Mental illness. It’s a stigmatized condition that all too often is ignored by those suffering and those closest to them—including colleagues and employers. But with one out of every five people experiencing a mental health illness, it’s a condition that can have serious consequences, including in the workplace.
“Depression in the workplace costs around $44 billion a year in lost productivity—people with depression lose an average of 27 workdays a year," says Rob Wesemann, executive director of the National Alliance on Mental Illness-Utah. “But mental health conditions can be managed very successfully. The problem is when the condition is not treated. Cancer untreated will get worse. A mental condition untreated will get worse. Unfortunately, up to 60 percent of people don’t seek help.
Having easy access to mental healthcare is one of the key components to ensuring people who need help will get help. Wesemann is an advocate of integrated healthcare, which combines medical and behavioral health in the same facility. “People are much more willing to discuss a medical condition than a mental health condition, but when you co-locate medical and behavior health, they’re more likely to seek help because you’ve gotten rid of some of the barriers to help. It’s been very successful."
Wesemann says the same is true for onsite workplace clinics. “Integrating mental health in an onsite clinic decreases barriers to help. It’s a good thing for employees and employers."
A healthy workforce is a productive workforce, and that includes mental health. As more employers discover the benefits of having an onsite healthcare clinic, it’s also an opportunity to bridge the gap to mental healthcare.
On-the-job care
Donna Milavetz, MD, started OnSite Care after 20 years of practicing internal medicine. She believed the modern healthcare system was broken and that she could do better. She launched Salt Lake-based OnSite Care to bring a different model of healthcare to patients—one that they could access right at work. Her goal was to generate better health outcomes with greater savings for both employers and employees. Working with employers, Milavetz has opened several onsite healthcare clinics in companies throughout Utah.
Though OnSite Care initially focused on physical health, Milavetz quickly realized a need to integrate mental health into the practice. “Mental health is the third-highest diagnosis for all visits seen in our clinics," she says. “Mental health and workplace stress is highly prevalent in the working-age population for many reasons, and having an on-location resource to help manage that stress is highly effective in both helping our patients and improving long-term health."
Today, Onsite Care has workplace clinics that include a myriad of mental health services. Some clinics offer on-location mental health counselors, and all offer EAP (employee assistant program) services. OnSite Care also provides on-location mental health medications that are either no cost or limited cost to employees.
“Having a medical model that offers these services not only enhances the patient experience, but provides a valuable service to the patient and the employer," Milavetz says. “Earlier time to diagnosis, more aggressive interventions and easier follow-ups allow us to save lives."
Milavetz has seen mental health services not only change lives of employees, but improve workplace outcomes. It’s a guaranteed win for everyone, she says. “When employers take on a culture of health, the downstream benefits absolutely positively affect the bottom line. Employees become more healthy, are more productive at work and feel valued," she says. “A culture of health embraces physical and mental health. Having an environment of acceptance and tangible resources that don’t cost a patient money have a huge return on investment."
Just like any physical health condition, Milavetz would like to see mental health prioritized in a way where people can easily access help without feeling stigmatized.
“Mental health is a public health issue. We need to take on this taboo topic and engage in strategies that take away the barriers to access care and to educate on warning signs of suicide," she says. “Even saving one life has a ripple effect on that person’s life, family and community."
The time has come for the private sector to take on this important public health threat to our communities.
Fulfilling a need
In 2011, CHG Healthcare recognized an opportunity to bring healthcare to its employees. The medical-staffing company began a year-long process to open onsite healthcare clinics at four of its locations, including its Midvale headquarters. “We believe in putting people first—it’s our core value, and opening onsite healthcare clinics was part of that," says Nicole Thurman, vice president at CHG.
Today, the clinics offer healthcare to employees and dependents at no cost. If strep throat is running its course through a family, for example, there’s no copay for each child—having an onsite healthcare clinic is a time and money saver for the family. “And what’s great about it is we’ve reduced our healthcare costs in the process," says Thurman.
While CHG’s onsite healthcare clinics have been successful from nearly day one, Thurman says that the company noticed the same trend about mental healthcare visits that Milavetz’s clinics experienced.
“When we got our clinic up and running, we realized almost immediately that our nurses and PAs (physicians assistants) were seeing people for anxiety, depression and drug abuse. We realized there was an additional need for mental healthcare—we had a gap," Thurman says.
CHG discovered that one out of every five people visiting the clinic was there with a mental health concern. In 2017, the company decided to integrate mental health services within the clinics, including adding onsite mental health counselors. The integration has been a win-win for employees and CHG.
“I suffer from mental illness and rarely get time to focus on myself and my own mental health," says Divina Mauchley, culture specialist at CHG. “Having my company recognize that mental health is a real issue and that by focusing on the whole employee, they are going to have better, more productive people is great. They are saying that they care about me as a mom, as an employee and as a person. … There is something so beneficial about being able to talk about anxiety and depression with somebody who is a licensed professional, who is an objective third-party person who is empathetic to what you’re going through."
“When someone gets sick, they can walk downstairs and nip it in the bud before they get other people sick, so we’ve saved with productivity and misery. It also works with mental health," says Thurman. “Mental health impacts their work and people around them."
And just like any traditional medical clinic outside of the workplace, the onsite clinic must adhere to HIPAA laws, which means employees never have to worry about the stigma of being seen for mental healthcare. “I may be seen for acid reflux or mental health—nobody would ever know," says Thurman.
While CHG experienced a measurable ROI after opening its onsite healthcare clinics, Thurman acknowledges the company hasn’t experienced a hard financial return upon adding mental health services. “It’s difficult to measure, but from our perspective it’s tapping into a gap that’s so prevalent in our country. We want to take care of our employees with [mental health] needs. They’re all good people, struggling at home with divorce or another issue. If we can help them in some small way, they’ll stay with us longer, be more productive, be more loyal and be happier."
Thurman encourages all employers with the resources to have an onsite healthcare clinic to consider integrating mental health services. “I personally underestimated the impact and value it would have for our employees—counselors are really helping them. I’m excited to see how this helps our trends and helps our healthcare business, but most importantly, we believe it’s the right thing to do."
A Head Start
5 tips to support mental health in the workplace
- Rebrand sick days as personal days and let your employees use the time however they see fit. Be supportive of mental health days and don’t require a doctor’s note for personal days.
- Be aware of how your company culture addresses mental health. How do your employees talk about their coworkers? Is there a stigma that exists in your workplace?
- Train supervisors, managers and other leaders to identify and appropriately address signs of a mental health condition or to seek help from an expert.
- If an onsite clinic isn’t a realistic option for your company, offer an EAP (employee assistance program). While they only provide short-term care, EAPs can help lead an employee in the right direction.
- Educate employees about your company’s mental healthcare benefits, including preventative care and EAPs.