Written by: Sara DePasquale
Each year during Mental Illness Awareness Week, National Depression Screening Day (NDSD) is held. NDSD was established in 1991 by Screening for Mental Health, Inc. (SMH), a non-profit organization. This year on October 9th, NDSD will include local clinicians in all 50 states that volunteer their time to offer free educational and screening programs at health facilities, malls, libraries, colleges, workplaces and senior centers.
Each depression screening is free, anonymous and takes less than ten minutes. At the screening, people have the chance to learn more about anxiety and mood disorders, complete a brief questionnaire, and speak with a mental health professional, confidentially.
What to expect during the free screening:
- A written screening questionnaire
- Discussion of results with a health professional
- A referral list of clinicians and treatment facilities in the person’s area
- The chance to watch an educational video
- Some pamphlets and brochures
- The opportunity to fill out a “friends and family questionnaire” for a loved one
If you or someone you know is interested in attending a free screening, locate a site in the area by going online at http://www.mentalhealthscreening.org/. To find out more information on depression, please visit our Working World Cafe Blog, or to visit www.perspectivesltd.com to check out our EAP, Managed Behavioral Healthcare & Wellness services.
Written by: Terry Cahill Vice President of Sales and Marketing, Principal
SURVEY RESULTS – UTILIZATION #3: An EAP is not an EAP is not an EAP
Thanks to the data analysis conducted by Mark Attridge, PhD, MA, which is summarized in the study, some of the most interesting descriptive findings were the differences in EAP utilization and EAP staffing across pricing models. A little more than ¾ of the respondents primarily utilized a per employee capitated pricing model, while the remaining quarter primarily used either a fee-for-service pay as you go model or a Free EAP model in which the EAP is embedded in another product (e.g. – Life Insurance, Long Term Disability) and for which the end user customer organization does not pay a fee. The comparative analysis across these models indicated that:
EAP Counseling utilization rates were respectively 3 and 4 times higher for the Capitated and Fee-for-service models than for the Free EAP model
EAP Organizational Service rates for services such as Supervisory Training, Employee Orientations/Seminars, Critical Incident Response, etc. were respectively 7 and 5.5 times higher for the Capitated and Fee-for-service models than for the Free EAP model
The Embedded Free EAPs had respectively 3.8 and 3.3 times the number of covered employees per EAP staff than the Capitated and Fee-for-service EAP
This has major implications for purchasers in differentiating the various types of vendors in the EAP marketplace. Those purchasers interested in generating EAP utilization and/or integrating the EAP into the workplace, might do well to consider the aphorism, “you get what you pay for”. It is important to note that there was no statistically significant difference amongst the three pricing models in average # of sessions per EAP Counseling case. Another area of further study might be to examine what percentage of these EAP Counseling sessions are delivered in-person or by video as opposed to telephone or LiveChat/email.
Stay tuned for Part 5 of EAP Utilization Date and Trends! Part 5 will bring results on the differences in utilization between larger and smaller EAP vendors. Does size matter? To get more information regarding this blog post, email email@example.com.
Written by: Terry Cahill Vice President of Sales and Marketing, Principal
UTILIZATION #2: Is that utilization enough? Are we reaching our client organizations? Is utilization really the right question?
