On the cost of caring

Each year, 217 million workdays are lost or less productive due to mental health concerns. Indirect mental health costs on companies are estimated at $59 billion. But some estimates put these costs as high as $80 to $100 billion. These staggering numbers often serve as motivators for human resources departments and corporations to take action and “solve” mental health crises.

For each specific diagnosis, the statistics vary widely. Researchers tend to look at indirect costs, direct health coverage costs, productivity disruptions, absenteeism, and failure to be mindful while on the job. One of the more common ones, depression, costs employers about $44 billion in lost productive time. Additionally, employees with depression miss about 4.8 days of work and 11.5 days of reduced productivity every 90 days.

Another frequent mental health concern in employees is anxiety. Symptoms of anxiety manifest in various ways, but generally are closely linked with stressors. Anxiety disorders cost about $42.3 billion in the 90s. Inevitably, that estimate would likely be far greater today.

The most expensive diagnosis is usually bipolar disorder. From absenteeism to lost productivity to medications, this disorder has a potent effect on profits. In fact, it costs about $6,836 per employee with bipolar disorder. Closely linked, suicide amounts to $34.6 billion in medical costs and work lost. And non-fatal suicide attempts cost $4.3 billion in lost wages and productivity.

Make companies care through stats

All of these statistics come from fairly reputable sources such as the Centers for Disease Control (CDC), National Institute of Mental Health (NIH/NIMH), National Alliance on Mental Health (NAMI), and peer-reviewed journal articles. As an academic, I trust that these organizations are estimating — to the best of their ability — the high price of mental health in America.

In the past, many companies discriminated against applicants with mental health concerns. Frequently, people were ruled out for jobs they would otherwise be qualified for because of mental illnesses. What the CDC, NAMI, and NIMH have worked tirelessly to do is normalize mental health concerns and reduce stigmas. They’ve worked to interject a hypothesis for companies, which is that everybody wins when you care for employees.

Each organization learned that to talk to companies you need to focus on the bottom line: profits. They’ve excelled at making terrific inroads with corporate giants that have instituted better fringe benefits, fun activities in the workplace, and greater time off. They know that companies want happy, healthy workers because that leads to greater sales, revenue, and shareholder returns. And, for the most part, it’s helped.

Treat the illness and profits will boom!

Mental health advocates in the corporate world seem to politely accept that companies are only motivated by numbers. They argue that untreated and undertreated mental concerns cost more than proper treatment.

Understanding this basic premise, companies have accepted a Mr-Fix-It-style psychology. Treat the illness, get better, and then get back to work! Similarly, healthcare companies rarely offer long-term mental health treatment, as it’s limited to short-term, brief therapy. To offer something more substantial would require companies to pay more profits to care for employees.

This pressure has led companies to ask researchers and academics to think of faster ways to treat distress. The question seems to be, How can we rapidly patch people up so that they can get back to work?

Models of treatment have focused on prescription pills and quick rounds of talk therapy to douse the fires. We’ve learned to cap emotional distress — to keep it in line with what corporate America needs.

Companies aren’t the victims, we are

Capitalism is predicated on a fatal flaw: work hard and be rewarded. Unfortunately, people are all born with different strengths and weaknesses, positions in society, and economic hand-me-downs. Working hard will look different for everyone. We are fundamentally created unequal, unlike the founding fathers suggested.

Men are generally taller than women, but that doesn’t mean they should get paid any different. Women live longer than men on average, but that doesn’t mean companies should begin to hire women because they could spend more years working. Our differences must be balanced out, because purely capitalistic forces fail to change the systemic problems.

And just like the aforementioned physicality and livelihood between genders, there’s great variety in mental health needs. People are not raised equally. Some parents are wonderful — others abusive. Some schools are the best in the country, and others are the worst. Some experience difficult traumas, and others seem to float by without incident. Our experiences from womb to tomb will vary greatly, and we need to learn to embrace this fact. Some people will need greater mental health care.

Flipping our understanding of mental health

Anything that gets in the way of working hard, being productive, and increasing revenue has — up until this point — been seen as an impediment. Being depressed has become a “bad” thing that you should avoid. Get that treated! It’s considered a flaw to suffer and hurt, because of the cost to a company’s bottom line. You’re causing profits to dip! Additionally, it’s encouraged people to stay tight-lipped and private about their struggles for fear of being ostracized.

When dollar signs flashed before corporations’ eyes, they listened. They understood that by making their employees healthier, they’d increase their bottom line. It would seem — for a moment — that capitalism was compatible with caring. But what if the money wasn’t there, would companies still care?

Companies desperately need to change the way they do business. Companies must see their employees as autonomous, capable, and creative humans. Companies must provide a space to excel, but also to seek freedom. Companies must look beyond the dollar amounts and pay for better time off and vacations. Companies must do their best to disregard the power of shareholders, in favor of respecting their employees.

Medical and mental health are in decline in America. Our system is bloated, expensive, and frankly, embarrassingly flaccid. It’s time we flip the paradigm. It’s time we say that workplaces need a reboot. It’s time for employers to receive the treatment. Perhaps it’s time to make companies work for us?