Wednesday, October 15, 2003

Guest Opinion: There is a way to cope with office depression

RON RUIZ, M.D.

Tucson Citizen

With increased demands on employees to maintain the highest level of workplace productivity during this challenging economic environment, the mental health of workers becomes increasingly important.

Behavioral health problems account for more than 20 percent of all disability claims in the United States, and depression exceeds other mental health disorders, heart disease, hypertension and diabetes as causes of short-term disability.

Left untreated, depression can cost the American economy more than $43.7 billion in absenteeism and lost productivity.

Depression has other associated costs as well. Data gathered by CIGNA Behavioral Health indicates that approximately 87 percent of primary care physician visits have a psychological component, and mental health conditions account for the greatest portion of all pharmaceutical expenses.

In addition, National Institute of Mental Health research reveals that individuals with heart disease, cancer and diabetes have a higher than average risk of being diagnosed with depression. One in three individuals who suffer a heart attack will also suffer from depression and 25 percent of cancer survivors will become depressed. Depression aggravates the health consequences of heart attacks, strokes and diabetes and leads to poor outcomes related to lung disease.

While 80 percent of patients with cancer, diabetes and heart disease receive treatment, less than half of people with depression get the help they need, costing businesses more in both health care expenditures and lost productivity.

It is estimated that behavioral health issues are also the leading cause of substandard job performance and employment loss in individuals ages 20 to 50. With data like this, it is no surprise that employers should be paying more attention to behavioral health concerns.

There is help. Employee Assistance Programs can help companies combat depression and reduce absenteeism associated with behavioral health concerns.

According to the National Institute for Occupational Safety and Health, more than 50 percent of U.S. companies offer EAPs to improve the ability of workers to cope with difficult work and personal situations. And, studies show that more than half of the behavioral health problems affecting the workplace can be resolved through short-term counseling services provided by EAP.

Companies should consider adding EAP to their employee benefit options as a means to help troubled workers and maintain workplace productivity. Research reveals EAP offered by leading companies show significant return on investment. For instance, CIGNA Behavioral Health has found that its EAP can save customers several hundred thousand dollars a year from unused medical costs and reduced absenteeism.

It is estimated that by 2020, depression will be the second most prevalent cause of disability in the world. Businesses that help managers recognize employees suffering from depression and encourage treatment will be better positioned to reduce productivity challenges caused by this treatable condition.

Employees who experience five or more of the following symptoms for more than two weeks, interfering with routine activities, should be encouraged to seek help from a mental health provider:

• Persistent sad, anxious, or "empty" mood.

• Feelings of hopelessness, pessimism.

• Feelings of guilt, worthlessness, helplessness.

• Loss of interest or pleasure in hobbies and activities that were once enjoyed.

• Decreased energy, fatigue, being "slowed down."

• Difficulty concentrating, remembering, making decisions.

• Insomnia, early-morning awakening, or oversleeping.

• Appetite and/or weight loss or overeating and weight gain.

• Thoughts of death or suicide; suicide attempts.

• Restlessness, irritability.

• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

Depression does not have to impact workplace productivity.

With education and added awareness about the problem, companies can intervene and successfully reduce absenteeism and turnover associated with depression.

The addition of EAP to employee benefit plans is a good place to start.

Ron Ruiz, M.D., is the senior market medical executive for CIGNA HealthCare of Arizona.