FundaMENTAL Health,

1. FundaMENTAL Health, Bottomline Sense

2. Why We’re Here • The state of the country’s health • Impact of mental health conditions • We Know What Works • Treatment • EAP • Health promotion • Call to Action • Employers’ role The Agenda

3. Why We’re Here

4. $7,500 $6,000 $4,500 US $ $3,000 $1,500 $0 78 79 80 81 82 Years Global Life Expectancy Life Expectancy at Birth vs Per Capita Total Health Expenditure at Average Exchange Rate U.S. $6,350 Germany $3,628 Australia $3,181 Italy $2,692 Korea $973

5. Global Life Expectancy Japan is 3rd Canada is 7th Jordan is 40th Bosnia is 43rd Two decades ago the United States ranked 11thin global life expectancy. Today… The United States is 47th

6. Chronic Disease Chronic diseases account for 7 out of 10 deaths in the U.S. Chronic diseases account for 75% of the nation’s health care spending. Mental health and substance use conditions are America’s most chronic illnesses. Chronic diseases account for 7 out of 10 deaths in the U.S. Chronic diseases account for 75% of the nation’s health care spending.

7. 15 20 5 10 Lifetime Prevalence Prevalence Bipolar Disorder Panic Disorder Generalized Anxiety Disorder PTSD ADHD Major Depression Percentage

8. Half of all people with a mental health diagnosis first experience it by age 14. Prevalence Half of all people with a mental health diagnosis first experience it by age 14. But won’t receive treatment until age 24.

9. Ronald C. Kessler, PhD Professor of Health Care Policy Harvard Medical School

10. 0% 4% 8% 12% 16% 20% 24% Disability Impact Illness Related Disability (U.S.) Alcohol/Drug Use Mental Health Conditions Cardiovascular Diseases Cancer Alcohol/Drug Use Arthritis Diabetes Infectious Diseases

11. Suicide More than 30,000 American lives are lost annually to suicide. More than 30,000 American lives are lost annually to suicide. 1 person every 16 minutes.

12. Counting the Costs

13. In 2002, serious mental health conditions were associated with $193.2 billion in lost earnings. Cost more than $600 per person in the country. Counting the Costs Cost more than the annual revenue for every Fortune 500 company except WalMart. In 2002, serious mental health conditions were associated with $193.2 billion in lost earnings. That’s more than $600 per person.

14. Direct and Indirect Costs Annual Costs Per Employee

15. Ronald C. Kessler, PhD Professor of Health Care Policy Harvard Medical School

16. Mental Illness & Other Chronic Diseases 4 3 Average Number of Impaired Days/Month 2 1 Hypertension Arthritis Asthma Ulcers Chronic Disease Chronic Disease and Mental Illness

17. Henry Harbin, MD Former CEO Magellan Health Services

18. Depression and Other Chronic Diseases

19. We Know What Works

20. We can reliably diagnose and effectively treat mental health conditions. Diagnosis and Treatment NIMH estimates that 80% of people with depression improve with treatment. We can reliably diagnose and effectively treat mental health conditions.

21. National Business Group on Health

22. We Know What Works Mental Health Parity

23. Jack Sweeney Publisher and President Houston Chronicle

24. Quality of Care • People with mental health conditions are most likely seen in a primary care setting. • Their condition is usually not identified. • When identified, the condition is not adequately treated.

25. What You Can Do • Providers screen patients with chronic illnesses for depression (reimbursed as a lab test). • Providers document mental health diagnoses and treatment plans in the medical record. • Disability plan administrators refer employees on disability for a mental illness to a behavioral health specialist. Health care vendors should develop protocols to ensure that providers are meeting these requirements. Work with your health care vendors to ensure quality of care. For example, in your health care contract, specify that:

26. We Know What Works Increased knowledge and supportive environments dispel myths and reduce discrimination. Stigma Reduction