The NBC study surveyed the participating external EAP vendors about business management issues in addition to utilization data. Respondents were asked to identify the most difficult objectives in working with their client organizations, difficulty defined by high monetary and time commitment. Those items ranked most difficult fell into two clusters, the first cluster being the difficulty in getting meaningful opportunities to build relationships with client organizations’ management at levels higher than the organizations’ designated EAP liaison. The following graphic indicates the percentage of respondents that indicated the item was High or Very High in difficulty:
60% – Getting “face-time” with executives to discuss EAP
51% – Relationship-building activities to renew contract
49% – Opportunities for more proactive/strategic role for EAP
The second cluster was getting the word out about EAP services to the end users – employees and their families, as well as managers. The following depicts the percentage of respondents that indicated the item was High or Very High in difficulty in this cluster:
52% – Promoting EAP among family members/dependents
47% – Promoting EAP among supervisors/management
45% – Promoting EAP among employees
It would seem from the survey results that there is room for better promotion of EAP services to end users, yet also a lack of access to client organizations’ power structures to cultivate the connections and influence necessary to achieve that end. This is the utilization dilemma facing EAPs. And while it is important to attempt to address this, (and a later section of the NBC study does indicate an emerging solution that will be discussed in this paper), it is also important to note that another approach to this issue is to focus not on how many, but on entirely different metrics that support the value of EAP services. Unfortunately, the final of the 7 most difficult items in working with client organizations based on percentage of High or Very High Difficulty was:
52% – Quantifying and demonstrating the value of EAP
And only 42% of the responding external vendors used validated outcome surveys, the most common of which was Chestnut Global Partners’ Workplace Outcome Suite. In order to change the conversation with client organizations from raw utilization statistics to the impact EAP services have on client organization performance, much greater use of validated outcomes instruments will be required. However, even within the quest for greater utilization, there are differences in results across EAP vendors per the next two sections of this paper.
Part 4 coming shortly on the differences in utilization between Capitated, Fee-For-Service and Free Embedded EAP models. To get more information regarding this blog post, email firstname.lastname@example.org.
Survey Results: Utilization#1: What is typical EAP Counseling utilization?
Written by: Terry Cahill, Vice President of Sales and Marketing, Principal
To reiterate, all data was reported anonymously so those participating had no competitive advantage to consider when filling out the survey. This may account for the lower utilization numbers than seen in previous reports of EAP utilization such as AON/Hewitt’s Study of their Request For Information (RFI) data from 2009-10 which indicated the average EAP Counseling rate to across vendors submitting response to their RFI as 5.7% and 6.0% respectively for 2009 and 2010. (External Employee Assistance Program Vendors: A Study of RFI Data from 2009-2010; EASNA Research Notes, Kathleen Mahieu and Chet Taranowski; Volume 3, Number 3, April 2013).
What should our EAP utilization be? How many counseling sessions should be built into our model? What percentage of cases should an EAP refer into the healthcare benefit?
Another way to ask these questions is how does our utilization stack up against others? For the utilization rate data item, the survey asked for the number of unique individuals receiving EAP assessment/counseling services, (not WorkLife or LegalFinancial services), annually divided by the total number of covered employees. Good arguments can be made to calculate this number differently. However, this was the definition settled upon for this survey as it was the one in most common usage and so easiest for respondents to retrieve and report for purposes of comparison.
The average reported EAP Counseling annual utilization was 4.5% with the median at 3.6%.
This is a far cry from some of the marketing claims made by EAP vendors. Of course, when utilization of WorkLife, Legal/Financial and online services are added, utilization is higher, but even then, are EAPs reaching enough individuals? The next subsection of this paper will look at that question. What about the average number of sessions per EAP Counseling case?
The average number of sessions per EAP Counseling case was 2.47, the median 2.36.
This survey result is especially interesting in that the 82 EAP companies surveyed had models that included from 3 to 12 counseling sessions per case. There are EAP vendors that market “unlimited” counseling sessions though their contracts often clarify that cases needing mental health or substance abuse services will be referred into the healthcare benefit without receiving unlimited counseling. This data makes the discussion about what are the actual differences between a 5 and an 8 and an unlimited counseling session model quite interesting. How much more service is an employer actually buying once they get past a 5 or 6 session model? As studies of this kind always generate more questions, one excellent question to research in this area is what percentage of EAP Counseling sessions are delivered by phone versus in person? The current study, in order to get the survey down to a manageable time allotment for participants, pulled this particular question from the original survey draft.
If the typical EAP case averages under 3 sessions, what percentage of the EAP Counseling cases are NOT referred into the mental health and substance abuse benefit?
82% of EAP Counseling cases are not referred into the mental health/substance abuse benefit.
