Disabled by depression - study analyzes costs, causes

October 31, 1999

ANN ARBOR---Depression in the work place has long been recognized as a costly illness for business. Until depression became the focus of research, occupational health programs primarily focused on common physical illnesses, but not depression, which is known to be one of the most expensive costs for business.

In a review of studies that focuses on the factors of depression and the cost of depression it the work place, Reg A. Williams, associate professor of nursing at the University of Michigan, identifies the costs and signs of depression in an article published in this month's issue of the American Association of Occupational Health Nurses Journal (AAOHN Journal). The article is co-authored by Patricia Strasser, U-M adjunct assistant professor of nursing and president of Partners in BusinessHealth Solutions in Toledo, Ohio.

"Occupational health nurses are seeing more people who suffer from depression in the work place and they don't feel prepared to manage it because up until recently, depression in the work place hasn't been a focus of work-place health," Williams said.

In recent years, employees have increasingly sought and been granted workers' compensation for psychological injuries, such as depression, thereby adding weight to the argument that depression is a legitimate work-related health problem. But because of the negative stigma attached to depression, in many cases, theillness goes untreated and that can be costly, Williams said.

"The indirect and direct cost of depression in the work place is immense. Consider the loss of employee productivity. Productivity and absenteeism losses associated with depression cost U.S. companies $24 billion annually, or about $3,000 a year per depressed employee," he said. The total cost of depression at work is estimated to be as high as $44 billion.

Williams points out that health-care workers in the work place focus much attention on the risk factors for heart disease, cancer, obesity and other illnesses, but place little emphasis on the risk factors for depression, which are: stress or negative change in personal life; negative changes in the work environment; difficulties in interpersonal relationships; working excessively long hours without a break; added responsibility; family history of depression; among other factors.

Work-place depression and depression in general are on the rise, Williams said. In the United States, estimates show that 17.6 million people will have an episode of depression each year and one out of five people will suffer from a mood disorder, such as depression, in their lifetime. According to the World Health Organization, depression is the fourth leading cause of disease burden in the world, which is the first time a psychiatric illness is considered a disease burden. By 2020, it is expected to be the second leading cause of disease burden.

Williams cites a study in which depression is the most expensive medical cost of all behavioral health conditions accounting for 52 percent of all claims of one major company. It was the most common diagnoses of those who sought help from the company's employee assistance program; it resulted in more days of disability and 12 month recidivism than employees who suffered from common chronic illnesses, such as heart disease, diabetes and back pain.

"People's awareness of how profound depression in the work place can be is starting to rise. The impact on employee performance is incredible, yet this is a highly treatable illness," Williams said.

Symptoms of depression in the work place include: employee is off work longer than the company allows for disability; loss of concentration; reduced productivity; loss of interest in work; withdrawn from colleagues; irritability; excessively late to work; high absenteeism; cannot reach employee by phone.

Williams is an R.N. whose research focuses on depression. He also holds a Ph.D. in higher education; master's degree in psychosocial nursing, CS (certification as a clinical specialist in adult psychiatric and mental health nursing), and is a Fellow of the American Academy of Nursing.
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University of Michigan

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