Concern about privacy is one reason the Internet is a major source of health information for adults in the United States. According to the Pew Internet and American Life Project report, Online Health Search 2006, nearly 80 percent of adult Internet users logged on last year to find information on major health topics. Of those, 22 percent sought information about depression, anxiety, stress, or mental health issues. Eight percent searched for information about problems with drugs or alcohol. Online screening tools provide a low-cost, non-intrusive means to encourage employees to engage in healthy behaviors and seek help when necessary. In addition, employers who encourage the use of effective online screening tools can achieve reductions in healthcare expenses and improvements in workplace productivity.

Online Screening Tools Are Effective When Anonymity is Protected
Only about nine percent of employees participate in workplace wellness activities, even though more than 25 percent know that these programs are available.¹ Low participation in health events at the worksite may be a sign that employees are worried about participating because they fear discrimination or punishment. In a 2007 study investigating the effectiveness of an online alcohol screening program, researchers found that employees who participated reduced their alcohol consumption. But researchers also found that low participation rates limited the effectiveness of the program, suggesting that screening efforts must address privacy concerns in order to reach more employees.²

Screening for Depression and Mental Health Issues
When identity is protected and kept private, online screening programs are widely used and effective. A study of an online depression screening tool found that private, Web-based testing was effective because it identified a large number of people with depression. The study also found that online depression screening identified many people who had never before been diagnosed or treated.³

Screening for Mental Health, Inc. (SMH) reported that in 2006 almost 600,000 people completed mental health screenings on issues such as depression, bipolar disorder, eating disorders, and post traumatic stress disorder via their Web site at MentalHealthScreening.Org. These screenings were offered free, online and through customized, anonymous employer-based Web sites. PacificCare Behavioral Health, a health provider that uses customized mental health screenings from SMH as part of their preventive health program, believes that wide-spread participation in online screening has led to more appropriate care and improved outcomes. Other employers who use online tools for mental health or alcohol screening include Johnson & Johnson, the Chevron Corporation, and the State of Michigan.⁴

Screening for Alcohol Problems
Online screening tools that offer Internet users safe, reliable information and links to local resources have proven to be effective in helping people with drinking problems. A 2005 study published in Preventive Medicine reviewed the behavior of people who visited AlcoholScreening.Org, a free service of Join Together. The study results showed that in a 14-month period more than 50,000 people completed alcohol screening. The study found that online alcohol screening tools attract a diversity of Internet users especially those who drink excessively. Given well-publicized, accessible, and validated screening and intervention techniques, online tools help people with alcohol problems get information and referrals to address their risky behaviors.⁵ 

Using AUDIT, one of the most widely validated alcohol screening methods, AlcoholScreening.Org has screened more than 200,000 people for risky drinking since its inception in 2001. The site also offers employers and other organizations free promotional materials and a syndication tool that integrates the screening options into the designs of company Web sites. Two employers who have used the syndication tool are Unity Health Systems and the Montana State University. 

Reducing Expenses and Bolstering Productivity
Alcohol-related productivity losses cost employers more than $134 billion annually.⁶ Employers who invest in screening and brief intervention for alcohol problems can receive a return on investment of at least 215 percent. Likewise, a recent study on depression found that improvements in depression treatment lead to increased productivity and decreased absenteeism. The specific results showed that enhanced care led to an increase of more than six percent in productivity and almost 23 percent fewer absences.

Ensuring Solutions to Alcohol Problems teamed with the Network of Employers for Traffic Safety (NETS) to develop promising workplace screening and intervention techniques. These resources are available on the Ensuring Solutions Web site.

Employers who use online tools for alcohol and mental health screening use them because they are valuable, available, inexpensive, and easy to maintain. Online screening tools also offer employees the privacy and anonymity necessary to help them feel comfortable enough to address difficult issues. Additional information about online screening tools is available at the following Web sites:

• AlcoholScreening.Org
  

• MentalHealthScreening.Org
  

• DrugScreening.Org
  

• DepressionScreening.Org
  

• MilitaryMentalHealth.Org
  

• DrinkersCheckUp.Com

Footnotes:
¹ Wall Street Journal Online/Harris Interactive Health-Care Poll. Health care poll. The Wall Street Journal Online: Health Industry Edition. 2003;2(10). Available at: http://www.harrisinteractive.com/news/newsletters_wsj.asp. Accessed on: November 12, 2007.
² Matano RA, Koopman C, Wanat SF, Winzelberg AJ, Whitsell SD, Westrup D, et al. A pilot study of an interactive web site in the workplace for reducing alcohol consumption. Journal of Substance Abuse Treatment. 2007;32: 71-80.
³ Houston TK, Cooper LA, Vu HT, Kahn J, Toser J, Ford DE. Screening the public for depression through the internet. Psychiatric Services. 2001;52(3):362-367.
⁴ Screening for Mental Health , Inc. WorkplaceResponse®: Overview. Presentation download available at: http://www.mentalhealthscreening.org/workplace/index.aspx. Accessed on November 12, 2007.
⁵ Saitz R, Helmuth ED, Aromaa SE, Guard A, Belanger M, Rosenbloom DL. Web-based screening and brief intervention for the spectrum of alcohol problems. Preventive Medicine. 2004;39:969-975.
⁶ Center for Substance Abuse Treatment. What you should know about alcohol problems. Substance Abuse in Brief. 2003; 2(1). Available at: http://kap.samhsa.gov/products/brochures/pdfs/SAB-04-2003.PDF. Accessed on November 12, 2007.