THE IMPACT ON EMPLOYMENT OF AN INTERVENTION TO INCREASE RECOGNITION OF PREVIOUSLY UNTREATED ANXIETY AMONG PRIMARY-CARE PHYSICIANS

Anxiety is a common, though often unrecognized, problem in primary car e settings. This study examines the effect on employment of an interve ntion designed to attune primary care physicians to previously unrecog nized and untreated anxiety. Primary care physicians in a mixed-model health maintenance organization (HMO) were randomized by practice site to groups with (intervention) and without (usual care) intensive one- on-one education about anxiety and periodic feedback about their patie nts with anxiety. All persons 21-65 years of age presenting to the off ices of these primary care providers were screened for anxiety with th e SCL-90-R on two occasions. Those meeting the SCL-90-R cutpoints for anxiety and whose medical records provided no evidence of recognition or treatment for a mental health condition within the last 6 months we re eligible for the study (n = 637). Of these, 573 (90%) completed two follow-up assessments. The present study evaluates the impact of the intervention aimed at the primary care physicians on the labor force p articipation rate of the persons with anxiety after 5 months of follow -up. The study also evaluates the impact of the intervention on hours of work and the presence of days spent in bed among the persons with a nxiety working at the baseline interview and after 5 months. At baseli ne, the patients of intervention and usual care physicians with previo usly unrecognized and untreated anxiety did not differ in labor force participation rates, At the conclusion of the study, the patients of t he intervention group physicians had significantly lower rates of labo r force participation than those of the usual care group physicians. A mong those working both at the beginning and conclusion of the study, the intervention had no impact on hours of work or the presence of day s spent in bed. We conclude that attuning physicians to anxiety may re duce labor force participation rates.