In a study report in the September 26 issue of JAMA it was revealed that workers who suffered from depression but took part in a program that included telephone outreach involvement seemed to eventually have fewer symptoms, worked longer hours and retained their jobs longer than other participants who received the usual care but not the telephone care treatment. Not only was there an improvement in their mental health but they showed greater productivity.
The report also refers to other studies that also present depression as one of the most expensive health problems for business managers and owners what with depression costing the US economy tens of billions of dollars in lost productivity alone!
From the National Institute of Mental Health, Rockville, Md, Dr. Philip S. Wang and team studied the effects of such an outreach-treatment program. They observed the effect it had on depression symptom relief, on job retention, sick leave and the rate of increased work productivity.
In a randomized controlled trial, 604 employees from 18 different companies were scrutinized and 304 of them who suffered from depression received further treatment which involved the telephone counseling besides their psychotherapy and normal medication. The other 300 subjects were given the usual care. They were then observed.
At the end of six months and at the end of a year the scientists discovered that depression was far less in those receiving intervention than those receiving the normal care-26.6% of those in the intervention group experienced recovery, compared to 17.7% in the usual care group- and that such subjects were more apt to recover.
There was a higher rate of job retention (92.6 percent vs. 88.0 percent) and the hours they worked were also noticeably higher in the intervention group than in the usual care group. They worked longer hours than the others, an average of two extra hours each week. This worked out to more than two weeks of work for a year.
The researchers reported, “The results suggest that enhanced depression care of workers has benefits not only on clinical outcomes but also on workplace outcomes. The financial value of the latter to employers in terms of recovered hiring, training, and salary costs suggests that many employers would experience a positive return on investment from outreach and enhanced treatment of depressed workers.”
It has been noted that in spite of various successful treatments many employees suffering from depression either do not receive them or are treated ineffectually. Bosses who buy corporate health benefits rarely consider enhanced depression screening-treatment programs as part of the package because the ROI for such programs is intangible.
Therefore the view points of, Kenneth B. Wells, M.D., M.P.H., and the Los Angeles University of California's Jeanne Miranda, Ph.D., in an accompanying editorial are interesting. "The monetary value of the increased work time under the program exceeded the direct intervention costs and likely exceeded or was within the range of cost increases due to greater mental health specialty use under the intervention," they said.
Dr. Wang and colleagues acknowledged that their study had limitations in that the depression screening instrument used by them could possibly have misclassified some patients. They also acknowledged that the WHO Health and Productively Questionnaire could possibly have been systematically biased.
Professor of psychiatry, epidemiology and public health at the University of Miami Miller School of Medicine, Dr. Ewald Horwath, described the study finding "extremely significant, because it demonstrates that an intervention which improved access to care for depression not only improves outcome for depression but also work performance.”
