Final WP#2 w/Revision Suggestions

I'm relatively happy with this revision of WP#2. As with WP#1, if I had more time I would have more firmly established my research question before composing this. After finishing this, I changed the focus of my research question, rendering some of these sources useless.
I also might have included some useful quotes or specific sections in the annotations, making for easier reference later on.
NOTE: Formatting was not retained when copy-and-pasting from MS Word. Please forgive, thanks.


Ryan MacNamara
ENG 102 – Rodrigo
WP#2 Final Revision
08/01/07

Employer Costs of Workplace Depression: A Review of Sources


Depression, along with phobia, is the most commonly occuring mental disorder among employed people (Sanderson, 2006). It effects 18.8 million Americans each ear, and has been predicted to become the second leading cause of worker disability by the year 2020. The associated costs pose a financial burden to employers not just in direct healthcare costs, but also in the form of absenteeism, disability leave, and lowered output while on the job (Langlieb, 2005).
The sources below will be synthesized into an argument for concrete measures that can reduce employer costs associated with depressive disorder.



Edlin, M. (2006, October). Depression can be a detriment to workplace
productivity. Managed Healthcare Executive, 16(10), 48-50. Retrieved
July 11, 2007, from Business Source Premier database.

This magazine article begins by stating the problem, in terms of lost production, with depression in the workplace. Based on secondary sources, it details some of the dollar amount losses attributed to depression-based absenteeism and presenteeism. It then describes a shift of focus in workplace treatment from traditional reactive methods to new managed care plans that take a proactive approach. The article presents the benefits of several specific provider programs that can be purchased by employers, such as the Aetna Depression Management program.
It mainly speaks to management and human resource personnel. The author’s perspective holds that employers’ views of mental health care must change if the expense of depression is to be minimized or reversed. Edlin cites some statistics that will be useful in my own argument. This source will not be used as much as some peer-reviewed journal articles I have found, as they will hold greater credibility with my audience.


Hirschman, C. (2004, December). Education, screening defang workplace
depression. Employee Benefit News, 18(15), 36-37. Retrieved July 11,
2007, from Business Source Premier database.

This magazine article is also directed towards company management and human resource departments. Hirschman lightly touches on the prevalance of depression and its effect of absenteeism and presenteeism on workplace productivity. The rest of the article presents screening and treatment suggestions for employers to implement. The article maintains its perspective on efficient programs that can also save companies money, and discusses cost-benefits of both medication and psychotherapy treatments.
Although the article presented me with a viewpoint on the issue, the information itself is not of much use in my own argument, with the exception of a small quote by Joseph Marlowe of Aon Consulting. This article, along with Edlin, must be used carefully because of its association with a commercial magazine that may have corporate interests high on its agenda.


Langlieb, A. Kahn, J. (2005). How much does quality mental health care
profit employers?. Journal of Occupational & Environmental Medicine,
47, 1099-1109.

This is a comprehensive peer-reviewed journal article that details prevalance of depression, its role in absenteeism and lost productivity, and cost-benefits of employer-provided health care. The article reviewed 103 different publications to establish support for its conclusions. The primary author is employed by Johns Hopkins School of Medicine, and the article was written for the American Psychiatric Association Committee on Business Relations.
The article is very useful to me because it focuses on how companies can increase profit through quality depression care. This will appeal to my audiences’ value of maintaining and maximizing corporate profit. It holds great credibility through its peer-reviewed status, as well as its analyses of many diverse sources.



National Institute of Mental Health. (2000). Depression (NIH Publication
No.00-3561). Retrieved July 12, 2007, from
http://www.nimh.nih.gov/publicat/depression.cfm#ptdep1

The document gives an overall description of depressive disorder. It includes sections on causes, symptoms, and treatment. It carries credibility as a government publication by an official mental health institute. This document will be cited in my argument to establish the general nature of depression. Unlike my other sources, it carries no correlation to specific applications in the workplace.


Sanderson, K., Andrews, G. (2006). Common mental disorders in the
workforce: recent findings from descriptive and social epidemiology.
Canadian Journal of Psychiatry, 51(2), 63-75. Retrieved July 12, 2007,
from Academic Search Search Premier database.

This article highlights the frequency of mental illness in the workplace and identifies its correllation with employee productivity. It finds that depressive disorders are the most common mental illness in the workplace, then briefly offers some words on reducing lost-productivity.
This article will contribute to my argument by establishing that depression is a commonly occuring illness in the workforce. It will also help establish that depressed employees present indirect costs to employers through reduced productivity. The article carries credibility as a peer-reviewed, fully notated publication by a psychiatric journal.

Steffick, D., Fortney, J., Smith, J., Pyne, J. (2006). Worksite disease
management programs for depression: potential employer benefits.
Disease Management & Health Outcomes, 14(1), 13-26.
Retrieved July 23, 2007, from Academic Search Premier database.

This article has brief sections on prevalance and effects of depression in the workplace, but focuses on employer implementation of health care management programs and other ways of coping with the issue. It cites specific examples of case studies in companies such as LL Bean and Ford Motor Company. It also focuses on measuring the cost-benefits of various programs to employers. The paper is a comprehensive and well-documented study.
It is a credible source from a peer-reviewed journal. Steffick is an assistant professor of psychiatry at the University of Arkansas, and carries a PhD in economics. Her viewpoint is more from a cost-benefit, rather than medical, standpoint. This source will appeal to my audience, who will be concerned more with profit than medical analyses.

Tanouye, E. (2001, June 13). Mental illness: a rising workplace cost --- one
form, depression, takes $70 billion toll annually; Bank One intervenes
early. Wall Street Journal. Retrieved July 24, 2007, from ProQuest
Newspapers database.

This article stresses depression’s indirect costs to employers, such as disability leave and presenteeism. It describes the specific case of Bank One’s effort to combat depression costs, using statistical support. It also contains a testimonial from the director of the company employee assistance program.
The article comes from a newspaper that is generally held in high esteem by my argument’s intended audience. Its review of Bank One’s situation will allow me to cite specific company cases in my own argument.

Wang, P., Patrick, A., Avorn, J., Azocar, F., Ludman, E., McCulloch, J., et al.
(2006). The costs and benefits of enhanced depression care to
employers. Archives of General Psychiatry, 63, 1345-1353.

This is a study of cost-effectiveness and cost-benefit of an enhanced depression care program implemented in the workplace. It uses a hypothetical group of 40-year old workers as a subject to estimate the costs and benefits from both a societal and an employer/purchaser standpoint.
Dr. Wang is employed by the National Institute of Mental Health, who funded this study. It is published in a peer-reviewed journal, and contains a full bibliography of all sources used.
My primary use of this study will be to cite numbers showing benefits of depression care programs to employers.




There is substantial research available that documents the high frequency and financial burdens of depressive disorders in the workplace. Less research exists that examines employer cost-benefits of implemented care programs. The lack of information in this area has contributed to a situation where employers lack data to make informed care purchasing decisions, and care providers are hesitant to invest in new programs without client demand.