Depression in the Workplace Detailed Analysis FINAL (2016 ... Survey Detailed Analysis.pdf ·...
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Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers November 28, 2016
Transcript of Depression in the Workplace Detailed Analysis FINAL (2016 ... Survey Detailed Analysis.pdf ·...
Depression in the Workplace: Detailed Analysis of TBGH’s 2016
Survey of Texas Employers
November28,2016
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers
Contents
Introduction...........................................................................................................................1
OverviewofDepressionintheTexasWorkplace....................................................................1
KeySurveyFindings....................................................................................................................2
DescriptiveAnalyses...................................................................................................................2
Summary...............................................................................................................................10
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 1
Introduction TheDepressionintheWorkplaceSurveywasconductedbytheTexasBusinessGrouponHealthinthesummerof2016inpartnershipwiththeMeadowsMentalHealthPolicyInstituteandwithpromotionalassistancefromtheDallas-FortWorthBusinessGrouponHealth,HoustonBusinessCoalitiononHealth,MentalHealthAmericaofGreaterHouston,andTexasAssociationofBusiness.Thisdocumentservesasareportofthesurveyfindingsrelatedtocurrentpolicies,practices,andstrategiesofTexasemployerstoaddressuntreatedandinadequatelytreateddepressionintheworkplace.ThereportincludesadescriptiveanalysissummarizingthecharacteristicsandperceptionsofparticipatingTexasemployers.Overview of Depression in the Texas Workplace DepressionisacommonbutseriousillnessexperiencedbyoneinfiveAmericanadultsintheirlifetime.1About7.5%oftheU.S.workforcehasdepressioninanyyear,2costingU.S.employersapproximately$187.8billionayear.3Thistotalreflectsbothlostproductivityduetoabsenteeism(misseddaysfromwork)andpresenteeism(reducedproductivitywhileatwork),aswellasincreasedhealthandmentalhealthcostsexacerbatedbyuntreateddepression.Untreateddepressioncanincreasethelikelihoodofanotherhealthcondition.Individualswithbothdepressionandanadditionalmedicalconditionexperiencegreaterdistress,increasedfunctionalimpairment,andarelessabletofollowmedicaltreatmentplans.Forexample,diabeticpatientswithsymptomsofdepressionarelesslikelytoadheretodietaryrestrictionsormedicalregimens,andmorelikelytousetheemergencyroomorinpatientsettings.4
1Kessler,R.C.,etal.(2005).Lifetimeprevalenceandage-of-onsetdistributionsofDSM-IVdisordersintheNationalComorbiditySurveyReplication.ArchivesofGeneralPsychiatry,62,593-603.Formajordepressionalone,thechanceofhavingthediagnosisatsomepointinone’slifeisoneinsix.2Kessler,RC,Merikangas,R.,&Wang,P.(April2008).TheprevalenceandcorrelatesofworkplacedepressionintheNationalComorbiditySurveyReplication.JournalofOccupationalandEnvironmentalMedicine,50(4):381–390.3Mrazek,D.A.,Hornberger,J.C.,Altar,C.A.,&Degtiar,I.(2014).Areviewoftheclinical,economicandsocietalburdenoftreatment-resistantdepression1996-2013.PsychiatricServices,65(8).Mrazeketal’scostanalysisincludedfouremployer/privatepayerclaimsdatabasesandoneMedicareclaimsdatabase.Estimateswerebasedona12-monthprevalenceofdepressionin16,000,000adults;thepercentageofpeoplewithtreatmentresistantdepressionwas12%(conservatively);averagedirecthealthcarecostsforpeoplewithtreatmentresistantdepressionwere$13,196annually;averagedirecthealthcarecostsforpeoplewithtreatmentresponsivedepressionwas$7,715;averageproductivity-relatedcostswere$6,924and$2,876,respectively.4Ciechanowski,P.S.,Katon,W.J.,&Russo,J.E.(2000).Impactofdepressivesymptomsonadherence,function,andcosts.JAMAInternalMedicine,160(21).Retrievedfromhttp://archinte.jamanetwork.com/article.aspx?articleid=485556.
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 2
Researchindicatesthatlessthan22%ofpeoplewithdepressionreceiveadequatecare,prolongingaperson’ssufferingandunnecessarilyraisingemployers’costs.5Thegoodnewsisthattreatmentworks:morethan80%ofpeoplewithdepressionimprovesignificantlywithtimelyandappropriatetreatment.5
Key Survey Findings
KeyfindingsfromtheDepressionintheWorkplaceSurveyconductedinthesummerof2016includethefollowing:
• Morethan80%ofsurveyedTexasemployersbelievethatdepressionisanimportantissuewithasignificantormoderateimpactforemployers.
