Mental Health Medications and the Risks for Manufacturers
A journey into the medicine cabinet
This morning, 40 million Americans woke up and, somewhere between putting on the coffee and walking the dog, headed to the medicine cabinet and took a mental health medication. Most breathed a sigh of relief, thankful that their anxiety or depression would feel manageable for another day. At the same time, many worried about the potential side effects of the medication and whether they’d be able to cope if they had to stop taking it.
Some of us are in this position ourselves, and we all know others who are. They are our coworkers, friends, and family, looking for the most effective mental health treatment that will enable them to excel in the workplace and at home. But managing mental health is complicated, especially when it comes to medications—each comes with a combination of benefits along with serious risks. And manufacturing employees face additional risks in the workplace because their daily tasks require heavy machinery, agile decisions, and awareness of surroundings, which can all be impacted by medication.
Mental health medications can transform a person’s life. There’s no doubt that these medications can lessen the disruptive symptoms brought about by anxiety, depression, or insomnia. Research shows that when someone takes a mental health medication it can improve their life satisfaction, increase productivity at work, and reduce the risk of suicide. It’s also true, however, that medications come with a host of potential risks and side effects. Side effects for the most common mental health medications range from undesirable—weight gain, sexual dysfunction—to downright dangerous, such as increased risk for seizures, accidents, and serious injuries. Plus, some mental health medications have a risk of dependence, meaning that tolerance builds over time, they can be difficult to stop taking, and discontinuation can lead to potentially life-threatening withdrawal. These risks might be part of why 75% of people prefer a non-drug intervention for their mental health (pssst... read an entire blog on this topic).
Medications are the most common intervention for mental health—82% of people who present for mental healthcare are prescribed medication. A main reason for this is the dearth of trained mental health providers, contributing to long waitlists and difficulty accessing care. A recent New York Times piece summarizing survey results from 1,320 therapists revealed that “75% reported an increase in wait times [during the pandemic]. Nearly one in three clinicians said that it could take at least three months to get an appointment or that they didn’t have room for new patients at all.”
With nowhere else to turn, people in need of mental health support go to their primary care provider (PCP)—which is where nearly 60% of all mental health medications are prescribed. PCPs are not experts in prescribing and monitoring mental health medications. But in an overburdened system without enough mental health providers, they have little choice but to prescribe, especially when their patients want relief immediately. This reality means that many people who receive mental health medications never get the opportunity to access other forms of care.
While for many, mental health medications are a path back to healthy living, for others it's a long, arduous journey of trial and error. Imagine trying multiple medications, with no way of knowing how much time or money you’ll have to invest to find one with adequate efficacy and manageable side effects—all while wondering whether your mental health will actually improve. Medications are a one-size-fits-all solution to a highly individualized problem.
If different people take the same medication at the same dose, each may respond differently. This is due to genetics, biology, age, and other health conditions or medications they’re already taking. There is no way to reliably predict who will have more or fewer side effects, or which specific medication will be more or less effective—even genetic testing doesn’t always offer a clear picture. As a result, many patients cycle through different medications or may need to change their dose multiple times. Everyone hopes to be among the lucky patients who finds a great fit on their first try, but many mental health medications have a remission rate of less than 50%.
With rates of mental health problems on the rise—over a third of Americans report recent depression or anxiety, and many say the healthcare system isn’t meeting their needs—no industry is exempt from the consequences of unmanaged mental health. People in every office and plant in the country are feeling these consequences. And they’re showing up in employers’ bottom line: mental health issues are a major contributor to absenteeism, reduced productivity, and costly turnovers.
Estimates for mental disorders in the manufacturing industry vary: one study found that 30% of workers in processing and manufacturing reported a mental health history, another found that 23% of manufacturing employees were depressed, and nearly 40% of female factory workers surveyed reported mental health issues. The manufacturing industry must also take into account gender disparities in mental health: women are underrepresented in manufacturing, and research reviewing male-dominated industries finds an above-average prevalence of depression. As mental health problems are significantly underreported, especially among men, these figures likely capture only part of the true burden of mental health in manufacturing.
But as one of the industries where dexterity and alertness are essential, those working in manufacturing face a dilemma where the most common mental health medications often carry dangerous downsides. Medications for anxiety and insomnia, for example, can have sedating effects that compromise employees’ safety at work. Popular anti-anxiety medications slow reaction time, and sleep medications increase risk of accidents. In fact, some related industries (like pilots and air traffic controllers) have outright bans on mental health medications. And certain mental health medications—like benzodiazepines for anxiety and Z-drugs for insomnia—are habit-forming, making them a risky choice for people who might already be prone to addictive behaviors (the roughly one-third of manufacturing employees who smoke or use other substances). Thus, manufacturing employees may be reluctant to take medications for their mental health—and they deserve better choices.
Individuals and employers hoping to achieve good mental health are left with a conundrum: Take the risk of experiencing side effects from medications and trying different medications to find the right one; or forgo what for many, is the only form of mental health treatment available. That's an unnecessary dilemma. We can reach more people in need of mental health support if we transform our system to offer more scalable mental health treatments—including safe and effective alternatives to drugs. Digital therapeutics (DTx) could help. DTx are evidenced-based behavioral treatments that have proven abilities to treat, prevent, or manage a disease or disorder.
View this on-demand webinar as Dr. Makori discusses the challenges with the mental health care system, barriers such as stigma and biases that prevent patients in need from accessing quality care, and the role of DTx.
Opinions expressed by contributing authors are their own.