Webcast: Mental Health in the WorkplacePrevention and Early Intervention

1

The Importance of Work

No other technique for the conduct of life attaches the individual so firmly to reality as laying emphasis on work; for his work at least gives him a secure place in a portion of reality, in the human community.

SIGMUND FREUD, Civilization and Its Discontents

2

Who is Maine Behavioral Healthcare?

• An organization that came together one year ago as a result of a merger.

• Spring Harbor is southern Maine’s only private nonprofit psychiatric hospital.

• We serve nearly 20,000 clients and patients • We have a large service area with over 30 locations. • We are the only behavioral health organization in Maine to

offer the complete spectrum of integrated care.

3

Current Grant Initiative

• Fundamental basis: Work is self-defining. • Families often face the burden of being the “shadow mental

health system.” • Spring Harbor Hospital is seeking foundation support for a

program to help people with mental illness meet employment goals.

• While each situation is different, one constant remains: families do not have to face the uncertainty and anxiety of a loved one’s mental health crisis alone.

4

Our Experience as an Employee Assistance Program• Our Lancaster Street location in Portland has been an EAP

provider for over 20 years.• Experience with national, regional, and local contracts serving

Maine citizens.• Offer assessment, brief counseling and crisis intervention.• Organizational training and HR support. • Serve local companies, organizations, school systems and

municipalities with 30-1200 employees.

5

Investment in Mental Health Pays Off

• Reduces work absenteeism, unnecessary doctor visits, etc.• Maximizes workplace performance• Strengthens positive and productive work environment• Reduces stigma of seeking help• Fosters recovery and resiliency• Not everyone wants/needs formal intervention

6

Costs to Employers

• $104 billion in direct costs• 217 million work days lost each year due to impact of mental

illness on employees or their family members• 6.6% of FT employed adults have experienced a major

depressive disorder episode in the past year• There are increased disability claims, lost productivity, etc.

Source: National Business Group on Health/Mental and Behavioral Health/Depression

7

Employers’ Top Priorities

• Recognize the impact of supporting mental health• Provide prevention education on mental health and substance

abuse for your managers and staff• Address prevention and early intervention to reduce

“presenteeism,” absenteeism and disability claims

• Understand:• Stressful and traumatic events happen to all employees• A broad range of illnesses impact employees and their families:

depression, anxiety, and more serious diagnoses such as schizophrenia and related disorders

8

Stressful Events Happen to Everyone

• Loss of loved one• Car accidents• School bullying• Workplace performance problems• Lay-offs• Divorce, illness, violence

9

National Prevalence of Posttraumatic Stress Disorder• Lifetime in U.S. 7.8%• Vietnam Veterans 31%• Motor Vehicle Accidents 19-47%• Cancer in adolescents 35%• Burns in children 50%• Oklahoma City 34%• Tokyo Sarin attack 24% at 5 years

10

11

Weeks toMonths

Months toYears

Years toDecades

100%

50%

0%

Typical Course ofPost-Trauma Responses

PTSD Unremitting PTSDTransition

Posttraumatic Responses

Provide Education on Prevention

• Recognition of early warning signs:• Change in energy or activity levels• Trouble relaxing or sleeping, or sleeping too much• Physical ailments• Increase in alcohol, tobacco or illegal drug use• Anger and frequent arguing• Crying frequently (sadness)• Worrying excessively• Difficulty concentratingChildren: other warning signsRecognize how past experiences affect current feelings

12

Social Supports

Childhood Experiences

Personality

Pre-existing Mental Illness

Event Related Factors Person Related Factors

Factors Related to Developing PTSD

SeverityProximity

Duration Family History

14

Population Exposure Model

Key Concepts of Critical Incident Reactions

No one who sees a critical incident is untouched by it

Adapted from DeWolfe, 2002.

A: Injured victims, bereaved family members

B: Victims with high exposure to traumatic event, or evacuated from disaster zone

C: Bereaved extended family/friends, first responders

D: People who lost homes/jobs/possessions, people with trauma history; at-risk groups, other disaster responders.

E: Affected people from community at large

Lay-offs and Workplace Events

• Circles of impact sometimes require group intervention• Survivor guilt• Sometimes things come up weeks after a traumatic event• Be alert for drop in productivity or attendance• Well-timed interventions (not too early or too late) are most

useful

15

16

Prevalence of Substance Abuse in Maine

Prevalence of Mental Health Concerns

17

Burden of Mental Illness : Child and Adolescent Behavioral Problems

18

Indirect Costs to the Workplace

• As families juggle work and family commitments, indirect costs to families impact the workplace:• Average of 1.4 lost workdays per month and 1.2 early departures

per month*• Anxiety is common concern with widespread prevalence• Absenteeism• Presenteeism • Termination of employment

*Source: An Employers Guide to Child and Adolescent Mental Health, National Business Group on Health/Mental and Behavioral Health/Depression

19

What about Serious Problems?

• Use EAP to identify the need for more intensive intervention• Signs of serious mental illness should be addressed early:

benefits are lifelong • Seek immediate help if someone threatens to harm

him/herself or others, have uncontrolled anger or a sharp drop in usual activities

20

The Role of the Employer

• Address insurance benefits design• Flexible leave policy• Flexible workplace practices• Utilize EAPs that provide education in the workplace• Host seminars on mental health and substance abuse

prevention• Refer employees to vocational counseling resources for

serious and persistent mental illness

21

Questions?

• Resources: • NAMI Maine• National Institute of Mental Health• National Association of School Psychologists• Bipolar Disorder Magazine• Mental Wellness Today• Contact FMI: Melania Turgelskymturgelsky@MaineBehavioralHealthcare.org

22