March 22, 2004 — Managers and their employees have very different views about how depression affects the workplace, according to a new survey.

The survey shows that most benefit and middle managers believe depression shouldn’t interfere with career advancement at their companies, but only 41% of employees with depression feel they can acknowledge their illness and still get ahead in their careers.

Researchers say the survey reveals a major gap between employer perception and employee reality of depression and shows a need for creating more supportive, stigma-free environments to encourage employees to access the mental health services available to them.

“The gap between what benefit managers think is going on and what employees actually do is a complicated one,” says researcher Thomas Carli, MD, director of community and corporate programs at the University of Michigan Depression Center.

He presented results of the study today at a meeting co-sponsored by the University of Michigan Depression Center and the National Mental Health Association in New York City.

Carli says depression not only makes it harder for people with the disease to seek treatment, but it also magnifies feelings of shame and stigmatization, which makes it even more important for employers to address depression in the workplace.

A variety of health problems can derail even the most promising ascent up the ladder. Check out WebMD’s special feature on 5 Career Busting Health Conditions.

Gap Between Perception and Reality

In the study, researchers surveyed 443 employees with depression, 300 middle managers, and 207 benefit managers via the Internet about depression in the workplace in January and February of this year. All of the participants worked at companies with at least 500 employees.

The survey was sponsored by the University of Michigan Depression Center and supported by Eli Lilly and Company, which is a WebMD sponsor.

The study showed that management and employees are at odds when it comes to their perception of depression in the workplace. For example:

89% of benefit managers and 76% of middle managers said employees with depression can acknowledge their illness and still get ahead at their company, but only 41% of employees agreed.

• 65% of benefits managers report having an employee assistance program (EAP) for depression, but only 14% of employees with depression have ever accessed one.
• 72%-83% of managers said their company has taken steps to ensure support by co-workers and supervisors for treatment of depression, but only 37% of employees agreed.
• 90%-95% of managers said people can acknowledge they have depression at their company and be treated with respect and compassion, but only 51% of employees felt the same way.

The survey also showed that most middle managers (those who supervise at least five employees) believe assisting employees with depression is part of their job, but only 18% have received the training necessary to identify depression and intervene successfully.

The Burden of Depression at Work

Previous studies have shown that at any time, one in 10 employees experiences depression, and depression cost companies $52 billion in 2000 in lost productivity and absenteeism.

“No employer is exempt from the adverse consequences of depression in the workplace,” says Paul Greenberg, MBA, MS, co-director of the Analysis Group, which conducted studies to quantify the economic impact of depression in 1990 and 2000.

Greenberg says far more people with depression were treated in 2000 than in 1990. But only 20% of depression sufferers currently receive appropriate care.

Carli says businesses now accept that they must play a role in the treatment of depression not only because they pay for over half of all health care costs, but because depression actually interferes with productivity.

“There is a business case for depression treatment,” says Carli.

Spotting Depression at Work

Experts say depression in the workplace can surface in a variety of ways. Aside from causing employees to miss more days from work and lowering their productivity, it can also affect their employees’ relationships at work.

“I see a lot of interpersonal conflict,” says Hollis Even, MSW, vice-president and manager of the employee assistance program at JPMorgan Chase. “It’s not just performance but behavior, too.”

“They may be a perfectly good performer, but if their behavior is such that it is disrupting and disturbing to people around them, it’s another issue we have to deal with,” says Hollis, who also spoke at the meeting. “It’s a part of depression that’s not often recognized.”

Researchers say some common symptoms of depressed employees include:

• Dramatic change in performance/productivity
• Loss of initiative, motivation, or drive
• Difficulty concentrating
• Consistently arriving late to work or leaving early
• Chronic physical pain
• Substance abuse
• Anger or unexplained outbursts

Experts say it’s not the job of managers to diagnose mental illnesses, but it is important to recognize potential problems and address them.

“They have to be taught how to approach an employee in a compassionate and yet professional and businesslike way,” says Even.

For example, Even says managers at her company are instructed to recognize performance issues and focus on their observations and evidence of performance issues in approaching an employee they think may be having a personal problem. Then they must learn how to direct that employee to the right place to get help without labeling their particular problem as depression or any other mental illness.

Carli says his survey also showed that the more programs employers had in place to raise the awareness of mental health issues, such as Internet screening tools, newsletters, and supervisor training, the more likely their employees were to make use of available treatment services.

“Fully treated employees experience greater symptom control and greater symptom reduction, which significantly improves productivity and optimism about their career advancement,” says Carli. “Companies gain a more productive workforce, which positively impacts their bottom line.”