Spring Health, Spring Care Inc, New York, New York.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
JAMA Netw Open. 2022 Jun 1;5(6):e2216349. doi: 10.1001/jamanetworkopen.2022.16349.
Investment in workplace wellness programs is increasing despite concerns about lack of clinical benefit and return on investment (ROI). In contrast, outcomes from workplace mental health programs, which treat mental health difficulties more directly, remain mostly unknown.
To determine whether participation in an employer-sponsored mental health benefit was associated with improvements in depression and anxiety, workplace productivity, and ROI as well as to examine factors associated with clinical improvement.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included participants in a US workplace mental health program implemented by 66 employers across 40 states from January 1, 2018, to January 1, 2021. Participants were employees who enrolled in the mental health benefit program and had at least moderate anxiety or depression, at least 1 appointment, and at least 2 outcome assessments.
A digital platform that screened individuals for common mental health conditions and provided access to self-guided digital content, care navigation, and video and in-person psychotherapy and/or medication management.
Primary outcomes were the Patient Health Questionnaire-9 for depression (range, 0-27) score and the Generalized Anxiety Disorder 7-item scale (range, 0-21) score. The ROI was calculated by comparing the cost of treatment to salary costs for time out of the workplace due to mental health symptoms, measured with the Sheehan Disability Scale. Data were collected through 6 months of follow-up and analyzed using mixed-effects regression.
A total of 1132 participants (520 of 724 who reported gender [71.8%] were female; mean [SD] age, 32.9 [8.8] years) were included. Participants reported improvements from pretreatment to posttreatment in depression (b = -6.34; 95% CI, -6.76 to -5.91; Cohen d = -1.11; 95% CI, -1.18 to -1.03) and anxiety (b = -6.28; 95% CI, -6.77 to -5.91; Cohen d = -1.21; 95% CI, -1.30 to -1.13). Symptom change per log-day of treatment was similar post-COVID-19 vs pre-COVID-19 for depression (b = 0.14; 95% CI, -0.10 to 0.38) and anxiety (b = 0.08; 95% CI, -0.22 to 0.38). Workplace salary savings at 6 months at the federal median wage was US $3440 (95% CI, $2730-$4151) with positive ROI across all wage groups.
Results of this cohort study suggest that an employer-sponsored workplace mental health program was associated with large clinical effect sizes for employees and positive financial ROI for employers.
尽管对缺乏临床获益和投资回报率（ROI）的担忧持续存在，但对工作场所健康计划的投资仍在增加。相比之下，直接针对心理健康问题的工作场所心理健康计划的结果仍然知之甚少。
确定雇主赞助的心理健康福利计划的参与是否与抑郁和焦虑的改善、工作场所生产力的提高以及 ROI 的提高有关，并探讨与临床改善相关的因素。
设计、地点和参与者：这项队列研究包括来自美国 40 个州的 66 家雇主实施的工作场所心理健康计划中的参与者，该计划从 2018 年 1 月 1 日至 2021 年 1 月 1 日进行。参与者是参加心理健康福利计划且有中度以上焦虑或抑郁、至少有一次预约和至少有两次结果评估的员工。
一个数字平台，对常见心理健康状况进行筛查，并提供自我指导的数字内容、护理导航以及视频和面对面的心理治疗和/或药物管理。
主要结果是患者健康问卷-9 抑郁量表（范围，0-27）评分和广泛性焦虑症 7 项量表（范围，0-21）评分。ROI 通过将治疗成本与因心理健康症状而离开工作场所的工资成本进行比较来计算，这是通过 Sheehan 残疾量表测量的。数据通过 6 个月的随访收集，并使用混合效应回归进行分析。
共有 1132 名参与者（724 名报告性别[71.8%]为女性的参与者中有 520 名；平均[标准差]年龄为 32.9[8.8]岁）被纳入研究。参与者在治疗前和治疗后报告抑郁（b = -6.34；95%置信区间，-6.76 至 -5.91；Cohen d = -1.11；95%置信区间，-1.18 至 -1.03）和焦虑（b = -6.28；95%置信区间，-6.77 至 -5.91；Cohen d = -1.21；95%置信区间，-1.30 至 -1.13）有改善。COVID-19 后和 COVID-19 前的抑郁（b = 0.14；95%置信区间，-0.10 至 0.38）和焦虑（b = 0.08；95%置信区间，-0.22 至 0.38）症状改善每对数天治疗相似。以联邦中位数工资计算，6 个月的工作场所工资节省为 3440 美元（95%置信区间，2730-4151 美元），所有工资组均实现正 ROI。
这项队列研究的结果表明，雇主赞助的工作场所心理健康计划与员工的大临床效果和雇主的积极财务 ROI 相关。