• Thethreemostfrequentlyreportedwaysthatuntreateddepressionimpactsthecorporateorganizationareproductivity,absenteeism,andmorale.
• Nearly90%thesurveyedemployersoffertraditionaldepressionbenefitsandanemployeeassistanceprogram(EAP).ManyTexasemployershaveeitheralreadyadoptedorwouldconsideradoptingoneormoreofthenew,evidence-basedstrategiestoimproveearlydiagnosisandeffectivetreatmentofdepression.
• Overone-third(36%)oftherespondentsbelievethatlackofawarenessaboutdepressionsymptomsandtreatmentisthemostsignificantbarrierthatpreventstimelyandeffectivetreatmentfordepression.
• Nearlyall(90%)respondentswhoexpressedanopinionthinkthattheirexecutiveleadershipteamislikelytosupportstepstoimprovetheavailability,affordability,andqualityofcarefordepression.
Benchmarkingsurveyslikethisprovidevaluablebaselineinformationtoemployersastheyrecognizethedevastatingimpactofuntreateddepressiononbothemployees,whooftensufferaloneandsilently,andontheorganizationsthatemploythem,whereproductivityandmoraleareadverselyaffected.TheTexasBusinessGrouponHealthwillcontinuetoprovideeducationalandactionableresourcesforemployerspertainingtotheincidenceandimpactofuntreateddepression. Descriptive Analyses
Summary
InAugust2016,theTexasBusinessGrouponHealthinvitedTexasbenefitsandhumanresourcesmanagerstoparticipateinanonlinesurveyofdepressionintheworkplace,whichwasdevelopedinpartnershipwithMeadowsMentalHealthPolicyInstitute.Descriptivefindingsfromthisreportprovideasummaryofthedemographics,characteristics,andperceptionsof135benefitsandhumanresourcemanagersinTexas.5Kessler,R.etal.(2003).Theepidemiologyofmajordepressivedisorder:ResultsfromtheNationalComorbidityStudyReplication(NCS-R).JournaloftheAmericanMedicalAssociation,289(23),3095-3105.
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 3
EmployerDemographics
Atotalof135individualsrespondedtotheDepressionintheWorkplaceSurvey.Mostrespondentsworkforemployersreportedtohavemorethan1,000employees.Welloverhalf(66%)oftheorganizationsidentifiedtheDallas/FortWorthareaastheirprimarylocationinTexas.Thesamplerepresentedacross-sectionofindustries;manufacturing,healthcare/socialassistance,transportation/warehousing,andfinance/insurancewerethemostcommon.
TotalRespondents
n=135
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%
Other
WestTexas
CentralTexas
Houston
Dallas/FortWorthPrimaryLocationinTexas
0% 4% 8% 12% 16% 20%
ManufacturingHealthcareandsocialassistanceTransportationandwarehousing
FinanceandinsurancePublicadministration
RetailtradeEducationalservices
Professional,scientificandtechnicalservicesMining
AccommodationandfoodservicesConstruction
Realestate,rentalandleasingUtilities
Agriculture,forestry,fishingandhuntingArts,entertainmentandrecreation
InformationIndustry
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ImpactofUntreatedDepressiononEmployeesandtheOrganization
Nearlyallemployersacknowledgedthatuntreateddepressionhasanimpactonemployees(94%)andtheorganization(92%).Overhalf(60%)ofthetotalsampleand68%oflargeemployers(definedasemployerswithmorethan10,000employees)indicatedthatuntreateddepressionhasasignificantimpactonemployees.Regardlessofsize,over80%ofemployersfeltthatuntreateddepressionhasamoderatetosignificantimpactontheirorganizationsandontheiremployees.
0%
10%
20%
30%
40%
50%
Morethan10,000 5,000-10,000 1,000-4,999 500-999 101-499 100orfewer
TotalEmployees
InTexas IntheU.S.
0%
20%
40%
60%
80%
100%
AnyImpact SignficantImpact ModerateImpact SlightImpact NoImpact IDon'tKnow
ImpactofDepressiononEmployeesandtheOrganization
OnEmployees(n=129) OntheOrganization(n=130)
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Employersindicatedthatuntreateddepressionisprimarilyimpactingtheirorganizationsintheareasofproductivity(98%),absenteeism(95%),andmorale(87%),while65%and56%(respectively)indicatedamedicalormentalhealthcarecostimpact.
