issue 012, 2019

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Improving access to behavioral health services in the workplace

BY Rhonda Stribling RN, Clinical Director, Workforce Absence

As those who have experienced behavioral health concerns first-hand know, the struggle to overcome issues ranging from depression and anxiety to alcohol and substance abuse is real, frightening and often debilitating.

Unfortunately, many times people with behavioral health issues suffer in silence for months or even years…and that must change. We need to start answering some of the more difficult questions related to mental health. We need to speed the process of accessing care for those in need, so they can return to a sense of normalcy in their life and work.

The size of the problem
Achieving such a goal presents numerous but not insurmountable obstacles. Behavioral health problems in the workplace are not a simple area to address, or a niche issue affecting a few. According to the Integrated Benefits Institute (IBI)1, one out of four people will have a diagnosable mental health condition in their lifetime. Despite the prevalence, two-thirds of people never receive care. That stat is especially concerning as conditions can worsen over one’s lifetime.

Understandably, the scope and depth of the problem have led to issues, challenges and, of course, increased costs in the workplace. According to a recently released FAIR Health Study2, claims with mental health diagnoses increased 108% as a percentage of all medical claims from 2007 to 2017…stop and think on that escalation for a moment.

Now consider just one component of behavioral health — depression. People suffering from depression submit an average of $14,967 per year in claims, compared with $5,929 a year for the total population according to a 2018 review3 of claims data from Willis Towers Watson. Additionally, those with depression make six times as many emergency room visits as the overall population.

Thomas Parry, president of the IBI, notes that not only do most employees who say they are depressed never get treatment; often their cases do not show up in medical and pharmacy claims. Poor access to data makes it difficult for employers to understand the impact of behavioral health problems on their organizations. 

Additionally, most mental health treatment is out of network and lacks care coordination, increasing costs and reducing effectiveness, says a study4 conducted by the National Alliance of Healthcare Purchaser Coalitions.

Overall, the Centers for Disease Control and Prevention (CDC) estimates that behavioral health-related problems, including depression, anxiety and addiction, cost the U.S. healthcare system and employers $237 billion every year.

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Employers are looking for answers
While the problems are significant, employers are just now starting to catch up to the need for more comprehensive diagnosis and treatment. At a recent IBI and Pacific Business Group on Health Symposium5 held in San Francisco, several large employers including Boeing, Microsoft, Johnson & Johnson, Teledoc and Ernst & Young met to discuss the issue and solutions. As we have at several previous symposiums, Sedgwick attended and contributed significantly to the event’s agenda and content. Sedgwick’s Bryon Bass, SVP, Workforce Absence, was a presenter, and several of our colleagues and clients attended.

Attendees identified a number of solutions as critical to adequately address the challenges behavioral health issues present in the workplace. These include:

  1. Connect people to care by making it socially acceptable to address mental health within your organization
  2. Make access to care easier, including having in-house therapists and appointment times within the workday
  3. Integrate mental health with primary care to ensure whole-person care
  4. Engage and integrate employee assistance programs (EAP) and recognize old-school approaches may no longer work (for example, Gap/Old Navy changed the name of its EAP to “Benefits Concierge Service”)
  5. Ensure early intervention as it can help lower claims while it helps employees access needed care

Sedgwick’s ongoing innovation in behavioral health
Sedgwick agrees with the recommendations outlined at IBI and has already taken steps to put those recommendations, as well as others, into place for its clients. Working with employers to ensure that mental health services are a core component of workers’ compensation and disability programs has been a foundation of Sedgwick’s programs for decades.

As part of our continuous commitment to finding new ways to care for workers, we’ve recently introduced a behavioral health program for workforce absence (see sidebar). We also are committed to taking steps that make a difference for our clients’ employees, for both workers’ compensation and disability programs. For example, our behavioral health programs stress the following core elements:

  • Intervene as early as possible in the process
  • Gather more clinical information before receiving medical so that a claim decision can be recommended more quickly
  • Enhance collaboration among the associate and disability specialist
  • Enhance awareness and knowledge for the associate and disability specialist
  • Emphasize best practice treatment protocols and entertain transitional return-to-work (RTW) options wherever possible 
  • Provide a wide range of resources to help workers better manage their condition (EAP, wellness programs, etc.)
  • Take a more active role in supporting a healthy and safe return to work through conversations with the associate and healthcare provider

Sedgwick data tells us that the earlier we identify problems and begin treatment, the lower the costs and the faster the return to work. This guiding principle is true for workplace injuries as well as behavioral health challenges. Incorporating programs that ensure fast access to quality behavioral health support is vital to the success of employers today. Our knowledge-based economy needs workers who are physically, emotionally and mentally healthy to ensure they perform their tasks at the optimum level and can compete on a global stage.

It’s part of our caring counts® philosophy to ensure our clients’ employees get the highest level of appropriate care for all workplace-related injuries and illnesses. We’ll be sharing more about the importance of strong behavioral health programs and outcomes from Sedgwick’s new program in the coming months. If you have questions, or need support yourself, please contact us at sedgwick@sedgwick.com.

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