From the perspective of an employer, what are the advantages of offering mental health benefits? Presuming that you'll see a lot of advantages, can you also try to address the possible disadvantages? --Judy

Employers need to understand that psychological and emotional problems can have an enormous impact in the workplace -- perhaps even more than physical or medical problems do. A three-year study of a large corporation showed that 60 percent of employee absences were due to psychological problems. In addition, 50-70 percent of visits to primary care physicians are for medical complaints resulting from psychological factors. Clinical depression costs an estimated $23 billion in lost work days each year, according to the National Institute of Mental Health.

The American Psychological Association (APA) reports that anxiety and depression are among the most frequent conditions seen by primary care physicians. Depression and anxiety can also worsen physical illnesses and prolong the recovery from physical illness. In addition, drug or alcohol dependency can exacerbate medical and psychological conditions -- and of course negatively affect job performance, too. (Most of the information I am citing here came from the APA's website and its paper on mental health insurance parity.

So, taking that information into consideration, what might an employer gain from offering mental health benefits? Possibilities include reduced employee absenteeism related to psychological problems and medical problems that stem from psychological factors; improved work efficiency and productivity from treating psychological conditions such as depression or anxiety that might interfere with concentration or performance; and improved quality of life for employees, which could translate into a happier, healthier and more productive workplace. Of course, these outcomes would depend upon employees actually USING the mental health benefits and resources.

As for possible disadvantages: I'm not sure about the direct costs of adding mental health benefits to employee benefits packages, but I assume that employers would have to pay more than they would for medical benefits alone. These costs would probably be offset by lowered use of medical services and increased productivity. But it may take a while for that to show up on the bottom line. I've heard that it takes more than 18 months after the addition of mental health services for some businesses to see reduced use of medical services. For some employers, that may seem like too long to wait.

Another possible drawback may be inroads into employees' confidentiality if the mental health benefits are managed by organizations that require extensive details about employees' problems in order to authorize services. If the mental health benefits are managed in-house by the employer, employees may be reluctant to reveal personal problems out of fear the information will reach coworkers or bosses. Also, some managed care organizations make the process of authorizing mental health treatment so complicated or intrusive that its enrollees drop out of the process before completing it.

From my perspective, any downside is offset by the pluses. Healthy employees are good for business.