Mental Health Awareness: Information and Resources for Employers Clare Miller, Director

1. Mental Health Awareness:  Information and Resources for Employers Clare Miller, Director

2. Partnership for Workplace Mental Health What’s the Partnership? An American Psychiatric Foundation educational program in collaboration with employers and the American Psychiatric Association. Mission To advance effective employer approaches to mental health. www.WorkplaceMentalHealth.org

3. What Does the Partnership Do? • Promotes the business case for quality mental health care, including early recognition, access to care and effective treatment. • Delivers educational materials to employer health care purchasers • Provides a forum for employers to explore mental health issues, share innovative solutions and take action.

4. Workplace Mental Health • Private employers finance ~50% of U.S. health care system. • Employers concerned about high health care costs; low quality (although direct mental health costs remain minimal, and in fact should increase). • “Brain-based economy” = increased attention to workplace mental health. • Mental illnesses affect people during their prime working years. • In any given year, 1 in 5 adults experience a diagnosable mental illness or substance use disorder. • Only 13.2% receive treatment, and • Privately-insured populations have even lower treatment rate: 5.5%. • SAMHSA 2004/NCQA 2002/Watson Wyatt Staying at Work Survey/ • Sederer LI et al: Integrating Care for Medical and Mental Illnesses. Preventing Chronic Disease, April 2006

5. Mental Illness Impacts Business’ Bottom Line

6. Cost of Mental Illness to Employers • Lost Productivity • Overall Healthcare Costs • Comorbidity with other diseases • Disability

7. Cost of Mental Illness to Employers Absenteeism and Lost Productivity • More workers are absent from work because of stress and anxiety than because of physical illness or injury. 2 • More days of work loss and work impairment are caused by mental illness than many other chronic conditions such as diabetes, asthma, and arthritis.1 • Employees with depression cost employers $44 billion per year in lost productive time.2 • Mental illness and substance abuse annually cost employers in indirect costs an estimated $80 to $100 billion.3 Overall Healthcare Costs • Individuals who are depressed but not receiving care for the condition consume two to four times the healthcare resources of other enrollees.3 1Stewart WF et al: Cost of Lost Productive Work Time Among U.S. Workers with Depression. JAMA, June 18, 2003. 2 Marlowe JF: Depression’s Surprising Toll on Worker Productivity, Employee Benefits Journal, March 2002. 3 An Employer’s Guide to Behavioral Health Services, National Business Group on Health, December 2005 .

8. Cost of Mental Illness to Employers Comorbidity with other diseases • Individuals with depression are about twice as likely to develop coronary artery disease, twice as likely to have a stroke, and more than four times as likely to die within six months from a myocardial infarction.1 Disability • Mental illness short-term disability claims are growing by 10% annually and can account for 30% or more of the corporate disability experience for the typical employer. 2 • 53% of employers surveyed by Watson Wyatt found that return to work is more difficult following a psychiatric disability than after physical disability.3 1 Sederer LI et al: Integrating Care for Medical and Mental Illnesses. Preventing Chronic Disease, April 2006. 2 Marlowe JF: Depression’s Surprising Toll on Worker Productivity, Employee Benefits Journal, March 2002. 3 Watson Wyatt Staying at Work Survey, 1998.

9. Depression Is Prevalent and Causes Significant Work Impairment Reason Days Impaired per 1000 Employees Population (%) Kessler RC, et al. J Occup Environ Med. 2001; 43:218-225.

10. Depression and Chronic Medical Illness Percent With Depression Medical Condition Pincus HA. J Clin Psychiatry. 2001;62 Suppl 6:5-9; Schatzberg AF. J Clin Psychiatry. 2004;65 Suppl 12;3-4.

11. The Good News: the Business Case for Quality Treatment

12. Treatment Works • Major depression can be treated successfully with antidepressant medications and psychotherapy in 65 to 80 percent of all cases - a success rate that exceeds many current common medical treatments for non-psychiatric illnesses. • Eighty percent of those treated for a mental illness reported “high levels of work efficacy and satisfaction.” • Seventy-five percent of patients who are depressed show significant improvements after CBT treatment. • Nearly 86 percent of employees who were treated for depression with antidepressant medications reported that their work performance improved. • Am J Psychiatry 150:10, October 1993 • Therapy in America 2004 • The University of Michigan Depression Center • Psychopharmacology Bulletin

13. Treatment Saves Money • One Fortune 500 company achieved a 1.7:1 return on investment by conducting a depression screening program. • When aggressive care management interventions for behavioral health issues were instituted at one Fortune 500 company, outpatient costs went down by $400,000 the first year and by $500,000 the next. • Open access to mental health results in lower psychiatric disability claims and productivity losses compared to restrictive plans. • A Mentally Healthy Workplace: It’s Good for Business

14. The Bottom Line • Mental illness is very prevalent in working populations – but few receive treatment. • Mental illness is frequently comorbid with other health conditions • Treatment works and is cost effective. • Treating mental illnesses improves outcomes for coexisting illnesses. • There is a clear business case for tackling workplace mental health.

