Depression Lurks Beneath Poor Health

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Wellness programs to help employees exercise, eat better and manage conditions like diabetes or hypertension are being embraced by companies looking to lower their health care costs and improve employee health. But one aspect of wellness often gets overlooked, and it’s the leading cause of lost productivity: mental health.

Employees miss more days of work and are less productive on the job because of mental illness than other chronic health conditions, including arthritis, asthma, back pain, diabetes, hypertension and heart disease, according to figures compiled by Employers Health, a national employer coalition based in Dublin, Ohio. And it’s costing employers an estimated $80 billion to $100 billion in indirect costs alone. In particular, employees with depression cost employers between $17 billion and $44 billion per year in lost productivity time.

Typically, employers don’t see the red flags until they review their medical and short-term disability claims, and even then, they are unsure how to address the problem, said Marcas Miles, senior director of marketing and communications for the coalition. Last year the group launched a workplace awareness campaign called Right Direction that focuses on the effects of depression on productivity. The Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation, is a co-sponsor of the initiative.

“Depression in the workplace has been cropping up in recent years. We’d sit down with an employer and go through their drug spending and utilization and more often than not depression and anxiety medications were in the top three,” Miles said. “Whether it was the CEO or the VP of HR, they would shake their heads and say, ‘Wow, look how many depressed employees we have,’ and then they would talk about instituting a walking program to combat high cholesterol. No one wants to talk about depression."

‘Whether it was the CEO or the VP of HR, they would shake their heads and say, “Wow, look how many depressed employees we have,” and then they would talk about instituting a walking program to combat high cholesterol. No one wants to talk about depression.’

—Marcas Miles, Employers Health

And yet 1 in 10 Americans suffer from the condition, according the U.S. Centers for Disease Control and Prevention. The implications for employers are evident in the data: Mental illness short-term disability claims are growing by 10 percent annually and account for 30 percent or more of the corporate disability expense for the typical employer, according to the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation.

Less obvious is the effect that a mental health condition like depression can have on the workplace.

“There are lots of ways that depression symptoms show themselves in the workplace,” Miles said. “If someone comes in and they’re tired, they may not be sleeping because they’re depressed. To others it might look like a lazy worker.”

Most of the time the red flag for employers is claims costs, experts say.

“There’s always been this elephant in the room that was driving claims costs and incidents and that was an underlying behavioral component,” said Marcia Carruthers, chairman of the Disability Management Employer Coalition, a nonprofit advocacy group based in San Diego. “But it’s broader than claims; it’s performance issues as well.”

Also overlooked is the link between depression and physical conditions like asthma or diabetes, adding to the “under the radar” aspect of mental illness in the workplace, Carruthers said. About 60 percent of all physical health conditions have a mental health component.

“Employers are dealing with asthma or carpal tunnel syndrome, but they’re not looking at the mental health piece,”
she said.

But employers face what some say is a more daunting obstacle in dealing with mental health issues: stigma. In spite of greater public awareness, issues like depression are often viewed as taboo topics, especially at work where people are afraid to speak out, said Clare Miller, director of the Partnership for Workplace Mental Health.

“When you look at the public’s understanding of depression, alcoholism and schizophrenia, it appears to be high, so you would think that when you ask, ‘How comfortable would you be having a family member or a neighbor with a mental health issue?’ people would be more accepting, but no,” she said. “One reason people are afraid to reach out at work is fear of losing promotional opportunities or fear that they could be fired, all of which are illegal. But still people are concerned.”