Cape Town health tech business Signapps recently hosted a successful webinar on Mental Health and Functional Rehabilitation in the Workplace, which was attended by more than 60 delegates, representing a variety of organizations including medical schemes, managed care organisations, insurers, employers and health care providers. The theme was "Closing the Gap."
The webinar, held in Mental Health Awareness Month, aimed to provide specialist insight into systemic obstacles that contribute to mental health relapse and innovative strategies and the technologies to support these.
Presented by a group of experts in the field of mental health in the workplace, the panel included Professor Stoffel Grobler, an expert of workplace wellness, Dr Kim Laxton, a psychiatrist in private practice, and Andrew Davies, CEO of Healthcent/Signapps.
While the effects of mental illness are felt across all aspects of society, a particular problem exists in the workplace, where mental illness has a negative impact on corporate performance.
Across the economy as a whole, mental illness in the workplace has a significant and measurable negative impact on the gross domestic product (GDP) of the country. The experts distinguish between absenteeism – where a person is not at work due to mental illness – and presenteeism, where the worker is physically at work but their performance is negatively impacted by their condition. Both have significant impacts on the individual, the employer and the economy.
Grobler explained, "Consider absenteeism: A study by Johnson in 2002 concludes that 'Once a person commences on sick leave, they start down a slippery slope leading to long term worklessness. The longer someone is off work, the less likely they are to return to work. If the person is off work for 20 days, the chance of ever getting back to work is 70%, for 45 days this reduces to 50% and after 70 days of sick leave, the chance of ever getting back to work is 35%.'
Another study by Waddel and Burton in 2006 around the effects of not working points to a number of possible negative outcomes for the individual, including an increase in medical consultations, hospitalization and the consumption of medicines. Compared with the working population, people not working are more likely to suffer from chronic illnesses such as cardiovascular disease and diabetes.
Significantly, the risk of suicide in this group increases six-fold. The American Medical Association puts it like this: 50% of people out of work for eight weeks will not return to work, while 85% of people out of work for six months or more, will never return to work."
Grobler continued, "Presenteeism results in another set of problems entirely. Because the person is at work but working below capacity, their productivity, and hence the effectiveness of the organisation, is compromised.
It has been estimated that, in South Africa, 49% of clinically depressed people will keep working despite their illness. Alarmingly, it has been estimated that 4.2% of South Africa's GDP is lost due to presenteeism linked to depression."
From a clinical point of view, Laxton explained, "In a typical situation, an employee suffering from a mental health illness is given sick leave and is treated, either in hospital or as an outpatient. Very often, when the employee returns to work, there is a relapse due to a breakdown in his or her managed care. There exists a gap between the initial return to work phase and successful reintegration of the patient into the workplace, fully rehabilitated.
Failure to “close the gap” can result in dire consequences for the person, the employer and the insurer. There currently exist systemic obstacles to the prevention of mental health relapse, meaning that relapse after treatment is a regular occurrence. Our objective is to guide and shape organizational strategies in this important area of care.”
To make matters worse, the COVID-19 pandemic has had an enormous impact on employment, pressure on corporate profitability and general anxiety and depression in the population. The levels of depression in both working and non-working people have increased significantly this year compared with previous years. One of the panellists called it "a tsunami of cases."
Andrew Davies stressed the importance of building an effective team to treat the employee. He said, "Typically, this is a big team. On the administrative side we have the person's line manager, HR department, legal representative and the case manager representing the health insurance company. On the medical side, there is usually the patient's GP, a psychologist to give psychotherapy, a psychiatrist for medication, often a dietician and finally the key person, the vocational occupational therapist, essentially the core around which the whole team operates.
Logically in such a big team, data collection and care co-ordination is difficult. To prevent disability we as a multi-disciplinary team need to communicate – often. We must stop working in silos. This is exactly where the Signapps platform comes in." Laxton concluded, "Look at the upsides. For the patient there will be continuity of psychotherapeutic clinical care with the emphasis on occupational rehabilitation and overall functional optimisation. For the insurer, a reduction in mental and behavioural disorder impairment and disability claims.
For the medical scheme, eliminating the cost of readmission, chronic psychiatric and other clinical co-morbidities. Finally, for the employer, a reduction in the risks and financial loss as a consequence of employee absenteeism and/or presenteeism. As a profession and as a country, we need to urgently address the closing of this important gap."
Issued on behalf of Healthcent