Depression at work: Too much lip service, not enough counseling and treatment
If you were to hold a depression recognition screening day in your workplace, how many employees do you think would show up?
If you conducted training classes for your supervisors in depression recognition, how much eye-rolling or nodding off would you see?
And if you placed confidential mental health self-rating sheets in your cafeteria, break rooms or bulletin boards, how many employees do you think would wait until no one was around to take one of the sheets?
These are just a few of the interventions recommended for employers to pursue to support employee mental health and promote greater awareness of the prevalence of mental health disorders and treatment options. NIOSH says the mental health of workers is an area of increasing concern to organizations, with growing recognition that depression, anxiety, and other mood disorders are major causes of disability, absenteeism, presenteeism, rising healthcare costs and productivity loss.
Is that a fact — this “increasing concern”? How deep does the concern run? Sure, if you poll executives and ask, “Are you concerned about the mental health of your employees?” most will answer “Yes.” What else are they going to say? Who wants to look like an emotionless Vulcan? Or a sociopath for that matter, interested only in their own agenda, with no concern for how their behavior (in this case ignorance, apathy or lack of compassion) affects others.
A wakeup call, really?
We hear a lot of talk these days about total worker health, health promotion programs, and of course the old standby, wellness programs. NIOSH has researched and written reams on evidence linking job stress with depression and other mental health problems. It points to several job stressors – high job demands, low job control, lack of social support in the workplace – that might be associated with depression. The media devotes more coverage of workplace mental health issues, most recently with the tragic case of the suicidal/homicidal Germanwings Airbus A320 co-pilot who hid an existing mental illness from his employer. “If you are an employer, let this be a wakeup call,” said a recent article in Inc. magazine.
Being conscious of a problem is one thing, doing something about is another. In 2015, obviously more employers are aware of the debilitating effects of excessive, prolonged job stress and mental health illnesses symptoms such as fatigue, headaches, dizziness, uncertainty, confusion, nightmares, poor attention, poor concentration, poor decision-making, anger, apprehension, irritability, social withdrawal, increased alcohol consumption, and changes in communication. Managers have read about these subjects, and perhaps been schooled by personal experience or the experiences of family members, friends or acquaintances.
After all, according to the National Alliance on Mental Health, one in four adults live with a mental disorder. In a given year, 18.8 million American adults (9.5 percent of the adult population) will suffer from a depressive illness, according to NIOSH. About 12 percent of U.S. workers have been diagnosed with depression at some point, according to a 2012 Gallup survey of 237,615 full-time employees and 66,010 part-time employees. Approximately half of those (representing 6.1 percent of all U.S. workers) are currently being treated for depression, according to Gallup.
Where’s the investment?
Despite these surveys and projections, only about half (51 percent) of all U.S. employers with 50 or more employees offer some sort of wellness program, according to a 2013 RAND employer survey. Most employers describe their wellness programs as a combination of screening activities and interventions. Of those employers offering wellness programs, again only about half (52 percent) offer stress management interventions, and 41 percent offer employee assistance programs (EAPs). Only six percent of employers providing clinical screenings in their wellness programs for job stress. Of all employers with disease management programs (56 percent), 53 percent target depression as a health condition.
Let’s step back and look at what the RAND numbers represent. About half of U.S. employers offer wellness programs, and about half of those offer disease management programs (or one in four). About half of those with disease management programs are serious about targeting depression in their workforce (or about one in eight of all employers). Bottom line: We’re not talking about a lot of proactive employers when it comes to screening and intervening for depressed employees.
There’s much more rhetoric than real action when it comes to depression and mental health in the workplace. Sounds like too many safety programs I’ve been told about. Employees of course see this lack of initiative and many conclude, “it’s better to let my sleeping demons lie.” This helps account for why, according to NIOSH, only 29 percent of all persons with depression reported contacting a mental health professional in the past year. Perhaps even stronger motivators are the fear of “coming out” and being labeled as unsteady, unreliable, unpredictable, unsafe, a risk, and unworthy of plum projects and career advancement, maybe even job retention. This despite research that suggests 80 percent of patients with depression will improve with treatment, according to NIOSH.
The rest of the story
OSHA and many safety experts in recent years have expressed serious concerns about the under-reporting of injuries and illnesses. They point to incentive programs that reward days without a recordable incident, pressure to keep workers’ comp costs down, an emphasis on zero-incident cultures, competition among companies and divisions of companies to win safest workplace awards, and job insecurity fears. There should be a similar national dialog about under-reporting, and under-treating, mental health illnesses in the workplace.
As a safety and health practitioner, what are you doing to combat lip service when it comes to depression, anxiety, and other mental health issues?