depression in the workplace detailed analysis final (2016 ... survey detailed analysis.pdf ·...
TRANSCRIPT
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
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 4
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)
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 5
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)
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 6
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
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 7
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)
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 8
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
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 9
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?
Depression in the Workplace: Detailed Analysis of TBGH’s 2016 Survey of Texas Employers Page 11
businesscostsrelatedtoproductivity,absenteeism,andturnover;andimprovequalityoflifeforemployeesandtheirfamilieswhoareaffectedbydepression.Inaddition,executiveleadershipissupportiveoftakingstepstoimprovetheavailability,affordability,andqualityofcarefordepressiontreatmenttoaddresstheseconcerns.Inlightofthesefindings,theTexasBusinessGrouponHealthandtheMeadowsMentalHealthPolicyInstituteareexploringopportunitiestocollaboratewithTexasemployerstosharetimelyandusefulinformation,includingbestpracticesfordesigningandcommunicatingbenefitplansandprogramsthatimproveoverallproductivity,generalhealth,andqualityoflifeforemployeesandtheirfamilies.