title: When could a stigma program to address mental illness in the workplace break even?
abstract: OBJECTIVE
  To explore basic requirements for a stigma program to produce sufficient savings to pay for itself (that is, break even).
  
  
  METHODS
  A simple economic model was developed to compare reductions in total short-term disability (SDIS) cost relative to a stigma program's costs. A 2-way sensitivity analysis is used to illustrate conditions under which this break-even scenario occurs.
  
  
  RESULTS
  Using estimates from the literature for the SDIS costs, this analysis shows that a stigma program can provide value added even if there is no reduction in the length of an SDIS leave. To break even, a stigma program with no reduction in the length of an SDIS leave would need to prevent at least 2.5 SDIS claims in an organization of 1000 workers. Similarly, a stigma program can break even with no reduction in the number of SDIS claims if it is able to reduce SDIS episodes by at least 7 days in an organization of 1000 employees.
  
  
  CONCLUSIONS
  Modelling results, such as those presented in our paper, provide information to help occupational health payers become prudent buyers in the mental health market place. While in most cases, the required reductions seem modest, the real test of both the model and the program occurs once a stigma program is piloted and evaluated in a real-world setting.
authors.affiliation: Head, Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Ontario; Senior Scientist and Health Economist, Centre for Addiction and Mental Health, Toronto, Ontario; Professor, Department of Psychiatry and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.
authors.forename: Carolyn S
authors.initials: CS
authors.lastname: Dewa
authors.affiliation: Director, Centre for Excellence in Economic Analysis Research (CLEAR), St Michael's Hospital, Toronto, Ontario; Associate Professor, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hoch
mesh_terms: D000041:Absenteeism; D002170:Canada; D003362:Cost-Benefit Analysis / Q000191:economics; D004185:Disability Evaluation; D006266:Health Education / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D018868:Insurance, Disability / Q000191:economics; D008605:Mental Health Services / Q000191:economics; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D018803:Models, Economic; D011287:Prejudice / Q000191:economics* / Q000517:prevention & control* / Q000523:psychology; D012929:Psychological Distance; D012050:Rehabilitation, Vocational / Q000191:economics; D057545:Social Stigma; D017132:Workplace / Q000191:economics* / Q000523:psychology