Employee depression is taking a toll on both employees and the organization. And you want to know how to best address it, right?
The suicide of comedian – actor Robin Williams has resulted in increased attention to the subjects of depression and suicide. Employee depression and suicide are very real issues for employers as well. This article will take a look at the subject of workplace depression by specifically addressing the relationship between depression and worksite wellness programs.
Worksite wellness programs need to better address employee depression for five key reasons:
1. The prevalence and cost of depression to employers
2. Treatment for employees with depression is under utilized
3. The co-morbidity between depression and other chronic illnesses typically addressed by worksite wellness programming and interventions
4. Core worksite wellness program interventions can be helpful in addressing depression
5. Worksite wellness programs are about prevention and depression can be prevented.
Depression Prevalence and Cost
A 2013 Gallup – Healthways Wellbeing Index finding was that “10.8% of U.S. full-time workers have received depression diagnoses, while 16.6% of the part-time workers reported having been diagnosed with depression.” (1) The same survey found that “depressed full-timers missed 8.7 days of work per year, 4.3 more days than people who are not depressed. As for part-time workers, they estimated that they missed even more days, some 13.7%, or 5% more than those who do not suffer from depression. ” (1)
In 1995, Conti and Burton reported that “depressive disorders in employees and their dependents pose a major occupational health challenge, with implications for productivity, competitiveness, disability program utilization and medical care costs.” (2) They found that depression in one major Midwestern employer “generated over half of all mental healthcare diagnoses and claims and even more days of disability and 12-month recidivism than chronic physical complaints such as heart disease, diabetes, high blood pressure and low back pain.” (2) In 2008, Conti and Burton continued to find that “depressive disorders are a major health issue in the US workplace. They are responsible for significant direct and indirect costs to the employer in terms of medical and pharmaceutical costs, time absent from work and decreased productivity while on the job (presenteeism).” (3) Kessler, et. al. found that “depression is a strong indicator of decrements in work performance.” (4)
Treatment Is Under Utilized
For a number of reasons, in a recent US study Kessler found that “only about half of workers with major depressive disorder received treatment in the year of interview and that fewer than half of treated workers received treatment consistent with published treatment guidelines. Although the treatment rate was higher for more severe cases, even some with severe major depressive disorder often failed to receive treatment.” (5) According to an article by Gonzalez, et al., although depression is a leading cause of disability in the United States, few Americans with recent major depression received any form of standard care and even fewer received care that is consistent with the American Psychiatric Association guideline. Of those meeting 12-month major depressive episode criteria, only 50.76% received any depression therapy and only 21.28% received adequate depression treatment. (6) Treatment under-utilization creates an opportunity for worksite wellness programs to fill some of the gap.
Connection With Sociodemographic Variables, Health Behaviors and Chronic Diseases
It is well established that depression, sociodemographic variables, health behaviors and chronic diseases are linked. The typical connections include:
• Current depression and lifetime diagnosis of depression and anxiety were independently associated with sociodemographic variables (being a woman, young, previously married or never married, or unemployed or unable to work), adverse health behaviors (current or former smoking, physical inactivity, or being overweight), and chronic health conditions (history of a stroke, cardiovascular disease, diabetes, arthritis, obesity, cancer, or asthma).
• Workers with occupational injury were more likely to become depressed than those with non-occupational injury.
• Because heavy alcohol use and daily smoking are each associated with depression, people who do both may be at an increased risk for depression.
Worksite wellness programming addresses many of these same variables, behaviors and chronic conditions.
Utilizing Core Worksite Wellness Program Interventions
Generally speaking, core worksite wellness programming and interventions include nutrition, physical activity and fitness, sleep hygiene and often, stress management. In his book, The Depression Cure (2009) (7), psychologist Stephen Ilardi discusses his Therapeutic Lifestyle Change (TLC) program.
The components of the TLC program include:
• Engaging activity
• Physical activity
• Sunlight exposure
• Social connection
• Enhanced sleep
By comparing traditional worksite wellness programming with the TLC components, you can see that the core components of the TLC program dove-tail very nicely with the core components of a traditional worksite wellness program. This becomes important when you realize how many employees do not receive treatment for their depression.
Depression Can Be Prevented
In his book, The Prevention of Depression (2009) (8), psychologist John Weaver notes that healthy thinking skills have been shown by researchers to “raise your resistance to being diagnosed with a depressive disorder and to assist you in recovering more quickly if you go through a period with a depressed mood.” Dr. Weaver lists the healthy thinking skills as being:
Dr. Weaver also noted that these same healthy thinking skills as also adding to one’s level of happiness.
Promoting employee altruism has also been shown by researchers to be “one of the greatest buffers against depression.” (9)
Based on these five reasons at least, worksite wellness programs have a role to play in addressing depression in the workplace. Worksite wellness programs can and should be making a significant contribution to the issue of employee depression.
(1) Roberts, Mark. 2014. Depression in the Workplace. Benefits and Wellness Excellence Essentials. August, Vol. 2, (8), pp. 12-13.
(2) Conti, DJ and Burton, WN. 1995. The Cost of Depression in the Workplace. Behavioral Healthcare Tomorrow. Jul-Aug, Vol. 4 (4), pp. 25-7.
(3) Burton, WN. Conti, DJ. 2008. Depression in the Workplace: The Role of the Corporate Medical Director. April, Vol. 50 (4), pp. 476-81.
(4) Kessler, R. White, LA. Birnbaum, H.Oiu, Y. Kidolezi, Y. Mallett, D. Swindle, R. 2008. Comparative and Interactive Effects of Depression Relative to Other Health Problems on Work Performance in the Workforce of a Large Employer. Journal of Occupational And Environmental Medicine. July, Vol. 50 pp. 809-16.
(5) Kessler, R. 2012. The Costs of Depression. The Psychiatric Clinics of North America. March, Vol. 35 (1), pp. 1-14.
(6) González, H. Vega, W. Williams, D. Tarraf, W. West, B. Neighbors, H. 2010. Depression Care in the United States: Too Little for Too Few. Arch Gen Psychiatry. 2010. January, Vol. 67(1), pp. 37-46.
(7) Ilardi, Stephen. 2009. The Depression Cure. Cambridge, MA: Da Capo Press.
(8) Weaver, John. 2009. The Prevention of Depression. Denver: Outskirts Press, Inc.
(9) Achor, Shawn. 2013. Before Happiness. New York: Crown Publishing Group.