The Employee Assistance Program (1.00)

EAPs Definition

"EAPs are workplace-based programs designed to address substance use and other problems that negatively affect employees' well-being or job performance" Have evolved significantly over time in response to workplace and societal issues Stressors (financial, societal, etc.), employer down-sizing/consolidation, managed-care, etc.

EAPS: History

"Occupational Alcohol Program" of the 1940's Alcohol only Early Employee Assistance Programs (1970's) Alcohol emphasis- some counseling to employee Modern Employee Assistance Programs (1980's) Wide range of personal and family concerns Contemporary Employee Assistance Programs: Managed Behavioral Healthcare/EAPs (1990's) "Broad-brush" programs addressing a wide spectrum including mental health, substance abuse, work-life, balance, marriage/family, stress, financial, legal, etc. *Some argue that the broadened range of services over the evolution of EAPs has diluted the traditional focus on substance use problems and also eroded the close relationship between workers and the EAP provider with most now being conducted via telephone or even online. *slide 9

When should an employee use an EAP? continued

An employee may also utilize the EAP's services when a problem does not currently exist. For Example: Prevent a situation from becoming a problem Gather information about mental health matters Get a mental health wellness "tune-up" Obtain information out of concern for another person's mental health

EAPs: Credentials

Certified Employee Assistance Professional (CEAP) 1. Provide a standard of requisite knowledge in employee assistance programming 2. Encourage continued professional growth in employee assistance programming 3. Establish, measure, and monitor the level of knowledge required for certification in employee assistance programming 4. Help employers, labor unions, health care providers, educators, and the public identify qualified employee assistance professionals 5. Recognize those individuals who meet the standards for certification set forth by the Employee Assistance Certification Commission (EACC).

EAP's and Confidentiality

Confidentiality is CRITICAL to the success of an employee assistance plan Elements of trust and confidentiality are essential in helping employees in need All information obtained in the functioning of an EAP is subject to strict federal and state regulations -Initial phone contact -Evaluation -Treatment -Follow-up Info must NOT be shared with the employer without the employee's informed written consent

Cost-Benefit Analysis

Cost: Often based on utilization and size of company i.e. 5% of employees use service for avg of 7 visits at $120 each = $42/employee/year Benefits (Employee Assistance Professionals Association Projections): 27% fewer worker compensation claims 57% improvement in absenteeism 48% less likely to leave their jobs 58% decline in employees reporting on the job physical health problems 70% decline in employees reporting on the job emotional health problems Employer's return for every dollar invested is between $5 and $16.

Types of EAPs: Wrap Around

Developed by smaller employers Response to restrictions imposed by managed care on the use of mental health services Smaller employers contract with EAP's to provide access to outpatient behavioral health benefits

Types of EAPs: Full Service EAP:

EAPs continue to grow and evolve based on business, society, and healthcare demands: Full Service EAP: (The All Inclusive EAP) Internal or external EAP covering a variety of services Most likely to provide: -Crisis management and critical incident debriefing -Employee counseling in response to worksite changes (i.e. downsizing) -Innovators in developing new services such as HIV, legal, and financial counseling -Disability management -Elder and child care assistance -Risk management and prevention Expensive to operate

The Future of EAPs

Employee Assistance Programs have evolved significantly since the 1940's. Evolution of EAPs will likely continue in response to: 1. EAP Enterprise -Ability to assess and demonstrate effectiveness -Intense market competition (trend to larger, external EAPs) 2. Workplace Demands -Demographic and Social Influences a. Women in the workplace (families at home, etc.) b. Second careers/displaced workers -Financial constraints (downsizing, pay freezes, etc.) 3. Society -Health insurance/health reform -Financial concerns -Federal/State regulations 4. Costs -Trend toward contracting with third parties to offer services due to expense of running on-site/in-house

EAPs Purpose

Employer paid benefit: -Allows eligible employees access to counseling, referrals... -Services may be provided via phone (95%),online (64%), or referrals to behavioral health providers - or some combination Improve psychological health of employees/families Help staff develop coping skills and a greater degree of personal responsibility Help to resolve individual, family, marital, and job performance problems GOAL: to advance workplace environment and maximize employee performance through improved employee & family health

When should an employee use an EAP?

Feel preoccupied with a problem Fail repeatedly in his/her efforts to solve it alone Spend a lot of energy denying a problem Feel sad, fearful, or unhappy most of the time Experience frequent mood swings Experience insomnia or sleep more than usual Experience loss of appetite or overeating Feel that some aspects of your life are unmanageable Decline in job performance Having trouble concentrating Missing deadlines Making many mistakes Frequent absences Having frequent accidents Avoiding co-workers

Outcomes of EAPs

Improve health (physical/psychological) of employees and families Create a positive workplace environment Boost company morale Create good public relations Company managers find that offering help to troubled employees, rather than punishing them, also helps the bottom line.

EAP Range of Services

Marriage and family problems Financial and legal difficulties Psychological and workplace conflict Stress, anxiety, depression Alcoholism or alcohol use Drug abuse Eating disorders Bereavement or coping with chronic illness Job or career concerns Other emotional and life challenges

Types of EAPs: Compliance

Monitor and comply with conditions of Drug-free Workplace Act, DoT and various State regulations, etc. (USED TO MEET REQUIREMENTS) Relatively few of these programs Often used as the least expensive mechanism to comply with regulations (instead of offering substance abuse programs, etc.) Central elements: Alcohol and drug testing, counseling services for detected abusers, medical review officer services.

Types of EAPs: Peer Assistance Program

Operated by labor and professional groups to support their membership Typically adopted to serve workers who are not provided with EAP coverage by their employers due to: -Small size of company -Mobility or geographical dispersion of employee group -Worker-employer relationship (i.e. contracted labor) May also be implemented by workers who have a concern about confidentiality of EAP services Typically rely on trained peer counselors and referral agents often with referral to self-help groups

EAP Services

Programs offer confidential: Assessment Referral Short-term counseling Legal advice Financial counseling Follow-up for employees and their families Most offer 3-8 visits for assessment and short-term counseling In 1998, 56% of employers offered an EAP In 2014, 74% of employers offered an EAP >97% of companies with >5000 employees

Why would an employee not use an EAP?

Stigma!! -Many employees still fear that their supervisors or insurance companies will find out they have a mental health condition -Concerned that the discovery will influence their opportunities for advancement or insurability. Some may resist treatment simply because they do not want to be labeled a "mental" patient Lack of motivation to seek care and shame about needing care -Because fatigue, hopelessness, and passivity are often characteristics of depression and/or addiction -Individuals who would benefit from depression treatment may postpone or completely avoid seeking help for their illness. In addition, some individuals may feel shame for having a mental/addictive illness. Ignorance about treatment -Some individuals may be unaware of treatment options or the effectiveness of care. Some may believe that treatment requires a "big commitment" -Viewed as complicated, lengthy, and expensive. Employee may fear that counseling diminishes in effectiveness the longer it is delayed.

Types of EAPs: The Integrated Program

The Integrated Program: Utilizes combination of in-program services and referrals Focuses on behavioral health benefit management by merging managed behavioral health care and employee assistance services -Attempt to unify assessment, service, and benefit management -Reduce administrative overhead (cost) and improve efficiency Most common with larger, self-insured companies and large internal union groups