Reprinted with permission from Partners and the National Association of Occupational Health Professionals.

Mental health disorders often elude detection in the workplace, and even when a condition is recognized it is likely to go untreated.

Occupational health providers who work closely with employers can help minimize the impact of mental health conditions on employee well-being and work performance by educating them about symptoms and facilitating referrals to mental health professionals.

An employer may review the symptoms of common problems such as depression, bipolar disorder, attention deficit hyperactivity disorder and anxiety in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, American Psychiatric Association, 1994). However, but that may not shed enough light on the situation. Such conditions tend to take on added dimensions in the workplace, according to Harvard University researchers.

For example, although the DSM-IV lists low mood as the defining symptom of depression, in the workplace depression is more likely to manifest itself in behaviors such as nervousness, restlessness or irritability, and in physical complaints such as aches and pains. In addition, employees may become passive, withdrawn, aimless and unproductive.

In addition, mental health issues may be compounded at work by factors such as the stigma associated with having a psychiatric disorder, fear of employment repercussions if treatment is sought and managers who are not well versed on appropriate interventions, Harvard Mental Health newsletter reports.

Meanwhile, when symptoms are acknowledged, treatment costs can present a barrier to recovery. From 2005 to 2009, private health insurance was applied by only a third of individuals who received outpatient mental health services in the past year, according to newly released findings from the National Survey on Drug Use and Health. By comparison, “self or family member” was the main source of payment for 26 percent of adults receiving outpatient mental health services. Among adults who paid for all or part of their outpatient mental health treatment, 2.3 percent had out-of-pocket expenditures of at least $5,000.

“The goal of mental health services is to help individuals achieve recovery and improve the quality of their lives,” it says in the national survey summary prepared by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. “However, many individuals remain uninsured because of financial barriers, and individuals who are covered by insurance may be undertreated” because their insurance caps visits.

Pamela S. Hyde, who directs SAMSHA, a public health agency within the Department of Health and Human Services, said opportunities to prevent and intervene early are being missed.

“The consequences for individuals, families and communities can be devastating,” she said. “If left untreated, mental illnesses can result in disability, substance abuse, suicides, lost productivity and family discord. Through health care reform and the Mental Health Parity and Addiction Equity Act we can help far more people get needed treatment for behavioral health problems.”

Under the equity act, deductibles, co-payments and treatment limitations that apply to mental health benefits must be no more restrictive than the predominant financial requirements or treatment limitations that apply to medical/surgical benefits. Similar rules apply to substance use disorder benefits.

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