Known for his balanced, engaging personality, Jackson seems to handle everything that comes his way without any undue stress. When Jackson started to have difficulty sleeping, a loss of appetite and difficulty concentrating, no one knew what to make of it, but the last thing they suspected was depression. Unfortunately, Jackson was not treated for his depression until he had suffered needlessly and his department lost many of the gains that they had attained under his leadership.
Prevalence of Depression and Anxiety
Jackson’s story is not atypical in today’s workplace. In fact, mental health issues related to anxiety and depression are so prevalent that they should be considered more critical concerns than work-related injuries such as carpal tunnel and back strain or health issues such as asthma and diabetes, which are more commonly on the radar screen of employers, according to Alan M. Langlieb, MD, MPH, MBA. Langlieb who has recently co-authored a study, How Much Does Quality Mental Health Care Profit Employers? has been investigating workforce and mental health issues for the last 30 years. It is Langlieb’s passionate hope that more employers will come to understand that screening their employees for depression and anxiety along with providing high quality treatment is a proactive measure that translates to profits on the bottom line.
Statistical data about the prevalence of depression and anxiety among Americans is alarming. A recent study by the National Institute of Mental Health estimates that 1 in 20 American adults will be depressed in any given year. The World Health Organization predicts that major depression will be the second leading cause of disability by the year 2020.2 Depression has been estimated to affect 18.8 million Americans each year. Anxiety has been estimated to affect 29% of Americans in their lifetime. Depression and anxiety cross all social strata and all organization levels. Employers can safely assume that the experience of the general population with depression and anxiety will apply to their organizations, and therefore is something they shouldn’t ignore.
High Cost to Employers
How much does failing to pay attention to depression and anxiety in the workforce cost employers? A 1998 study of more than 46,000 employees by the Health Enhancement Research Organization (HERO) estimated that each employee with depression generated $3189 annually in health care costs, compared with $1679 annually for nondepressed employees. If the depressed employees also were under high stress, then the costs skyrocketed and 147% more was spent on health care costs for those employees than on those with depression alone. Clearly, the cost associated with treating these illnesses is significant.
So what dollar savings can employers expect to realize if they treat their employees with depression and anxiety beyond having a healthier workforce? Langlieb suggests that “if you look at the savings, in terms of increased time at work, less time out on disability, improved productivity and some of the other indirect measures of job satisfaction, it is quite evident that the savings outweigh the costs. Obviously there is a cost to treat and provide quality care, but the savings more than pay for themselves.”
It has been estimated that United States employers spend $33 billion per year as a result of work and productivity loss from depression. The cost of treating depression is only $1 out of $4—with $3 dollars resulting from lost productivity, earnings and workdays. A recent study compared the cost of lost earnings from employees with depression with the cost of treating employees with depression and concluded that the cost of treatment for depression was fully offset by the savings from the reduction of lost workdays alone. When measured in regained earnings, depression treatment actually provided a net annual profit of $877 per patient. Says Langlieb, “So when you factor in the number of days depressed people stay out of work, and the fact that when they are at work they are not functioning up to speed, there is an enormous cost to the organization.”
Opportunities for Social Workers
These data make a compelling argument that every organization should both screen and identify depressed and anxious employees and provide quality treatment from a professional. By doing so, the organization will be supporting the health of its employees, improving productivity and generating profit that goes to the bottom line.
Understanding the value of treating depressed and anxious employees in the general workforce creates important opportunities for social workers. Social workers have a critical role in getting the word out about the prevalence of depression and anxiety in the workforce as well as the benefits of treatment. Social workers also have a role to play in developing and administering screening tools for employees in the workplace and participating in the treatment of these employees.
Best Practices in Organizations
Langlieb suggests that there are many organizations that are doing a better and better job addressing mental health issues, including depression and anxiety. Activities that these organizations have found helpful, include: holding mental health awareness days; making employee assistance programs available to do some initial evaluations on site; accessing on-line resources to support the organization becoming better educated on these issues; employing screening tools that can be done at an office desk. All of these activities are feasible without excessive effort and with only minimal cost. They help break down barriers resulting from stigma and create a culture where employees feel comfortable coming forward to identify a fellow worker who may be suffering from depression or anxiety.
Depression and anxiety are facts of life for a significant percent of the workforce in America. The good news is that these mental health problems do not need to be devastating for either the individual or the organization. Early identification and quality treatment of depression and anxiety turn out to be a win-win–cost effective for the organization and supportive of the employee’s mental health.
 Langlieb A M, Kahn JP. How much does quality mental health care profit employers? Journal of Occupational and Environmental Medicine. 2005; 47: 1099-1109.
 Depression can break your heart. NIMH 2001. Available at: www.nimh.nih.gov/publicat/heartbreak.cfrm#5; Internet accessed July 7, 2005.
 Depression. NIMH 2004. Available at http://www.nimh.nih.gov.publicat/depression.cfm; Internet; accessed July 7, 2005.
 Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005; 62: 593-602.
 Goetzel RZ, Ozminkowski RJ, Sederer LI, Mark TL. The business case for quality mental health services: why employers should care about the mental health and well-being of their employees. J Occup Environ Med. 2002;44:320-330.
 Greenberg PE, Kessler RC, Nells TL, Finkelstein SN, Berndt ER. Depression in the workplace: an economic perspective. In: Feighner JP, Boyer WF, eds. Selective Serotonin Re-uptake Inhibitors: Advances in Basic Research and Clinical Practice. New York: Wiley & Sons; 1996:327-363.
 Zhang M, Rost KM, Fortney JC. Earnings changes for depressed individuals treated by mental health specialists. Am J Psychiatry. 1999; 156:108-114.