Comorbidities: The Link Between Mental and Physical Health

Posted by: 
Dan Jolivet
A woman at her desk on her cell phone and stretching her neck

The pandemic has increased awareness of employees’ mental health. In fact, 46% of workers report suffering from mental health issues, such as depression or anxiety.1 And as our understanding of health shifts toward a more holistic approach, the relationship between mental health issues and physical medical conditions is becoming much clearer. Understanding how physical and mental health challenges can impact each other is crucial for how employers identify, plan for and support the health of their employees.

The Connection Between Mental and Physical Health

People with mental health issues, such as anxiety and depression, are more prone to make less-healthy lifestyle choices, including poor-quality diet2,3 decreased physical activity4,5 poor sleep6 and tobacco7,8 and alcohol use. This can lead to obesity9,10 and other physical issues, such as musculoskeletal conditions11,12 or back pain, as well as addiction.

Over 4,600 employees with mental health or substance abuse conditions have participated in The Standard’s Stay at Work and Return to Work programs.

Additionally, people with anxiety and depression are at elevated risk for accidental injuries13,14 likely because of impaired focus, fatigue and slowed reaction times.

On the flip side, people with physical conditions frequently experience mental health issues as they deal with pain, loss of function and reduced quality of life.15,16 For example, there is a strong relationship between pain and poor sleep quality, which can contribute to depression.17 Also, people coping with pain tend to make lifestyle choices that increase their risk for anxiety and depression. Chronic pain is associated with poor quality diet18, obesity19 and decreased physical activity20 — all of which are associated with anxiety and depression.21

Without the proper resources for dealing with depression and anxiety that often accompanies pain, many people may be at risk of creating a cycle of pain and mental health issues. Because there can be stigma around mental health issues, some people may not seek out the appropriate treatment.

The Impact on Employee Productivity

Even prior to the pandemic, behavioral health conditions were associated with lost productivity totaling more than 5% of the average company’s payroll. As more Americans report mental health and substance use issues in response to the stresses of COVID-19, that has increased to more than 10%.1

People dealing with mental health issues often hide these conditions from their treating providers or focus on accompanying physical issues instead. People with a history of depression or anxiety are twice as likely to file a disability claim for a physical condition than people who are not experiencing depression or anxiety.22 Subsequently, those who file a disability claim for a physical condition are four times more likely to be treated for depression or anxiety within 12 months of submitting a claim.22

What Employers Can Do

Employers can support employees by creating a work environment that nurtures well-being. Introduce or reinforce a company-wide anti-stigma initiative and train managers to identify and support those in need. Enhance or create wellbeing programs that specifically educate workers on how mental health and substance use conditions can lead to poor lifestyle choices, along with coaching programs to improve nutritional choices and increase exercise. Smoking cessation programs and weight management offerings can also assist employees to manage their overall wellness despite behavioral health challenges.

You can also revisit your benefits to ensure employees have access to mental health services, such as an Employee Assistance Program (EAP). Communicate regularly about benefits and resources available to employees, and develop an early intervention plan to provide accommodations for those in need as soon as possible.

It’s also important to partner with a benefits provider who understands the relationship between behavioral and physical health challenges. The Standard’s Workplace Possibilities Program is a proactive, whole-person approach to disability that provides customized solutions to help employees with behavioral and physical health conditions stay at work or return sooner. 90% of participants successfully stayed at work and 68% of participants successfully returned to work — more than double the average for people who go out on disability leave for behavioral health conditions.23

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