Depression :: Depression intervention in workplace increases employee productivity

A study conducted by Harvard Medical School, Group Health Cooperative’s Center for Health Studies and OptumHealth Behavioral Solutions (formerly United Behavioral Health) found that a systematic approach to identifying and treating depression not only improves clinical outcomes but also results in higher job retention, decreased sickness, lower work-absence and increased work productivity.

The study was published in Journal of the American Medical Association. It was funded by the National Institute of Mental Health.

The article entitled, “Telephone Screening, Outreach and Care Management for Depressed Workers and Impact on Clinical and Work Productivity Outcomes: A Randomized Controlled Trial,” is the first study to examine the impact on clinical outcomes and work productivity from an employer-based depression screening, outreach and treatment program. The telephone intervention program included proactive outreach, systematic needs assessment for psychotherapy and pharmacotherapy, monitoring and support for treatment adherence, and for those refusing treatment, included telephonic psychotherapy.

“This study provides clear evidence that implementing depression care programs through employer-sponsored managed behavioral health not only lessens depression, but helps employees to retain their jobs and perform more effectively in those jobs,” said Jeanne Miranda, Ph.D., professor, Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles. “The approach can be characterized as ‘building a village’ of health plans, clinicians, and resources to ‘surround’ depressed persons with opportunities to learn about and engage in quality care for their depression. The benefits from such care extend beyond the employee and his or her family and community and into the workplace as well.”

“As the study shows, employer-sponsored depression programs like those offered by OptumHealth Behavioral Solutions can help lessen depression and increase the number of hours worked, as well as employee retention,” said Francisca Azocar, Ph.D., assistant vice president of OptumHealth Behavioral Solutions’ Behavioral Health Sciences Group and study co-author.

Participants in the study included 604 employees who met the criteria for depression through the World Health Organization Health and Productivity Questionnaire (HPQ). The participants were 18 years and older, enrolled in OptumHealth Behavioral Solutions and spanned the spectrum of 16 large companies from diverse sectors including airline, insurance, banking, public utility, state government and manufacturing. Identified participants were further screened using the Quick Inventory of Depression Symptoms Self-Report (QIDS-SR) assessment. Those identified with moderate depression were randomized into an intervention group or usual care group.

For the intervention group, blinded outcomes assessments using the QIDS-SR were conducted at baseline, six and 12 months to measure outcomes. The HPQ measured work hours (absenteeism), job performance, job turnover and critical workplace incidents also at baseline, six and 12 months.

Key findings:

Work Performance Outcomes

There was a 2.6 hour improvement per week in overall work functioning among intervention participants due to a combination of increased job retention, decreased sickness absence and increased hours worked.

While actual dollar figures were not part of the study, the $1,800 annualized value of higher mean hours worked among intervention participants (based on the median annual salary in the U.S. Civilian labor force), by itself, far exceeds the $100 to $400 outreach and care management costs associated with lower to moderate intensity interventions used in the study.

Depression Outcomes

QIDS-SR scores were significantly lower in the intervention group than in the usual care group by six months (10 percent vs. 11 percent). This was also true at the 12-month mark (8.9 percent vs. 10 percent).

The proportion of participants whose symptoms improved was significantly higher among the intervention group than the usual care group at the 12-month mark (30.9 percent vs. 21.6 percent).

The proportion of participants experiencing recovery was significantly higher in the intervention group than the usual care group at 12 months (26.2 percent vs. 17.7 percent).

Intervention group participants were more likely than those in usual care to receive mental health specialty treatment (but somewhat less likely to obtain any depression treatment in primary care).

“Outreach and enhanced care for depressed workers might be better thought of as an opportunity to invest in improving the productive capacity of workforces rather than as workplace costs, especially when you factor in the cost of hiring and training new workers,” said Azocar.

Leave a Comment