Phone-Based Work Counseling Improves Occupational, Clinical Outcomes in Veterans With Depression

Adding phone-based counseling on work issues to standard depression care offered by the Veterans Health Administration (VHA) improved both work productivity and depression severity in US veterans with depression and work limitations, according to a study published online in JAMA Network Open. 

“Since 2007, the VHA has implemented evidence-based, primary care mental health integrated care for depression,” researchers wrote, “which consists of screening, clinical informatics, measurement-based care, brief behavioral interventions, and referral to specialty mental health care to reduce symptom severity, delivered by multidisciplinary teams.”

Investigators conducted the randomized clinical trial to gauge whether adding the phone-based Be Well at Work intervention was more helpful than the standard depression care program alone. The study included 253 veterans with major depressive disorder or persistent depressive disorder who were experiencing limitations at work. Among them, 144 were randomized to mental health integrated care, and 139 were randomized to the Be Well at Work intervention in addition to mental health integrated care.  

The 4-month Be Well at Work intervention consisted of eight biweekly, 50-minute phone counseling sessions with doctoral-level psychologists, as well as one booster phone session 4 months later. During calls, psychologists worked with patients to identify functional barriers and to adopt cognitive-behavioral and work-modification strategies. 

Patients who received the work counseling intervention in addition to mental health integrated care had greater reductions in at-work productivity loss and depression symptom severity than patients who received only mental health integrated care, according to the study. What’s more, improvements persisted 4 to 5 months after the intervention’s end. 

Be Well at Work cost $690.98 per patient. Researchers calculated a 160% return on investment. 

“Depression and difficulty functioning in occupational roles and settings pose significant barriers to achieving success,” researchers wrote. “Building telephonic work-focused care into integrated care offers a holistic, accessible, and economical solution.”  —Jolynn Tumolo