Take Home Messages:

Depression is a common and disabling condition in the community. Many people suffering from depression are employed. As depression gets worse it becomes hard for patients to work and they are often less productive.

Traditionally depression has been managed just by a doctor and the patient alone. This has been shown to be relatively ineffective. Instead, new research has shown that there is a broader role for the community and employers in managing depression.

The study shows that self-management also has a place in depression management, which includes educating patients in how to manage their condition. Employers too can have a significant role in managing and preventing depression in their employees. Some suggested strategies include:

• Creating an environment that promotes a healthy lifestyle;
• Monitoring workloads and employee stress levels;
• Identifying people in the workplace who might be at a higher risk of mental illness and fostering open and honest communication with them; and
• Working with the employee to encourage return to work after a period of illness.

Why the research matters:

Major depression is a common condition that often runs a chronic and relapsing course. A major problem for patients with depression is their reduced ability to work. Sometimes they are too sick to attend work and other times they can work but have trouble concentrating or working at their normal level. Because depression is so common and is a condition that impacts on patients’ ability to work, there is a role for employers in the treatment of depression.

What the research involved:

This research article reviews the literature on current management practices for depression. The key aims of the research were:

• To assess current practices of treating major depression both in the community and clinical settings;
• To look at expanding the role of the employer in managing and preventing depression; and
• To show readers how a more integrated approach to treating depression can improve outcomes.

The article looked at current practices and identified ways in which these could be improved to help people with depression function well even when they are sick. It also offered suggestions on how employers could help prevent and manage depression in their employees.

Summary of research findings:

The research describes the following regarding the prevalence and impact of depression:

• Depression is both common and disabling;
• Depression is very frequently chronic and patients need long term treatment strategies; and
• Many patients with depression are employed and their illness impacts on their capacity to work.

The article also considers self management and the role of this in the management of depression. Self management involves educating patients to help themselves using a variety of management strategies for their illness. This allows them to take on a role in their treatment and play an active part in getting better.

Importantly, the article addressed the issue of how employers can help prevent and manage depression in their employees. Employers have a role in preventing and managing depression. They should feel that they can work proactively and be involved in helping the patient return to full capacity. Employers can do a number of things to prevent depression in the workplace:

• Environment is important – a workplace should be conducive to wellness. Employers should address workplace cultures that are not.

• Employees should be able to undergo adequate training for their job and also training in stress management and conflict resolution.
• Monitoring employees’ signs of stress or withdrawal is useful. Keep communication lines open so that they feel able to discuss problems while they are still small.
• Have an established Return To Work plan for cases of depression. Show your employees that you are accepting and prepared to help manage their condition and they will be more likely to seek an earlier RTW.
• Be ready and willing to modify jobs if employees are not coping. Emphasise self care as of the greatest importance and encourage work-life balance.
• Finally, have a relapse prevention program. Do what you can to prevent this chronic disease taking over.

Original Research

Integrated management of depression: improving system quality and creating effective interfaces.

Myette TL.

J Occup Environ Med. 2008 Apr;50(4):482-91.

Link to PubMed abstract