Depression

Depression is a common illness, but few employers know how to spot employees who are affected – or how to deal with them. Jessica McCallin writes

It is the illness that dares not speak its name. Depression, like any mental illness, evokes fear and ignorance among the general populace. Few will admit to suffering from it, scared that they will be misunderstood, or accused of being weak and attention seeking.

Yet an estimated one in four people will suffer from depression at some point in their lives, and the illness is on the increase. According to a 2001 World Health Organisation study, depression will be the second most debilitating illness in the world in 2020, second only to heart disease. Its growing incidence has huge implications for business.

Depressed employees will not be as productive as their undepressed colleagues. Many will require time off work; the most severe sufferers may possibly need several months off. If treatment is covered by company health insurance, it is likely to be costly, as there is no magic pill to cure depression.

Depression is already believed to cost US companies between $40bn and $70bn a year in lost productivity and medical expenditure. Mind, a UK mental health charity, says 40 million working days each year are lost to it.

To risk managers, depression poses a myriad of problems. Just recognising it in an employee can be problematic enough. The symptoms can mirror those of other common illnesses, and employees are likely to want to hide the fact that they are ill. It is also difficult to know what to do about depression in an employee.

Ron Bracey, a consultant clinical psychologist who helps companies with their depressed employees explains: "The impact on the company will depend to some extent on what the depressed employee's role is. Someone whose job is stacking shelves might be able to make it through the day, going through the motions and doing the job more or less as normal. But, at the other end of the scale, a strategic employee, a creative driver behind the company, might find it impossible to fulfil their responsibilities when they are depressed. The cost to the company is significantly higher if the depressed employee is a crucial member of staff."

Do not assume that high-flying staff members and members of the board of directors are not the 'type' to succumb to depression. Consider some of the world's more famous depressives. Winston Churchill was a sufferer, calling his depression his black dog. American Presidents Abraham Lincoln and Lyndon B Johnson were others. Beethoven, Charles Dickens, Leo Tolstoy, Virginia Woolf, Hans Christian Anderson, Ernest Hemingway, Marilyn Monroe, Laurence Olivier, and the founder of CNN and current chair of AOL Time Warner, Ted Turner.... the list goes on. There is, in short, no correlation between depression and lack of ability. Some of the most talented people in history were periodically crippled by depression. Companies which hire and fire depending on whether someone is a sufferer could be losing valuable manpower.

"As with all illnesses, early intervention is best," says David Gamble, executive director of AIRMIC. "Line managers should be aware of the symptoms and should support employees if they succumb, but there is always a question mark over what companies can actually do."

Responsibility
No one really knows what causes depression, although doctors agree that there is rarely a sole cause. Its current increase has been ascribed to a combination of better diagnosis and the increasingly fragmented, insecure and stressful lives we lead, cut off from family, friends and social support networks. The unstable job market does not help. But these are not the responsibility of individual companies, so should individual companies be held responsible for employee depression?

Well, yes and no. While work is unlikely to be the only thing making an employee depressed, it might not be helping, and some work environments help less than others. Stressful, bullying work environments can compound depression and should be avoided. Constant change is also harder for some people to internalise than others.

"Good risk management dictates that you look after all your employees and try to reduce stress for all of them," continues Gamble. "Good management will look out for, and manage, the stress of all its employees. Companies which do this already will be better able to deal with depressed members of staff."

Companies also need to decide whether or not depression will be covered by the company health insurance. Depression is not a cheap illness, requiring time off work, drugs and talking therapy Average recovery periods vary between four and eight months.

Some companies might choose to subscribe to an employee assistance programme, which gives employees confidential access to counsellors and therapists. This can be offered as a positive, proactive employee perk, possibly linked to health insurance, or can be offered to give the company an element of protection – providing proof, in the event of employee action, that it has thought about depression, and offers support. There are already signs that depression could soon enter the realm of lawsuits and company tribunals. "It is just a matter of time before a personal injury case puts forward the argument that someone's job made them depressed," says Bracey.

However, since depression is so multi-faceted – there is no one single cause – it is unlikely that many court judgments will blame a company exclusively for a person's depression. The main risk to companies lies in the fact that, at any given time, one in four of their employees, could be suffering from a disease which hampers their work and therefore the company's performance. Companies who find a way to spot and support depressed employees will be ahead of the game in the years to come and they, like society as a whole, strive to catch up with and understand the illness.

Jessica McCallin is a freelance journalist

Depression: what is it and what causes it?
Classic symptoms are: