Depression in the workplace Dr Olivia Stubbersfield Psychiatry Registrar

What we will cover: What is Depression and why does it matter? Mental Health in New Zealand Depression in the workplace Research study Literature review Survey What can we do

The bleakness of the landscape is unimaginable The bleakness of the landscape is unimaginable. It is as friendless and alien as a Dali painting. A week is a long time in a Dali landscape.

Depression in aotearoa Depression is a common and pervasive mood disorder that causes persistent low or depressed mood that affects ones cognition, behaviour, sleep, appetite, energy and impairs one’s social and/or occupational functioning. 350 million people worldwide have experienced depression In NZ : 1 in 6 experience a mental health episode in their lifetime 1 in 8 people have experienced psychological distress in the past four weeks 3rd leading cause of mortality and morbidity in NZ Māori, Pacific and socio-economically deprived areas are over-represented

Why do we care? Every 15 hours in New Zealand a person will commit suicide

Suicide in AOTEAROA 668 suicides in last 12 months Female suicide rates increased but ratio still disproportionate at 1: 2.5 At risk age groups:15-24 years and 45-49 years Highest rate in Māori males 1 in 7 deaths Female to males 475: 193

SUICIDE - occupational context 41 % of people were in stable employments Awareness of methods in relation to resources available in workplace CCDHB 5th highest in NZ - 40 in 12 months

What do we do with our day? Depression is a common and pervasive mood disorder that causes persistent low or depressed mood that affects ones cognition, behaviour, sleep, appetite, energy and impairs social and/or occupational functioning.

Depression Workplace

Occupational Consequences of untreated depression Depression in the workplace Loss of employment Absenteesim Presenteesim Work unaffected

Depression in the workplace research Literature review Depression in the workplace Screening Health promotion and prevention Survey of NZ OHP Depression Barriers

Awareness Identification Appraisal Barriers These were the four main concepts that emerged from the literature. Awareness of depression in the workplace, Identifying who is or at risk of being affected, efficacy of the methods of identification and the barriers in place that make this processes difficult. We used this as a foundation for our survey- Under these domains we chose to ask the following questions to our NZ Occupational health professionals. Awareness: To what extent do you believe depression is a problem in the workplace? Identification: How often do you screen for depression in the workplace? AND Which depression-related screening tools do you use? Appraisal: Do you believe screening for depression in the workplace is effective? Barriers: What barriers do you believe are involved when screening for depression? I would like you to take a moment to think about these domains with regard to how you personally feel about depression and its impact within the workplace.whether that is part of your job description or not although I argue we all have a hand in being responsible.

Awareness

Identification: Screening tools Patient Health Questionnaire- PHQ-9 Becks Depression Inventory – BDI *Impairment in social or occupational functioning

Identification: Screening tools

Appraisal Despite >70% reporting depression is a moderate to large problem in the workplace

#1 Stigma and Discrimination Barriers Employee Provider Other Employer Unsupportive environment Funding Stigma Confidentiality Discrimination Fear of job security Denial New Zealand's attitude to mental health Treatment Ineffective screening tools Source of depression Suboptimal training in mental health Time constraints #1 Stigma and Discrimination

CORRECT IDENTIFICATION OF AT RISK POPULATION a maths problem: Validated Tool + Implementation = + AWARENESS SCREENING = CORRECT IDENTIFICATION OF AT RISK POPULATION

workplace mental health initiatives www.mh101.co.nz www.workwell.health.nz www.depressionalliance.org

What can you do ? Aware Identify Appraise Be Aware! Mental Health is Everywhere! Don’t be afraid to ask Identify Choose a screening tool Use it! Explore others as a second opinion Appraise Keep track of who you screen and why Follow up patients where possible

Your own wellbeing comes first Balanced diet Exercise Mindfulness Sleep hygiene Wellness toolbox Medications Counseling

Thank you