Friday, April 7, 2023

Employers Focus on Mental Health to Improve Bottom Line

It seems to be a good and important time to discuss the effects mental health has on the workplace and the new trends in getting help. According to the National Institute of Mental Health, 26% of American adults suffer from a diagnosable mental illness such as anxiety or depression every year. Unfortunately, more than half of people with a mental health concern don’t receive treatment, according to Mental Health America report, “State of Mental Health in America 2017.”

Mental health conditions cause more days of work loss and work impairment than any other chronic health condition, including arthritis, asthma, back pain, diabetes, hypertension, and heart disease.

New Ways to Battle Mental Health

Whether it is the stigma associated with mental health or access to mental health providers, standard employee assistance programs (EAPs) are being used with other services to reach and engage different employees or dependents. Teletherapy is appealing to individuals in rural areas, those with mobility problems, or people who don’t have time to visit a therapist in person.

Mental health conditions cause more days of work loss and work impairment than any other chronic health condition, including arthritis, asthma, back pain, diabetes, hypertension and heart disease.

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In another example of technology improving healthcare, more than 10,000 mental health-related apps are available for download1. These tools are providing people anonymity, and allowing them to avoid the stigma associated with mental health. Some apps provide self-help tools, including self-assessments, self-guided cognitive therapy tools, and mood tracking functions.

According to the Journal of Medical Internet Research, 58% of mobile phone users have downloaded at least one health-related mobile app.

Growing employer interest in mental well-being is evidenced by results from the 2015 Promoting Mental Well-Being international survey from Conduit HR Services. The ten fastest growing programs and activities promoting mental well-being offered to individual employees (by rank) are:

  1. Resilience training
  2. Stress awareness campaigns
  3. Vitality or energy management programs
  4. Time management or delegation skills
  5. Financial well-being resources
  6. Leadership training
  7. Yoga/meditation/relaxation/mindfulness programs
  8. Work life balance support programs
  9. Personal lifestyle management coaching
  10. Online healthy lifestyle programs.

Notably, program offerings in these areas reflect growing employer interest in moving upstream along the healthcare continuum by proving preventive mental health services.

To combat prescription drug abuse, employers have implemented a number of initiatives2 including:

  • Requiring prior authorization of outpatient opioid prescriptions in excess of a specific number of days (43% of respondents)
  • Providing alternative pain management treatments (17%)
  • Offering a fraud tip hotline (8%)
  • Requiring written permission from a healthcare provider before a prescription is switched from an abuse-deterrent drug to one that is not (5%)
  • Monitoring hospital discharges to look for drug abuse events (5%).

The Cost of Mental Health and Substance Abuse and Correlative Analytics

A study available on NCBI states that about 33% of the annual cost of mental illnesses ($51 billion) is related to productivity losses.

  • About 8.5% of adults in the study experienced a depressive episode in the past year.
  • The regression results indicated that people who had a severe depressive episode were significantly less likely to be highly productive.
  • Compared with people who had a moderate or severe depressive episode who did not have treatment, those who did have treatment were significantly more likely to be highly productive.
  • However, about 50% of workers with a moderate or severe depressive episode did not receive treatment.

Every year, employers lose 27 work days per employee with depression.

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According to the National Business Group on Health, 6-7% of full time workers experienced major depression in the past year. Every year, employers lose 27 work days per employee with depression. An employer’s cost of depression in lost work days is as great or greater than the cost of many other common medical conditions.

Multiple Conditions

A study of insurance claims data, published in the Journal of Occupational and Environmental Medicine, revealed that costs for treating patients with comorbid mental health and substance use disorders can be two to three times higher than those for patients without the comorbid conditions. For example, there is a high prevalence of depression for patients with asthma (45%) and diabetes (27%).

Other findings include:

  • Individuals who are depressed are twice as likely to develop coronary artery disease or stroke.
  • They are more than four times as likely to die within 6 months from a heart attack.
  • There is a strong linkage between depression and obesity, where those with depression had a 58% greater risk of developing obesity than individuals not suffering from depression
  • People with obesity had a 55% increased risk of being depressed than non-obese individuals.

To top off this concerning trend, people with depression also exhibit poor adherence to medication and other prescribed treatments.

The Benefits of EAP

With the publicity of mental health disorders and the studies revealing the effect on companies’ bottom lines, an increasing number of employers are focusing on mental health as a critical component of their population health management strategy. Recent research by CuraLinc Healthcare showed certain EAP models can impact behavior change that leads to decreased absenteeism, increased productivity, and improved health outcomes for employees with depression and alcohol abuse.

An analysis of 3,497 EAP cases in 2016, first during the initial clinical assessment, and again after treatment was completed, revealed the following health and productivity related outcomes3:

EAPs provide support, care, and advocacy for employees suffering from depression.

  • 86% of EAP participants with severe or moderately severe depression migrated into minimal, mild, or moderate categories.
  • 90% of participants with depression showed significant or moderate improvement after using the EAP.

EAPs have a positive, measurable impact on employee productivity.

  • The average “presenteeism” index score increased from 19.9 (moderate productivity) to 24.5 (high productivity).
  • 81% of EAP participants reported high productivity after using the EAP, relative to 52% prior to using the program.

EAPs reduce unscheduled employee absences.

  • Average time away from work caused by the employee’s mental or emotional health concerns decreased by 6.8 hours after using the EAP.

EAPs help employees address alcohol abuse.

  • The average alcohol use index score for EAP participants who presented with alcohol use or abuse improved from 6.5 to 3.9—a significant reduction in the use and abuse of alcohol.
  • 37% of participants reported misusing alcohol (an index of 8 or higher) during the initial clinical assessment, compared to just 7% after EAP treatment was completed.


1Torous J, Roberts LW. Needed Innovation in Digital Health and Smartphone Applications for Mental Health Transparency and Trust. JAMA Psychiatry. 2017;74(5):437–438. doi:10.1001/jamapsychiatry.2017.0262).

2 The Society for Human Resource Management, Mental Health Support Begins by Recognizing the Need.

3 Goetzel, Ron, Z., PhD, et al. Mental Health in the Workplace: A Call to Action Proceedings From the Mental Health in the Workplace—Public Health Summit, Journal of Occupational and Environmental Medicine: April 2018 – Volume 60 – Issue 4 – p 322–330.

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