The COVID-19 pandemic has negatively affected many people’s mental health and created new challenges for those already suffering from mental illness. According to the Kaiser Family Foundation (KFF), approximately 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder, up from one in ten adults who reported these symptoms from January to June 2019. A KFF Health Tracking Poll from July 2020 also found that many adults are reporting specific negative impacts on their mental health and well-being, such as difficulty sleeping (36%) and eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%).
Needless to say, the emotional and mental stress is taking a toll on employees across the county. For this reason, many employers are focused on the emotional wellbeing of their employees and turning to their benefit advisor to evaluate the services provided by Employee Assistance Programs (EAP’s). What they are finding is that there is a difference in the level of service providers and the level of available services. Thankfully, there are resources for not only the emotional wellbeing of their workforce, but physical, financial, and social wellbeing as well, leading to higher levels of employee engagement.
Evidence shows that when an employee is holistically balanced there are equal benefits to the employer in their ability to attract and retain quality employees. In a Harvard study, 71% of employers ranked employee engagement as “very important to achieving overall organizational success.” Yet, many of those same leaders said they knew employees were not highly engaged. So, how is an EAP one of the solutions to achieve employee engagement?
Fundamentals of Employee Assistance Programs
EAP’s came into existence in the early to mid 20th Century. Starting as hybrids of 19th Century community social services programs, occupational social work programs were developed to support the workers and their families and were considered as early human capital management programs. These social work programs included hiring and supporting management with personnel issues and focused on the wellbeing of the employee and those in the family affecting the employee.
In the 1940s and beyond EAP programs were expanded to include:
- Alcohol treatment programs.
- Support of employers compliant with the Drug Free Workplace Act.
- Services that assisted women transitioning by the multitudes in the workforce during WW1 and WII.
- Financial services for those affected by war times.
In the 1980s, professors Terry Blum and Paul Roman sought to develop a definition of Employee Assistance Programs as well as the core technology of such programs. Their definition says EAPs are “the work organization’s resource that utilizes specific core technologies to enhance employee and workplace effectiveness through prevention, identification, and resolution of personal and productivity issues.”
Blum and Roman identified those core technologies for EAP’s, which have been modified through the years as:
1. Consultation with, training of, and assistance to work organization leadership (managers, supervisors, and union officials) seeking to manage troubled employees, enhance the work environment and improve employee job performance.
2. Active promotion of the availability of employee assistance services to employees, their family members, and the work organization.
3. Confidential and timely problem identification and assessment services for employee clients with personal concerns that may affect job performance.
4. Use of constructive confrontation, motivation, and short-term intervention with employee clients to address problems that affect job performance.
5. Referral of employee clients for diagnosis, treatment, and assistance, as well as case monitoring and follow-up services.
6. Assisting work organizations in establishing and maintaining effective relations with treatment and other service providers, and in managing provider contracts.
7. Consultation to work organizations to encourage the availability of and employee access to health benefits covering medical and behavioral problems including, but not limited to, alcoholism, drug abuse, and mental and emotional disorders.
8. Evaluation of the effects of employee assistance services on work organizations and individual job performance.
The first of these technologies has to do with prevention and workplace consultation. Many believe EAPs are for the employee and family members only, but the reality is counseling and life management services are a portion of how EAPs work with employers. Employers seek to mitigate risk within their organizations to avoid increased costs and yet often there is a failure to see the biggest asset – human capital – is also the biggest risk. A work organization that understands that prevention of risk equals awareness of changes in human behavior and a plan to eliminate the risk and retain the employee is an organization that gets the value of EAP. Employee assistance is first and foremost about the work organization and retaining employees. The cost of salvaging an employee through the utilization of an EAP is much less than losing that employee, hiring, and retraining a new employee.
EAP In Action
Life happens, and events occur every day that we rarely give a second thought to while we go about our daily routines almost mechanically. We may even have disruptive events that can come about with minimal or zero impact on the disruption of our lifestyle. We get up, we go to work. If the car has a flat tire, we stop and put air in the tire. If we run out of milk, we go to the grocery store. This is how life happens and we easily can move through our day.
High impact life events, however, are another story. When a high-impact life event occurs, not only does it disrupt our daily routine, but it can stop us dead in our tracks and affect us physically, emotionally, financially – and even socially. These events can be joyous occasions or tragic happenings. Even the planning for such an event to occur can seem to be overwhelming and disruptive and as shown in the chart below, can impact one or more of the areas of our wellness.
When the person going through a high-impact life event is an employee, the repercussions can even have a ripple effect throughout the workplace. The distractions of the event can cause good performance to deteriorate, absenteeism to occur, cooperation with team members can erode, and a once focused employee becomes distracted. Supervisors and Human Resources traditionally have dealt with these issues through Performance Improvement Plans (PIP) up to and including termination of employment. Consideration should be given to using the EAP in conjunction with PIPs to set an employee up for success.
As an example, take the case of Jack, a sales manager and highly valued employee for a manufacturing company. Jack has been employed for over 15 years and has been promoted to a leadership position. The plant manager, Jim, has been approached by several members of Jack’s team with concerns about his explosive temper. Multiple employees have threatened to quit because of his anger. Jim doesn’t want to lose his sales manager or employees, and he knows he needs to have a conversation with Jack. As a first step, Jim goes to HR who suggests he call the company’s EAP. She explains to him, although he did attend training for workplace leadership, the EAP consultant can walk him through the conversation he needs to have with Jack as well as discuss the operational changes Jim expects from Jack. They will also discuss the EAP formal workplace referral process where Jack will be put in touch with the consultant. The EAP consultant will assess with Jack the change in his behavior as well as his understanding of the workplace expectations. The conversation Jim has with Jack will also discuss the behavioral expectations and the EAP referral is confidential. Jack will sign a release so Jim can know of his attendance, participation, and progress in the EAP. Depending on the EAP, Jack could be seen by an internal counselor/consultant or be referred out to someone in the EAP’s provider network. That referral source will follow up with Jim each session as well as seek to see if there are changes in Jack’s workplace behavior. The counselor will have an understanding this referral is due to Jack’s behavior at work and the expectations of the workplace. They will do a thorough assessment of Jack to see if he is experiencing any mental health or substance use problems or issues around life management.