This speaks to a huge shift in EAP service delivery in that most EAP cases well into the 1980s were “Assessment & Referral”, the premise of EAP work being to get the client to the help that best matched their EAP-assessed need. The EAPs role was to provide a comprehensive assessment and then find a resource to fit the assessed need, often, though not always, within the mental health portion of the healthcare benefit. Clearly, the EAP field has evolved to a more of a brief counseling model in which cases are not referred nearly as frequently into the benefit plan. This shift does speak to a challenge for today’s EAP, which is how to deliver both the brief goal-focused counseling in keeping with the repositioning of EAPs as a resource for everyday living while also still providing a comprehensive assessment in order to identify high workplace impact issues like substance abuse. These two ends of the service delivery continuum speak to the pull for EAPs to both increase utilization and prove their value. While EAP vendors struggle to increase utilization, can they also set aside resources to deliver services that demonstrate the workplace impact of their services? The next set of survey results addresses that question.
Stay tuned for Part 3 where we ask the questions, Is that utilization enough? Are we reaching our client organizations? Is utilization really the right question? To get more information regarding this blog post, email email@example.com.
Written by: Adria Passey
We all know, whether we have kids or not, that caring for children is demanding, time-consuming work, filled with both joys and struggles. Caring for our aging parents can be much the same. What if you had to do both on a daily basis? And go to your job? Carpools, Medicare, doctor visits, teachers conferences, estate planning, play-dates, Social Security, meal planning and don’t forget about that deadline at work!
The Sandwich Generation is a phrase coined to describe this population of people who are both raising children, caring for their elderly parents and working. These people tend to be in their 30s through 50s. According to MetLife’s 8th Annual MetLife Study of Employee Benefits Trends, one in five full-time workers are caregivers for an older relative, while nearly three-quarters of those employees also have children under the age of 18 at home. That’s a lot of employees! Not only that, but according to the Pew report, 47% of adults in their 40s and 50s have a parent 65 or older, and are also taking care of their young adult children – those “grown-up” kids who are struggling to find their feet financially due to the Great Recession.
Like most of us, the Sandwich Generation worries about money – MetLife also reports that 26% of Sandwich employees turn to their HR department for financial information and advice, as opposed to 10% of employees with only children at home – but they have added stressors as well. Caregiving can be exhausting, while also being very rewarding, and maintaining a healthy work-life balance becomes even more difficult when you are juggling so many balls.
Tips for Caregivers:
- Accept your feelings. Guilt, worry, love: these are all valid responses.
- Ask for help. You can’t do it all. Delegate, if you can. It can be hard to ask for help, but people are often pleasantly surprised at what they receive when they do ask.
- Don’t forget about yourself. If you are not taking good care of yourself, you will not be able to care for your children and parents. Eat well, sleep and exercise.
- Take advantage of your company’s benefits. If your employer has an EAP, they will be a valuable resource to assist you in finding the help your family needs. Check with HR.
For more information on Caregiving, you can email Adria Passey at firstname.lastname@example.org.
Written by: Terry Cahill, Vice President of Sales and Marketing, Principal
What should our EAP utilization be? How many counseling sessions should be built into our model? What percentage of cases should an EAP refer into the healthcare benefit? Are there differences in these EAP metrics across EAP vendors by size of the EAP company and/or dominant pricing structure (i.e. – capitated fee vs. fee-for-service fee vs. free embedded EAP)? How do we prove the value of what an EAP does? Has it all come down to pricing or are there also new opportunities?
The answers to these questions have been either elusive or embellished in marketing claims. And there has been no common industry data with which to compare the data individual EAP vendors and their client organizations experience. Thus, the Les McCann and Eddie Harris reference in the subtitle of this paper, “Tryin’ to Make It Real Compared to What”. But now there is empirically derived comparative data that addresses these and many other questions about the EAP field. Published as the only article in the November/December 2013 issue of the Journal of Workplace Behavioral Health (Stan Granberry, Mark Attridge, Terry Cahill, Pat Herlihy; Volume 28, Issue 4, 2013), the National Behavioral Consortium Industry Profile of External EAP Vendors study is the first study to provide publicly available comparative EAP metrics based on a large and diverse set of external EAP providers. This study was funded by a grant from the Employee Assistance Research Foundation (www.eapfoundation.org) to the National Behavioral Consortium (www.nbcgroup.org) with Dr. Stanford W. Granberry, PhD., as the Principal Investigator. Represented in the study are 82 external EAP vendors with over 35,000 client companies covering over 69 million employees and over 164 million total covered lives in the U.S., Canada and ten other countries.
