Why It’s More Critical Than Ever to Support Mental Health and How Insurers Can Help
Editor’s Note: The Council for Disability Awareness – led by Fred Schott and its research committee – has closely monitored the impact of mental health on short-term, long-term, and individual disability claims for several years. Given the exponential increase in attention the pandemic and recent societal events brought to this topic, we are opening up our files and publicly sharing the knowledge we’ve been collecting. The following post is the first in a multi-part series covering The CDA’s research findings.
The Household Pulse Survey: Anxiety and Depression
Since the pandemic hit its stride in April 2020, we’ve been talking and thinking and posting about depression, anxiety, stress, burnout and loneliness almost daily.
And we should be. Between April of last year and March 29, 2021, 34 percent to almost 45 percent of U.S. 18 to 64 year old adults indicated they were anxious and/or depressed in the Household Pulse Survey. As of May 24, 2021, prevalence dropped to just above 30 percent. But that’s up from a steady 11 percent (recorded in January through June of 2019).
Most of Us Will Develop A Mental Health Disorder at Some Point in Our Lives
Is this trend new for the United States – and the world for that matter – or were we struggling before SARS-CoV-2 came to our towns?
Deep insight about one township’s health (including mental health) comes from Dunedin, New Zealand. The Dunedin Multidisciplinary Health & Development Study is an ongoing prospective study that’s followed the lives of 1037 babies born between April 1, 1972 and March 31, 1973 at Queen Mary Maternity Hospital, since their birth almost 50 years.
A group of Duke researchers mined the Dunedin Study data and determined most people will develop a diagnosable mental disorder during their lifetime, suggesting only a minority experience enduring mental health.
Put another way, the study shows you are more likely to experience a bout of mental illness (at least briefly) than you are to acquire diabetes, heart disease or any kind of cancer whatsoever. Other researchers corroborated these findings from similar cohorts in New Zealand, Switzerland and the U.S.
So the underpinnings for susceptibility to mental health challenges were always there. The pandemic then became the straw that broke the camel’s back – especially for adults under 45 years old.
And this wasn’t the only study that made The CDA research committee pay closer attention to mental health.
Kristina A. Theis et al published a research article in the January 2018 Disability and Health Journal entitled “Prevalence and causes of work disability among working-age U.S. adults, 2011–2013, NHIS.” The researchers used data obtained from the National Health Interview Survey for the years 2011 through 2013 to help discern the major causes of work disability.
[Note: The researchers defined work disability by a “yes” response to one or both of these questions:
• “Does a physical, mental, or emotional problem NOW keep you from working at a job or business?” and
• “Are you limited in the kind OR amount of work you can do because of a physical, mental or emotional problem?”]
Overall, 20.1 million adults (10.4% of the working-age population) reported a work disability. The top three most commonly reported causes were:
• Back/neck problems (30.3%),
• Depression/anxiety/emotional problems (21.0%), and
• Arthritis/rheumatism (18.6%).
Musculoskeletal conditions were among the three most common causes of work disability overall and by age- and sex-specific respondents across diagnosed chronic conditions. And mental health conditions not only represented at least one in five reasons why someone was unable to work – they were often the secondary cause of a work disability.
Pre-Existing and New-Onset Depression and Anxiety Among Workers With Injury or Illness Work Leaves
The Council for Disability Awareness’ research committee decided to conduct a formal research project in cooperation with member company MDGuidelines on pre-existing and new-onset depression and anxiety in the working population. The results were published in October 2020 in the Journal of Occupational and Environmental Medicine.
This study examined matched disability and medical claim data, and summarized the impact of mental health on absence from work, and absence on future mental health challenges. Fraser Gaspar, PhD, was the lead author.
The research found that depression and anxiety are both risk factors for and subsequent outcomes of injuries or illnesses that require a work leave.
Specifically, the odds of a work leave within a year were 2.10 times higher in people with depression and/or anxiety compared to those without.
And the odds of developing a new-onset depression and/or anxiety within a year of an absence from work was 4.21 times higher in individuals with a work leave compared to those without.
What Might the JOEM Results Tell us About Anxiety, Depression and The Pandemic?
Given that the United States still has over 30 percent of working-age adults indicating they are anxious and/or depressed, we need to jump into action. The JOEM-published study results indicate this group has more than a two-times greater risk of a work leave in the next 12 months than those who are not currently anxious or depressed. And, for employees who left the workplace due to a COVID-19 infection, their risk of developing anxiety or depression within a year of this absence is at least four-times greater than for those who did not leave the workplace.
According to MetLife’s Employee Benefit Trends Study 2021, employers are “evolving their benefits approach to meet the changing needs of employees, build employee resilience, and support worker well-being.” Of particular note, 74 percent of employers surveyed indicated they are offering (or intending to offer) more value-added services for employees, such as mental health programs and employee assistance programs.
Perhaps one of the positive outcomes of the pandemic will be an overall commitment by the employer and health care communities to fully address our collective propensity – as identified in the Dunedin Study – to experience a mental challenge at some point during our lives.
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