27. Tom Johnson Former CEO and President CNN

28. We Know What Works • Ensure EAPs provide easily accessible services to people who are developing health problems • Increase employee engagement in EAP benefit: • Promote EAP services through internal communications channels • Integrate the EAP with other programs (e.g., disability, FMLA) Employee Assistance Programs

29. Daniel Conti, PhD Senior VP and Manager, Employee Assistance and WorkLife Programs JPMorgan Chase

30. We Know What Works Health promotion programs aim to: • Increase awareness of health issues through newsletters, health fairs and workshops • Help employees make lifestyle changes that promote good health (e.g., stress management) • Leverage corporate policies and practices to promote a supportive environment and healthy culture Health Promotion Programs

31. 0% -10% -20% -30% Health Promotion A 2005 review of workplace health promotion programs showed: Workers’ comp/disability management claims costs Health Costs Absenteeism Return on investment $5.81:$1 - 26% - 27% - 32%

32. Wellness Councils of America (WELCOA) Benchmarks for a successful program • Capture CEO support • Create wellness teams • Collect data to drive health efforts • Craft an operating plan • Choose interventions • Create a supportive environment • Evaluate outcomes

33. Philip Burguières Vice Chairman Houston Texans

34. FundaMENTAL Sense Health care expenditures continue to rise. Mental illnesses dramatically impact direct and indirect costs, and increase burden of other chronic illnesses. • Mental illnesses cause • dramatic direct and indirect burden and expense. • an increase in cost and impact when they occur with other chronic illnesses. Health care expenditures are continuing to increase dramatically and are not sustainable. Making mental health a priority will decrease health care costs and ensure a healthier, happier and more productive workforce.

35. Resources Mental Health Assoc. of East Tennessee offers: • Technical Assistance via the “Mental Health Matters in the Workplace” Program • Mental Health Matters in the Workplace Toolkit • Employer Consulting • Employee Consulting • Worksite Educational Programs • Free Access to Mental Health Screenings • Worksite Wellness, Health & Benefits Fair Participation

36. Resources www.workplacementalhealth.org Partnership for Workplace Mental Health Delivers educational materials and provides a forum to explore mental health issues and share innovative solutions • Mental HealthWorks, a free quarterly publication • Employer Innovations Online, a web-based database of employer case examples

37. Taking the Lead Business leaders are increasingly responding to the importance of a healthy workforce.

38. Tom Johnson Former CEO and President CNN

39. Philip Burguières Vice Chairman Houston Texans

40. Taking the Lead The need is real. The return on investment is real. The difference you can make in employees’ lives is real.

41. Daniel Conti, Sr VP and Manager, Employee Assistance and WorkLife Programs, JPMorgan Chase Ronald C. Kessler, Professor of Health Care Policy, Harvard Medical School Jack Sweeney, Publisher and President, Houston Chronicle Tom Johnson, Former CEO and President, CNN Alan Langlieb, Director of Workplace Psychiatry, Johns Hopkins Hospital

42. Acknowledgments Thank you for your participation: Jim Lafferty and Bonita Benson, Mental Health Association in Delaware Graham Campbell & Paddy Kutz, Mental Health America of Licking County Jeanne Rohner, Mental Health America of Colorado Betsy Schwartz, Mental Health America of Greater Houston Sarah Schwartz, Mental Health America of Georgia Carol Wozniewski, Mental Health America of Illinois Philip Burguières, Houston Texans Dr. Wayne Burton, JPMorgan Chase Dr. Daniel Conti, JPMorgan Chase Eschol Curl, State Farm Dan DeLawder, Park National Bank Dr. Ron Goetzel, Emory University Dr. Henry Harbin, former CEO, Magellan Health Services Tom Johnson, former CEO, Cable News Network (CNN) Dr. Ronald Kessler, Harvard Medical School Dr. Alan Langlieb, The Johns Hopkins Hospital Jack Sweeney, Houston Chronicle Clare Miller, Partnership for Workplace Mental Health, American Psychiatric Foundation

43. This project is made possible through an unrestricted educational grant from Wyeth Pharmaceuticals.

44. FundaMENTAL Health, Bottomline Sense