Tackling depression: The opportunity no one takes
Tackling depression: The opportunity no one takes
One in 20 employees may suffer in silence
On any given day, depression may be sidelining one in 20 of your workers. They may call in sick, or they may show up but struggle through the day with lower productivity.
At Mercy Medical Center-North Iowa in Mason City, depression has moved from the shadows to the forefront of employee health and wellness. Education, awareness, and counseling have targeted depression and enabled the hospital to provide services without stigma, says Kelly Putnam, MA, the hospital’s health promotion coordinator.
Although it’s difficult to directly link counseling and education on depression to productivity, the hospital has seen a reduction in work-related injuries, lost workdays, and workers’ compensation costs since it began, she says.
"This is the world-class opportunity for employee health that virtually no one is taking advantage of. We know that [depression] is prevalent; it’s expensive. The good news is that it’s highly treatable." Putnam explains.
There are some other bottom-line reasons to address depression in hospitals, she notes. Workers with depression have almost twice the annual medical claims as nondepressed counterparts. Depression is more prevalent among women — and the health care work force is predominantly female.
Those were arguments Putnam used to convince hospital administrators that depression was an important employee health issue to tackle.
"This is a huge opportunity to not only address some short-term costs and productivity issues, but also to help people feel better," she points out.
Mercy Medical Center’s program stems from its highly successful wellness program, called Kailo (pronounced ky-lo), which means "whole," "uninjured," or "of good omen."
Kailo differs from traditional wellness programs that focus on nutrition, diet, exercise, and health promotion.
In 1996, Putnam and her colleagues conducted an employee survey and focus groups to find out about employees’ health concerns.
"Psychosocial health concerns were their No. 1 primary concern — stress, depression, fatigue, relationship issues, even domestic violence," she says.
Putnam and her colleagues built a wellness program that emphasized those issues, such as work-life balance and reducing stress.
Not like anything you’ve seen’
Wellness needed an image makeover, Putnam decided. She wanted Mercy Medical Center’s 2,800 employees to check out Kailo, even if they had never before attended a wellness seminar. It was marketed as a new twist on wellness — not mass health screenings or weight-loss programs or guilt trips about what employees should be doing.
"Kailo: It’s not like anything you’ve seen before," the marketing campaign said.
Employees were intrigued. When they attended the lunch-and-learn sessions, called Kailo Breaks, they received food, camaraderie, motivational talks, and a true break from work. The programs are held during work time.
Meanwhile, employees still have access to cholesterol, blood pressure, and other screenings, on an individual and confidential basis. The fitness classes focus on stretching and relaxation. There are raffles and prizes, but they reward participation, not weight loss or fitness goals.
"We decided from the beginning we needed to not make this a behavior-based program; it was a supportive-based program," says Putnam.
"People were exhausted and stressed out," she says. "There were lots of shaky relationships in the workplace and home. The last thing they needed was a wellness program that said, By the way, we want you to be thinner and eat better.’"
Putnam also spent time in all the units, building relationships. That trust was essential before the program could expand to address depression, she says.
One-on-one counseling offered
Kailo grew, becoming a popular, employee-centered program. It has three employees, including Putnam, and a budget of $300,000.
Kailo for One was added as an individualized counseling service that is an alternative to the traditional employee assistance program (EAP). Laura McKibbin, a licensed clinical social worker, leads one-on-one sessions with employees. (She is paid through the EAP budget.)
Kailo for One promotes a "You talk; we’ll listen" approach: If it’s important to you, we want to hear it. The old paradigm of a restricted number of sessions is gone. (The hospital still has a traditional EAP that handles issues such as fitness-for-duty referrals.)
This is a "nonstigmatized, comfortable place where people trust coming for help," Putnam says. Employees responded to the concept — in the first year of the program, utilization of counseling services rose by 171%, she says.
Employees who visit Kailo fill out an assessment that includes the Beck Depression Inventory. Of 950 assessments completed, 77 indicated the employee was at high risk for depression.
They received letters inviting them to come to Kailo for One. (Four employees who were identified as at risk for suicide received immediate phone calls.) Forty-five employees ultimately attended counseling sessions.
A post-counseling Beck Inventory showed a success rate of reduced symptoms of more than 80%, Putnam says.
Hospitalwide campaign promotes program
Mercy Medical Center took a direct approach to depression with a hospitalwide awareness effort dubbed "Beyond Bootstraps."
First, senior administrators and supervisors received training on the signs of depression and how to refer employees who may need help. Health educators and wellness staff attended departmental meetings and launched a marketing campaign with fliers, brochures, e-mails, newsletter articles, and health fair displays.
Ultimately, about 1,000 employees attended educational sessions on signs and symptoms of depression. The message: Go "Beyond Bootstraps" to help friends, family, and co-workers who suffer from depression.
"It kind of detoxified the diagnosis of depression," says Jenean Wolterman, MA. "People are more comfortable with the diagnosis, and they recognize that it’s not a personal defect. It can be something chemical, it can be situational, and it’s treatable.
"It helps the employees themselves and their families to seek medical care earlier than they might have," she says. "It helps co-workers not to just look at people and [think] Just get over it.’"
Combating depression remains an important part of the Kailo program. About 60% of employees who come to Kailo for One measure positive for depression, says Putnam.
"It’s a sensitive area, but there are ways to handle it that are perfectly legal, respectful, and compassionate, yet more proactive," she says.
(Editor’s note: Mercy Medical Center provides an education depression kit in its Kailo to Go program. It also provides consulting for other hospitals that want to re-create the program. More information is available at www.kailo.org.)
Reference
1. Putnam K, McKibbin L. Managing workplace depression: An untapped opportunity for occupational health professionals. AAOHN Journal 2004; 52:122-129.
On any given day, depression may be sidelining one in 20 of your workers. They may call in sick, or they may show up but struggle through the day with lower productivity.Subscribe Now for Access
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