counseling service, paid for by the employer, designed to help employees and family members who have personal problems that can interfere with their work and family life.

17 EAP Success Rates The Labor Department reports EAPs reduce: Sick leave usage by 33% Work related accidents by 65% Workers compensation claims by 30% Employer studies report EAPs to be associated with: 30-60% fewer on-the-job accidents On/off-site accident rate reduction of 40-80% 33-52% decrease in sick days or disability units 43-50% decrease in absenteeism 79% decrease in grievances

18 Workplace Wellness: A Program Example Modeled after Air Force Suicide Prevention Program, considered a best practice program, resulting in 79% reduction in suicide completion in five years. Working Minds adapted program with: Workplace guidelines for post-ventative bereavement help for employees Training DVD Social marketing strategies to increase help-seeking Reintegration strategies: Bereaved and suicide attempts handled similarly to other forms of disability ODMHSAS has trained over 40 state agency employees as trainers of the curriculum. State agencies include: OKDHS, DOC, OKHCA, OJA, OKDRS, TRAVELOK, OSRHE. ODOT and the OK Chapter of the Society of Human Resources Management have received presentations on using Working Minds to complement existing EAP services.

19 Smart on Crime The Biggest Cost to Taxpayers? The biggest direct economic cost is the cost to our criminal justice system costs that can be avoided with better access to treatment services before becoming engaged with the criminal justice system, and targeted programs for persons already in the criminal justice system that are designed to reduce repeat incidents and problems in the future.

20 Smart on Crime ODMHSAS has introduced a Smart on Crime proposal with interventions across the spectrum of criminal justice engagement. Independent studies confirmed the proposal s merits and ability for the state to avoid millions in future costs if funded in full. The proposal was endorsed by numerous law enforcement and community organizations (including the 2008 Oklahoma Academy Town Hall). ODMHSAS has proposed a Smart on Crime package to reduce the fiscal impact of untreated mental illness and addiction on the state s criminal justice system and overall budget

21 Smart on Crime The annual cost of drug court is $5,000 compared to $19,000 for incarceration. That alone is a significant benefit. But, what really tells the story are the improved outcomes. Drug courts

22 Smart on Crime There are much improved outcomes for reoffending compared to released inmates. In addition to a 94.4% drop in unemployment, a 113.3% jump in monthly income, a 153.3% increase in participants with private health insurance; and a 70% increase in participants who are able to again live with their children. Drug courts

23 Compare the cost of treatment against some of the alternatives

24 Treatment works. There is hope, and there is help. Website: Facebook: Department Commissioner White

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