• Education, Awareness, and Support in the Workplace
• Prevalence of Substance Use and Mental Disorders in the Workplace
• Health Reform Substantially Affects the Workplace
• Addressing Substance Use and Mental Disorders in Your Workplace
• Additional Recovery Resources
• Sources

The majority of people with substance use and mental disorders are employed. In fact, of the 20.8 million adults aged 18 or older classified with substance use dependence or abuse, 70 percent are employed full or part time.¹ In addition, depression, the most common mental health problem in the workplace, affects about 1 in 10 employees.² Increasing access to treatment and recovery support services will improve employee health, lower health care costs, reduce absenteeism, reduce the risk of injury, and ultimately improve job performance and productivity.³

Sponsored by the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT), within the U.S. Department of Health and Human Services (HHS), National Recovery Month: Prevention Works, Treatment is Effective, People Recover (Recovery Month) raises awareness of substance use and mental disorders and stresses that prevention works, treatment is effective, and people can and do recover from these conditions. Recovery Month shares that all individuals have the fundamental and inherent value to be accepted and treated with respect, dignity, and worth. This year's theme, "Join the Voices for Recovery: Recovery Benefits Everyone," emphasizes that:

• All American's have the opportunity to access provisions within the Affordable Care Act and Mental Health Parity and Addictions Equity Act (MHPAEA), aimed to improve physical and emotional health while ensuring people will receive the care they need at a more reasonable cost.
• Public awareness will increase access for those in need of essential substance use and mental health treatment and recovery support services, including behavioral health treatment.
• These legislative changes will improve the overall health and well-being of people in the United States.

The passage of the MHPAEA provides parity, or the recognition by insurance services—both public and private—that substance use and mental disorders are treated comparably to other physical health and medical conditions.⁴

Through its Health Reform Strategic Initiative SAMHSA encourages people to understand the major themes of the Affordable Care Act: integration between primary care and behavioral health, accountability, quality home- and community-based services, and availability of wellness and prevention services. Recovery Month also supports SAMHSA's Strategic Initiatives by increasing public awareness of substance use and mental disorders and offering recovery support through an individual, program, and system approach.

In addition to educating employees about the positive benefits that health reform will have on their overall health and well-being, all employers can implement effective prevention, wellness, and support programs at their workplace and refer employees in need to assessment and treatment.⁵

This document will outline the importance of prevention and support in the workplace, the prevalence of substance use and mental disorders among employees, and factors in the workplace that contribute to increased substance use and mental disorders. Additionally, it will discuss how health reform helps small and large businesses and ways employers can get involved with Recovery Month to address substance use and mental disorders in all work settings.

Education, Awareness, and Support in the Workplace

Employee education, awareness, and support campaign, which educate employees on the overall impact substance use and mental disorders can have on their family and coworkers, are effective in preventing problems both in and out of the workplace.⁶ Through these prevention, treatment, and wellness programs, employers can promote healthy lifestyles and reinforce the following positive messages to their employees:⁷

• Drug-free workplace policies protect the health and safety of all employees, customers, and the public.
• By effectively addressing substance use and mental disorders, employers can see benefits such as improved employee morale, quality of work, employee satisfaction, and decision-making, as well as reduced absenteeism and tardiness.
• Implementing exercise programs and beginning other health-oriented activities can help improve physical and emotional health issues among employees, such as weight problems, high blood pressure, diabetes, depression, or gastric problems and can help reduce stress.

In short, prevention works, treatment is effective, and people do recover from substance use and mental disorders while contributing to their jobs. Visit the Mental Health America website, for various tips and resources to help identify employees who have a mental health problem and help them access treatment services.

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Prevalence of Substance Use and Mental Disorders in the Workplace

Use of substances may occur both on and off the job, equally affecting one's overall health, well-being, and work performance. According to a national survey, in the course of a year, more than 2 million people used illicit drugs during work hours, and approximately 7 percent of Americans used alcohol during the workday.⁸ Specific occupations—including construction workers, sales personnel, restaurant workers, and transportation workers—have the highest rates of reported substance use. Additionally, mental health problems—especially depression—are extremely common,⁹ affecting approximately 1 in 10 employees.¹⁰ It's estimated that 72 percent of people in the workforce who have depression are not properly diagnosed, causing over $63 billion lost annually due to decreased productivity.¹¹ Prevention, awareness, and support campaigns in and out of the workplace are essential to combat these treatable, yet common, public health problems.

