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Making the business case

November 1, 2007
by Mark Attridge, PhD
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Plenty of studies prove that employers should invest in their workers' mental well-being

Recent surveys show growing appreciation among employers for the importance of supporting workplace mental health.1 There is good reason to be concerned about employees' mental health, as mental illness is common among working-age people. The most recent nationally representative study found that an estimated 26% of Americans ages 18 and older—one in four adults—have a diagnosable mental disorder in a given year.2 This prevalence rate for mental health disorders among workers—and their family members—puts pressure on employers to respond to this problem with effective and informed action.

The good news for employers is that major review papers, offering important insights into this complex area, recently have become available. The research results provide a compelling case for why businesses should invest in employees' mental health.

The Need

Last year the World Health Organization (WHO) released a major literature review report that profiled the general nature of major mental disorders, their prevalence, their cost burden, the effectiveness of treatment, the cost-effectiveness of treatments, and the social policy implications of these findings.3 Similarly, Watson Wyatt Canada recently completed a comprehensive literature review of the research on workplace mental health in Canada and the United States.4 This paper reviewed findings from more than 150 studies and summarized what is known today about mental health in the workplace, as well as identified the gaps in research that need more study.

A number of conclusions from these reviews support the need for more employer attention to workplace mental health issues:

  • Mental health disorders are widely experienced among working-age populations.

  • Many people with mental health disorders also suffer from chronic medical conditions (such as heart disease, diabetes, and hypertension).

  • People with alcohol and drug addictions also have a high rate of mental health disorders.

  • People with mental health disorders often are underdiagnosed and undertreated.

  • Untreated mental health disorders place a large cost burden on employers and society.

  • Many factors contribute to the development and exacerbation of mental health disorders, including biologic, social, and workplace conditions.

  • Most mental health treatments are clinically effective and cost-effective.

  • Mental health treatment cost savings from workplace outcomes (improved employee productivity in particular) are typically far greater, and occur much sooner, than the savings obtained from reductions in overall healthcare costs.

  • Enough evidence now exists to support a "business case" for providing workplace mental health disorder prevention and treatment.

  • Additional efforts are still needed, however, to increase access to mental health services and overcome stigma and lack of awareness about mental health issues.

Clinically Effective

According to a 1993 landmark study that examined more than 300 meta-analysis papers (each paper itself a review of other many original studies), outpatient mental health treatment is largely effective at improving patient functioning.5 National surveys of mental healthcare consumers also have found generally positive perceived outcomes from the perspective of clients who see therapists.6,7 More recently, a 2005 WHO report concluded that "Over the last two decades, numerous studies in mental health promotion and mental disorder prevention have proven that such programmes can be effective and lead to improved mental and physical health and social and economic development."8

Treatment in outpatient settings. Mental health treatment is delivered most often in outpatient clinical settings by licensed psychologists, psychiatrists, social workers, or other professionals. The success rates for this kind of treatment for some of the most common mental health disorders are quite high. People with major depression, bipolar depression, anxiety, social phobias, and panic disorders typically get relief from these problems and can work effectively again.9,10

Treatment in workplace settings. The majority of large and mid-size companies now provide mental health disorder prevention, assessment and referral, and brief intervention treatment services through employee assistance programs (EAPs). Studies show that when appropriately administered, these services produce positive clinical change; improvements in employee absenteeism, productivity, and turnover; and in a few studies, savings in medical, disability, or workers' compensation claims.11,13