Behavioral Health Risk Assessment:  Predicting Absenteeism and

Workman’s Compensation Claims with the Gain Short Screener

Richard Lennox

Michael Dennis

Mark Godley

David Sharar

This study was designed to assess the capacity of the GAIN Short Screener (GSS) as a behavioral health risk measure that can detect absenteeism and workman compensation claims in a population of employees and their dependents.  The GSS is a twenty-item version of the 2 hour full biospychosocial version of the GAIN I.  The GSS has been extensively validated and has been shown to share approximately 80% of its total variance with the full GAIN's core psychopathology measures.  Using GSS data from 1469 employees collected as part of a voluntary health risk assessment; we will show that the GSS is predictive of absenteeism and workman's compensation claims.   The results provided evidence that behavioral health issues are prevalent in the work force and important predictors of these key workplace outcomes. The discussion suggests that routine use of the GSS could provide a basis for detecting persons at risk of these and other types of adverse workplace characteristics and could be used to target them for EAP or other assertive or early intervention programs. Employers are advised to carefully examine the type of behavioral health questions that are inserted into an HRA to insure the behavioral health questions have predictive value.

Behavioral Health Risk Assessment:  Predicting Absenteeism and Workman’s Compensation Claims with the Gain Short Screener

ADM Pilot (n=1469) with an earlier 14 item version

24%

10%

11%

8%

19%

11%

3%

2%

1%

0%

1%

16%

3%

1%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Significant problems sleeping

Feeling trapped, lonely, sad

Feeling anxious, nervous

Distressed/upset by memories

Hard time paying attention

Hard time listening

Threatened other people

You lied or conned to get things

Have you hit someone

Tried to Hide AOD Use

Fam/co-workers complain about use

Used AOD weekly

Kept using though got you in trouble

Spent lot of time getting/using AOD

Internalizing Disorder Screener

Externalizing Disorder Screener

Substance Disorder Screener

ADM Pilot (n=1469) Triaged by Severity

69%

77%

83%

52%

25%

21%

16%

32%

7%

17%

1%

2%

0% 20% 40% 60% 80% 100%

Internal Disorder

External Disorder

Substance UseDisorder

Total DisorderScreener

Low Moderate High

Source: Collected as part of ADM health risk assessments from 11/05 to 8/06; Total Disorder Screener is based on 14 of 20 GSS items (one item in the internal not asked, and the violence and crime screener were not asked).

Workman’s Comp Claims Paid ($138,362 total)in the Next 12 Months by Individual (n=44)

The first 22 (50%) of the people were responsible for less

than 5% of the claims

The top 4 people (10%) were

responsible for 50% of the claims

The top 9 people (20%) were

responsible for 83% of the claims

Source: ADM Pilot (n=44 with claims; 3% of 1469)

Percent with High Cost (>$6900) Workman’s Comp Claims in the 12 months before and after screening by Severity

Source: ADM Pilot (n=1469)

0.0%

0.4%

0.7%

1.3%

0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

1.8%

2.0%

Before After Before After

Low (n=761) Mod/High (n=708)

1.4 Odds Ratio of Increase in High Cost Claims

Hours Absent (72,576 Total)in the Next 12 Months by Individual (n=429)

The first 210 (50%) of the people were responsible for less

than 17% of the hours

The top 44 people (10%)

were responsible for 37% of the hours

The top 86 people (20%) were

responsible for 53% of the hours

Source: ADM Pilot (n=429 with hours; 29% of 1469)

Percent with Hours Absent (>284 hours/year) in the 12 months before and after screening by Severity

Source: ADM Pilot (n=1469)

2.6%

3.3%3.1%

5.2%

0%

1%

2%

3%

4%

5%

6%

Before After Before After

Low (n=761) Mod/High (n=708)

3.3 Odds Ratio of Increase in % highly absent

76%

90%

35%

82%

31%

15%

3%

8%

14%

17%

9%

53%

4%

7%

56%

0% 20% 40% 60% 80% 100%

Internal Disorder

External Disorder

Substance UseDisorder

Violence and Crime

Total DisorderScreener

Low Moderate High

Clinical Sample of Workers 12 Months AfterSA Treatment (n=115)

Source: ERI (Dennis & Scott) Interviews conducted between 1/05 and 5/05

$0

$3,000

$6,000

$9,000

$12,000

$15,000

$18,000

$21,000

$24,000

$27,000

$30,000

$33,000

Low (0) Moderate (1-2) High (3+)

$0

$3,000

$6,000

$9,000

$12,000

$15,000

$18,000

$21,000

$24,000

$27,000

$30,000

$33,000

Costs of Service Utilization in the NEXT 12 Months by Total Disorder Screener (n=115)

Source: ERI (Dennis & Scott) Interviews conducted between 1/05 and 5/05; p<.05

Each has a sharp right

skew

Higher Median Costs