Depression on the job

Editorial Notebook

April 30, 2005|By Peter Jensen

MUCH LIP service is given to the value of human capital. In the modern economy, it's not the bricks and mortar or factory equipment or inventory that give a company value. It's the quality of the people who work there.

That's a prime reason why it makes sense for employers to actively promote the health and welfare of their workers. Yet for too many business executives, the words "health care" are usually followed by the words "cost containment." Matters of health are seen by these short-sighted managers as an obligation, not an opportunity.

But that attitude may be changing.

Nowhere is this more evident than in the field of mental health, where the cost of health care insurance is exceeded by the even greater cost of employees who don't get help. The U.S. Surgeon General estimates that depression causes businesses to lose an astronomical $79 billion per year in absentee days and reduced productivity. Yet depression is highly treatable. Studies suggest that three-quarters or more of sufferers will respond to some form of therapy. The problem is that too many aren't getting it.

In Kansas City, they've come up with an innovative plan to address this problem. Since 1999, some of the city's largest employers have been researching and exploring this single issue -- depression in the workplace -- and looking for ways to help employees in a collaborative effort with local insurers, doctors and academics. And they've found some intriguing things, including:

Some primary care doctors purposely avoid diagnosing depression. Why? Because they think they won't get reimbursed for their efforts. Insurers had to prove otherwise -- and train office managers in the proper coding for claim forms. They've also had to work hard to persuade specialists such as surgeons and cardiologists to diagnose depression when it appears in patients being treated for other illnesses.

Mental health benefits need to be adjusted. Does a co-pay on an initial visit to a doctor make sense if it discourages a reluctant employee from seeking treatment? The merits of employee assistance programs, which provide prompt, short-term counseling and medical referrals to workers, became clear.

Educating employees is important, but companies needed a tailored approach, from Web-casts to postcards. A survey of some 45,000 workers proved particularly valuable at identifying what people don't know (such as where to get help) or got wrong (such as the 24 percent of respondents who linked depression to violence).

Business leaders in Kansas City don't assume they've licked the problem. There isn't an easy yardstick with which to measure employee mental health. But experts are impressed by what's been accomplished, particularly the collaborative, multidisciplined approach. The American Psychiatric Association recently hailed the initiative as "bold and innovative." If it works in middle America, why can't it work in Baltimore?

We need this kind of leadership and vision in Maryland's business community, and not just some token hiring of consultants or internal human resource audits by one or two employers.

A manufacturer that failed to keep its machinery and equipment in good repair would never succeed. In the modern service economy, the same can be said of employers who neglect the mental health of their work force. This isn't altruism, but a sound business practice. Consider it an update of the old adage about GM and the rest of the country: What's good for people is good for the bottom line.

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