Contributing Factors to Substance Use and Mental Disorders in the Workplace

Occupational, personal, and social factors play a role in increased substance use and mental disorders in and outside the workplace. For example, job responsibilities that have low satisfaction or inconsistent supervision may contribute to increased substance use and mental disorders.¹² Additionally, personal stressors, such as an illness, trauma, or marital strain,¹³ as well as economic worries, are common troubles that also can contribute to a substance use or mental disorder.¹⁴

The following signs may be present in employees who are dealing with these issues:¹⁵

• Increased work absences and on-the-job accidents;
• Inconsistent work quality or work not up to its usual standards; and
• Extended lunch breaks, late arrivals, or early departures.

Employers should support Recovery Month's efforts by encouraging employees and company leaders to brainstorm and apply positive ways to help prevent substance use and mental disorders within the workplace, and refer colleagues to treatment and recovery support resources if needed.

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Health Reform Substantially Affects the Workplace

Based on combined data from 2006 through 2009, almost 37 percent of people aged 12 or older who needed substance use treatment, felt a need for treatment, and made an effort to receive treatment, didn't receive it because they didn't have health coverage or couldn't afford the cost.¹⁶ Additionally, more than 42.5 percent of the 6.1 million adults aged 18 or older who reported an unmet need for mental health care, but didn't receive services, cited the inability to afford care as a barrier to treatment.¹⁷ However, with the passage of the Affordable Care Act in 2010, coverage will expand to approximately 32 million Americans who were not previously insured.¹⁸

The Affordable Care Act includes many provisions aimed at improving prevention coverage and access to essential substance use and mental health treatment and recovery support services, including behavioral health treatment. Small and large employers should keep several things in mind as the legislation is implemented. For instance, as of 2010, a small business may qualify for a tax credit of up to 35 percent to offset the cost of providing health insurance to employees. This applies to companies that have up to 25 employees, pay average annual wages below $50,000, and provide health insurance.¹⁹ For large employers that have more than 50 employees, the health plan that was in effect on March 23, 2010, when the Affordable Care Act was passed is exempt from certain provisions in the Affordable Care Act if no major changes are made to coverage.²⁰ For more information on how health reform will affect employers, visit http://www.HealthCare.gov. Additionally, refer to the "Fast Facts About Health Reform, Substance Use and Mental Disorders, Treatment, and Recovery" document in this toolkit for more information on health reform and the positive effects it, along with the MHPAEA, will have on access to treatment and recovery support services.

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Addressing Substance Use and Mental Disorders in Your Workplace

This September and throughout the year, SAMHSA encourages all employers and workers to become involved in Recovery Month and work to improve the overall health and well-being of people in all workplace settings. Specifically, as an employer, you can:

• Write a comprehensive alcohol- and drug-free policy;
• Train supervisors to detect signs of substance use and mental disorders and educate your employees about how they can impact the workplace;
• Provide an employee assistance program (EAP);
• Start a drug testing program;
• Encourage work-life balance;
• Sponsor a Recovery Month event; and
• Offer free space to your employees to hold support group meetings.

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Additional Recovery Resources

A variety of resources provide additional information on Recovery Month, substance use and mental disorders, and prevention, treatment, and recovery support services.

• Substance Abuse and Mental Health Services Administration (SAMHSA) Website – Leads efforts to reduce the impact of substance use and mental disorders on communities nationwide.
• SAMHSA's National Helpline, 1-800-662-HELP (4357) or 1-800-487-4889 (TDD) – Provides 24-hour free and confidential information about substance use and mental disorders, prevention, treatment, and recovery referrals in English or Spanish.
• SAMHSA's "Find Substance Abuse and Mental Health Treatment" Website – Contains information about all treatment options and special services located in your area.
• SAMHSA's Division of Workplace Programs – Provides guidance for employers on workplace drug-testing issues and can also be accessed by calling 1-800-Workplace (967-5752).
• SAMHSA's ADS Center – Provides information and assistance to develop successful efforts to counteract prejudice and discrimination and promote social inclusion.
• National Suicide Prevention Lifeline, 1-800-273-TALK (8255) – Provides a free, 24-hour hotline available to anyone in a suicidal crisis or emotional distress.
• Mental Health America – Offers resources about the realities of mental health and mental illness.

As health reform continues to be implemented, use the following resources to learn how to access treatment and recovery support services:

• HealthCare.gov – Managed by HHS; provides information to the general public on how the new law affects access to health care.
• The Kaiser Family Foundation – Provides a summary of the comprehensive health reform law.
• The Parity Implementation Coalition's Parity Toolkit – Aids individuals in seeking recovery, and their families, providers, and advocates, in understanding their rights under the MHPAEA law.

Click here for a longer version of this guide. Information about treatment options and special services in your area can be found by calling 1-800-662-HELP (4357) or 1-800-487-4889 (TDD), as well as at http://www.samhsa.gov/treatment.

Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.

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Sources

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