0%
20%
40%
60%
80%
100%
AnyImpact SignficantImpact ModerateImpact SlightImpact NoImpact IDon'tKnow
ImpactofDepressiononEmployees:AllEmployersandLargeEmployers
AllEmployers(n=129) Employerswith>10,000Employees(n=25)
0%
20%
40%
60%
80%
100%
AnyImpact SignficantImpact ModerateImpact SlightImpact NoImpact IDon'tKnow
ImpactofDepressionontheOrganization:AllEmployersandLargeEmployers
AllEmployers(n=130) Employerswith>10,000Employees(n=26)
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GeneralDesignofEmployeeBenefitsforTreatmentofDepression
Mostorganizationsofferemployeesaccesstopreferredproviderorganizations(PPOs),healthmaintenanceorganizations(HMOs),orexclusiveproviderorganizations(EPOs)fortheirhealthbenefitsplans.Themostcommonbenefitsfordepressiontreatmentincludedoutpatientandinpatientcoverageformentalhealthconditions(90%),employeeassistanceprograms(EAPs;89%),andpaidtimeoff(PTO)fordisabilityduetodepression(39%).
Productivity Absenteeism Morale Medicalcare EmployeeTurnover
Mentalhealthcarecosts
n=133 97.7% 94.7% 87.2% 64.7% 57.9% 56.4%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%WaysUntreatedDepressionImpactsOrganizations
PPO HMO EPO Other Subsidizedenrollment
Indemnityplan None
n=118 81.4% 32.2% 21.2% 11.9% 4.2% 4.2% 5.1%
0.0%
15.0%
30.0%
45.0%
60.0%
75.0%
90.0%HealthBenefitsPlansSponsoredbyYourOrganization
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BarrierstoTimelyTreatmentofDepression
Texasemployersoverwhelminglyidentifiedlackofawarenessaboutdepressionsymptomsandtreatmentasthemostsignificantbarrierpreventingemployeesandtheirdependentsfromreceivingtreatment.Largeemployersweremorethantwiceaslikelythanallotheremployerstoidentifyaccess(e.g.,beingunabletofindaprovider,orhavingtowaittoolongtobeseen)asthemostsignificantbarriertotreatment.
Heathplancoveragefor
mentalhealth
conditions
EAPPTOfor
disabilityduetodepression
Healthplanwith
condition/care
managementformentalhealth
conditions
Healthplanwith
behavioral/mentalhealthbenefits
carved-outorcontractedw/specialtyprovideror
MCO
Healthplanthatallowsparticipation
inAccountableCareOrgs
Healthplanthat
promotesaCenterofExcellence
Other
n=118 89.8% 89.0% 39.0% 28.8% 15.3% 12.7% 3.4% 2.5%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
BenefitsAvailabletoYourEmployeesforTreatmentofDepression
0% 10% 20% 30% 40%
Idon'tknowNoneOther
MedicationsideeffectsDoubtsthatdepressiontreatmentworks
PrivacyconcernsCost
Access(e.g.,can'tfindprovider,waittimes)Inconvenience(e.g.,missingworkforappts)
Lackofawarenessaboutdepressionsymptoms…
MostSignificantBarriersPreventingEmployeesandDependentsfromGettingTimelyandEffectiveTreatmentforDepression
AllEmployers LargeEmployers(n=22)
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Overhalfofemployersreportedprovidingonlinelifestylecoachingandmentalhealthpromotionalmaterialsorseminarstoaddressbarrierstotreatment.Whileonly13%ofemployersarecurrentlyprovidingdepression-relatedtextorchatservices,17%wouldconsiderdoingsointhefuture.Inaddition,17-18%ofemployerswouldconsideraddingtelemedicineortelepsychiatryanddepression-relatededucationalseminarsormaterials.
Thereareresearch-basedstrategiesthatcanimprovethecost-effectivenessofdepressiontreatment,andTexasemployersareincorporatingsuchstrategiesintotheirbenefitstovariousdegrees.SurveyresultsalsosuggestedawillingnessofTexasemployerstoconsideradoptingadditionalevidence-based,cost-effectivestrategiesinthefuture.OverhalfofTexasemployers(53%)indicatedthattheirorganizationcurrentlycoversdepressionscreeningbyprimarycareproviders(PCPs),while43%providecarecoordinationand36%providetargetedtreatment(i.e.,adjustingthetreatmentplanbasedonsymptommeasures).Whilelessthantenpercentofemployerscurrentlyprovidecoverageforadministrationofoutcomemeasurementtoolsoroutcome-basedproviderreimbursement,over16%saidtheywouldconsidercoveringsuchservicesinthefuture.
0% 10% 20% 30% 40% 50% 60%
Text/chatdepression-relatedservices
Onsitementalhealth/EAP/wellnessservices
Telemedicine/telepsychiatry
Depression-relatededucationalseminarsormaterials
Mentalhealthpromotionalmaterialsandseminars
Onlinelifestylecoaching
DoYouProvideCoverageforAnyoftheFollowingServicesthatMayAddressCertainBarrierstoMentalHealthServices?
