Experts call for greater integration of mental health policies and workplace interventions
Experts in a recent op-ed write, ‘mental illnesses pose difficulties for workers because their symptoms can interfere with essential workplace skills.’
The health care industry is not doing enough to focus on mental illness, according to a new opinion piece on HealthAffairs.org.
“Despite advances in the diagnosis and treatment of these conditions, and considerable progress on including mental health care in health insurance, people with mental illness — including those with moderate illnesses such as depression or anxiety — continue to be tenuously connected to work and, hence, to full participation in society,” Amanda Goorin, Richard G. Frank, and Sherry Glied collectively wrote. “Mental illnesses pose difficulties for workers because their symptoms can interfere with essential workplace skills, such as participating effectively in teams, interacting with customers and co-workers, and maintaining concentration.”
Goorin is a 2020 graduate of the Wagner School of Public Service and now works at Deloitte Consulting, Frank is the Margaret T. Morris Professor of Health Economics at Harvard Medical School and served in the Obama Administration, and Glied (who also served in the Obama Administration) is currently dean and professor of public service at New York University and director of NRx Pharmaceuticals, which is developing a behavioral health drug.
The National Institute of Mental Health reports that nearly one in five U.S. adults lives with mental illness — 51.5 million in 2019.
In their piece, Goorin, Frank, and Glied argued that workplace accommodations required under the Americans With Disabilities Act for employees suffering from mental illness and comprehensive benefits that include health insurance and paid leave could provide a “framework [to] go beyond ‘usual care’ and improve both mental health and workplace productivity for this population.”
That framework could potentially include medication therapy, psychotherapy, care management, job coaching, switching from full-time to part-time work hours, the gradual introduction of tasks, and more.
The authors cited the Work and Health Initiative, which integrates vocational and mental health improvement techniques through an Employee Assistance Program (EAP) counselor for depressed workers. According to the National Center for Health Statistics (part of the Centers for Disease Control and Prevention), almost 5% of the U.S. population over 18 years old experiences regular feelings of depression.
“Through telephone sessions, the EAP counselor provides medical care coordination and work coaching to reduce personal or environmental barriers to effective functioning at work, developing a customized plan to change specific work behaviors, work processes, or environmental conditions,” Gooring, Frank, and Glied wrote. “The intervention also provides work-focused CBT [cognitive behavior therapy] to help participants learn to identify the thoughts, feelings, and behaviors that are eroding their work functioning and to respond with more effective coping strategies.”
They added that studies indicate WHI reduces the severity of depression symptoms and improves time-management and mental-interpersonal job tasks: “In the treatment group of one trial, at-work productivity improved 44% (compared to 13% in the usual care group), absence days declined by 53% (compared to 13% in the usual care group), and absence-related productivity loss improved 49% (compared to 11% in the usual care group).”
Effective interventions will cost money, and the authors cited the Mental Health Parity and Addiction Equity Act, under which employer-sponsored health insurance coverage should provide access to appropriate psychosocial services. “Many large employers already have EAPs that might provide a foundation for additional work supports,” they noted. “But because of the episodic nature of mental illness, maintaining employment is also likely to require flexibility to take time off work when symptoms are exacerbated.”