context of depression and employment
TRANSCRIPT
CONTEXT OF DEPRESSION AND EMPLOYMENT
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Depression in the workplace
• By far, the greatest contributor to the overall economic impact of depression is loss in productivity…. but
• Beliefs reported by employers (survey of 500 UK employers) – 44% thought employees ‘suffering from stress are able to work effectively at
all time points
– 42% thought workplace policies for mental health / stress were designed to avoid litigation
• Global INDIGO survey (35 countries) showed 71% of people with depression conceal their diagnosis in the workplace
• Public stigma and workplace culture may influence both openness and disclosure and productivity
2 Lasalvia, et al., 2013 Lancet; Henderson et al. 2013 BJP
DO WE STILL STIGMATISE PEOPLE WITH DEPRESSION?
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Social distance
Schomerus et al., 2012
National policies Country benefits scheme (replacement ratio OECD)
National policies Country benefits scheme (replacement ratio OECD)
Probability of rejecting a person with depression for a job, by employment status
Angermeyer, M., Matschinger H., Schomerus, G., SPPE, 2013
0
5
10
15
20
2006 2010
% u
ne
mp
loye
d
No mental healthproblems
Mental healthproblems
Recession, unemployment, stigma (EU)
Source: Evans-Lacko, Knapp, McCrone, Thornicroft, Mojtabai PLOS ONE 2013
Recession widened the gap in
unemployment rates between
individuals with and without MH
problems …
The disadvantage facing people with mental health problems is greater in countries with higher levels of stigmatizing attitudes towards mental illness.
Study aims
Study 1 (7 European countries):
• To investigate individual, workplace and societal factors associated with
• greater perceived discomfort in relation to depression in the workplace
• greater likelihood of employees with depression taking time off work,
• greater likelihood of employees disclosing depression to employer
Study 2 (16 diverse countries)
• Describe the relationship between disclosure of depression / manager responses and workplace productivity
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SURVEY AND METHODS
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Data source
• Global IDEA survey (Impact of Depression in the Workplace Audit) survey
• Participants were recruited through an online market research panel
• 16 diverse countries • 7 European countries: Denmark, France, Germany, Italy, Spain, UK,
Turkey
• 9 additional countries: Brazil, Canada, China, Japan, South Korea, Mexico, South Africa, USA
• 1,000 respondents / country who were in employment
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Measures
Employee variables • Sociodemograhics (age, gender, education, marital status, working status) • Previous diagnosis of depression
Among employees with a diagnosis of depression
• Openness and disclosure--didn’t tell manager because of (i) fear of losing job / economic climate and (ii) felt manager wouldn’t understand / know what to do
• Presenteeism & absenteeism (WHO Health and Work Performance Questionnaire)
Manager responses in relation to depression • Offered help to employee • Avoided talking about it • No support offered to managers in dealing with depression • Encouraged them to talk to a healthcare professional
National policies
– Country benefits scheme (replacement ratio OECD)
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Analysis
• Multivariable logistic regression models investigated factors associated with relevant outcomes
• Country contextual characteristics were computed as an average rating for each country across respondents, and each variable was standardized (i.e., z score was computed)
• GEE parameter estimates to model within country correlations
• Post-stratification weights, based on gender, age and region, which were aligned with nationally representative figures, were used in all analyses.
RESULTS: STUDY 1
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Individual
Workplace
Country level
Likelihood of taking time off
Likelihood of disclosure to employer
Perceived discomfort regarding depression in the workplace
Aims
Participant characteristics (n=7,065)
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20% of employed respondents reported a previous diagnosis of depression
Employees who reported a diagnosis were more likely to be:
• Female
• Divorced
• Working part time
• In the middle or older age groups
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Country / Population level
variable Individual level variable
0.7
0.73
1.55
2.08
1.03
0 0.5 1 1.5 2 2.5
Female gender
Offered help
Offered flexible working pattern
Avoided talking about it
Replacement ratio
Odds ratio
Employees feeling uncomfortable
Greater than 1 represents a greater likelihood of discomfort
Likelihood of taking time off work for employees with depression
Population level variable Individual level variable
0.75
0.75
0.58
1.21
0.34
0.95
0 0.2 0.4 0.6 0.8 1 1.2 1.4
University education
Offered help
Offered flexible working pattern
Encouraged talking to healthcareprof.
