A study led by a Johns Hopkins
School of Medicine psychiatrist highlights the toll
anxiety and depressive disorders exact on workplace
performance and profits, and points to employer-guaranteed
specialized psychiatric care as both cost-effective and
humane.
According to the report in the Nov. 10 issue of the
Journal of Occupational and Environmental Medicine,
employees with anxiety and depressive disorders work fewer
hours, are more likely to end up on disability and are less
productive than their counterparts without these
disorders.
The study further shows that anxiety and/or depression
complicate other medical conditions and seem to have a
ripple effect in the work setting, creating low morale
among co-workers and a higher turnover rate.
Lead author Alan Langlieb, an assistant professor of
psychiatry at Johns Hopkins, examined
more than 100 published studies exploring how mental
illness affects the workplace.
"After reviewing and analyzing the literature, it is
clear that we have reached a tipping point," Langlieb said.
"It is now pretty much indisputable that depression and
anxiety in the workplace are an enormous expense to
employers in terms of health care costs and
productivity."
Evidence shows that one in every 20 Americans will be
depressed in a given year and that major depression will be
the second leading cause of disability in the year 2020,
Langlieb said. Anxiety disorders, he said, will affect 29
percent of Americans in their lifetime.
"Anxiety and depressive disorders, which often go hand
in hand, create tremendous social and economic burdens on
our society. They can be as debilitating as any major
chronic illness," Langlieb said.
It is estimated that the United States spent $83.1
billion in 2000 for costs associated with depression and
$63.1 billion in 1998 for costs associated with anxiety
disorders, the most recent years for which statistics are
available. Langlieb said that such costs include not only
direct health care but also "indirect" costs stemming from
suicide, increased medical morbidity, reduced adherence to
outpatient treatment leading to relapse and
hospitalization, lost wages caused by missed work and
decreased workplace productivity.
Langlieb cited a 1998 study of more than 46,000
employees, which estimated that each employee with
depression generated $3,189 in annual health care costs
compared with $1,679 annually for non-mental-health
illnesses. If depressed employees also were under high
stress, the cost skyrocketed: 147 percent more was spent on
health care for these individuals than on those with
depression alone.
Langlieb said the best way to combat these costs is to
guarantee that employees have access to quality,
specialized psychiatric evaluations. "Studies are showing
that if you start with a comprehensive psychiatric
evaluation and create a treatment plan that might then
involve psychologists, primary care and/or social work,
employees will have less disability, greater work
productivity and improved quality of life compared with
those who received evaluation and treatment solely by a
primary care provider."
Langlieb said quality treatment might be more
expensive in the short term, but the long-term benefits
clearly outweigh the initial treatment costs. "The old
adage that you get what you pay for applies here," he
said.
Jeffrey P. Kahn, of the Weill Medical College of
Cornell University, contributed to the study. Langlieb and
Kahn are co-editors of a book titled Mental Health and
Productivity in the Workplace: A Handbook for Organizations
and Clinicians.