Addressing behavioral health in the workplace
Workplace productivity is significantly impacted by behavioral health issues, such as depression, substance abuse, anxiety, stress and disrupted sleep. These are the findings of a landmark 2007 study entitled “Health and productivity as a business strategy: a multiemployer study,” by Ronald Loeppke, Michael Taitel, et.al.
Since the study’s publication, the adverse effects of behavioral health problems on the well-being of our workforce have become more evident. Mental disorders in the United States have cost the business sector $50.7 billion. In fact, behavioral health problems are a leading cause of illness and disability. Fortunately, a parallel line of research has demonstrated that employers can implement workplace strategies and services that promote good behavioral health practices, minimize total workplace costs, and provide early and efficient referrals for treatment.
Scope of the Problem
Nearly one in five US Adults experienced a mental, behavioral, or emotional disorder in the past year. Even more alarming, 71% of those in the workforce suffering from these conditions have never reached out for help for their illness.
These disorders cost employers both directly and indirectly, presenting opportunities for employers and health plans to support the well-being of their employees with proven and effective health management programming. Employees suffering from depression and stress have health expenditures that are 70% and 46% higher, respectively, than their healthier counterparts. With nearly 28 million workers experiencing a mental or substance abuse disorder, employers bear a substantial portion of these direct costs.
In addition, the financial impact of the indirect costs weighs heavily on employers. These indirect costs include workers’ compensation, short- and long-term disability, presenteeism and absenteeism. In one study, employees suffering from depression missed an average of 4.8 work days and suffered 11.5 days of reduced productivity over a three-month period.
This presents a critical opportunity for employers and health plans to bring mental health focused health management programming to alleviate the distress and improve outcomes.
Early identification is key
The symptoms of a behavioral health problem can manifest themselves in many ways. Conditions may affect a person’s thinking, feeling, or mood. Some are severe and disabling; while others are mild. Some may affect someone’s ability to relate to others and function each day. Employers can train their managers to recognize some of the more common red flags of common conditions, like depression and anxiety, to help them properly and effectively engage their employees when concerns arise.
Screening tools can be built into employee health plan health risk assessments or provided in a secure and confidential manner for individual use by employees. By identifying and working with individuals early, treatment of reversible conditions can be started, and other symptoms can be addressed, leading to a healthier way of life both personally and professionally.
Workplace tools to improve behavioral health
Research has shown that behavioral health treatment can help empower people to live better lives. Employers who bring workplace health tools to their employees are well-served by thinking strategically around a total health approach — addressing and integrating employee physical and mental health. Employers need to think outside the standard health and wellness programs and implement strategies that encourage people to think about their emotional health.
Some experts feel a necessary first step is for employers to recognize and break down the organizational barriers that prevent them from taking proactive approaches to managing workplace behavioral health problems. This proves to be difficult, as many employers feel ambivalent about their role in the management of common behavioral health problems like depression, much in the same way that employees may be hesitant to seek help for behavioral health conditions. Reducing the personal and organizational stigma often associated with mental health problems is a necessary strategy to benefit from utilizing workplace behavioral health tools to address behavioral health challenges.
Employees participating in disease management and wellness programs can work with their coaches to identify symptoms in their earliest stages and be encouraged to seek treatment. This is a proven, cost-effective method to improve employee well-being. These services require health coaches to integrate physical with mental health, develop a trusting relationship with the employee, support the employee’s development of coping skills, provide education materials, encourage the employee to seek professional help when indicated and assist the employee with necessary professional referrals. The coach should also evaluate the member’s current support system to ensure they have the proper team supporting them. Coaches capable of taking a total health approach help employees recognize the challenges they face due to mental illness and work with them to overcome the stigma of the illness. Effective total health coaches pinpoint triggers in medication adherence and behavior shifts, supporting the employee’s development of self-management skills.
Employee Assistance Programs are a valuable resource available to employers dedicated to the total well-being of their employees. Although the original focus for EAPs was alcohol and substance abuse counseling, they have expanded their scope into multiservice programs that include addressing behavioral health problems that affect job performance. EAPs offer short-term, confidential, behavioral counseling in person or by telephone. Employees may be referred by their supervisor or self-refer. In some circumstances, short-term counseling will adequately address an employee’s need, but in others, the employee may be referred to behavioral health treatment outside the EAP and provided follow-up support as needed.
Employers who are working with an EAP will be well served by an outreach program that includes manager training to increase EAP awareness, works to reduce the stigma toward behavioral health problems, and communicates clearly the confidentiality and utility of the EAP. This visible commitment to employee total well-being will have a positive effect on EAP utilization by all employees in need of EAP services.
In addition to formal workplace health tools, the use of management strategies to mitigate workplace-related stress from demanding work environments, high work demand and a poor social climate also present an opportunity for change. Employee health outcomes are influenced not just by personal behavioral patterns but also by perceptions of work and experiences in the workplace. Employee behavioral health is as much a management concern as it is a health concern.