"At least five males in the Lexington workforce completed suicide as a result of untreated depression during my last ten years as an employer assistance program (EAP) therapist. In addition to loss of life, I witnessed the loss of hundreds of days and thousands of hours of productivity to the local business community. At the EAP, my colleagues and I were routinely first on the scene in diagnosing this disabling illness. Scenarios of needless suffering throughout the workplace hierarchy were revealed as clients described their fears about seeking help. Many had tried to "go it alone," not realizing that an episode of "feeling down" had deepened into clinical depression. Others were worried about being perceived as "weak" or "crazy," particularly in the workplace where repercussions could damage an established career. Some entered treatment through the side door of a mandatory referral, dispatched by the workplace to correct a work performance problem that in reality stemmed from depression. Many simply did not know where to go or were daunted by the cost of accessing medical benefits.
Treatment at the EAP involved a three-pronged approach: (1) prompt relief of suffering with an effective regimen of medication, education and counseling; (2) rapid return to work; and (3) collaboration with the employer to facilitate accommodations necessary for full recovery, such as short-term disability. This evidence-based model enabled the majority of depressed employees to return to full productivity at work within two to four weeks, symptom-free. Unfortunately, the magnitude of the problem is not captured in service reports prepared for organizational customers. According to Tom Wallace, marketing director at the Behavioral Medicine Network, cases of depression are rolled into medical benefits, thus rendering the problem invisible in the year-end EAP summary.
Nationally ranked companies such as Bank One have implemented depression-specific programs to facilitate early detection, decrease stigma and expedite access to treatment. The most powerful common denominator is an online screening tool that permits employees and their family members to easily perform confidential self-assessments. Passionate endorsements credit these online screens with literally saving lives and demonstrate the critical importance of this feature to the success of the model.
None of the companies surveyed for this article offered online screening or a specific program targeting depression, but the EAP was cited as a reliable safety net when managers note changes in employee behavior. Carole Owen, HR director for Bluegrass Family Health, reports that managers recommend the EAP when they observe differences in an employee's behavior at work. "We might notice that an employee seems down — maybe more withdrawn than usual. We let them know that the EAP is available and that it's OK to get help."
She added that the EAP provides educational information on depression at health fairs. Jim Green, HR director of the Lexington Herald-Leader, also described the EAP as a resource: "We have a close relationship with our EAP and act quickly when an employee is in crisis. Also, we have developed a culture where asking for help and getting treatment for our employees is a common practice."
Betty Spohn, director of business services at the Behavioral Medicine Network, commented on the status of depression as a business issue: "Wellness programs are on the increase, but remain targeted to physical well-being, which clearly impacts medical claims. We haven't achieved parity for mental health, but I see hope that business is moving in this direction." She identified a growing trend for HR personnel to collaborate with wellness coordinators in identifying critical workplace issues.
"I definitely think this partnership shows promise for bringing mental health issues into the foreground," she said.
Spohn also validated the effectiveness of an EAP in diagnosing depressed employees, regardless of the employer's level of awareness. "From the HR perspective, your focus is on behavior, and you refer to the EAP to get the employee back on track," she said.
Spohn described effective, low-cost measures available to all companies. She stated that BMN always includes educational materials on depression at health fairs, including an excellent brochure from NIMH on men and depression. "This one is so popular that we always run out of copies by the end of the day," she said. She also recommended paycheck stuffers and company-wide e-mails.
In closing, Green acknowledged the need for more education of the whole workforce about depression. "Depression impacts all Kentucky workplaces every day, and we need to do a better job of dealing with it before it becomes a crisis."
The World Health Organization predicts that depression will be on the rise through the next decade. Given the availability of local resources and strong national models, Lexington's workplace has an excellent opportunity to step up to the plate. "