APA Chips Away at Corporate Aversion to Better MH Coverage
Convince business leaders that you can speak their language, if you want to make a case for mental health benefits, advised Paul W. Heck, manager of the Global Employee Assistance Program at DuPont.
Heck was the lead speaker at the workshop “How to Convince Corporate CEOs That Mental Health Is a Good Investment” at APA’s 2002 annual meeting in Philadelphia in May.
“We’ve had an outstanding reception to our outreach activities,” Clemens said. “In fact, employers say, ‘Where have you been?’ ”
Lloyd Sederer, M.D., APA’s director of clinical services, later explained that the initiative is an effort “to go upstream” from insurance companies to the corporate decision makers about what gets purchased in terms of health benefits.
The psychological impact of the terrorist attacks on September 11 heightened awareness of the importance of mental health issues and also helped destigmatize mental illness. In April, with financial support from the Center for Mental Health Services (CMHS), APA hosted a conference titled, “Disaster, Terror, and Trauma in the Workplace: What Did We Know Before 9/11, and What Have We Learned Since Then?”
The conference was offered under the auspices of the National Partnership for Workplace Mental Health, a joint APA-business effort to address the psychological problems in the workplace resulting from the terrorist attacks.
APA recently issued a publication, “The Business Case for Mental Health,” which contains excerpts from a major symposium with corporate leaders held June 2001 at the Carter Center (Psychiatric News, July 20, 2001).
Clemens noted, however, that funding for mental health services has drastically deteriorated. Whereas the total value of the private health care system diminished by about 10 percent, with general health value diminishing by a little over 7 percent, the behavioral health value diminished by 54 percent over the period 1988 to 1997.
Obstacles to Improved Coverage
Heck described the obstacles to making the business case for mental health. Employers fear that work will be “the first thing sacrificed” if a person is treated for mental illness. They anticipate the employee might be encouraged to take 30 to 60 days off to relieve immediate distress from symptoms of mental illness.
The problem of time away from the work site is exacerbated by the fact that some firms are instituting layoffs, which increase the workload of those who remain with the company. The remaining employees often resent time off by a colleague in treatment because they cannot see a physical impact of the illness.
Delay in treatment is a problem as well, according to Heck. Often, there is a long wait before an employee can get a first appointment to see a psychiatrist and another delay before the impact of medication can be felt by the employee and perceived by employers.
Clemens also noted that corporate executives have complained about lack of availability of psychiatrists willing to take patients in managed care plans. He and other members working through the business initiative are encouraging reform or replacement of the managed care system that will induce psychiatrists to return to panels.
A number of European countries have nationalized systems of health care, and corporations in those countries do not have the primary responsibility of paying for benefits. American companies that compete in a global marketplace with their European counterparts, therefore, are at a competitive disadvantage in terms of employee benefits. In addition, employers can no longer count on the controls of managed care to restrain escalating health care costs.
Speaking the Language of Business
“What gets measured gets done,” Heck told the audience about the business environment.
He encouraged psychiatrists to find ways of measuring the impact of mental health coverage on the bottom line for corporations and added that even the choice of treatment for various forms of mental illness often seems subjective to corporate officials.
Keep the business case up front and tailor each presentation to the specific corporation, he said. It’s helpful for mental health professionals to emphasize the value of work as a tool of recovery and to assist companies to develop innovative preventive services.
“The Business Case for Mental Health Care” contains data and additional ideas that can help demonstrate to corporate executives the value of good mental health benefits.
Ron Z. Goetzel, vice president of consulting and applied research at the Medstat Group, for example, helped develop the Work Productivity Short Inventory to collect data on absenteeism and presenteeism for certain disease conditions.
He and his colleagues collected data on more than 1,000 employees to look at the number of unproductive hours in a typical workday associated with certain conditions. For individuals with depression, stress, or anxiety, about two hours out of each workday is “basically unproductive.”
They conducted another study that looked at the relationship between quantifiable risk factors and short-term health care costs and found that depression and stress turned out to be the most predictive of short-term increased health care costs.
That study reported that holding all the demographics and other risk factors constant, people who were depressed were 70 percent more expensive to their employers in terms of health care costs than everybody else. People who reported feeling under high stress and not able to control that stress were 46 percent more expensive.
“Educated companies are the best customers for mental health services,” Sederer reminded the group.
Information about APA’s National Partnership for Workplace Mental Health is posted on the Web at www.workplacementalhealth.org. “The Business Case for Mental Health Care” can be obtained by sending a request via e-mail to [email protected] or calling APA’s Managed Care Help Line at (800) 343-4671. ▪
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Published online: 21 June 2002
Published in print: June 21, 2002
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Persuading corporate officials of the value of mental health services requires the ability to see the world through their eyes.
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