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Mental and Behavioral Health / Depression

Why Employers Care

Mental and behavioral health conditions continue to be a significant business challenge for employers. These conditions encompass a broad range of illnesses, such as depression and other mood disorders, anxiety disorders, antisocial personality disorder, schizophrenia, and other non-affective psychoses, and generate more than $104 billion in direct costs.1 Additional costs, including a rise in disability claims, lost productivity and providing services through Employee Assistance Programs (EAP), increase the amount of spend even more. Mental health conditions are also associated with more days of work loss and work impairment than many other chronic conditions (i.e., diabetes, asthma, and arthritis).2 Approximately 217 million days of work are lost annually due to productivity decline related to mental health conditions.3 Consider the following:

  • An estimated 26.2% of Americans age 18 and older — about one in four adults — suffer from a diagnosable mental health condition in a given year.4

  • Major depression, the most common mental health condition, is the second most common chronic condition seen by primary care providers.5 Among patients with depression, more than 40% are diagnosed by a primary care physician.6

  • According to the 2006 National Survey on Drug Use and Health, 6.6% of full-time employed adults and 7.6% of part-time employed adults experienced a major depressive episode in the past year.7

  • Co-morbid mental and physical health conditions are common and costly. According to the American Psychiatric Association, up to 25% of people with certain illnesses, such as diabetes, will develop major depressive condition during the duration of their illness. Health care use and health care costs are up to twice as high among diabetes and heart disease patients with co-morbid depression, compared to those without depression, even when accounting for other factors such as age, gender, and other illnesses.8

What Can Employers Do?

Research and experience has shown that proactive initiatives that address prevention and early intervention may help employers reduce presenteeism, absenteeism, and disability claims associated with mental health conditions.

Employers can assist employees and their dependents with mental health conditions by providing:

  • Robust behavioral health benefits.
  • Mental health benefit coverage levels that are equal to physical health benefit coverage levels.
  • Employee assistance services.
  • Disability management coverage for behavioral health disorders.
  • Prevention and educational resources on substance abuse and mental health disorders.

Relevant Tools and Resources Include:

References (show references)

1 The World Health Organization. The World Health Report 2004: Changing History, Annex Table 3: Burden of disease in DALYs by cause, sex, and mortality stratum in WHO regions, estimates for 2002. Geneva, Switerland: World Health Organization; 2004.

2 Kessler RC, Greenberg PE, Mickelson KD, Meneades LM, Wang PS. The effects of chronic medical conditions on work loss and work cutback. J Occup Environ Med. Mar 2001;43(3):218-225.

3 U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General — Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999. Available online at:

4 Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-627.

5 American Academy of Family Physicians. Screening for Depression Across the Lifespan. 2002;66:1001-8.

6 American Academy of Family Physicians. Mental healthcare services by Family Physicians (Position Paper). Available at: Accessed May 12, 2008.

7 Substance Abuse and Mental Health Services Administration. Results from the 2006 National Survey on Drug Use and Health: National Findings. Rockville, MD: SAMHSA Office of Applied Studies; 2007. NSDUH Series H-32, DHHS Publication No. SMA 07-4293.

8 National Center on Quality Assurance. State of Healthcare 2004: Industry Trends and Analysis. Washington, DC: NCQA;2004 AND Lustman BJ, Clouse RE. Depression in diabetic patients: The relationship between mood and glycemic control. Journal of Diabetes and Its Complications, 2005;19:113-122.

Page last updated: September 11, 2012

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