Avoided talking about it
Replacement ratio
Greater than 1 represents a greater likelihood of discomfort
Likelihood of disclosure to an employer
Population level variable Individual level variable
1.49
3.06
2.05
0.5
1.31
2.16
0.5
0.59
1.02
0 0.5 1 1.5 2 2.5 3 3.5
Female gender
Older age (45-54 relative to 16-24)
Middle age (25-44 relative to 16-24)
University education
Working in a larger company
Offered help
Offered flexible working pattern
Encouraged talking to healthcare prof.
Replacement ratio
Greater than 1
represents a
greater likelihood
of discomfort
Summary
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The experience of having and coping with depression in the workplace varies across Europe
Both individual and sociocultural factors are associated with how people with
depression are perceived and treated in the workplace Managers and organisations play an important role in supporting employees
with depression Structural factors / benefits and offering flexible working hours can be helpful,
but are not necessarily the best strategy—especially in isolation. A better option is for managers to offer direct help to depressed employees. Avoiding employees with depression only adds to ignorance
Results: Study 2
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Individual
Workplace
Country level
Presenteeism
Absenteeism
Aims
HOW DO THESE FACTORS RELATE TO PRODUCTIVITY
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0 0.5 1 1.5 2 2.5
Avoid talking about it
Offered help
No manager support
Fear losing job
Employer wouldn't understand
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Country / Population
variable
Individual level variable
Factors associated with absenteeism
Greater than 1
represents a
greater likelihood
of absenteeism
Controlled for: gender, age, education, country prevalence depression, GDP
*
*
*
*
0 0.2 0.4 0.6 0.8 1 1.2 1.4
Avoid talking about it
Offered help
No manager support
Fear losing job
Employer wouldn't understand
Factors associated with presenteeism (subset of 8 countries) among employees with depression
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Country / Population level
variable
Individual level variable
Greater than
1 represents
a greater
likelihood of
presenteeism
Controlled for: gender, age, education, prevalence depression, GDP
*
*
*
*
Summary & Conclusions
• Depression is a significant issue among workplaces worldwide. • There is substantial variation across countries in terms of openness
around depression and also comfort and knowledge of managers on how to deal with depression in the workplace.
• Manager responses and workplace culture have significant consequences for productivity
• More openness and an environment where mangers can feel comfortable to offer help and support the employee rather than avoid them is associated with less absenteeism and more presenteeism.
• Further support for managers to directly help employees and
support to help employees feel open and comfortable to discuss mental health issues are needed
Acknowledgments
Co-authors: Martin Knapp
Funding for the data collection was provided by the European Depression Association and Lundbeck. The funders had no role in study design, data collection and analysis or decision to publish.
GB
Denmark
France
Germany
GB
Italy
Spain
Turkey
Employee characteristics
Dx depression
Female 21% 23% 24% 36% 17% 26% 32%
Male 18% 16% 15% 19% 9% 18% 19%
Days off work
0 52% 51% 44% 47% 57% 53% 77%
1-10 14% 13% 10% 14% 24% 17% 7%
11-20 8% 12% 14% 8% 8% 6% 4%
20+ 26% 24% 32% 32% 12% 23% 12%
Manager reactions
Offered help 51% 45% 39% 53% 40% 56% 55%
Flexible working 13% 10% 9% 12% 8% 9% 14%
Encouraged talk to health prof
30% 42% 28% 40% 39% 45% 36%
Avoid talking 2% 5% 8% 3% 12% 6% 9%