Take Home Messages:

Many people still view depression as a personal weakness rather than a treatable medical illness. Depression interventions should focus on removing the stigma attached to mental illness.

Improving the recognition of depression through education, training and health promotion will improve outcomes in depression and reduce its impact on organisations. Examples of education include lunch time seminars on ‘feeling down’, or company emails addressing stress management.

Promotion of return to work programs and supervisor training and education in optimal return to work practices will reduce the amount of time lost to depression. Having people return to work should be the goal of such programs. This may include part time work or altered duties. 

Making a business case for improved management of depression may be useful in organisations. A business case presents the cost of not treating depression properly against improved productivity through optimised management.

Why the research matters: 

Each year depression will affect about one in ten people in the workplace. It is most common between the ages of 30 and 40 when workers are in their prime. People with illnesses that affect mood will miss an average of 27 to 65 days per year. They also have reduced productivity.

Many people who have depression are not properly diagnosed. Of those who are, many do not receive adequate treatment. This causes employees unnecessary distress and affects the bottom line of business.

At least 80% of people with depression can be treated successfully with medication, psychotherapy or a combination of both.

Occupational and environmental practitioners should be able to respond to this health issue in the same way that they respond to more traditional problems such as back injury.

What the research involved:

The authors have reviewed research relevant to depression in the workplace and produced a report for people who manage workplace depression to help them optimise its management. 

The focus of the report is improving organisational structures and mechanisms to improve the diagnosis and treatment of depression, and to optimise the management of affected workers.

Summary of research findings:

The economic impact of depression has only recently been recognised. In the past twenty years expenditure by organisations on mental health has decreased. Over the same time period the number of days lost through depression has increased.

Many people still view depression as a personal weakness rather than a treatable medical illness. Depression interventions should focus on removing the stigma attached to mental illness. This will facilitate earlier identification and appropriate treatment.

Interventions, including benefit structures and disability management programs should be constantly evaluated and improved.

Workplace health practitioners may need to present a ‘business case’ to organisations to argue for improved depression management.  

Health promotion programs to raise depression awareness should focus on the following three messages:

1. Depression is an illness not a personal flaw or weakness.  If recognised it can be treated.
2. Effective medications and psychological treatments exist. They are often used in combination.
3. Even the most serious forms of depressive illness usually respond rapidly to treatment.

Suggestions for the implementation of depression awareness programs include:

• Lunchtime seminars on mental health topics, such as identifying and coping with stress;
• Emails on mental health topics, such as “everyone feels down sometimes”;
• Posters promoting wellness topics, including advice about available help;
• Articles in employee newsletters on topics such as “holiday blues”; and
• Website information on corporate health services, or depression education.

The goals of management for people with depression on short term disability should be:

• Ensuring people receive appropriate care;
• Examination and mitigation of contributory workplace issues;
• Provision of support and follow-up for the employee’s return to work;
• Liaising with human resources and supervisors to accommodate return to work; and
• Recognition that return to work through altered duties or part time work is optimal.

These interventions have been found to:

• Decrease the average number of days absent; and
• Reduce the likelihood of another depression-related absence.

As depression impacts multiple areas of the workplace, optimal response requires multiple interventions.

The authors recommend interventions by occupational and environmental practitioners focus on:

• Rational health benefit design;
• Employer and management training and education;
• Effective employee assistance programming;
• Disability management; and
• Employer policies and procedures.

Care providers should also be aware that antidepressant medications have side effects that may affect workplace safety and educate appropriately.

Original research:

Depression in the Workplace: The Role of the Corporate Medical Director

Wayne N. Burton, MD Daniel J. Conti, PhD

J Occup Environ Med. 2008 Apr;50(4):476-81.

Link to PubMed abstract