Michigan Psychiatrist Teaches Company About Depression

Blue Cross Blue Shield of Michigan (BCBSM) may be the only company in the United States that requires all its leaders—vice presidents, directors, managers, supervisors, and team leaders—to attend a workshop on depression awareness. APA member Beth Goldman, M.D., M.P.H., an employee of BCBSM, has been at the center of developing and conducting the company's depression awareness workshops, and she talked to Psychiatric News about her experience.

“If you like to teach,” said Goldman, “conducting this sort of workshop in a business environment is rewarding and fun. People are hungry for up-to-date, accurate information about mental illness and its treatments.”

Because companies increasingly recognize the need to address mental health at the workplace, according to Clare Miller, director of APA's Partnership for Workplace Mental Health, she hopes Goldman's experience encourages others to work with the business community.

Winning Management's Support

BCBSM's Depression Awareness Workshops evolved over several years. About eight years ago the company's board of directors identified mental health as part of its “social mission,” which is intended to improve the health status of all Michigan residents. Goldman was invited to join others in developing the activities for the company's mental health social mission, which focused on depression because of its prevalence in the workplace. Some of the social-mission activities included a depression tool kit, which was sent to about 7,000 primary care physicians; public service announcements; grants to schools and senior residential and activity facilities to develop depression awareness and screening programs; and lunchtime information sessions for employees.

The lunchtime sessions were so well received that Goldman and others suggested holding sessions for the company's leaders. It took about a year to write an instructor's manual, compile the participants' workbook, and hold pilot workshops. Armed with that experience and a strong business case, they convinced the board to support the half-day workshops.

For their proposal, Goldman and her colleagues collected data on the costs, especially the business-related costs, of major depression nationwide and its cost to BCBSM specifically. They noted that although only 10 percent of people may suffer from some form of depression at any one time, its impact may be 100 percent on the professional relationships around that individual.

“The business case was essential,” Goldman said, “and it was then that we realized we'd have to convince workshop participants as well, so we ended up including the cost data in the workshop.”

Role Playing Key to Workshop Success

So far, 355 BCBSM leaders (excluding those who were involved in the pilot course) have participated in the workshops. The workshops are given on a regular basis throughout the year and open to the first 20 to 25 individuals who register. At each workshop, facilitators cover stigma, the clinical picture, intervention techniques, and services available through the employee assistance program (EAP).

Although participants come from a wide variety of occupations in the company, Goldman finds their knowledge of depression fairly sophisticated. They normally pepper her with detailed clinical questions, emphasizing the need for a psychiatrist's expertise in the room.

“The real need of participants, though, is learning how to intervene effectively with an employee who may be depressed,” she said.

Facilitators carefully walk attendees through the steps of supporting and confronting an employee, but it isn't until attendees are led through a series of role-playing exercises that they realize how much practice it takes to handle such a situation effectively.

“Most supervisors don't realize how difficult it is to confront an employee effectively until they try it,” Goldman explained. “If people don't try it, they won't have the confidence necessary to make intervention work.”

Nearly all participants have given the workshops an “excellent” rating. Furthermore, since the workshops began, employee use of EAP services at BCBSM has doubled. Goldman noted, however, that the necessity for making the business case never goes away. She summed up her experience this way.

“Working with corporations is never a static situation, which makes it always interesting and a challenge. The economic picture changes, the social climate changes, and businesses respond in various ways. When you're training business leaders, you're on the front line, and my experience tells me that psychiatry has something important to offer.”

Information about the BCBSM Depression Awareness Workshops is available from Beth Goldman, M.D., M.P.H., at [email protected] or (248) 448-6145. ▪