The Clock Is Ticking . . . .

According to the World Health Organization,
by the year 2020 depression will be the
number two cause of premature death worldwide.

How close are we?


There Is NO Health
Without Mental Health!

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Job Stress Leading To Burnout Print E-mail
Thursday June 1, 2006

It's like a TV game show. Here are the answers:

Your job. Your boss. Your computer. Your paycheque. Your security.

The question: what are the factors driving working Canadians to an early burnout?

You don't need Alex Trebek around to know they're putting their health in jeopardy.

And a new survey from Desjardins Financial Security shows changes in the workplace and worries over money are creating increasing problems for employees away from it.

Part of the dilemma is they simply can't seem to get away from it at all.

Because many can't afford to.

The study indicates 44 percent of those asked admit financial needs supercede their health requirements.

"That's your livelihood," explains one worker. "You need money to live, especially in Toronto."

Another agrees money was at the root of his work evil. "I resigned as a partner of one of the Bay Street firms two years ago because my child support was basically already in the bank," he boasts. "That's the only reason I was ever there."

It all takes its toll.

"The costs and effects on people and companies are tremendous," warns Dejardins' Alain Thauvette.

"Forty-eight percent of Canadian workers, who took time off of work because of physical health problems relating to mental health issues, told us they were absent from one to five business days from work.

"But 37 percent of Canadian workers, who attempted to keep to their work schedule while dealing with physical health problems resulting from a mental health issue, said they had to return to work to avoid lost wages.

Seeking Savings, American Businesses Choose To Prevent Illness Print E-mail

A recent New York Times article described how American businesses are beginning to understand that preventing illness is a more efficient and cost effective method of delivering health care to employees. The article stated, "Many businesses are seeking to reduce their medical bills by paying for programs to help employees stop smoking. A decade ago, such programs were rare. But recent surveys indicate that one-third of companies with at least 200 workers now offer smoking cessation as part of their employee benefits package. Among the nation’s biggest companies, the number may be nearly two-thirds of employers."

It went on to say, "The programs are yet another example, along with various other corporate wellness efforts like weight management and diabetes control, of how private employers are taking health care reform into their own hands, even as politicians continue to debate proposals and tactics in Washington and on the campaign trail.

"For businesses, it is a bottom-line calculus. Spending as much as $900 or so to give a participant free nicotine patches and drugs to ease withdrawal, as well as phone sessions with smoking addiction counselors, can more than offset the estimated $16,000 or more in additional lifetime medical bills that a typical smoker generates, according to federal health data."

The article goes on to explain that initiatives such as these may be beyond the reach of small employers. Chances are good, however, that based on the successful implementation of these programs in large business settings similar programs targetted at small and medium sized businesses will probably not be far behind.

Initiatives like these go a long way to support the philosophy at Cognimmune that preventing mental illness is more cost efficient - and ultimately more profitable - than treating it or suffering the adverse effects it creates. What is even more significant is the fact that the cost of a Cognimmune program is a small fraction of the cost of the smoking cessation program cited while the lifetime medical bills generated by mental illnesses can be substantially larger than the $16,000 generated by a typical smoker. This means that the costs are not prohibitive to small and medium sized organizations and they stand to gain the same financial benefits of much larger businesses.

It is also important to remember that mental illness can effect anyone and, unlike smoking, is never an individual choice or lifestyle decision! This simply means that prevention strategies need to be more inclusive and aggressive. However, as we have mentioned, there can be substantial cost benefits to this kind of an approach.

To learn more about how Cognimmune can help your organization feel free to use the "contact us" link or simply click on the "What We Do" link in the menu.

To read the entire New York Times article, use the link below.

Seeking Savings Employers Help Smokers Quit

Kansas City Coalition Attacks Depression Through Workplace Print E-mail

Kansas City Coalition Attacks Depression Through Workplace

Sandra Hass

Sandra Hass is a consultant to APA's Office of Healthcare Systems and Financing and is the executive editor of MentalHealth Works.

Kansas City shares the news that investment in mental health benefits for employees makes good business sense. How the city learned this lesson could be a model for other cities.

