Treating Depression Through the Workplace

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As bloggers Jan Chait and David Spero discussed in their blog entries ("Diabetes-Savvy Mental Health Professionals Needed" and "Depression and Type 2 Diabetes—Symptoms or Disease?") this week, people who have diabetes are also more prone to depression. Depression is highly treatable, but a large percentage of people with depression are not diagnosed or treated, and depression is a leading contributor to disability worldwide. A study published last month, however, shows that the workplace may be an effective—and cost-effective—place to diagnose and treat depression.

The study, published in the September 26 issue of The Journal of the American Medical Association, involved employees enrolled in a managed-care behavioral health plan. An Internet and telephone screening process identified 604 people with depression; the researchers then divided these people into two groups. Members of one group received their usual care, which consisted of feedback on their depression screening results and advice to see their regular health-care provider. The other group was assigned to a “care manager” who offered support and education over the telephone. Members of this intervention group also received their choice of telephone psychotherapy, in-person psychotherapy, or antidepressant drugs.

At both the six-month and one-year points, members of the care management intervention group were less depressed and more productive at work. Compared to the usual care group, the intervention group reported significantly less severe depression and were 40% more likely to recover from depression over the course of the study. What’s more, the intervention group also worked significantly more hours (the equivalent of two more weeks a year) and were 70% more likely to stay employed than the other group. The researchers estimated that the value of this increased employee productivity, about $1800 per employee per year, far outweighed the cost of the intervention program, which was $100-$400 per employee.

Many of the researchers who carried out this study were also involved in a study on the subject published last year in the December 2006 issue of Archives of General Psychiatry. That study used data from dozens of previous trials to create a simulation of how companies providing enhanced care for employees’ depression might fare when the cost of such a program was compared with the benefits.

From the simulation, the researchers determined that savings from reduced employee absence from work and reduced employee turnover would make such a program profitable by its second year. The program proposed in this study consisted of a master’s-level health professional managing the care of a hypothetical group of depressed 40-year-old workers. The care manager would be responsible for assessments of depression and referrals for further treatment. The researchers determined that this type of care management would be most effective in higher-level employees who had influence over the productivity of other workers.

In short, helping employees get diagnosed and treated for their depression seems to be a smart move for companies not only in terms of their employees’ well-being, but in terms of the bottom line.

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