The Employee Assistance Research Foundation’s (EARF) call was for original research study proposals to advance the “Understanding the Current State of the EAP Field”. The rationale for the NBC Industry Profile study is set out in the study abstract:
“It is common practice in many professions, fields and industries to disseminate comparative information. Absent this vital resource an individual company cannot accurately evaluate their performance against a similar cohort and therefore must rely upon anecdotal information. The findings of this study address this deficiency in the Employee Assistance Program (EAP) field by reporting empirically derived comparative data for external providers of EAP services.”
The lack of comparative data in the EAP field is in part due to external EAP vendors protecting data that is perceived as potentially damaging from a competitive point of view if made public. The NBC study addressed this issue by offering anonymity to respondents to the survey. The credibility of the project also benefited from having the endorsements of both of the major professional organizations in the field – The Employee Assistance Professionals Association (EAPA) and The Employee Assistance Society of North America (EASNA) – as well as an independent funding source (EARF). Finally, an Institutional Review Board for research approved the study methodology.
Before proceeding to the results of the study, the answers to those often asked EAP questions, a bit more about the study respondents to demonstrate their breadth and diversity on top of the large sample of over 164 million covered lives.
Stay tuned for Part 2 on the survey results on what is typical EAP Counseling utilization. To get more information regarding this blog post, email email@example.com. If you’d like to get the full White Paper, go to https://www.perspectivesltd.com/news.aspx and sign up to receive it.
Written by: Jonathan Eisler, Director of Perspectives Organizational Consulting Group
When’s the last time you felt extremely happy after a grueling day at work? For me, it was last week after a busy day last week filled with coaching clients, securing a new training engagement, lunch with an old colleague and the standard mix of internal meetings. I was heading home exhausted….yet exhilarated and as I said, feeling extremely happy! The next morning I reflected on the day before, and realized that I was overwhelmed by the excitement I felt in anticipation of getting to the office. I ended up arriving at the office a bit before the majority of my colleagues, so I took advantage of the calm to reflect on the juxtaposition that I found myself in: happiness and work. Not to say that work is drudgery, but the 8-5 workday isn’t always associated with happiness.
I like seeing individuals happy and I’m passionate about helping organizations increase the performance, commitment and engagement of their people, so I took a few minutes to explore the drivers of employee happiness as I was experiencing the two having a positive correlation.
As my coffee cooled, it hit me; in regards to what employers can control, there are really three main reasons employees feel happy at work.
- They know and understand what is expected of them.
- Uncertainty leads to fear, anxiety and withdrawal.
- They feel supported and valued by the organization.
- Having to fend for yourself or not being recognized leads to feelings of isolation.
- They feel competent to do their job effectively (which most often includes working with others).
- No one likes feeling inadequate.
You may be saying, “Jonathan, this sounds a lot like employee engagement” and I’d say absolutely! However, I believe that engaged employees are not always happy and happy employees are not always engaged, but I do know that unhappy employees are NEVER engaged. So I propose focusing on happiness first!
If you find yourself unengaged at work, ask yourself if you’re happy. If the answer is no, look at the list above and see what may be driving the unhappiness. Do you know what is expected of you? Do you feel supported/valued by your employer? Do you have the skills needed to fulfill your duties effectively (including interpersonal skills if relevant…. and they usually are)? If the answer to any of these is “no” and you want to change your current situation, you now have specific areas to explore with your supervisor. I’m sure there are outliers, but in my experience, I’ve yet to meet a manager that didn’t appreciate an employee’s proactive approach to improving their own performance.
If you’re responsible for the performance of others and their performance is not what it should be, ask them where they’d rate themselves on each area of the list. The caveat here is that you must first communicate that the responsibility for the areas you wish to explore fall on the organization’s shoulders, not the employee’s.
