An Ecological Study of a Universal Employee Depression Awareness and Stigma Reduction Intervention: "Right Direction"

Benjamin Doty; Adrienne Grzenda; Seungyoung Hwang; Sean Godar; Darcy Gruttadaro; Kimberly A Hauge; Bruce Sherman; Diana E Clarke

doi:10.3389/fpsyt.2021.581876

An Ecological Study of a Universal Employee Depression Awareness and Stigma Reduction Intervention: "Right Direction"

Front Psychiatry. 2021 Aug 20:12:581876. doi: 10.3389/fpsyt.2021.581876. eCollection 2021.

Authors

Benjamin Doty¹, Adrienne Grzenda^{1

2}, Seungyoung Hwang^{1

3}, Sean Godar⁴, Darcy Gruttadaro¹, Kimberly A Hauge⁵, Bruce Sherman⁶, Diana E Clarke^{1

7}

Affiliations

¹ American Psychiatric Association, Washington, DC, United States.
² Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA-Olive View Medical Center, Los Angeles, CA, United States.
³ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
⁴ Employers Health, Dublin, OH, United States.
⁵ Human Resources, Kent State University, Kent, OH, United States.
⁶ School of Medicine, Case Western University, Cleveland, OH, United States.
⁷ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

Abstract

Objective: Right Direction (RD) was a component of a universal employee wellness program implemented in 2014 at Kent State University (KSU) to increase employees' awareness of depression, reduce mental health stigma, and encourage help-seeking behaviors to promote mental health. We explored changes in mental health care utilization before and after implementation of RD. Methods: KSU Human Resources census and service use data were used to identify the study cohort and examine the study objectives. A pre-post design was used to explore changes in mental health utilization among KSU employees before and after RD. Three post-intervention periods were examined. A generalized linear mixed model approach was used for logistic regression analysis between each outcome of interest and intervention period, adjusted by age and sex. Logit differences were calculated for post-intervention periods compared to the pre-intervention period. Results: Compared to the pre-intervention period, the predicted proportion of employees seeking treatment for depression and anxiety increased in the first post-intervention period (OR = 2.14, 95% Confidence Interval [CI] = 1.37-3.34), then declined. Outpatient psychiatric treatment utilization increased significantly in the first two post-intervention periods (OR =1.89, 95% CI = 1.23-2.89; OR = 1.75, 95% CI = 1.11-2.76). No difference was noted in inpatient psychiatric treatment utilization across post-intervention periods. Unlike prescription for anxiolytic prescriptions, receipt of antidepressant prescriptions increased in the second (OR = 2.25, 95% CI = 1.56-3.27) and third (OR = 2.16, 95% CI = 1.46-3.20) post-intervention periods. Conclusions: Effects of RD may be realized over the long-term with follow-up enhancements such as workshops/informational sessions on mindfulness, stress management, resiliency training, and self-acceptance.

Keywords: anxiety; depression; ecological study; employee depression awareness; health care resource utilization; substance use disorders; wellness program.