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March 10, 2009

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If you could offer a service that increased productivity, facilitated teamwork, and improved the lives of many of your employees, all for a reasonable cost, would you do it? What if the service could actually save an employee's life?

A number of organizations offer confidential screening for common mental health issues, including depression. It can be offered as part of an Employee Assistance Program (EAP) or as a stand-alone service.

Mental health issues affect as many as 20 percent of people at some point, according to some experts. Depression is a serious illness that can render people less effective in their jobs and in their personal relationships. Besides the debilitating effects it has on the individual, an employee's depression also affects the workplace.

According to a recent study by the American Medical Association, lost productivity in the workplace due to depression costs American employers $44 billion annually. That's more than three times the estimate of lost productivity for nondepressed workers.

One of the organizations that offers screening, Screening for Mental Health Inc., uses telephone and Internet screening tools that are not designed to replace any services you already have in place. Rather, says Rondi Chapman, program manager for interactive screening programs, SMH works with your EAP or healthcare providers.

"Employees calling or accessing the tools via the Internet first get a welcome message," Chapman says. "Our privacy policy is at the foot of each page online, and sometimes companies wish to also add something to it. Companies provide a customized referral message for the end of the screening after somebody hears [or reads] whether or not their symptoms are consistent with depression, or any of the other issues we have available.

"Most companies put in information about where to call for additional information. The whole goal of the customized referral is to direct people that are in need of help, or perceive that they're in need of help, to the right venue. That's the biggest benefit of our anonymous program-directing people to the services they already have."


Mental health issues and performance problems

Ron Hesslein, vice president of EAP Services at Resource Management Consultants, agrees that getting people to the help they need is the number one goal. Coming in second, though, is protection of the employer.

"If you look at mental health issues, like alcohol, substance abuse, depression, anxiety disorders, and eating disorders, data suggest that there are a significant number of individuals inside a corporation who are either suffering from one of these concerns or have a family member or loved one who is suffering from one of these concerns," Hesslein observes.

"A lot of the symptoms of depression cause people to have lower productivity at work and obviously can cause problems with tardiness or presenteeism," he adds. "Also, so many organizations today have team environments where employees are required to interact intensively with each other."

"An employee who is suffering even from mild to moderate depression is going to have a hard time staying in touch with the team and responding appropriately," Hasslein continues. "And in the case of a family member, it can cause problems in terms of productivity because there are a lot of things an employee has to do in terms of making sure their loved one is properly treated. There are often issues going on that cause them to be on the phone at work. They themselves may have what appear to be performance problems."

"Typically," explains Hesslein, "what we find is that one-half to two-thirds of the individuals who complete the tests have some degree of clinical symptoms. If you have 10,000 employees, you might have 150 people that year taking the screening tests. Let's say 100 of them show some sort of clinically recognizable symptoms. Those people are encouraged then to go see a mental health professional or call their EAP. While relatively few employees actually take the tests, of those who do take them, you can see there's a self-selection process."

Self-assessment tools impact liability, legal issues

And that's where companies can benefit, from a purely fiscal point of view. Hesslein acknowledges that companies are concerned first about their employees.

Choosing his words carefully, he adds, "But in a lot of cases, HR knows too much. If employees can self-access, and go get help without it coming to the attention of the boss or of HR, that lets the company focus on the performance and on the core business. They don't have to be concerned with the employee's mental health because they've offered the tools to do these things.

"Once the employee comes to you and says: 'I'm suffering from depression, I think I need help,' now you've got Americans with Disabilities Act (ADA) concerns. Now it's reached the point where the person is probably going to end up on short-term disability leave. There may be some performance issues now that have to be reviewed, rethought out. The company wants to be humanistic about it and doesn't want to get dragged into court for wrongful termination. It gets very complicated."

Both Hesslein and Chapman relate stories in which the screening tools reaped positive results. Chapman discusses a client, the San Francisco Giants. "They've been using the program for a few years now and offer screenings not only to their employees, but also to their adult family members and retirees. On their customized referral message, they provide the cell phone number of their EAP director.

"One night at 2 a.m., he got a phone call from the daughter of one of their coaches. He hooked her up with appropriate providers and got her into help.

"Later, the family came up to him and said that their daughter was later able to tell them that she was very much contemplating suicide, and that the intervention most likely saved her life."

Productivity improves with treatment

While that is an extreme case, say Chapman and Hesslein, those situations do occur. More common, though, is the day-to-day issues that can be solved by providing employees easy access to services.

"Most people with depression do not actually call in sick," Chapman reports. "They come to work, but they're just not doing very much, or what [or as much as] they can do or have previously done. It's much easier to slip through the cracks if you're coming to work. My HR department will notice if I've been in only two days in the last two weeks. But it might take awhile for them to notice that I'm not very productive. By then, people are in danger of losing their jobs. And it's just depression; it's treatable!"

"Corporations these days are concerned about pharmacy costs," admits Hesslein. "Let's say a company is self-insured, and it would cost $100 a month to put an employee on [a name brand drug used for treating depression].

"If you have a senior manager in a corporation, and they have to take the time to deal with performance issues of the depressed employee-consultations with the person's manager about their performance-then HR gets involved and corporate legal gets involved because they don't know if the person is fit for duty. Should they go on disability? Can we discipline them if they're depressed?

"And what about ADA? The cost of those things is way over the roughly $1,000 a year that would be spent on the medication for the employee," Hesselein emphasizes.

"You're losing money to depression whether you want to acknowledge it or not," says Chapman. "These tools give people the opportunity to realize they need help before it becomes an inpatient issue."

More information is available on the Screening for Mental Health's website, at http://www.mentalhealthscreening.org.

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Filed Under: Workplace Issues
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