5 Ways to Manage Behavioral Health Issues Before They Take a Toll on Your Business

Behavioral health issues can come at a huge cost to businesses. A recent webinar from Mercer reported that employees with depression accrue annual health care costs that are $6,000 more expensive on average than employees without behavioral health conditions.

Depressed workers also have a tendency to rack up absences,  missing between 6 and 25 more days annually than their peers. Treatment for behavioral health conditions is also heavily stigmatized, so many people suffering from them are afraid to seek help.

“Stigma is something that we’re all aware of and know to be a factor. I think it’s changing and I think it’s getting better … I think it’s happening, but again it’s going to take awhile for that to really kind of chip away and be less of a challenge,” said Sandra Kuhn, a partner at Mercer and one of the webinar presenters.

Kuhn led the webinar with Dr. Alisa Trugerman, a principal at Mercer. Together they discussed ways that employers can identify and address behavioral health conditions. Here are five key takeaways.

Don’t Silo Medical and Behavioral Health

One method Kuhn and Trugerman recommended for identifying behavioral health issues early on was focusing on holistic treatment methods for workers.

“[Treat] the member in a holistic manner when thinking about treatment plans. Not the behavioral health silo and not the medical silo, but a combined… treatment approach. So that we can be sure we’re addressing comorbidities, whether it be for a primarily medical reason or a primary behavioral health reason,” Kuhn said.

Considering both medical and behavioral health when making treatment plans can also save companies money. According to Kuhn and Trugerman, patients with comorbid physical and mental health conditions are two to three times more expensive to treat.

They noted that effective integration of medical and behavioral health could save between $26 billion and $48 billion annually.

Effective integration of behavioral and medical health could also help with issues of addiction and substance abuse.

A CVS Insights report found that 25% of all workers’ compensation cases involve prescription opioids. The report also noted that receiving more than a one week supply of opioids doubles the risk of disability for workers.

“In disability, substance use also comes up because mental health is such a large portion of disability and diagnoses and so many mental health diagnoses are occurring with substance use,” Trugerman said.

“I know one client who made mental health screening a part of the initial part of accessing the disability benefit [and] found tremendous impact on the overall number of days absent, and how quickly folks returned.”

Invest in Training Managers

Training managers to identify and discuss behavioral health conditions with employees can also be key to addressing problems before they become unwieldy. But many managers don’t know how to address these issues comfortably with their employees.

“We’re looking more and more at the training efforts for managers and supervisors and giving them the resources for having some of the more difficult conversations with employees, whether it relates to productivity or just out of concern,” Trugerman said.

Many times workers become managers because they are good at what they do. But many high-performers still need training on dealing with mentally ill co-workers, Trugerman said.

Having designated people within the office whom employees can go to talk to about behavioral health issues can be especially effective for people struggling with addiction. Peer support groups can prevent addicted workers’ from feeling alone and hiding their struggles rather than seeking help.

Trugermann said peer support training programs are proving effective.

Pay Attention to Social Determinants

Social determinants, such as economic stability, community support and access to education and health care, can be key predictors of what types of behavioral health issues employees may have and where they might find treatment. Financial stress, for instance, can be a key predictor of an employee’s mental state.

“Financial stress and emotional stress are sort of tied at the hip,” Trugerman said.

In fact, she said many suicides are money-related.

Kuhn said social determinants are often the “root causes” of mental health conditions. They can tell employers a lot about what kind of support an employee may need.

“If you are not stable with employment or you’re in a situation of poverty and you’re challenged with literacy and you don’t have the social support systems or the transportation, the ability to enter into a behavioral health program is very challenged,” she said.

“What I think we need to do collectively is continue to push in the vendor community to really identify ways to suggest a member’s needs for social supports like this and then look to the community resources and other outreach efforts to help solve for these very fundamental issues.”

Fortunately, new technologies are making it easier than ever for employers to figure out which social determinants their employees may be facing.

Worker segmentation approaches to addressing behavioral health issues, for instance, involve employers collecting data, such as employee zip codes, and using it to create “personas” which predict what types of social determinants they may be facing.

Kuhn said those personas can predict behaviors and preferred communication methods. They can also predict how someone uses medical and behavioral health services.

Investigate the Hidden Risk of Alcohol

When it comes to substance abuse disorders, all eyes are currently on the opioid epidemic. But Trugerman cautions employers to make sure they’re focusing on another addictive substance as well: alcohol.

“We know that the alcohol disorders have a large impact on absenteeism, productivity and turnover rate and also healthcare costs,” Trugerman said.

“Folks who have an alcohol use disorder have almost twice the cost of healthcare than those that do not. They have more emergency room visits and they spend many more days in the hospital,” she added.

In addition to costs accrued from health care, the 2006 study “Economic Costs of Excessive Alcohol Consumption” found that workplace productivity losses accounted for 33 % of the $223.5 billion in annual alcohol consumption losses.

Despite these high costs, many employers aren’t focusing on helping employees overcome issues with alcoholism.

“We don’t have much focus on alcohol use and misuse,” Trugerman said.

Trugerman said most employers don’t focus on alcohol consumption, other than limiting what they offer at company events.

“While this is a substance that we enjoy and use in our society, we’re not focusing on the misuse of it or the overuse of it in the ways that we should,” she added.

Use Technology to Reduce Stigma

When it comes to identifying and addressing behavioral health issues in the workplace, stigma plays a huge role in why some people fail to seek help.

“The power of stigma is pretty deep. Stigma’s going to affect how willing we are to reach out to people who need help; it’s also going to effect people who need help in stepping forward; and it has an overshadow for those who might think that they want to improve their skills, but are a little bit tentative stepping forward and participating,” Kuhn said.

Kuhn and Trugerman recommended online services, such as R U OK?, Stamp Out Stigma and One Mind at Work, and texting and televideo services as potential methods for providing care for people who are worried about stigma and as resources for educating employees about mental health risks.

“The interesting reality on [televideo services] is that utilization remains woefully poor both on the medical side and on behavioral health,” Trugerman said.“Probably the place where we see the most change is often in the chat and text based approaches and they’re being used for both coaching and therapy.”

“It’s about convenience and it’s about maybe addressing geographic limitations, but it’s really a delivery that’s sort of the same. It’s face to face, it’s relying on a verbal exchange between the patient and the provider,” she added.

Kuhn also believes that making the process of accessing behavioral health services as easy as possible will attract members who may not have actively sought out the services due to the stigma associated with mental health conditions.

“Remember that first call that someone makes to receive care is very, very difficult. If they have to make five or six calls to find a provider or find an available appointment, that’s even more difficult and we lose people with each hoop that they need to jump through,” she said. &