Do depression screening, or face lower productivity

Consequences are costly

If an employee is absent more often and supervisors report an impaired work performance, suspect depression.

Researchers measured both presenteeism and absenteeism in 286 employed adults with a diagnosis of depression, and 193 employees without depression. Both of these factors were significantly worse for the depression group.1

Presenteeism was associated with more severe depression symptoms, poorer general physical health, psychologically demanding work, and less job control. The results suggest that workers with depression may benefit from care involving medical and vocational interventions, says Debra J. Lerner, MS, PhD, the study's lead author and director of the Program on Health, Work and Productivity at Tufts Medical Center's Institute for Clinical Research and Health Policy Studies.

Employees are rarely screened for mental health, but this can have costly consequences for a company," says Douglas Nemecek, MD, senior medical director for Bloomfield, CT-based CIGNA. "Depression is one of the most common illnesses suffered by employed adults."

Depression in the workplace leads to low productivity, absenteeism, increased use of health care and mental health services, substance use, job dissatisfaction, and accidents, adds Nemecek.

"All these issues can be reduced with effective treatment and intervention," Nemecek says. "While depression may occur on its own, it is also found in up to 50% of people with other chronic illnesses such as diabetes or heart disease. Many injured and disabled workers also develop depression, which can develop from the stress associated with the recovery process."

Poor performance

The study documents some aspects of workplace stress that are especially problematic for depressed workers. "But the larger point is that depressed workers cost corporate America a lot of money in terms of lost productivity," says Ronald C. Kessler, PhD, a professor in the department of health care policy at Harvard Medical School in Boston.

"We have to address this problem by treating the illness, rather than by trying to modify the amount of stress in the workplace so as to make sure depressed workers don't experience stress," says Kessler.

He points to several recent studies which evaluated the cost-effectiveness of screening and treating depressed workers. "Based on these studies, it seems that it makes good sense from a human capital investment perspective for employers to develop special programs to detect and treat depressed workers," says Kessler.

It's important, though, to maintain high treatment quality standards. "Occupational health professionals have a big role to play in providing quality assurance to depression intervention programs," says Kessler. "Expanded screening can be cost-effective only if a system is put into place to guarantee high quality of treatment and ongoing treatment quality assurance monitoring."

Reference

1. Lerner D, Adler DA, Rogers WH, et al. Work performance of employees with depression: the impact of work stressors. Am J Health Promotion 2010; 24(3):205-213.

SOURCES

For more information on depression in the workplace, contact:

• Debra J. Lerner, MS, PhD, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston. E-mail: dlerner@tuftsmedicalcenter.org .

• Ronald C. Kessler, PhD, Professor, Department of Health Care Policy, Harvard Medical School, Boston MA. Phone: (617) 432-3587. Fax: (617) 432-3588. E-mail: kessler@hcp.med.harvard.edu