# Presentation: 880042

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

**YIW  TA Training & Seminars**
**Chapel Hill, NC**
**December 1, 2005**

## Goals of Session

Discuss prevalence, cost and co-occurrence

Present conceptual models

Present/discuss workplace interventions

Discuss how YIW grantees can incorporate relevant interventions

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

## PREVALENCE AND COST OFWORKFORCE SUBSTANCE ABUSE

- 75% of illicit drug users 18 and older are employed
- Rates of illicit drugs use of highest for the 18–25 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 18–25 years olds  - 41% (binge) and 15% (heavy)
- Cost of substance abuse estimated at over $100 billion

## PREVALENCE AND COST OFWORKFORCE 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.

## 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 18–25 year olds.
- 8.1 % of the population report a major depressive episodes (MDE) in past year; highest rates (16.6%) of MDE were for 18–25 year olds.
- Mental illness cost $150 billion in lost productivity; $ 44 billion of this is paid for by businesses.

## CO-OCCURRENCE OF MENTAL HEALTHPROBLEMS 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.

## REASONS FOR ADDRESSING STRESS,MENTAL HEALTH, AND SUBSTANCE ABUSEIN 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

## CONCEPTUAL MODELREDUCING STRESS, PSYCHOLOGICAL SYMPTOMS AND SUBSTANCE ABUSEDavid Snow, Ph.D.

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**Avoidance**
**Coping**

**Work & Family**
**Stressors**

**Social**
**Support**

**Active**
**Coping**

**Psychological**
**Symptoms**

**Substance**
**Use**

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## COPING WITH WORK AND FAMILY STRESSA Workplace Stress Management ProgramDavid 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 1⁄2 -hour, weekly sessions (15–18 employees per group)
- Implemented at the worksite during regular work hours with company providing release time

## 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

## CONCEPTUAL MODEL REDUCING STRESS AND SUBSTANCE ABUSERoyer 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**)

## THE STRESS MANAGEMENT CONNECTIONA Workplace Stress Management/Substance AbusePrevention ProgramRoyer Cook, Ph.D.

- A Video–based program, presented in three one-hour sessions
- Use of Cognitive–Behavioral techniques
- Main Content:
- Understanding the Stress Response
- Strategies for Avoiding Negative Coping (AOD)
- Strategies for Making Positive Choices

## THE STRESS MANAGEMENT CONNECTIONRESEARCH FINDINGS

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

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

- _GetFit_ - SAMHSA’S 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

## 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
- ISA’s recent field test of Health Connections - - effects shown on levels of distress, dietary practices, physical activity and substance use