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Vulnerable to Depression

By Andrew R. McIlvaine | Human Resource Executive 
November 28, 2007

Some occupations offer more likelihood of depression than others, usually affecting those with little authority but great responsibility. Researchers also have found a great awareness of the problem of stress in the workplace, but see little help being offered by employers.

Some occupations offer a much greater risk for depression than others.

According to the National Survey on Drug Use and Health, people working in personal care and services are the most depressed, with nearly 11 percent experiencing a "major depressive episode" in the past year.

At No. 2 are those in the food preparation and serving business, with 10.3 percent. Interestingly, engineers, architects and surveyors are the least depressed, with just 4.3 percent reporting an episode.

Dr. Nada Stotland, a professor of psychiatry at Rush Medical College in Chicago and a board member of MentalHealth America (formerly known as the National Mental Health Association) in Alexandria, Va., says the lower down the "totem pole" employees are in the workplace hierarchy, the more vulnerable they are to depression.

"Depression is a risk factor when you're in a position in which you have little authority but lots of responsibility," she says, citing catering staff and waitpersons as examples.

Meanwhile, architects, engineers and the like tend to have more control over their jobs, she says, which could explain the lower rates of depression among those occupations.

Stotland says employers in the personal-care and food-services businesses should do everything they can to encourage their workers to seek help through their employee-assistance programs and mental-health benefits, provided they offer them.

"It's as much a business issue as anything else," she says. "These businesses rise and fall on the attitudes and attention of their line staff. If their employees are distracted and irritable, have no cheer or are unable to concentrate -- all symptoms of depression -- then customers obviously won't return."

But most employers are not addressing mental-health matters in the workplace and most employees don't understand their current mental-health benefits, according to a recent survey by Meritain Health and the Partnership for Workplace Mental Health.

The Meritain/Partnership survey of 411 full-time employees with medical benefits found that employees are keenly aware that stress negatively affects them in the workplace, with 94 percent reporting that stress affects job performance.

More than half (56 percent) of respondents said stress affects their general attitude. Nearly 40 percent said it affects relationships with other workers and 36 percent said stress affects their productivity.

At the same time, 52 percent of employees said their employers do not address stress, work/life balance or mental-health issues with their workers. Moreover, 40 percent of employees said they aren't aware of the mental or behavioral health benefits offered by their employers.

"Offering mental-health benefits isn't going to do much good if no one knows about them," says Clare Miller, director of the Partnership for Workplace Mental Health, part of the American Psychiatric Association in Arlington, Va.

Dr. Larry Luter, the chief medical officer at Meritain Health, a Buffalo, N.Y.-based provider of administrative and medical management services for self-funded health plans, says he wasn't at all surprised by the survey's findings.

"I travel around the country talking with employees, and whenever I ask them what they think is the No. 1 thing driving health-care costs in America, one of the top three answers is -- without exception -- stress," he says.

While he admits that stress is hardly new to the workplace, Luter says the subject is receiving more attention now due to the combination of an ever-more competitive global economy and rising health-care costs.

"We're paying attention to health-care costs in a way that we haven't before, and we're paying attention to productivity in a way we haven't before, and this means we absolutely have to pay attention to stress," he says.

Some degree of stress is an inevitable byproduct of the drive for increased productivity, says Luter, but stress affects different people in different ways.

"The same amount of stress that's driving one person to be more productive may be too much to handle for another person. For employers, the key is to monitor, watch and pay attention to their workforce with the understanding that these forces are at play."

The symptoms they should be looking for -- disorganization, poor time management, an inability to set goals or define priorities -- are classic signs of stress that can undermine productivity, he says.

More than one-third of respondents (36 percent) to the Partnership survey said they'd be more likely to use their mental/behavioral health benefits if their employer did a better job of promoting them.

But combating stress involves more than putting out periodic reminders to employees, says Luter.

"The key is creating a safe environment -- and by 'safe,' I'm not referring to OSHA, but an environment in which employees feel comfortable in raising the issue of stress and where they can get help dealing with it," he says. "It's incumbent upon managers and HR to let employees know that it's safe to talk about these things and that it won't affect their careers."

In doing so, he says, managers should talk about it -- literally.

"Written materials won't do the job," says Luter. "You need to tell them verbally that the EAP and mental-health benefits are there for them, that they're on par with physical ailments and that their jobs won't be affected by coming forward. Those levels of reassurance don't go over so well in written materials."

Copyright 2007© LRP Publications

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