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Workplace Depression Screening, Outreach and Enhanced Treatment Improves Productivity, Lowers Employer Costs

Enhanced and systematic efforts to identify and treat depression in the workplace significantly improves employee health and productivity, likely leading to lower costs overall for the employer, according to a study published September 26, 2007, in the Journal of the American Medical Association. The study was funded by the National Institutes of Health’s National Institute of Mental Health (NIMH).

Previous studies have shown that employees who are depressed are less productive and are absent more often. Other studies have shown that organized screening and enhanced depression treatment can significantly improve health. However, few employers have implemented such programs, in part because their return on investment is unclear.

“This study provides compelling evidence of the importance of workplace depression screening, outreach, and enhanced treatment,” said NIMH Director Thomas R. Insel, M.D. “It is in the interest of workers’ health and the company’s bottom line to ensure depressed employees are effectively treated.”

Philip Wang, M.D., Dr.P.H., formerly of Harvard University and now director of NIMH’s Division of Services and Intervention Research, and colleagues conducted a trial with 604 employees enrolled in a managed behavioral health care plan, all of whom were identified as having clinically significant depression during a Web-based and telephone screening process. Half of the participants were randomly assigned to an intervention that included telephone support from a care manager and their choice of telephone psychotherapy, in-person psychotherapy or antidepressant medication. The other half of the participants were assigned to usual care, which included feedback about their screening results, and advice to seek care from their usual provider.

After 12 months, those in the intervention group were 40 percent more likely to have recovered from their depression compared to those in usual care. Participants in the intervention group also were 70 percent more likely to stay employed, and worked an average of two more hours per week than those in usual care.

Although the data did not lend itself to a comprehensive cost/benefit analysis, the researchers noted that just the value of more hours worked among those in the intervention group who were employed, estimated at $1,800 per employee per year, far exceeds the $100-$400 per person costs associated with the type of outreach and intervention program used in the study.

“For many people, a large chunk of their lives is devoted to work. Depression affects not only a person’s health, but also his or her ability to work,” noted Dr. Wang. “Employers should consider a depression screening and intervention program as a healthy, win-win investment.”

Reference: Wang PS, Simon GE, Avorn J, Azocar F, Ludman EJ, McCulloch J, Petukhova MZ, Kessler RC. Telephone screening, outreach and care management for depressed workers and impact on clinical and work productivity outcomes, a randomized controlled trial. Journal of the American Medical Association, Sept 26, 2007; 298(12): 1401-11.

Source: National Institute of Mental Health

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