As health care premiums continue to rise and employers either absorb these costs or find ways to charge the costs to employees, the inability to quantify the value of behavioral health care has led most organizations to look at price rather than outcomes of reduced absenteeism and improved job productivity as the main factor in determining which benefits to purchase. Managed behavioral health organization PacifiCare Behavioral Health (PBH) set out to determine the dollar value of behavioral health care through a four year study.

Two validated proprietary measures for assessing health status to quantify outcomes were used: the life status questionnaire (LSQ) for adults and the youth life status questionnaire (YLSQ) for children and adolescents. Treatment was provided by a network of contracted clinicians trained to use these patient self-report measures. A baseline score was taken prior to the beginning of treatment and assessments were made at set intervals throughout the course of treatment.

A component of the LSQ is a five question section on work impairment. When an employee scores above a set limit on this section, he or she can be classified as "work-impaired." During the study period, PBH found 31 percent of people assessing services met criteria for being work-impaired. People in the remaining 69 percent are still experiencing some degree of psychological distress, and their problems have not yet had a substantial impact on day-to-day functioning.

After three weeks of outpatient treatment, the data demonstrated that the percentage of work-impaired individuals and productivity loss was reduced from 31 percent to 18 percent. After nine weeks of treatment, fewer than half of those who originally felt work-impaired still met impairment criteria. There were, however, 13 percent of people showing impairment after five months of treatment. This factor is attributed to chronic behavioral health conditions that need more intense services with careful monitoring. The statistics show that many people benefit very early from behavioral health treatment.

U.S. employers incur a huge expense due to absenteeism in the workforce. According to a Sederer and Clemens article, "The business case for high-quality mental health care," (Psychiatric Services, February 2002, Vol. 53, No. 2, pp. 143-145) the cost of substance use disorders is estimated at $100 billion. With the calculation of reduced productivity losses from depression and substance use disorders in the workforce, behavioral health care services can be seen as a worthwhile investment.