Jack meets with his counselor and explains he is dealing with a lot of stress. His father has been ill and in and out of the hospital. Jack has been trying to help his mother and make decisions for his father. He also reports he and his wife are having communication issues that have led to a lot of tension at home. He admits he has been more hot-headed at work. The counselor, along with Jack, set goals for how he will work on these underlying issues. The counselor is aware the EAP can help Jack with his questions regarding plans for his father through their elder care services. The counselor also lets Jack know the EAP can help with legal and financial questions as well. They discuss how Jack can be more emotionally aware of when he is feeling tense and improve communication at work and home. They set a plan for several more sessions to work on understanding feelings and communicating more effectively and a suggestion is made to Jack that he could benefit from some leadership coaching and recommends he mention this to Jim. Many EAPs offer coaching alongside other training for managers. It is also recommended Jack and his spouse seek to do some work to strengthen their marriage.
Jack returns to the workplace with a renewed interest in being his best self at work. He meets with his sales team and reviews the services of the EAP and encourages others to reach out confidentially. Jim and Jack talk about the improvement in Jack’s performance as well as the performance of the sales team. They discuss with HR other ways they can utilize the services of their EAP and talk specifically about a situation from several years ago when a beloved employee died in a car accident and employees struggled with the loss.
Most EAPs offer crisis management or disruptive event services to help the workplace and employees when events happen that disrupt workflows, such as an employee death or a workplace robbery. Having someone onsite to normalize and discuss emotional reactions makes good business sense for the organization. It shows the employer cares about its workforce, and it provides stability in what can sometimes be a traumatic situation.
There are so many things Employee Assistance Programs can do to help the organization as well as its employees. Most EAPs offer counseling and life management services to employees and family members. It is important to understand that when an EAP is workplace-focused, it can provide a variety of components to prevent the people problems that can derail a company and create a loss. Seek to find out how EAPs work with member organizations and their vision for helping the workplace.
Evaluating EAP’s
A trusted advisor will want to understand the needs of the organization’s workforce to offer the right EAP solutions to the employer. For example, is the employer looking to provide referral support to employees undergoing specific mental health situations? Alternatively, is the EAP needed to support management in employee relations, counseling, leadership training, and assist in moments of workplace crisis?
Some questions to consider during the evaluation process:
- Do the EAPs being evaluated offer up the eight core technologies outlined above?
- Are services provided for not just mental health, but financial, social, and physical health?
- How does the EAP work with the organization to promote utilization?
- What is turnaround time from when an employee accesses the EAP?
- How is management supported in handling employee relations situations?
- If referrals are made for an employee to the EAP what guidance is provided to ensure that the employee’s work performance is also addressed?
- What is response time if a workplace crisis occurs?
- What are the credentials of the counselors?
- What is the cost of the program?
- Are policies in place to support EAP programs, i.e. Drug Free Workplace and rehabilitation policy?
An EAP can be offered as part of a carrier’s group health plan or EAPs exist as a stand-alone service. Some EAPs just offer referral services to outside providers while others provide what would be considered health-related services and these may be subject to ERISA, COBRA, ACA, and/or Mental Health Parity and the Addiction Equity Act (MHPAEA). Advisors should also be aware of any state-specific laws that may apply as well. It will be important for the advisor to guide their employers through the compliance maze.
Be sure when providing solutions that the employer is not just checking a box that an EAP is in place. Understanding the organizational needs will uncover other questions to properly evaluate individual solutions. A solution that is not needed, not promoted, and not supported will ultimately fail.
EAP at the Worksite
Many times EAPs are promoted once a year during open enrollment. With this type of exposure, the EAP the return on such a highly valuable program is diminished. The EAP should be a prominent fixture in the workplace. From posters to webinars, to training programs, HR should be taking advantage of all the available marketing material.
Employers will want to erase any existing bias or stigmas that employees may have towards an EAP. Therefore, the more exposure to all the available services, the confidentiality in employees using an EAP, and most importantly the support of leadership will be critical to the success of the program. It will be important that HR is supporting management in training on the services, introducing an EAP referral when appropriate, and positively promoting the service when talking to employees.
Conclusion
In determining the components of the EAP, benefit advisors can help their employers think strategically and not only about the employee’s top concerns. Helping the employer move towards a corporate philosophy focused on its employee’s wellbeing, the benefit advisor can then begin to establish the framework for the structure of an EAP as a component of a wellness plan to meet that philosophy. This philosophy is then translated into the operating plan for the program.
Bobbi Kloss is the Director of Human Capital Management Services for the Benefit Advisors Network – an exclusive, national network of independent employee benefit brokerage and consulting companies. For more information, please visit: www.benefitadvisorsnetwork.com or email the author at bkloss@benefitadvisorsnetwork.com.
With more than 30 years of EAP experience, Lucy Henry, LPC, CEAP, is Vice President of Stakeholder Relations at First Sun EAP. For more information, visit https://firstsuneap.com or contact the author at lucy.henry@firstsuneap.com.