This session at the 2016 California Workers’ Compensation & Risk Conference addressed some of the latest thinking and research related to the impact of mental well being and behavioral health in the workplace.
- Denise Zoe Algire, National Director, Managed Care & Disability, Corporate Risk Management, Albertsons/Safeway
- Dr. Teresa Bartlett, Senior Vice President Medical Quality, Sedgwick Claims Management Services, Inc.
Mental health is a key component of wellness. It is a state of well-being in which an individual can cope and become a contributor. It includes how someone feels, thinks and acts and helps to determine how we handle stress, relate to others and make choices. Ultimately, mental health is about balance, resiliency and the ability to return to normal when something goes wrong. Mental health is also directly associated with performance in the workplace.
- 16% of people in the workplace are depressed and 57% of those are untreated.
- 14% have chronic fatigue, with 83% untreated.
- 15% suffer from anxiety, with 66% untreated.
- 6% have chronic sleeping problems, with 61% untreated.
The top two drivers of overall healthcare costs are stress and mental health – far more than physical illness or injury. In fact, 33% of the 40.2 million work days lost are due to stress, anxiety and depression.
Mental and physical health are intrinsically linked and will trickle into workplace health and workers’ compensation claims. 30% of those living with a disease report a concurrent mental disorder. Past experiences also have a large impact. Adverse childhood events are a strong predictor of being at risk for delayed physical recovery.
What Can an Employer Do?
Albertsons/Safeway instituted an early intervention program to identify employees that might be at risk for delayed recovery related to poor mental health. They conducted a pilot study where all 80 back-injury claims returned to work in a reasonable amount of time.
Delayed recovery can manifest itself in many ways in a claim – anger perceived as injustice, protracted recovery, catastrophic thinking, external loss of control, minimal resilience and fear avoidance and embellishment.
Albertsons/Safeway rolled out their program, initially screening all claims at two weeks post injury. They conduct a ‘care call’ with a voluntary pain screening questionnaire that has 21 questions covering pain attitudes, catastrophizing, mood, behavior response to pain and ADLs. For those that are identified as ‘at risk’, they are put into health coaching with a nurse case manager and claims examiner. The nurse then sends a letter to the treating provider because their buy in is essential. The medical director works with the treating doctor to understand the program, creating a collaborative atmosphere. The doctor then approaches the injured worker first to introduce cognitive behavioral therapy as part of the treatment plan.
Albertsons/Safeway was able to identify 12% of high-risk claims for delayed recovery found that the primary care doctors became more aware and are beginning to refer to the program earlier. It also yielded positive return-to-work results with around 30% improvement in rates. They are firm believers in the positive results related to cognitive behavioral therapy.