Michael Friedman, Ph.D.
The tragic death of Robin Williams has brought international attention to the devastating effects of depression. More and more people are becoming aware that depression is not simply being in a “bad mood,” but rather a serious mental disorder associated with intense suffering, loss of functioning and, in the most severe and tragic cases, death. As a result, the World Health Organization is calling depression a “global public health concern.” Depression is rated as the second leading cause of overall disability worldwide, and one of the most insidious ways that it causes damage is through loss of work productivity. Understanding and managing depression is crucial to creating a strong corporate culture, and should be a top concern of every employer.
Depression is a substantial risk for poor productivity at work. When considering how depression is associated with symptoms such as low energy and poor concentration, it is easy to see how depression can almost immediately destroy your business. Research clearly demonstrates that depressed individuals are less productive at work and more likely to be absent from work. Estimates suggest that at any time, 10 percent of any given workforce is depressed, missing almost 9 days a year due to poor health. Further, depression and associated fatigue may be one of the reasons that employees leave their jobs; research suggests that employees who leave their workplace because of “emotional exhaustion.” This can be costly to employers; the Centers for Disease Control estimates that depression costs employers $17-$44 billion annually.
A very serious consequence for employers is that depression can send a ripple effect through a corporate culture. Witnessing a co-worker being depressed or demonstrating a lack of engagement at work can be contagious. Another co-worker not performing at his or her best because of depression may reduce team morale. Research suggests that people may “catch” depressive thinking from others. For example, college roommates of depressed individuals may be more likely to demonstrate negative thinking and depressed mood. A problem for one employee can quickly become a problem for many employees, increasing turnover rates and costs for companies.
So what can be done?
The good news is that we have treatments that can work for depression. There is evidence that medications and psychotherapy both have efficacy in reducing depressive symptoms. There is particular evidence that in the case of more severe forms of depression, combining medication and psychotherapy is particularly efficacious. Not only is the evidence that these treatments are efficacious, but also cost-effective when considering effect of depression on health care costs and disability. Further, it is encouraging that the majority of businesses (75 percent) report having Employee Assistance Programs (EAP) that often represent the first and only line of defense against depression for many people.
However, there is less encouraging news suggesting that half of depressed people still do not receive any care. One possible reason is that while EAP programs exist, employers may not seek out these programs because of lack of information on their effectiveness. And there is some reason for this skepticism: There is evidence that specialized workplace programs designed to reduce disability are not effective. Further, there is disagreement as to whether specialized workplace depression programs reduce symptoms. Some initial reviews suggest that there is a small improvement seen in symptoms, whereas other reviews suggest that the evidence shows no overall improvement.
Therefore, there is considerable room for businesses to show leadership in this area by not only directing victims to the best resources, but also developing and evaluating creative workplace programs to prevent and manage depression. In order to accomplish this goal, businesses need to have a clear, systematic and serious way of managing depression among employees. Perhaps as important as the procedures and structures is the executive “buy in” — the sense that depression is an important issue for the company and will be dealt with seriously.
To facilitate environments in which employees will disclose depression, employees, employers and human resources officials need to be educated on the signs and consequences of depression, as well as corporate procedures to handle it effectively. Further, clear and firm policies need to be in place to investigate depression. This includes directives on whom an employee should speak with if managing depression, as well as strict investigative and legal policies to protect employees. Further, human resources and employee assistance workers should be trained to detect and provide the proper referrals for care for victims of depression.
Depression is a serious but preventable mental disorder that can impact employee well-being and work productivity. Workplaces are unique in that they not only represent opportunities to identify and treat depression and all mental health issues, they also set the tone for valuing mental health treatment and de-stigmatizing depression. It is time for businesses to take a leadership role in helping address and prevent this serious public health issue.
About the Author
Dr. Mike Friedman is a clinical psychologist in Manhattan and a member of EHE International’s Medical Advisory Board. Follow Dr. Friedman on Twitter @DrMikeFriedman and EHE @EHEintl