After six years of meetings and surveys and trial balloons, Kansas Citians were ready to tell their story about the success of the Community Initiative on Depression in Kansas City. More than 250 people—including representatives from two-dozen employers based in cities such as New York, Chicago, Atlanta, and Minneapolis—met in Kansas City in late March to hear the story.

Two events were held. The first, the Town Hall Meeting on Depression sponsored by the Greater Kansas City Chamber of Commerce, drew more than 200 people on March 29 to learn how Kansas City–based companies, including Sprint and Cerner, were addressing depression in the workplace.

The following day APA and the American Psychiatric Foundation's National Partnership for Workplace Mental Health hosted the National Invitational Conference in collaboration with the Mid-America Coalition on Health Care, which had launched the Kansas City depression initiative in 2000. APA sent out 40 invitations to the conference and quickly had to compile a waiting list, according to Clare Miller, director of the partnership.

"These two events were spectacular successes," said Norman Clemens, M.D., chair of the APA Committee on Business Relations. "Not only was APA in the game," he said, "we moved the ball significantly down the field. Kansas City has a model that could work for communities across America."

Joining Clemens in the conference were Marcia Goin, M.D., immediate past president of APA, and Stuart Munro, M.D., chair of the department of psychiatry at the University of Missouri Kansas City School of Medicine and medical director for the depression initiative.

APA and the National Partnership for Workplace Mental Health have been involved with the Kansas City project for three years.

"Early on," said Irvin (Sam) Muszynski, J.D., director of the APA Office of Healthcare Systems and Financing, "APA recognized the potential of the Kansas City project. We were particularly impressed with the community's commitment and the outstanding staff and leadership of the coalition."

William Bruning, J.D., M.B.A., president of the Mid-America Coalition on Health Care, said simply, "We couldn't have done it without APA."

Community Involvement Helps

The coalition's depression initiative represents a collaboration of 14 Kansas City employers and the stakeholders in the region's health care delivery system, for example, clinicians, health plans, hospitals, state and local administrators, educators, and researchers.

The effort is unique in two ways: it is the first communitywide initiative undertaken to address undiagnosed and untreated depression, and it brings all stakeholders to the table to address the problem.

"If there's one thing we have learned," said Bruning, "it's that employers need to understand the enormous cost of depression in the workplace. Once employers understand what undiagnosed and untreated depression is doing to their bottom line, business becomes the engine for change since they're the major purchasers of health care in the community."

By June, 12 Kansas City employers will have rolled out their version of a depression initiative in their companies. (See APA's newsletter MentalHealth Works, first quarter 2005, for a description of Sprint's roll out. The newsletter's Web address appears at the end of this article.) "By anyone's standards, that's a success," said Muszynski.

The coalition also worked with primary care physicians (PCPs) and insurers to correct the misperception that PCPs would not be reimbursed by third parties if they identified and treated patients for depression in their offices.

"If psychiatrists work with PCPs to improve referral patterns, this effort will help solve an access problem for patients and eventually could lead to better care," said Clemens.

APA Offers Assistance

As communities such as Atlanta and New York City prepare to replicate parts of the initiative, APA is poised to help. "We hope the Kansas City experience will be a springboard for other cities," Muszynski said.

Bruning seconded the idea. "A major goal for the coalition at this point is to work in partnership with APA to formalize a national network of other communities interested in replicating the initiative," he stated.

Thomas Carli, M.D., director of the Depression Center Workplace Initiatives at the University of Michigan Health System and a conference participant, also suggested that APA might serve as the of best practices to which employers and health plans could turn.

"The richness of the dialogue throughout the day was impressive and exciting," said Goin.

Kansas Citians know they did something right. A reporter writing in the Kansas City Star about the initiative observed that it is not often that New Yorkers look to the Midwest for advice, but in the last week in March they did just that.

Highlights from the Town Hall Meeting on Depression and the National Invitational Conference will be available later this year.

Suicide and Antidepressants. The Hidden Danger. Print E-mail
(The information that follows is not widely known. There are no scientific studies proving or disproving it but it is something that is whispered about by those “in the know”. I may very well land in a lot of trouble by disclosing this information here but it is IMPORTANT. Very important.

