Benefits to employers outweigh enhanced depression-care costs

December 04, 2006

It may be in society's and employers' best interests to offer programs that actively seek out and treat depression in the workforce, suggests an analysis funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH). A simulation based on dozens of studies revealed that providing a minimal level of enhanced care for employees' depression would result in a cumulative savings to employers of $2,898 per 1,000 workers over 5 years. Even though the intervention would initially increase use of mental health services, it ultimately would save employers money, by reducing absenteeism and employee turnover costs, according to Drs. Philip Wang and Ronald Kessler, of Harvard University, and colleagues, who report on their findings in the December 2006 issue of the Archives of General Psychiatry.

"Depression exacts economic costs totaling tens of billions of dollars annually in the United States, mostly from lost work productivity," noted Wang. "Yet we're not making the most of available services and treatments. Our study calculates what employers' return on their investment would be if they purchased enhanced depression treatment programs for their workers."

The analysis simulated an enhanced intervention in which master's-level health professionals managed the care of a hypothetical group of 40-year-old depressed workers diagnosed with depression. In this scenario, after assessments had detected the workers' depression, the care managers did further assessments and, when necessary, referred the workers for treatment in this scenario. The researchers gauged the cost-effectiveness for society and cost-benefit to employers, using data from existing trials and epidemiological studies, including the National Co-morbidity Survey Replication, a nationally representative household survey of 9,282 U.S. adults, conducted in 2001-2003.

The hypothetical workers were assigned to either the enhanced care or "usual care" - care-seeking and treatment patterns that would normally occur in the absence of care management. For both groups, treatment was defined in terms of visits to either a primary care physician or a psychiatrist who prescribed an antidepressant. Every three months, the hypothetical workers' illness status could change, based on depression prevalence, remission and ongoing treatment rates, and the probabilities of various outcomes, including increased risk of death by suicide.

Using results of recent primary care effectiveness trials, the researchers estimated how successful care managers might be in helping workers seek out and adhere to adequate treatment regimens. While the cost-benefit analysis from employers' perspectives weighed only monetary factors, quality of life figured into the cost-effectiveness to society calculation.

Savings from reduced absenteeism and employee turnover and other benefits of the intervention began to exceed the costs of the program by the second year, yielding a net savings of $4,633 per 1,000 workers. These savings were somewhat reduced in years 3 through 5, based on conservative assumptions that benefits wane after care management ceases, while increased use of treatments continues. The intervention became more expensive than usual care (no workplace depression management) when there was greater use of psychiatrists (instead of primary care doctors) or brand-name (instead of generic) drugs. It also ceased to be cost-saving if employees spent more than 4 hours of work time in treatment per 3-month cycle. Enhanced care had the most benefit in cases of higher-level employees who influenced the productivity of co-workers.

The intervention yielded gains when the simulated costs for care were consistent with those charged in the real world, suggesting that providing such programs for workers "appears to be a good investment of society's resources," say the researchers. It will be important to see if the findings are replicated in effectiveness trials that directly assess the intervention's impact on work outcomes, they added.
-end-
EMBARGOED For release December 4, 2006, 4:00 PM ET

Also participating in the study were Amanda Patrick, Dr. Jerry Avorn, Brigham and Women's Hospital; Dr. Francisca Azocar, Joyce McCulloch, United Behavioral Health; Dr. Evette Ludman, Dr. Gregory Simon, Group Health Cooperative.

The research was also supported by the Robert Wood Johnson Foundation.

NIMH is part of the National Institutes of Health (NIH), the Federal Government's primary agency for biomedical and behavioral research. NIH is a component of the U.S. Department of Health and Human Services.

NIH/National Institute of Mental Health

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.