While it’s worth noting that many factors contributing to an individual’s happiness fall outside of an employer’s control, never underestimate the value of a high-quality workforce/organizational development partner and Employee Assistance Program.
Let’s focus on creating a happier workforce and who knows, one Friday afternoon we may just overhear someone exclaim without sarcasm, “I can’t wait for Monday!” …alright, that may be a stretch.
To learn more about creating a high-performing workforce, you can email Jonathan Eisler at firstname.lastname@example.org.
Written by: Brea Seder, LCSW
It’s here! Part 2 of 10 Super Foods for Happiness. If you’re just checking in, read Part 1 here.
Go Nuts! These nuts are packed with omega-3s, which help fight off depression and mood swings and can also improve your memory and focus. Walnuts are one of the richest dietary sources of serotonin, the chemical in your brain, that helps create calm and happiness. Providing new evidence that serotonin may be directly absorbed from food into the body, a recent Spanish study found that those who ate a daily 1-ounce combo of walnuts, hazelnuts, and almonds had more of this feel-good substance than a nut-free group.
This leafy green is packed with magnesium and folic acid, both found to boost your mood and increase energy levels. This super food also contains phenylethylamine which is responsible for the production of endorphins, an instant pick me up. Spinach is a great antioxidant that works to protect your brain cells from free radicals, which can lead to low energy and mood swings. This green giant is super rich in iron, which helps deliver energy-sustaining oxygen to your cells.
Milk products are rich in tryptophan, an amino acid our brain needs in order to make serotonin. . Milk also contains antioxidants, vitamin D, and vitamin B12 that help fight stress and aging. Foods that are rich in calcium will naturally help to boost your spirits and excellent for your bones. 1-2 glasses of milk a day can be a natural mood booster that can help a person to feel happier and more productive. Drink a glass of warm bed to catch some Z’s.
Blueberries, strawberries, and raspberries contain anthocyanidins and anthocyanins — nutrients that help reduce stress and depression. These super fruits help stave off the brain aging that can lead to slower thought processing. Thank the anthocyanins (antioxidants that lend berries their hues); these substances may work with other compounds in the fruit to block enzymes that short-circuit normal communication between brain cells. Since each type of berry has its own mix of phytochemicals, go for a variety.
Peas, beans, and peanuts are a rich source of protein, especially for vegetarians. Legumes release hormones like dopamine and norepinephrine, which signals the body to stop craving for food and they also make you happy. Legumes are also packed with magnesium, a mineral that plays a core role in your body’s energy production. “When you exercise, magnesium is redistributed throughout the body to help energy molecules get to where they’re needed,” explains Forrest H. Nielsen, PhD, a research nutritionist in the USDA’s Agricultural Research Service. A deficiency may cause you to fizzle out more easily.
To get more information on Super Foods for Happiness, read part 1 now! For other blogs similar, check out Happiness without a Prescription: 10 Natural Mood Enhancers Part 1 and Part 2 or visit http://blog.perspectivesltd.com.
Written by: Bernie Dyme
Last week was a very painful one for many of us as we learned about the tragic suicide of a comedy icon, Robin Williams. In the time since his death, there has been much speculation in the media about why and how. But what’s most disturbing is the conversation about whether or not this was an act of selfishness on the part of Mr. Williams. I even heard one commentator speak about Mr. Williams’ suicide as an act of cowardice.
Now I realize that people’s natural response is to be angry, and since the easiest person to be angry at is the victim, I get it. But I think that this really does miss the point.
Although we may never know exactly what lead to his action, my guess is that it was an attempt on his part to deal with horrific pain. While we may or may not agree with his method of dealing with pain, what’s most significant here is to understand that he was in pain and so are many folks who are dealing with depression. And what we should really be dealing with here is how to prevent this in the future.
Prevention begins with bringing this illness out of the closet so that people can feel free talking about it openly and get the help needed to prevent it. Shame and guilt doesn’t do anybody any good. If we can encourage those suffering from depression or anxiety or chemical dependency to open up about this, we might be able to prevent or mitigate against much of this kind of pain.