My motivation is simple. This information may well save lives. Even if only one life is saved then the risk will be worth it. I am only mentioning this here because I want you, the reader, to be apprised of the reality of what is to follow. Read it with an open mind and draw your own conclusions.)

Depression has been shown to be a contributing factor in suicide. However, depression comes in many levels of severity. In actual fact, those people who are experiencing a severe episode of clinical depression are less likely to commit suicide than are those who are only mildly or moderately depressed. The reason for this is quite simple.

How many daily activities do we take for granted? Activities like getting out of bed, showering, getting dressed, eating, maybe going out to do grocery shopping. Ask anyone who has ever lived through a bout of severe depression and they will tell you just how difficult these activities can be. In some cases they are just plain impossible!

What does this have to do with suicide? Almost everything. Suicide is something that takes effort, at least a certain amount of planning and resolve. These things are all but impossible for most people suffering from an episode of severe depression. This is not to say that it can't happen (there are no absolutes when it comes to dealing with mental illnesses) but the likelihood is remote.

When a severely depressed person is finally able to seek help, whether through their own efforts or those of concerned friends and loved ones, the situation can become more tenuous. As a first step toward recovery most patients will be placed on a treatment program that includes antidepressants. This may or may not be done in conjunction with other types of therapies such as psycho analysis or some other “talking” therapy. It is the medication component of this treatment that is of concern here.

Treating depression with antidepressant drugs is an elaborate chemistry project. It is NOT an exact science! Every individual has different brain chemistry so each individual will respond differently to antidepressant drugs. What does remain consistent, however, is the fact that these medications do not begin to work immediately. There is what is commonly referred to as a “ramp up” period during which an individual begins to enjoy the benefits afforded by antidepressant drugs. After the ramp up period, if the drug works, the patient will begin to enjoy life again as the depression slips away. If the medication does not yield the desired results, the patient will have to be weaned off the medication over a period of a few weeks before a new ramp up program on a new medication can begin.

It is these ramp up and weaning periods that must be monitored very closely! As antidepressant medications begin to work, or cease to do so, most patients will begin to notice changes in their mood and energy. Those activities that seemed impossible only a few days before suddenly don't seem so daunting. The underlying depression is still there but the sense of hopelessness and feelings of lethargy will begin to subside. And this is where the danger lies.

If a person was prone to suicidal thoughts or tendencies it is now that they might have the strength and energy to follow through on them. Remember, the depression is still there but the person has renewed energy and will power.

If you are a depressed patient or if a friend or family member is going through this process it is important to remain vigilant. Watch for signs that suicidal behavior is evident and act accordingly. (There are many excellent resources available on line that will provide you with information on warning signs to watch for) The appropriate action could include calling a suicide hot line, consulting a medical professional or going to a local emergency ward. Whichever course you ultimately choose it is a good idea to have your medication available as well as information on dosages and how long you have been using the antidepressant in question.

The most important thing to keep in mind is that this ramp up period is a passing thing. Once a patient has responded favorably to a treatment regimen they can begin to enjoy life again. If you are the individual going through this process, keep this thought in mind. Whatever you might be feeling at this moment is going to pass and THINGS WILL GET BETTER! If the patient in question is a friend or family member, tell them the same thing and reinforce it often.

Mental health is something we all have a right to enjoy but like any kind of health it is precious and must be safe guarded. Please do everything in your power to do just this. If you need help or direction you can begin with this website to find additional information and resources. Above all, don't be afraid to seek whatever kind of help you need if your mental health is not all it should be. Almost any kind of help you can imagine is available to you, and there are many organizations ready to help you in a variety of ways but you have to ask for that help in order to get it.

The Invisible Disease: Depression Print E-mail

Depression is a serious medical condition. In contrast to the normal emotional experiences of sadness, loss, or passing mood states, clinical depression is persistent and can interfere significantly with an individual's ability to function. There are three main types of depressive disorders: major depressive disorder, dysthymic disorder, and bipolar disorder (manic-depressive illness).



SAMHSA's Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health