Behavioral health, including depression and stress, is an increasing area of concern to employers, according to the DMEC 2012 Behavioral Risk Survey by the Disability Management Employer Coalition.

The survey of small, medium-sized and large companies shows that concerns and costs, including direct medical expenses, lost productivity, workers' compensation and disability payments, are made more challenging due to the uncertain future of the Patient Protection and Affordable Care Act (PPACA).

DMEC coined the term "Behavioral Risk Management" in 2006 to describe employer efforts to address and minimize the costs attached to illness, absence and disability caused by mental health conditions. The DMEC 2012 Behavioral Risk Survey was conducted in an economic climate in which these health conditions continue to be among the top noncommunicable diseases and a growing cost center for employers:

• The direct costs of mental health care represent around 6 percent of overall healthcare costs.
• Nearly 30 percent of young adults (those aged 18 to 25) were estimated to have had a diagnosable disorder, which is more than any other age group. The estimates for adults between the ages of 26 and 49, and those 50 and over, were 22.1 percent and 14.3 percent, respectively.
• Overall, 11.4 million U.S. adults (about 5 percent of the adult population) have a disorder that greatly impairs their ability to function in daily life.
• Mental illness and substance use disorders, combined as a group, are the fifth leading cause of short-term disability and the third leading cause of long-term disability for employers in the United States.
• Excessive workloads and long hours are a top source of employee stress.

According to the DMEC 2012 Behavioral Risk Survey, 47.7 percent of respondents believe behavioral risk is an important emerging area of concern. Also, 40 percent indicated they include a behavioral component in their integrated or coordinated disability/absence management program. The survey indicates adoption of behavioral health programs could be impacted by the uncertainty surrounding healthcare reform. According to the DMEC press release, under PPACA, individual and small group insurance plans will most likely be required to offer parity in behavioral health benefits. With 78.3 percent of respondents noting that their behavioral health component is a "carve-in" and is attached to their health plan, they may be reluctant to add or develop programs such as behavioral health if they have to "carve it back out" due to the potential for increasing health insurance costs and the uncertainty associated with the legality of the PPACA.

"Behavioral health conditions are among the most widespread, damaging and yet preventable illnesses from which people suffer," said Marcia Carruthers, CEO of DMEC. "It is heartening that awareness of behavioral health and its costs to employees, employers and the entire health care system continues to grow. Employers need legal and regulatory certainty to enable them to effectively manage and reduce these costs."

The full DMEC 2012 Behavioral Risk Survey is available online.