Could mental health training cut sick leave costs?

A four-hour mental health training program for managers could yield fewer employee sick days and a roughly 10-to-1 return on investment.

“Across the developed world, mental health has taken over as the leading cause of long-term work absence,” said senior study author Samuel Harvey of the University of New South Wales Faculty of Medicine in Sydney.

“From both a society and employer point of view, there’s a strong economic argument for talking about mental health in the workplace,” he said.

“Mental health is taking young people out of the workplace and they’re finding it hard to get back, which is a real disaster.”

For a trial of their training program in 2014, the study team recruited 128 managers at the level of duty commander in Fire and Rescue New South Wales, the seventh largest urban fire service in the world, according to the authors.

Roughly half of the managers were randomly assigned to participate in a four-hour face-to-face mental health training program that focused on symptoms of depression, anxiety, post-traumatic stress and alcohol misuse and how to recognize them in the workplace setting. The program included the key features of common mental health issues, the roles of senior officers in employee mental health and the development of skills for discussing mental health with staff.

The other managers were put on a waiting list to go through the program at a later time.

Researchers followed-up six months after the training with all the managers, analyzing changes in sickness absences among the 2,000 firefighters and station officers supervised by the study participants.

They analyzed rates of work-related sick leave and standard sick leave separately to distinguish between the leave taken under Australia’s workers’ compensation program, which is directly related to an injury or illness at work.

Among employees of managers who had the training, the average rate of work-related sick leave dropped by 0.28 of a percentage point, from 1.56 %to 1.28 percent, which corresponds to a reduction of nearly 6.5 hours per employee over six months, the study team writes in The Lancet Psychiatry.

In the comparison group, the rate of work-related sick leave increased by 0.28 of a percentage point, from 0.95 %to 1.23 percent, during the same period. Average rates of standard sick leave increased in both groups by about one third to half of a percentage point, from roughly 5 percent.

The total training cost was about AUD$1,017 (about US$946 in 2014) per manager, and based on the firefighters’ hourly wage, researchers calculated the reduction in work-related sickness absences associated with training had saved AUD$10,152 (US$9,441) in costs per manager.

“For a while, we’ve had increasing evidence that managers were key players in thinking about mental health in the workplace,” Harvey said. “What stuck out for us was the pretty dramatic return on investment for a relatively brief training program.”

“If you want to make a difference in the workplace, you have to talk about profit. The return on investment creates a real incentive to get workplaces involved in mental health,” said Dr. John Greden of the University of Michigan Comprehensive Depression Center in Ann Arbor, who wrote an accompanying editorial.

“Supervisors can be allies who help their employees get assistance,” he said in a phone interview. “It’s a commonsense approach to talking to the people you’re supervising and asking how they’re doing.”

Greden is studying the most effective training programs and how to tailor them to different workplace settings. Ultimately, he said he wants workplaces to be part of the equation and choose the best options for their staff.

“Society can reinforce these efforts, or we can continue paying a high price with the disruption of families through divorce, the loss of jobs and suicide,” Greden said. “The better approach is to take on these issues and incorporate them into our workplace.”

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