The Hackett Center Newsletter, June 2023

In the United States, one in five adults (20%) will experience a clinically significant form of depression in their lifetime. About 7.5% of the US workforce has depression in any year. The impact of an employee’s depression extends beyond the suffering of the individual to impact family, friends, coworkers, and eventually, the bottom line.

The Personal Cost

Untreated depression can increase the chances that someone will experience another medical condition. Individuals with depression and a medical condition experience greater distress, increased functional impairment, and are less able to follow medical regimens. As a result, depression can increase medical costs and negatively affect treatment outcomes.

The Business Cost

Depression costs U.S. employers approximately $187.8 billion a year. This includes $134 billion in health care (health and mental health combined), $20.9 billion in absenteeism, and $32.9 billion in lost productivity. Research shows that untreated depression is a significant contributor to workplace disability costs, reduced work performance and “presenteeism,” absenteeism, safety issues, employee turnover, and legal costs.

Barriers to Effective Care

Effective depression treatment can improve medical outcomes, reduce medical costs and decrease associated business costs. Nearly 74% of Americans who seek help for symptoms of depression go to a primary care physician (PCP) rather than a mental health professional, and a diagnosis of depression is missed 50% of the time in a primary care setting.

Using an integrated care model, this clinic addresses clients’ physical, mental, and emotional needs together for better outcomes and longer lives.

Removing Barriers: The Collaborative Care Model

Collaborative Care can significantly improve outcomes by increasing the number of individuals who access and successfully complete treatment for depression. Collaborative Care implements specific interventions that promote the detection of depression, “in-place” treatment (no referral needed), and treatment adherence.

Research on the cost-effectiveness of Collaborative Care interventions, compared to that of treatment for depression on its own, is relatively new but the results are positive. Several studies evaluating Collaborative Care interventions relative to routine care in primary care settings demonstrated healthcare savings over time.

Further Reading

• Increasing the Cost-Effectiveness of Depression Treatment with Collaborative Care.

At the request of the Boys and Girls Clubs of Greater Houston (BGCGH), The Hackett Center reviewed documents and facilitated listening sessions with BGCGH leadership and their Blue Ribbon Panel, a group of community leaders committed to youth development and after school programming. Goals for this work were to (1) identify and co-create solutions to address inequities exacerbated by COVID-19 and (2) provide guidance on resiliency initiatives that focus on social justice, health, education, and economic development. Findings and recommendations are provided in our final report.

These youth are beautiful and bold, and we must be there for them and provide transformational opportunities.

– Blue Ribbon Panel Member

BGCGH serves more than 30,000 youth in the Greater Houston area. In recent years, Houston youth have been significantly impacted by weather events (e.g., hurricanes, freezes), the ongoing COVID-19 pandemic, and a heightened awareness of racial tension and inequities. In response, BGCGH created a “Blue Ribbon Panel,” convened and facilitated by The Hackett Center, to develop a strategic approach to youth resilience programming in the aftermath of COVID-19 and other adverse experiences.

During the Blue Ribbon Panel, The Hackett Center identified a set of guiding principles, and decided that any strategy, program, or intervention BGCGH planned to implement should be:

• Operated through a “whole child and whole family” lens
• Equitable
• Culturally informed, sensitive, and responsive
• Evidence-based
• Community-connected
• Measured and evaluated

Consistent with these guiding principles, some of our key recommendations included:

• Implement a tiered system of supports
• Extend supports and trainings to families
• Hire a full-time staff member charged with developing and stewarding community partnerships related to programming
• Perform evidence-based fidelity assessments

The final report outlines 15 recommendations to enhance BGCGH’s current programming, discusses the larger contextual issues related to youth trauma and loss, and provides a rubric for evaluating strategies.

This project was made possible through the generous support of BHP. We would also like to acknowledge and thank the 22 Blue Ribbon Panel members and the Boys and Girls Clubs of Greater Houston leadership for their thoughtful and caring approach, and for offering critical insights during this process.

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The following Power of Parenting series is co-sponsored by the New York Life Foundation and the National Child Traumatic Stress Network. In partnership with researchers, clinicians, and individuals with lived experience, Dr. Julie Kaplow-Kline-Kline developed these resources to help parents and caregivers support children facing bereavement, including in the context of the pandemic.