Yes Notnow,butwouldconsiderinthefuture
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n=108
EmployeePerceptionofDepressionBenefits
Nearly60%ofemployersreportedbeingunawareofhowsatisfiedemployeesarewiththequalityofcareandlevelofbenefitstheyreceivefordepressiontreatment.Amongthe40%whowereawareofemployeesatisfaction,62%indicatedtheiremployeesaresomewhatsatisfiedandanother21%indicatedtheiremployeesarecompletelysatisfied.Noemployersperceivedemployeestobecompletelydissatisfiedwiththeirdepressionbenefits.
EmployerPerception:EmployeeSatisfactionwiththeQualityofCareandLevelofBenefitsTheyReceivefortheTreatmentofDepression
0% 10% 20% 30% 40% 50% 60%
Outcomes-basedproviderreimbursement
Administrationofoutcomemeasurementtools
ClinicalconsultationsupportforPCPswhotreatdepression
Evidence-baseddepressioninterventions
Targetedtreatment(adjustingthetreatmentplanbasedonsymptommeasures)
Carecoordination
DepressionscreeningbyPCPs
BenefitsandTargetedStrategiestoImproveDepressionTreatment
Yes Notnow,butinthefuture
41%
59%
Otherresponses
Idon'tknow
0%
10%
20%
30%
40%
50%
60%
Completelysatisfied
Somewhatsatisfied
Somewhatdissatisfied
Completelydissatisfied
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 10
LeadershipRoleforMentalHealthIssues
Animpressivequarterofrespondentsbelievedthattheirexecutiveleadershipwouldsupportstepstoimprovetheavailability,affordability,andqualityofcarefordepressiontreatmentwithintheirorganization.Additionally,overtwo-thirds(71%)ofTexasemployersbelievedthattheirexecutiveleadershipwouldlikelysupportsuchefforts.Astheimpactofuntreateddepressiongainsmoreattention,employerswillbemakingimportantdecisionsabouttheirroleinmitigatingthecoststobusinessandorganizationalproductivity,improvingemployeewell-being,andsupportingcommunityhealth.
Summary ThesurveyresultsdemonstratethatTexasemployersrecognizethesignificantimpactthatuntreateddepressioncanhaveonboththeiremployeesandorganization.Decreasedproductivity,increasedabsenteeism,andlowermoralearethemostcommonconcerns,followedbyincreasedmedicalclaimscosts.Mostemployersidentifiedemployeelackofawarenessofsymptomsandtreatmentastheprimarybarriertoeffectivetreatmentfordepression,butlessthanhalfknewwhetheremployeesweresatisfiedwiththeirtreatmentoptionsorthequalityofcarereceived.ThemajorityofemployerssurveyedoffertraditionaldepressionbenefitsandanEAP,butlessthanathirdreportedcoveringevidenced-basedtreatmentsfordepression.Abouthalfofemployersreportedcoverageforprimarycarephysicians’(PCPs)depressionscreening,butonlyafifthcoveredclinicalconsultationforPCPstoeffectivelytreatdepression.Evenso,over70%ofrespondentsindicatedthattheirexecutiveleadershipwouldlikelysupporttakingstepstoimprovetheavailability,affordability,andqualityofcarefordepressiontreatment.Insummary,Texasemployersunderstandthesignificantimpactdepressioncanhaveonworkplaceproductivity,healthcarecosts,andemployeemorale.Employerswantprovenbenefitstrategiesthatreducehealthcarecosts;improvehealthcareoutcomes;decrease
Yes Probably No Idon'tknown=96 25.0% 45.8% 8.3% 20.8%
0.0%10.0%20.0%30.0%40.0%50.0%
Doyouthinkyourexecutiveteamleadershipwouldsupportstepstoimprovetheavailability,affordability,andqualityofcarefordepressiontreatment
withinyourorganization?
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businesscostsrelatedtoproductivity,absenteeism,andturnover;andimprovequalityoflifeforemployeesandtheirfamilieswhoareaffectedbydepression.Inaddition,executiveleadershipissupportiveoftakingstepstoimprovetheavailability,affordability,andqualityofcarefordepressiontreatmenttoaddresstheseconcerns.Inlightofthesefindings,theTexasBusinessGrouponHealthandtheMeadowsMentalHealthPolicyInstituteareexploringopportunitiestocollaboratewithTexasemployerstosharetimelyandusefulinformation,includingbestpracticesfordesigningandcommunicatingbenefitplansandprogramsthatimproveoverallproductivity,generalhealth,andqualityoflifeforemployeesandtheirfamilies.
