WHI program improves depression-related work disruption

A work-focused, telephone counseling program for depressed employees not only improves depression but also leads to increased productivity and decreased costs, reports a study in the February Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

Debra Lerner, MS, PhD, of Tufts University and colleagues evaluated the program, called the Work and Health Initiative (WHI). Identified by an anonymous on-line screening survey, 79 Maine State Government employees with depression and reduced job productivity were randomly assigned to the WHI program or usual medical care.

Over eight weeks, workers in the WHI group received telephone sessions with a trained counselor. Counseling included:
•Work coaching and modification, targeting job problems related to depression.
•Coordination of care, working with patients' doctors to ensure high-quality medical treatment for depression.
•Cognitive-behavioral therapy strategies, helping to change depression-related thoughts and behaviors that interfere with daily functioning.

The WHI program improved depressive symptoms along with a number of work-related outcomes, including increased productivity and fewer missed work days. Mainly by reducing work absences, the WHI program led to significant cost savings: more than $6,000 per worker per year, on average.

Depression is common in working-age adults and has a significant impact on work performance—including an increased risk of job loss. Medical treatment may not be enough to overcome depression-related work disruption. Taking a cue from work-focused treatment programs for other chronic health problems, the WHI regarded return to effective functioning as an important goal of treatment for depressed workers.

"The WHI was superior to usual care in helping employees with depression function more effectively and productively," Dr Lerner and coauthors write. While acknowledging the need for more research, they believe the WHI is a step forward in shifting treatment for depression "from a strictly biomedical to a functional paradigm."