Telephone cognitive behavioural therapy for depressed employees could have beneficial effects on not only clinical outcomes, but also workplace outcomes, according to research published in the Journal of the American Medical Association.

Philip Wang of the Division of Services and Intervention Research at the National Institute of Mental Health, along with seven other researchers, held a randomised controlled trial involving 604 employees of a leading US business.

Depression is among the most costly of all health problems to employers, the researchers wanted to evaluate the effects of a depression outreach-treatment program on workplace outcomes.

Wang reports: “The primary outcomes included not only depression symptom relief but also job retention, decreased sickness absence, and increased work productivity.”

All employees were invited to take part in a telephone health risk appraisal survey. Trained staff read to participants an informed consent script, followed by a chronic-conditions checklist, screen for psychological distress, questions about occupation and work performance, and sociodemographics.

Employees whose screen results were positive for possible depression were then invited by an introductory letter to participate in a second-phase telephone interview that assessed depression more specifically using the Quick Inventory of Depression Symptoms Self-Report survey which scores the severity of depression.

Based on the score, the call handlers could then ensure the employee gets the appropriate counselling to help them overcome their depression in the best possible way.

Wang explained: “The structured telephone intervention program (provided without charge to participants who were randomly assigned to receive the intervention) systematically assessed needs for treatment, facilitated entry into in-person treatment (both psychotherapy and antidepressant medication), monitored and supported treatment adherence, and (for those declining in-person treatment) provided a structured psychotherapy intervention by telephone.”

Those employees, who used telephone care, instead of in-person treatment, were allocated personal care managers who maintained regular telephone contacts with the employee, based on the severity of their symptoms. Employees could call personal advisers at any point if they needed help.

All care management activities were organised and supported by an electronic decision support system. Blinded outcome assessments were performed at baseline and at six and 12 months by trained survey interviewers at the research firm conducting telephone interviews.

The care manager record system recorded system recorded contacts for recruitment monitoring and telephone psychotherapy.

Wang said: “The results suggest that enhanced depression care of workers has benefits not only on clinical outcomes but also on workplace outcomes…These observations suggest that outreach and enhanced care for depressed workers might be better conceptualised as an opportunity to invest in improving the productive capacity of workforces (referred to by employers as “human capital investments”) than as workplace costs.

“Further study is needed to determine whether intervention costs are offset by these workplace benefits and the variation in this offset across different employment settings…availability of Web-based, e-mail, and interactive voice recognition technologies should ensure that the costs of screening and recruiting depressed workers into interventions are low.”