Workplace Mental Health: Research on Preventing Lost Productivity & Work Disability

By Glenn Pransky, MD

Scientific Advisor
Lincoln Financial Group

By David Berube, MD

Chief Medical Officer
Lincoln Financial Group

By Jana Martin, PhD

CEO
The American Insurance Trust

Significant mental health illness (MHI) affects almost 20% of employees and costs employers over $80 billion annually, mostly for lost productivity and absenteeism.¹ Anxiety, depression, and substance abuse are the most common mental diagnoses; together, they account for over 8% of all long-term disability claims.² Although treatment may improve mood, behavior, productivity, and absenteeism,³ and can be cost-effective for employers,⁴ studies have shown that many people with MHI don’t get proper treatment.⁵

Why does this problem persist? Several factors may be involved. Employees and their family members may not be aware that they have a significant problem or that it’s treatable; screening for MHI may not be adequately addressed in primary care.⁶ Some workers may be concerned about stigmatization and discrimination at work or in their community. Co-pays for healthcare visits and pharmaceuticals can be daunting, and insurance coverage for therapy may be limited.⁷

Patients often wait a month or more for an appointment with a psychiatrist.⁸  Primary care physicians, who have limited training and specialization in MHI, may have to fill in for mental health professionals. Quality of care has been a problem; in one study, only 14% of insured MHI patients received care that met best practice guidelines.⁹ Employers are often unsure about how to help someone with MHI stay at work or return to work, citing concerns about confidentiality, stigma, managing the employee, and accommodations.¹⁰ They may not recognize or address psychosocial and organizational job characteristics that affect work outcomes.¹¹

For all these barriers to effective treatment, effective solutions are available. Scientific investigations and consensus recommendations provide evidence that can help employers achieve better results. Studies show that with good health insurance coverage for MHI, workers are much more likely to pursue treatment.⁹ Online and in-person resources can educate employees about early recognition and treatment, how mental health professionals can help people cope with life’s challenges, and expected results in terms of better function at work and at home.¹² Confidential screening for MHI, in person or by phone, can identify MHI and engage people to initiate treatment early on if linked to the right interventions.¹³

New healthcare delivery options may help as well. Providing psychological services using telecommunication technologies (telepsychology) can be as effective as in-person therapy and may help address the shortage of professionals available for in-person treatment.^14,15 However, positive results will depend on engaging trained, licensed mental health professionals who are adept at using telepsychology.¹⁶

Regardless of how care is delivered, scientific evidence supports specific treatments that are most effective. Health insurers can have a significant role in ensuring quality and compliance — especially through MHI disease management.¹⁷

Accommodations for employees with MHI can be challenging, but the basic principles are similar to those for other medical conditions. Having clear policies as well as strong, consistent leadership support for treatment and return to work (RTW) is an important starting point. Employers have generally had success when they offer encouragement, respect confidentiality, inquire about what types of accommodations would be helpful, and engage case managers and RTW coordinators to facilitate communication and the RTW process in a supportive environment.¹⁸ RTW strategies may include modified training and supervision, and gradually increasing hours and work demands.¹⁹

Effectively addressing MHI is challenging, but material evidence now exists for what works and how to achieve better results. Early recognition, appropriate treatment, and productive accommodations are good for your bottom line and, more importantly, good for your employees.¹

References

All references can be retrieved at https://drive.google.com/file/d/15lLcylGYCK9oID-NU2HqgSqBtzuxdy6u/view