Treating Depression Expected To Reduce Disability Costs

“The longer folks are away from work, the less confident and capable they feel about going back,” Axelson said. “We encourage psychiatrists to get patients back to work at least part time or in some limited capacity sooner to assist in their recovery.”

The partnership is developing guidelines for insurers and physicians to encourage early detection, diagnosis, and treatment of mental illness among patients affected by other ailments or injuries.

Research suggests that only half of the millions of Americans who are affected by depression each year seek help.

Untreated depression results in an estimated $44 billion a year in lost productivity and work absences, according to another study. Major employers have described depression as the greatest negative impact on productivity for nonmanufacturing companies.

A 2005 study sponsored by the National Institute of Mental Health indicated that the U.S. mental health system lagged behind the needs of consumers and that improvements are needed to speed initiation of treatment and enhance the quality and duration of treatment.

The National Comorbidity Survey Replication, a household survey of 9,282 English-speaking adult respondents, found that over a 12-month period, 60 percent of those with a mental disorder received no treatment at all (Psychiatric News, July 15, 2005).

Aetna's response to the claims-data study includes continued development of integrated programs to address depression among workers. Aetna Depression Management, begun in October 2005, for example, provides clinical tools for physicians, training for office staff, access to Aetna nurse case managers, and support from Aetna's network of behavioral health specialists. The Depression Management program stems from Aetna's decision to bring all behavioral health business in-house, effective this past January 1, when it ended its contract with Magellan Behavioral Healthcare. The change aimed to integrate two data systems and care processes.

The company also increased reimbursement for physicians who screen and talk with patients to evaluate the presence of depression (Psychiatric News, January 20). Such patients include those at high risk for depression such as those with diabetes, coronary artery disease, chronic back pain, and other chronic conditions linked with depression.

Another Aetna response is that its disability case managers will make disability claimants aware of an educational Web site,<www.reawake.com>, which Aetna developed to educate people at risk for depression and their family members.

Although medical treatment has become a large part of mental health care, the company does not plan changes to its drug formularies as a result of the research, Kittredge told Psychiatric News.

Previous insurance industry research in this area generally looked at the incidence of depression and not its duration among beneficiaries. The findings on the length of the illness are particularly important for workers because extended illness costs them financially, as well as physically.

“Our focus is to try to help people get back to work and back to firm financial footing as quickly as possible after an illness, and depression can slow that process down,” Kittredge said.

Information on the Aetna study is posted at<www.aetna.com/news/2006/pr_20060424a.htm>. Information on the NIMH study is posted at<www.nimh.nih.gov/press/mentalhealthstats.cfm>.▪