15. Tools to Help Employers Take Action

16. Information for Employers Partnership E-Updates on timely and relevant topics Dynamic web site with useful content Parity resource portal Business case for quality mental health Tool kits for employers on depression and anxiety Depression cost calculator Alcohol cost calculator www.workplacementalhealth.org

17. Depression Calculator • Free Online Tool translates research findings about prevalence and cost for specific company. • Users customize for industry type, location, number of employees, etc. • Used to make business case within company for action. • Uses business language – ROI- it’s not about doing the “right thing,” it’s the economically smart thing.

18. Research Works New series focused on translating research to action Specific workplace question answered with research, action steps and corporate case examples Employee Personal Financial Distress and How Employers Can Help Mental HealthWorks Free quarterly newsletter for business Research summaries, corporate examples Latest issue : Overview of parity legislation Houston Texans experience with parity New research on AD/HD and workplace

19. Employer Innovations Online • A web-based, searchable database that profiles employers’ innovative programs and practices for addressing mental health at the workplace. • Actual practices of leading companies in key areas including: • Employee Assistance Programs • Disability/Case Management • Integration/Partnerships • Benefit design • Pharmacy Benefits • Why/How Employer Addressed Mental Health • Results – outcomes on employee health and ROI

20. Information for Employees • HealthyMinds.org, consumer web site about mental health and mental illnesses and effective treatments. • Tip Sheets – Back to School, Winter Blues, etc. • Let’s Talk Facts brochures for distribution to employees and families (print & online): • Anxiety Disorders Eating Disorders • Bipolar Disorder Phobias • Choosing a Psychiatrist Posttraumatic Stress Disorder • Childhood Disorders Teen Suicide • Depression What is Mental Illness? • Domestic Violence

21. So What Can Employers Do? • Use purchasing power to leverage the system and demand quality. Ask questions! • Ensure access to quality treatment. • Provide coverage to mental health equal to medical/surgical benefits. • Align incentives to change care-seeking behavior and encourage treatment. • Provide education at the workplace about mental illnesses, their impact on work, and the importance of seeking treatment.

22. Special FocusResearch Works: Employee Personal Financial Distress and How Employers Can Help

23. Employee Personal Financial Distress and How Employers Can Help • One in every 4 American workers reports feeling seriously distressed by their personal financial situation. • Almost two-thirds (61%) of Americans report having ‘serious financial problems.’ • paying for gas (44%), • getting a good-paying job or a raise (29%), • paying for health care and health insurance (28%), • paying rent or mortgage (19%), • paying for food (18%), • problems with credit card debt or other personal debt (18%), and • losing money in the stock market (16%). April 2008 survey by Kaiser Family Foundation

24. Employee Personal Financial Distress and How Employers Can Help • A survey found that most Americans are stressed and anxious about their financial future. • The study reports that about 8 in 10 people identify money (81%) and the economy (80%) as significant sources of stress in their lives. • Other sources of stress include work (67%), family health problems (67%), housing costs (62%), relationships (62%), personal health concerns (61%), job stability (56%), and personal safety (48%). American Psychological Association survey in 2008.

25. Health and Work Consequence of Employee Financial Distress • Workers with financial distress report poorer overall health. • Distressed workers reported spending time on the job dealing with or worrying about money problems. • 13 percent on the job dealing with money matters • Record high utilization of employee assistance programs and outpatient mental health services. • EAP providers survey found dramatic increase in requests for financial services from employees (up 88% since past year) and for help with laid-off employees and downsizing (up 60%). • Five to ten percent increase in hospital admissions for psychiatric and substance abuse services related to financial problems and accompanying symptoms, such as depression and anxiety.

26. Employer Action Steps • Communicate with employees. • Frequent communication from management to employees on issues of company viability in general and employee job stability in particular. • Good communication with supervisors is essential so workers know what is expected of them. • Provide Prevention and Treatment Services • Personal Financial Education • Credit Counseling and Debt Management • Employee Assistance Programs (also positioned to provide brief psychological counseling and stress management support).

27. Employee Personal Financial Distress and How Employers Can Help • Case Examples • Home Depot • IBM • Pepsi Bottling Group • USAA • Resources

28. DPN Call To Action • Navigators, in coordination with One-Stop Business Services staff, can share this information and free resources with: • Employers, including: • Marketing and outreach activities (e.g., the Business Case) • Employment organizations, including: • Chamber of Commerce, Rotary, Better Business Bureau • Employer related activities, including: • Job/Career Fairs • Employer Forums • Interagency Committees and Partner Agencies

29. DPN Call To Action • Review Mental Health Resource Guide • Tailor the MH Resource guide to fit your individual workforce area(s) • Follow and build upon suggestions provided within the MH Resource Guide

30. Contact Us Miranda KennedyTraining Coordinator National Disability Institute P: (720) 890-3990mkennedy@ndi-inc.org www.dpnavigator.net www.ndi-inc.org Clare Miller Director 1000 Wilson Blvd., Ste. 1825 Arlington, VA 22209 P: 703-907-8673 cmiller@psych.orgwww.WorkplaceMentalHealth.org