EAP Essentials #3: The Business Case for Employee Assistance Program Mental Health Services

Mark Sagor

mental-healthThe compelling logic that supports organizations investing in EAP mental health and substance abuse services is based on some well-documented facts*:

Mental health and substance abuse disorders are prevalent in the workplace

  • In the U.S. 30-40% of the population experience mental health and/or substance abuse disorders at some point in their lives
  • 15-20% require professional assistance in a given year
  • 10% of workers are heavy alcohol users
  • 8% use illegal drugs

Treatment for these disorders is highly effective

  • The majority (65% to 80%) of individuals improve with appropriate mental health diagnosis, treatment and ongoing monitoring. (This success rate exceeds that for many medical treatments for non-psychiatric illnesses)
  • The data is less clear cut for substance abuse treatment. While some studies show that up to 70% of patients treated for substance dependence eventually recover, the pattern of relapse in addiction is common and has led treatment professionals to regard substance abuse as a chronic medical condition.

Most people with these disorders do not receive adequate treatment (or any treatment at all)

  • U.S. epidemiological surveys show that the majority (about two-thirds) of people meeting the clinical criteria for mental and substance abuse disorders do not receive any treatment
  • This startling statistic results from an array of complex factors including the social stigma surrounding mental health and substance abuse issues and a lack of awareness of resources and their effectiveness

Untreated (and inadequately treated) mental health and substance abuse disorders impact employers significantly in the following areas

  • Employee work productivity and performance
    • More work absences and work impairment are caused by mental health issues than by other chronic health conditions including arthritis, asthma, back pain, diabetes, hypertension and heart disease.
    • Studies indicate that substance abusing employees are 3 times more likely to be late for work and two and a half times more likely to have absences of 8 days or more.
  • Disability costs
    • Mental health diagnoses are the fastest growing area of short-term disability claims and account for 30% or more of the disability burden for employers
    • A Watson Wyatt survey found that return to work is more difficult for employees following an absence for a psychiatric disability than after an absence for a general medical disability.
  • Health care costs
    • Employees with substance abuse disorders have health care costs that are more than twice as high per year than people without these disorders.
    • These higher costs are driven by a variety of factors including lack of clinical recognition, frequent medical diagnosis, the under treatment of mental health and substance abuse disorders and the fragmentation of a health care system that separates psychological care from medical care.

EAPs are perfectly positioned to remedy many of the problems which are detailed above. Because effective EAPs are embedded within organizations and develop relationships with key management, human resources, health and safety professionals they can:

  1. Facilitate early identification of mental health and substance abuse issues, an important key to successful intervention and treatment.
  2. Reduce the barriers to accessing professional mental health and substance services by being visible in the workplace, available 24/7 and offered at no cost to the employee.
  3. Reduce the stigma of accessing mental health and substance abuse services by being a familiar and respected resource that has been validated and recommended by co-workers in the workplace.
  4. Ensure appropriate referral, follow up and advocacy for employees and family members who require specialized professional and/or community services. EAPs act as a guide and advocate for employees and family members as they navigate a very complicated, and often inhospitable, behavioral health network.

I will close with a couple of caveats. EAPs which do not develop relationships and establish a high level of visibility within their host organizations will be much less successful in achieving the first three of these four crucial goals (early identification, reducing barriers and reducing stigma). With respect to the fourth outcome, EAPs which are bundled with insurance have an inherent conflict of interest. They are not independent actors and are suspect in their ability to effectively monitor and advocate for employees and family members trying to access services from the same payor that provides their compensation.

*If you would like me to provide any, or all, of the research references supporting the statistics used in this piece please feel free to email me at msagor@compeap.com.