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Rethinking Depression Care: What Employers Can Do

In-depth stories provide a deeper dive into IU Health related news.

Untreated mental illness wreaks havoc on individuals and families, and costs employers billions in direct and indirect costs. Developed by researchers and leading clinicians, the Collaborative Care model utilizes an evidence-based and team-based model of care in which primary care providers are supported by behavioral healthcare managers and psychiatric consultants. This approach effectively brings mental health treatment to the places people feel comfortable receiving care.

| INDIANAPOLIS—Approximately 1 in 5 U.S. adults experience mental illness in a given year, according to the National Institute of Mental Health. Many, however, never seek or receive treatment. Untreated mental illness wreaks havoc on individuals and families, and costs employers billions in direct and indirect costs. Depression, in particular, has a precise impact on employers because of its high cost—$17 billion to $44 billion in lost work days each year, according to the Centers for Disease Control and Prevention; and because it is commonly accompanied by co-occurring (and costly) conditions, such as diabetes and heart disease.

Increasingly, efforts to improve depression care are focused on primary care settings. That’s because the majority of people (nearly 75 percent) who seek help for symptoms of depression will go to a primary care physician rather than a mental health professional; and 42 percent of patients diagnosed with clinical depression were first diagnosed by a primary care physician, according to the National Business Group on Health.

But receiving a diagnosis is not a direct path to treatment. Many patients who are diagnosed with depression by their primary care provider never follow through with their treatment plan; 30 to 50 percent of people referred from primary care to an outpatient behavioral health clinic don’t make a first appointment, according to the American Psychological Association.

Because so many patients remain untreated, many providers, payers and employers are collectively seeking more effective solutions and embracing a type of integrated care known as the Collaborative Care model. Developed by researchers and leading clinicians, the Collaborative Care model utilizes an evidence-based and team-based model of care in which primary care providers are supported by behavioral healthcare managers and psychiatric consultants. This approach effectively brings mental health treatment to the places people feel comfortable receiving care.

How it works

In the Collaborative Care model, the patient’s primary care provider works with a care manager (a nurse, social worker or qualified health coach) to develop and implement a treatment plan. The care manager provides patient education, arranges follow-up care and monitors progress. Together, the care manager and primary care provider consult with a psychiatrist to adjust treatment plans if the patient does not improve. Case management can be provided in person or by telephone.

Research shows that utilizing the Collaborative Care model improves upon usual depression care, as it leads to better patient outcomes, improved functioning and reductions in healthcare costs. According to the AIMS Center at the University of Washington:

  • For every dollar spent on Collaborative Care, $6 in healthcare costs are saved.
  • Consistently employed patients treated under Collaborative Care saw absenteeism fall by 28.4 percent (12.3 days) over two years at an estimated value of $619 per employee.
  • Collaborative Care treatment resulted in an average net benefit to the employer of $40 per-participating worker in year one of the intervention and $257 per-participating worker in year two, for an estimated two-year ROI of 302 percent. 

Learn more

To learn about more innovative strategies for managing depression and behavioral health costs, read our latest white paper, Closing the Gap. On-site solutions connect employees to behavioral health services and help curb costs related to untreated mental illness. 

Sources:

http://www.cdc.gov/nationalhealthyworksite/docs/Issue-Brief-No-2-Mental-Health-and-Chronic-Disease.pdf
http://www.apa.org/monitor/2010/12/patient.aspx
https://www.businessgrouphealth.org/pub/f3139c4c-2354-d714-512d-355c09ddcbc4
https://aims.uw.edu/collaborative-care/dollars-sense

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