The Invisible Costs

Total employer costs of mental health disorders is often underestimated because both direct and indirect medical costs contribute to the overall financial burden. Direct costs are “visible” costs that comprise medical claims and pharmacy costs, whereas indirect costs such absenteeism, presenteeism and work disability are more difficult to accurately quantify and are “invisible” in that these costs are not included in financial statements.

Depression and comorbid conditions are also associated with workplace safety. One study of chronic illnesses and their impact on workplace productivity and workplace accidents found that the leading cause of lost work hours, measured through absenteeism and presenteeism, was depression.1 In another study of a nationally representative sample of U.S. employees, MDD was associated with 27 lost work days per employee per year with annual per capita cost of $4,426.2 In contrast, bipolar disorder is associated with roughly 66 lost days of work per employee at an annual per capita cost of $9,619 per ill worker.3 These exorbitant employer costs are also likely to be underestimated because stigma often prevents people living with mental health disorders from seeking early diagnosis, even though clinically effective treatments exist. 4,5, 6, 7

A Leading Cause of Lost Work Hours

Major Depressive Disorder is associated with 27 lost work days each year per employee with MDD. $4,426 per employee with MDD.
Bipolar Disorder is associated with 66 lost work days each year per employee with bipolar. $9,619 per employee with bipolar disorder.

Sources: Lost work days depression and bipolar8

Footnotes

  1. Frey, J. J., Osteen, P. J., Berglund, P. A., Jinnett, K., & Ko, J. (2015). Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories. J Occup Environ Med, 57(4), 436-444. doi:10.1097/jom. 0000000000000383.
  2. Kessler R.C., Akiskal H.S., Ames M., Birnbaum H., Greenberg P., Hirschfield R.M., . . . PS., W. (2006). Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. American Journal of Psychiatry. doi:https://doi.org/10.1176/ajp.2006.163.9.1561. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16946181
  3. Kessler R.C., Akiskal H.S., Ames M., Birnbaum H., Greenberg P., Hirschfield R.M., . . . PS., W. (2006). Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. American Journal of Psychiatry. doi:https://doi.org/10.1176/ajp.2006.163.9.1561. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16946181
  4. Weinberger A.H., Gbedemeh M., Martinez A.M., Nash D., Galea S., & Goodwin R.D. (2018). Trends in depression prevalence in the USA from 2005 to 2015: widening disparities in vulnerable groups. Psychological Medicine. doi:10.1017/S0033291717002781. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29021005
  5. Riolo S.A., Nguyen T.A., Greden J.F., & C.A., K. (2005). Prevalence of Depression by Race/Ethnicity: Findings From the National Health and Nutrition Examination Survey III. American Journal of Public Health. doi:https://dx.doi.org/10.2105%2FAJPH.2004.047225. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449298/
  6. Shim R.S., Baltrus P., Ye J., & G., R. (2011). Prevalence, Treatment, and Control of Depressive Symptoms in the United States: Results from the National Health and Nutrition Examination Survey (NHANES), 2005–2008. Journal of the American Board of Family Medicine. doi:https://dx.doi.org/10.3122%2Fjabfm.2011.01.100121. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161724/
  7. Whiteford H.A., Harris M.G., McKeon G., Baxter A., Pennell C., Barendregt J.J., & J., W. (2013). Estimating remission from untreated major depression: a systematic review and metaanalysis. Psychological Medicine. doi:10.1017/S0033291712001717. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22883473
  8. Kessler R.C., Akiskal H.S., Ames M., Birnbaum H., Greenberg P., Hirschfield R.M., . . . PS., W. (2006). Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. American Journal of Psychiatry. doi:https://doi.org/10.1176/ajp.2006.163.9.1561. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16946181