Behavioral Health Risk Assessment: Predicting Absenteeism and

1. Behavioral Health Risk Assessment:  Predicting Absenteeism and Workman’s Compensation Claims with the Gain Short Screener Richard Lennox Michael Dennis Mark Godley David Sharar

2. Behavioral Health Risk Assessment:  Predicting Absenteeism and Workman’s Compensation Claims with the Gain Short Screener This study was designed to assess the capacity of the GAIN Short Screener (GSS) as a behavioral health risk measure that can detect absenteeism and workman compensation claims in a population of employees and their dependents.  The GSS is a twenty-item version of the 2 hour full biospychosocial version of the GAIN I.  The GSS has been extensively validated and has been shown to share approximately 80% of its total variance with the full GAIN's core psychopathology measures.  Using GSS data from 1469 employees collected as part of a voluntary health risk assessment; we will show that the GSS is predictive of absenteeism and workman's compensation claims.   The results provided evidence that behavioral health issues are prevalent in the work force and important predictors of these key workplace outcomes. The discussion suggests that routine use of the GSS could provide a basis for detecting persons at risk of these and other types of adverse workplace characteristics and could be used to target them for EAP or other assertive or early intervention programs. Employers are advised to carefully examine the type of behavioral health questions that are inserted into an HRA to insure the behavioral health questions have predictive value.

3. ADM Pilot (n=1469) with an earlier 14 item version

4. 0% 20% 40% 60% 80% 100% Internal Disorder 69% 25% 7% 2% External Disorder 77% 21% Substance Use 83% 16% 1% Disorder Total Disorder 52% 32% 17% Screener Low Moderate High Source: Collected as part of ADM health risk assessments from 11/05 to 8/06; Total Disorder Screener is based on 14 of 20 GSS items (one item in the internal not asked, and the violence and crime screener were not asked). ADM Pilot (n=1469) Triaged by Severity

5. The first 22 (50%) of the people were responsible for less than 5% of the claims The top 4 people (10%) were responsible for 50% of the claims The top 9 people (20%) were responsible for 83% of the claims Workman’s Comp Claims Paid ($138,362 total)in the Next 12 Months by Individual (n=44) Source: ADM Pilot (n=44 with claims; 3% of 1469)

6. 1.4 Odds Ratio of Increase in High Cost Claims Percent with High Cost (>$6900) Workman’s Comp Claims in the 12 months before and after screening by Severity 2.0% 1.8% 1.6% 1.4% 1.3% 1.2% 1.0% 0.8% 0.7% 0.6% 0.4% 0.4% 0.2% 0.0% 0.0% Before After Before After Low (n=761) Mod/High (n=708) Source: ADM Pilot (n=1469)

7. The first 210 (50%) of the people were responsible for less than 17% of the hours The top 44 people (10%) were responsible for 37% of the hours The top 86 people (20%) were responsible for 53% of the hours Hours Absent (72,576 Total)in the Next 12 Months by Individual (n=429) Source: ADM Pilot (n=429 with hours; 29% of 1469)

8. 3.3 Odds Ratio of Increase in % highly absent Percent with Hours Absent (>284 hours/year) in the 12 months before and after screening by Severity 6% 5.2% 5% 4% 3.3% 3.1% 3% 2.6% 2% 1% 0% Before After Before After Low (n=761) Mod/High (n=708) Source: ADM Pilot (n=1469)

9. Clinical Sample of Workers 12 Months AfterSA Treatment (n=115) 0% 20% 40% 60% 80% 100% 76% 15% 9% Internal Disorder 7% 90% 3% External Disorder Substance Use 35% 56% 8% Disorder 82% 14% 4% Violence and Crime Total Disorder 31% 17% 53% Screener Low Moderate High Source: ERI (Dennis & Scott) Interviews conducted between 1/05 and 5/05

10. Each has a sharp right skew Higher Median Costs Costs of Service Utilization in the NEXT 12 Months by Total Disorder Screener (n=115) Source: ERI (Dennis & Scott) Interviews conducted between 1/05 and 5/05; p<.05