Each year approximately 36 million days of work are lost because of declines in productivity related to mental illness. It is therefore critically important that the U.S. employer-supported health care system promote accurate diagnosis and effective treatment with a focus on return to work and that employers adopt policies that facilitate early return to work. To that end, the Partnership for Workplace Mental Health has developed a set of recommendations and tools for use by physicians and employers. The Partnership is a program of the American Psychiatric Foundation, with nearly 30 of the nation's top businesses, including Coca-Cola, 3M, Caterpillar, Dow Chemical, and Merrill Lynch.
The recommendations and tools are presented in a 42-page report, Assessing and Treating Psychiatric Occupational Disability: New Behavioral Health Functional Assessment Tools Facilitate Return to Work. The report includes four recommendations for physicians and patients. First, physicians should consider it a psychiatric crisis when a person leaves work because of a mental health condition. Second, the employee must secure an accurate diagnosis, with an emphasis on assessment of functional impairment as the basis for treatment and return-to-work plans. Third, treatment plans should address preservation or improvement of function and return to work. Fourth, psychiatric conditions should be considered in all cases of disability, not just those labeled as resulting from a psychiatric cause.
Specific recommendations for employers are also presented, which include establishing policies and procedures to ensure that employees can readily obtain an objective assessment and accurate diagnosis. In addition, employers should intervene early in an employee's absence from work and maintain regular, caring contact with the individual. A team-based approach should be used for return to work by individuals. The teams can be formal or informal and should include the employee and treating physician, employer, the employee assistance program, and health and disability plan representatives.
The report provides five basic assessment tools to assist clinicians in making reliable and consistent work function status assessments as the basis for treatment and return-to-work plans. Among these are two Job Function Forms, one completed by the employer and one completed by the clinician with the employee, that are designed to provide a picture of the mental and cognitive demands of a particular job. The Work Function Assessment Form helps the clinician correlate the job tasks that the patient has not been able to do (disability) with the mental functions (impairment) that the clinician has determined are the medical basis for each functional disability.
In addition to the assessment tools, the report also presents the results of a survey of employers conducted by the Partnership for Workplace Mental Health to document current practices in regard to helping employees with psychiatric disabilities return to work. The report is available at workplace mentalhealth.org/disabilityreturntowork.aspx.
