Plunging Into The Eap

In a global economy where the competition for the best and brightest workers is perhaps even more intense than the competition for new customers and markets, the health and safety of employees and workplaces are critical to the success of any organization. EAPs, under the direction of or in cooperation with occupational physicians or medical directors, can help employers manage the health of their workers and worksites and promote greater employee productivity.

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My own experience in this area is instructive. As a plant physician several years ago, and later as regional medical director, I helped administer an occupational health program that provided both injury and illness treatment as well as preventive health services at the worksite, such as health screenings and initiatives for blood pressure monitoring, hypertension control, and diabetes education and detection. Many of these activities and initiatives eventually were folded into what evolved as a joint labor-management preventive health program called LifeSteps.

At one location, I was responsible for the health and safety of about 15,000 employees, most of whom were hourly production workers represented by the United Auto Workers (UAW). During that time, I oversaw the evolution of our employee assistance program from a very small concern with one full-time staff member to a three-shift-a-day program with both hourly and salaried support staff. The growth in staff was accompanied by a growth in services: The EAP evolved from being mainly a substance abuse (primarily alcohol-based) program with an in-house 12-step effort into a program that addressed concerns well beyond substance abuse, such as psychological and emotional issues, family concerns, or other problems that underlay performance problems at work.

As the EAP evolved, it began to play a more prominent role in our ability to identify and resolve potential employee health problems. As various employee concerns–financial difficulties, child and elder care, stress, and so on–surfaced at work, EAP staff sometimes were able to discern underlying issues that might affect workplace health and productivity To help address these issues, we initiated a worksite mental health program that incorporated a psychiatrist who would visit one day each week. The psychiatrist would talk to employees who had been in contact with the EAP to assess their emotional health and determine what steps should be taken to prevent their condition (if any) from becoming more severe. Supervisors and others also got involved as necessary.

The EAP spearheaded a very active effort to educate supervisors how to recognize individuals with possible mental health problems and refer them for assessment before their problems resulted in long-term absences or discharges from work. In conjunction with my office and local facilities and organizations, our EAP team conducted self-help programs to help people recognize whether they might have problems that needed attention.

In these and other areas, such as helping coordinate training for employees and union officials in addition to supervisors, our EAP proved extremely effective in identifying and helping resolve potential health problems. Whenever EAP staff saw specific health issues that required their attention, they got involved and assumed responsibility for necessary activities.

One thing I noticed as I watched our EAP evolve and play a larger role in our occupational health efforts was that the more knowledgeable and professional the employee assistance personnel, the more effective the employee assistance program. Someone assigned to the EAP staff who didn’t have a lot of interest in employee assistance tended not to have the same level of effectiveness as someone who had been trained and had acquired expertise in the field. Our joint program made sure that our EAP personnel got that training, both the union representatives and the salaried people as well.

Handle on Costs

The need for training and professionalism is even more imperative today because there’s been such a strong move in the direction of outsourcing EAP services. As that process has continued, the level of direct involvement between the medical director and the EAP has significantly decreased, although the need for that involvement is as great as ever because many problems that come to the attention of EA professionals require confidentiality and a health expertise that people in the human resources area may not possess. The physician needs to be made aware of these problems.

The outsourcing of EAPs has been accompanied by another development that’s having a profound effect on occupational health–the rise of the Internet. I see a great future in this area with respect to health services for employees, especially as organizations and the economy become more global. The range and incidence of problems that affect a global workforce will exceed anything we have ever seen before, and employers will recognize that increasing the knowledge base of their employees–in particular, by providing low-cost access to the Internet–is a cost-effective method to assist in addressing and preventing these problems.

Within the next year, I think we’ll see more and more Internet access afforded to employees, even to the point where they can access it from home. Some companies like Ford have actually provided low-cost computers–they’re literally giving them away–to employees to increase access to the Internet. Other companies are addressing this in different ways, but all companies, I think, are finding that it pays to facilitate easier access to the Internet for their workforce.

In addition to providing employees access to the Internet, I expect employers, through their EAPs, to begin using the Internet aggressively to educate workers on preventive health concerns. But even the Internet, with its unparalleled reach and breadth, is no panacea for occupational health problems. Even with the Internet, we’ll still have drug abuse–the drug itself may change, but the problem won’t go away. And we’ll still have workers who have problems with stress and family issues. These problems may, if I can look forward with wishful thinking, decrease in terms of both degree and frequency, but I think they’re still going to be there.

I also think we’re going to have a greater need for early intervention, because early intervention is necessary if we’re to get a better handle on costs. That’s one thing we’re setting out to do in all of industry–get a better handle on all health-related costs, either by eliminating them or reducing their prevalence to the point where they’re far less frequent and we have far fewer complications to address. EAPs and other preventive health efforts are critical to early intervention, so they need to be able to show, over time, the impact they have on health costs. That’s where EAPs and other efforts are going to pay off. But I don’t see these problems going away. It’s just the nature of the human beast.

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