Depression, a complex condition marked by changes in thinking, mood or behavior, is 1 of the most common mental disorders in the U.S., affecting people of all ages and socioeconomic groups. It is known to reduce worker productivity but the symptoms of depression aren’t always recognized, much less treated.

The personal toll on employees can be significant and the economic consequences on organizations add up, too. Data from the Centers for Disease Control and Prevention (CDC) show depression results in about 200 million lost workdays each year, at a cost to employers of $17 to $44 billion. On average, people with depression miss 4.8 workdays and suffer 11.5 days of reduced productivity during a 3-month period. In addition, major depression carries the heaviest burden of disability of all mental and behavioral disorders, according to the World Health Organization.

Fortunately, even those with the most severe depression frequently respond well to a variety of treatments, including psychotherapy and medications, according to the National Institute of Mental Health. However, a study from the Centre for Addiction and Mental Health (CAMH) in Toronto found that many workers who are depressed experience barriers to getting the mental health care they need. And 1 of the top problems is that symptoms of depression too often are not recognized.

For the CAMH study, published in the Journal of Occupational and Environmental Medicine, researchers surveyed 2,219 Ontario adults between the ages of 18 and 65 who had been employed for the past 12 months or longer. Approximately 40% of the research participants reported significant symptoms of depression — but more than half didn’t perceive they had a problem that needed treatment. Previous studies in the U.S. and Australia have produced similar findings.

“Our results suggest that a significant number of workers who are experiencing symptoms of depression do not recognize they could benefit from help, and so do not get it,” said Carolyn Dewa, PhD, director of CAMH’s Centre for Research on Employment and Workplace Health. “This barrier has a significant impact on health and work productivity and is an area where employers can focus efforts to reduce work productivity loss.”

The study found that while not recognizing the need for depression treatment is clearly a barrier, there are other difficulties experienced by depressed workers that keep them from accessing mental health care. For example, many worry about the stigma of being diagnosed with a mental illness if they seek help and some don’t believe that treatment for depression is effective. There can also be financial limitations and difficulty getting to the appropriate mental health care provider.

Dewa, a health economics expert, and her colleagues estimated that if organizations embraced strategies to increase the use of mental health services by employees with symptoms of depression, the result would be a 33% decrease in work productivity loss. And loss of work productivity could be reduced by nearly 50% if organizations removed all barriers to depression recognition and treatment, the researchers concluded.

“The most effective workplace mental health strategies will acknowledge the complexity of the problem and address all aspects in a comprehensive way,” Dewa said. “It’s important for employers to know where to start when it comes to tackling productivity loss related to untreated depression. Our study suggests that helping workers understand when they should be seeking help would significantly boost work productivity.”

The CDC recommends these strategies to help employers support their employees’ mental health:

• Hold screenings for depression.
• Place confidential depression symptom self-rating sheets in cafeterias, break rooms and on bulletin boards.
• Promote greater awareness of depression symptoms and treatment through employee assistance programs. Train supervisors in depression recognition.
• Ensure workers’ access to needed psychiatric services through health insurance benefits and benefit structures. — Sherry Baker