Stress, Mental Health and Substance Use in the Workplace Royer Cook, Ph'D' The ISA Group

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Stress, Mental Health and Substance Use in the
WorkplaceRoyer Cook, Ph.D.The ISA Group

• YIW TA Training Seminars
• Chapel Hill, NC
• December 1, 2005

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• Goals of Session
• Discuss prevalence, cost and co-occurrence
• Present conceptual models
• Present/discuss workplace interventions
• Discuss how YIW grantees can incorporate relevant
  interventions

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PREVALENCE AND COST OFWORKFORCE SUBSTANCE ABUSE

• 75 of illicit drug users 18 and older are
  employed
• Rates of illicit drugs use of highest for the
  1825 year olds (19.4)
• 79 of binge drinkers and 80 of heavy drinkers
  are employed.
• Both binge and heavy drinking rates are highest
  for the 1825 years olds - 41 (binge) and 15
  (heavy)
• Cost of substance abuse estimated at over 100
  billion

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PREVALENCE AND COST OFWORKFORCE STRESS

• Estimates of stress problems among workers range
  from roughly 1 in 10 to 7 in 10 workers.
• National survey 13 difficulty in daily coping,
  25 stressed often or very often, 36 felt used
  up by end of workday.
• Goetzel, et al. study (1998) 19 of workers
  reported almost always troubled by stress
• Overall cost of stress in the U.S. estimated at
  150 billion per year
• Workers reporting high stress had annual medical
  costs 46 higher than low and moderate stress
  workers (Goetzel et al., 1998)
• Workers reporting high stress and high depression
  were found to be 147 more costly than other
  workers.

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PREVALENCE AND COST OF WORKFORCE MENTAL HEALTH
PROBLEMS

• 1 in 10 adults reported serious psychological
  distress (SPD) in past year highest rates
  (13.7) of SPD were for 1825 year olds.
• 8.1 of the population report a major depressive
  episodes (MDE) in past year highest rates
  (16.6) of MDE were for 1825 year olds.
• Mental illness cost 150 billion in lost
  productivity 44 billion of this is paid for by
  businesses.

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CO-OCCURRENCE OF MENTAL HEALTHPROBLEMS AND
SUBSTANCE ABUSE

• Among adults with serious psychological distress
  (SPD), 27.6 report using and illicit drug,
  compared to 11.8 without SPD.
• Adults with SPD report only slightly higher heavy
  alcohol use (9.7) than those without SPD (7).
• Persons with a major depression episode in past
  year were more than twice as likely to have used
  illicit drugs (28 to 13.8).
• 22 persons with MDE were dependent on or abused
  alcohol or illicit drugs, compared with 8.6 of
  those without MDE.

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REASONS FOR ADDRESSING STRESS,MENTAL HEALTH, AND
SUBSTANCE ABUSEIN YIW INTERVENTIONS

• High degree of co-occurrence among the three
  problems
• The stigma of substance abuse can be reduced by
  imbedding the topic into stress and/or mental
  health materials
• Employers are likely to be more receptive to
  programs that address the costly stress/mental
  health problems

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CONCEPTUAL MODELREDUCING STRESS, PSYCHOLOGICAL
SYMPTOMS AND SUBSTANCE ABUSEDavid Snow, Ph.D.
Avoidance Coping
Work Family Stressors

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Psychological Symptoms


Substance Use
-
-
Social Support
-

Active Coping

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COPING WITH WORK AND FAMILY STRESSA Workplace
Stress Management ProgramDavid Snow, PH.D.

• Increasing use of cognitive, behavioral, and
  social support coping
• Reducing avoidance coping, including the use of
  alcohol, drugs smoking, or eating to reduce
  tension
• Enhancing employees use of social support and
  reducing social withdrawal
• Consists of 16, 1 ½ -hour, weekly sessions (1518
  employees per group)
• Implemented at the worksite during regular work
  hours with company providing release time

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COPING WITH WORK AND FAMILY STRESS RESEARCH
FINDINGS

• Reduced stressors both work and family
• Increased Social Support from work
• Increased Active Coping, decreased Avoidance
  Coping
• Decreased symptoms of Depression, Anxiety and
  Somatic Complaints
• Effects demonstrated across varied work settings
  and diverse employee groups

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CONCEPTUAL MODEL REDUCING STRESS AND SUBSTANCE
ABUSERoyer Cook, Ph.D.
AVOID NEGATIVE COPING (ALCOHOL AND DRUGS)
WORK AND PERSONAL STRESS
REDUCED STRESS AND SUBSTANCE USE
PRACTICE POSITIVE COPING (MENTAL, BEHAVIORAL,
AND ENVIRONMENTAL STRATEGIES)
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THE STRESS MANAGEMENT CONNECTIONA Workplace
Stress Management/Substance AbusePrevention
ProgramRoyer Cook, Ph.D.

• A Videobased program, presented in three
  one-hour sessions
• Use of CognitiveBehavioral techniques
• Main Content
• Understanding the Stress Response
• Strategies for Avoiding Negative Coping (AOD)
• Strategies for Making Positive Choices

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THE STRESS MANAGEMENT CONNECTIONRESEARCH FINDINGS

• Reduced work and personal stress
• Increased positive coping
• Decreased alcohol and drug use
• Decreased use of AOD to relieve stress

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THE ELECTRONIC ALTERNATIVEWeb-Based Programs
Addressing Stress,Mental Health and Substance
Abuse in the Workforce

• GetFit - SAMHSAS program addressing physical
  health, mental health and substance abuse
• ISA programs
• Health Connection containing segments on stress
  management, substance abuse, nutrition/weight
  management, and fitness
• Stress and Mood Management containing segments
  on stress management, substance abuse,
  depression, and anxiety
• Healthy Worklife (DVD) containing segments on
  stress and anger management, tobacco cessation,
  healthy eating, and substance abuse

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ADVANTAGES OF WEB-BASED PROGRAMS

• Can reach thousands/millions of workers instantly
• Workers can access anytime, any place Internet is
  available
• With broadband increasingly available, programs
  can include engaging multi-media segments
• Accumulating evidence of effectiveness
• Wantland review found web-based interventions to
  be effective
• ISAs recent field test of Health Connections - -
  effects shown on levels of distress, dietary
  practices, physical activity and substance use