Research Proposal: How Does Depression Affect Productivity?

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Depression in the Workplace

The Centers for Disease Control and Prevention (CDC) estimates that in any given year, about 18.8 million adults in the United States -- that is 9.5% of the adult population -- will suffer from depression. About 80% of those 18.8 million, the CDC explains, will experience "some level of functional impairment," and 27% of the 18.8 million will have "…serious difficulties in work and home life" (CDC, 2011). Moreover, in any 3-month period, people with depression miss approximately 4.8 workdays "…and suffer 11.5 days of reduced productivity" (CDC, p. 1).

What are employers doing to help those suffering from depression in the workplace? The peer-reviewed literature shows a variety of responses to this health problem. One survey reports that managers with "less familiarity with depression" showed "greater reticence to seek help" (Martin, 2010); another study reflects that when depressed employees receive treatment there is "decreased sporadic absenteeism" and "productivity improvements" and "workplace savings" (Birnbaum, et al., 2000). This paper presents scholarly research showing that employers with a proactive approach to helping depressed employees save money, increase productivity, and set a good example for other businesses to follow suit.

Literature Review and Hypotheses

Hypothesis I: Since depression has a negative affect on worker productivity, is it financially beneficial for the employer to support treatment that increases productivity? In the Birnbaum, et al. research paper, the authors used a data source that offered medical, pharmaceutical and disability claims from a national U.S. manufacturer, and from that data the authors measured "…the extent of disability before and after initial treatment for major depression" (Birnbaum, 2000, p. 163). The participants in the data bases were 1,260 employees, each of whom had at least one medical or disability claim "…for major depression based on the International Classification of Diseases, 9th edition (ICD-9) codes in 1996 or 1997" (Birnbaum, 163).

The authors used each patient that had experienced "major depression" as her or his own control for the research; the authors then conducted a longitudinal analysis of workplace disability based on depression (Birnbaum, 164). The researchers compared "…the extent of employee disability in the period following initiation of major depression treatment vs. their disability experience prior to treatment" (Birnbaum, 164). Once the longitudinal control approach was in place, the authors identified the first major depression-related treatment within a window of time (first three months of 1996 / final four months of 1997).

Employees that were treated for "major depression" were absent from their place of work, according to the authors, an average of "just under 1.0 disability day per 10-day observation window prior to their first depression treatment" (Birnbaum, 166). Contrasted with that data, the company-wide average for all employees was about half a day per ten days. This boils down -- for those that were treated for major depression -- to a loss of 10% of work time juxtaposed with 5% loss of work time through the entire employee roster (Birnbaum, 166).

In their conclusion, the authors state that the costs of being treated for depression for many workers are "…exceeded by employer disability cost savings alone" (Birnbaum, 169). When the costs are prorated over the first 30 days of the treatment for depression, those costs might in fact "understate" the actual incurred costs to the employer. However, the costs to the employer if no treatment is received by the employee would be greater.

Moreover, the employer will have additional cost reductions once the depressed worker has received proper care, because there will be a reduced use of prescription medicines; and also, additional benefits will "accrue to the employer" from improved work performance (Birnbaum, 170).

In their discussion, the authors acknowledge that typically a depressed patient will not necessarily be returned completely to his or her pretreatment level of competence and emotional stability. but, they continue, certain prescribed drugs may be helpful when the worthiness of the medication is fully assessed. If the benefits resulting from the depression treatment "…exceed the usual costs of depression treatment" then a more "aggressive outreach" to other employees that may also suffer from depression may be justified, simply based on the dollars and cents realities for management, albeit this has "yet to be shown in formal studies" (Birnbaum, 170). Hypothesis I: In this research, it is financially beneficial for the employer to provide treatment for the employee since the employee can return to productive work habits.

Hypothesis II: Does offering an intervention for employees' primary care depression improve productivity -- and reduce absenteeism -- at work? Statement of Problem: Management is concerned about absenteeism and poor production from employees that are depressed. A research study -- using patients from twelve community primary care clinics/centers -- published by the National Institutes of Health tested whether an intervention (with a depressed employee or employees) could improve the productivity and reduce absenteeism over a two-year period. The researchers used pre-screening information to identify depressed primary care patients / employees.

Methods Employed / Procedure: The mental health centers trained clinicians specifically as to how to correctly treat depressed employees that were detected at the workplace. Over a 24-month period, the twelve centers "provided improved depression management," treating 479 depressed patients -- 326 patients of whom were either part-time or full-time employees (Rost, et al., 2004, p. 42). An evaluation was conducted -- as to productivity and absenteeism -- at six, twelve, eighteen and 24-month intervals, Rost explained. The patients chosen had attended clinics between April 1996 and September 1997 were given a 2-page screening test to determine which patients had reported "5 or more of the 9 Diagnostic and Statistical Manual-III Revised criteria for major depression" within the 2 weeks prior to being screened.

Discussion: The results showed that those patients that underwent enhanced care for their depression reported (on average) "6.1% greater productivity and 22.8% less absenteeism over 2 years" (Rost, p. 1202). The financial "value" of this intervention -- for those workers that showed at least an 8.2% increase in productivity over 2 years -- was an estimated $1,982 (Rost, p. 1202). For that worker whose absenteeism was reduced by 24.4% (or 12.3 days) the value of not being absent over the 2-year period was estimated at $619 per "depressed full-time equivalent" (Rost, 1202).

The authors encourage further research in terms of understanding the "cost-benefit" aspects vis-a-vis productivity gained and lack of absenteeism. Hypothesis II: Employers that offer intervention to depressed employees do see increased productivity and less absenteeism.

Hypothesis III: The treatment for depressed employees has a direct link to work productivity. Background / Statement of Problem: The authors (Dewa, et al., 2011) report that of the annual cost of mental illness in America -- $51 billion -- one third of that cost is due to losses in productivity at work. The authors seek in this research to determine how depression is associated with productivity at work.

Method / Participants: The authors in this research used data from 2,737 adults (between ages 15 -- 65) that had participated in a community survey of employees in Alberta, Canada. The researchers sought to reach people living in Alberta who had been employed in the local workforce for at least 12 months prior to the survey. Those potential participants were contacted using "random digit dialing" and were told their participation was voluntary and the information gleaned from them would be kept confidential. The rate of response to the random phone calls of workers was 42.3% (Dewa, 744). In the survey it was learned that 8.5% of those 2,737 workers had "experienced a depressive episode" in the previous twelve months (Dewa, p. 744).

Procedure: In the first two weeks of recruiting participants, the response rate was just 28.8% and 27.0%, so a "quality improvement approach" was brought into the research plan. In other words, higher quality (more persuasive) interviews were… [END OF PREVIEW]

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