There are many places in which we can exercise this influence. My particular focus is on the workplace. After all there is no other place where we spend more time, more energy or have a greater chance of impacting people’s lives.
So what can we do to bring this out into the open? In fact there are many things. Here are a few:
- Educate employees about the importance of good mental health. After all, we spend a lot of time and money doing this around physical health so why not treat mental health in the same fashion? And this should happen throughout the entire organization, from the C Suite to line level employees.
- Encourage all employees to speak with counselors whenever the need arises. Again, we think nothing of encouraging employees to get an annual physical so why not do this in the area of mental health?
- Teach managers the workplace manifestations and signs of mental illness as well as how to talk to folks who might be suffering and encourage them to get help.
- If a suicide should impact your workplace, encourage discussion about mental health and provide support to your workforce, especially those who may have known that person.
- Have good mental health professionals available to provide confidential support to anyone in need. The most logical place to get this is by having an Employee Assistance Program (EAP). They can help educate, provide counseling and on-site groups for employees coping with a tragedy like this.
- Check into resources that might be helpful such as the National Action Alliance for Suicide Prevention or feel free to download “A Manager’s Guide to Suicide Postvention in the Workplace”. This is an excellent pdf that provides action steps for dealing with the aftermath of a suicide. I know because it was developed by the Workplace Taskforce of the National Action Alliance for Suicide Prevention; a committee that I have been honored to serve on.
There are lots of resources out there so let’s take this opportunity to honor Robin Williams’ memory. With all of the good work that he has been involved in, I know that he would want us to take this seriously and try and prevent this from happening to anyone else. And that is not selfish.
If you or someone you know feels suicidal, please visit http://www.suicidepreventionlifeline.org/ or call 1-800-273-8255.
Written by: Brea Seder, LCSW
Good nutrition is a key ingredient with physical and mental health. Do you ever feel happier just by eating? Need a boost? According to new research, some foods have the same effect on your body as taking a prescription mood-enhancing drug. Nutritionists swear that particular foods can make you feel amazing.
Researchers have studied the association between foods and the brain to identify ten nutrients that can combat depression, and boost our mood. These nutrients are calcium, chromium, folate, iron, magnesium, omega-3 fatty acids, vitamin B6, vitamin B12, vitamin D, and zinc. Try to incorporate more of these feel good super foods in your diet today!
Avocado contains vitamin B3; a serotonin-boosting (feel-good neurotransmitter) ingredient. They are also high in monounsaturated fat and potassium, both of which help lower blood pressure, according to the National Heart, Lung, and Blood Institute. Monounsaturated fat also helps keep receptors in the brain sensitive to mood-boosting serotonin. These green giants also contain omega-3 fatty acids, which have been linked with brain health and function and mood regulation. Avocados are also good for your skin, hair and nails!
If you needed another reason to indulge in dark chocolate, it’s this one: dark chocolate can make you happier. A study in the Journal of Psychopharmacology found that consuming chocolate high in cocoa flavonols increased levels of calmness and contentedness. Dark chocolate is high in magnesium, a mineral that calms your muscles and helps to reduce anxiety. It also contains tryptophan, which helps reduce symptoms of depression. Cocoa also contains phenylethylamine, which is responsible for the production of endorphins, which instantly boost your mood.
Lentils are a good source of folate which is essential for your mood and well being; Just one cup of lentils provides 90 percent of the recommended daily allowance of folic acid. Lentils also contain the amino acid L-tyrosine, which your brain uses to make the neurotransmitters norepinephrine and dopamine, helping your brain fight depression.
These spears are another green high in folic acid and packed with tryptophan which helps produce serotonin, also known as the “happy hormone” that helps regulate our mood, emotions and sleep.
Salmon is loaded with omega 3 fatty acids, especially easily absorbed ones like EPA and DHA. While all omega-3s are healthy, you get the most benefit from EPA and DHA, which found is also found in tuna, and other fatty fish. “Fatty acids help to keep our brains stable,” advises Dr. Usula Wemeke, Royal College of Psychiatrists. Several studies have shown a omega-3 has a distinct antidepressant effect.