Suppose they gave an EAP and nobody came?
“Employee assistance” can take many forms; the trick is making it easy for employees to take advantage of it, in all of its forms, to deliver on the potential for a healthier, more productive and motivated workforce.
One way that can happen is broadening the scope of programs under the framework of employee well-being. Another, complementary strategy involves giving it the visibility required to capture the attention of employees with varying needs and preferences for receiving information.
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One of the pioneers in doing both of those is EY, formerly Ernst & Young, the global professional services company whose motto is “building a better working world.”
EY Assist has evolved over the 35 years since its creation to include the following components:
- Personal counseling and referral services for emotional and substance abuse problems, i.e., the traditional core EAP service;
- Child, adolescent and adult care support, subsidies and referral services;
- Wellness (“staying healthy”) programs;
- Home maintenance and repair service referrals;
- Discount merchandise purchasing programs;
- Vacation and party planning and service referrals; and
- Academic coaching and research for parents with students of all ages, including college-bound.
The goal of EY Assist, as explained to employees, is to “provide a range of services so you can take certain tasks off your plate and, by doing so, reduce stress and free up time and energy for what’s most important.”
Holistic assistance
This holistic employee assistance model enjoys broad employee support. Maintaining that support, however, requires constant focus on finding timely promotion opportunities. “We try to create as many access points as possible,” says Dr. Sandra Turner, who has run the program for nearly the last two decades.
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For example, an internal EY electronic newsletter has frequent articles about topics such as depression awareness month, or the traditional spike in drinking and driving during the holidays, that feature links to information about EY Assist programs that can help employees address these issues.
Turner and her staff also get in front of front-line supervisors on a regular basis. “We attend a lot of meetings with them; they are our biggest source of referrals to the program,” she says.
Supervisors and, ultimately, the heads of business units are EY Assist’s most powerful advocates because they can see the evidence of the beneficial effects it has on employee attitudes, morale and performance. HR and benefits executives are often advised to make a pitch for support for assistance programs to the C-suite to garner the resources required to run a robust program.
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Turner takes a different approach. “We have helped so many business units that they do my bidding” when budget time rolls around, she explains. And they do so not just with kind words, but performance metrics that command attention.
Her metrics for gauging program impact include a consumer business measurement, “customer satisfaction.” About 15% of employees who use EY Assist comment on their experiences. The higher the survey participation rate, the more reliable the results. She considers 15% satisfactory, but is aiming higher.
Performance monitoring
“We scrutinize the results carefully,” Turner says. She looks for survey participation — and program satisfaction levels — to be representative of EY’s large, demographically diverse and geographically dispersed employee population.
“If it’s only one group, I have a concern,” she says.
Participation rates are another fundamental performance barometer. Naturally, those rates vary by program — from 99% for the discount program, to 15% for counseling services.
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That 15% figure has been fairly consistent except for occasional upticks during times of major stress, such as the economic crisis of 2008-2009 and hurricane Sandy in 2012, which affected many EY employees in the path of its destructive force.
Turner’s department was at the center of a company-wide ambitious coordinated response to Sandy in which EY employees who came through the storm unscathed and had living space to spare could volunteer to share it with those who were less fortunate. Three hundred employees did so, Turner reports.
That large offer of help may be indicative of another factor, albeit indirect, that Turner uses to assess the effectiveness of EY Assist: company culture. One important indicator of a positive workplace culture at EY is the company’s frequent accolades in various “best places to work” listings.
EY uses six external service providers to manage the various facets of EY Assist. That approach might not be viable for smaller employers, but as the scope of employee assistance services has broadened, so too have those of some companies that began with a primary or exclusive focus on employee counseling.
Deploying gamification
One such company, ACI Specialty Benefits, is in the process of launching a service called MacroLife. It ties together ACI’s own EAP, wellness and concierge benefits into other benefits offered by companies, accessible through what ACI president Erin Krehbiel calls a “gamification platform.”
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The service deploys “advanced gamification” features to engage employees, and dishes out “small bite-sized, digestible information about their benefits” so that they will see how they relate to each other and take full advantage of them, according to Krehbiel. Employees can access it via mobile devices, as well as other platforms.
“A lot of vendors aren’t proactive” in devising ways to help employers get employees to learn about and take advantage of the full menu of health-oriented benefits available to them, including EAP services, and see them as part of an integrated whole, Krehbiel contends.
An employee who might be expressing concern to a counselor about strained finances and the financial challenge of paying for a child’s braces might be unaware that a dental benefit could help. “We have concepts to support corporate initiatives while educating them about holistic approaches to health benefits, and they can be rewarded in that process” through the gamification dimension of the communication tool.
“If you don’t make these things work together, you’re going to lose the employee,” says Krehbiel says.
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You will also “lose” the employee by attempting to promote the program using what used to be traditional methods — giving a lecture to a seated audience. “Sitting through long enrollment meetings is a thing of the past,” she says.
Myths and prejudices
On some topics the communication challenge can’t easily be overcome simply with games and mobile apps. Myths and prejudices about mental health services — the core of the original EAP concept — remain stubbornly present, according to Dr. Mark Attridge, an EAP consultant and expert on the integration of traditional EAP and complementary health services.
He points out, for example, that between 20% and 25% of employees on an annual basis “meet thresholds for most mental health and addiction issues, according to national epidemiological studies, and most EAPs’ clinical case rate is about 4% of all employees, with only half of those EAP cases dealing with those most severe issues.”
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Often, he says, organizations whose senior management is reluctant to throw its weight behind robust mental health and addiction services, there is no equivalent resistance to “all kinds of support programs for cancer, heart disease and other chronic conditions with high costs,” even though alcoholism, anxiety, and depression fall under the same heading.
“This is part of the view that such conditions are personal defects of individuals and their lifestyle, rather than accepting the research and provider evidence that these are true medical issues in need of care and treatment,” he adds.
Attridge, who devotes much of his time to research, also believes it’s critical for senior management to understand that while EAPs can identify and help to address the handful of “high-risk cases” that present themselves, “the typical EAP case has mild but acute issues that do affect work performance and may affect absence from work.”
Merging silos
What Attridge considers the larger challenge is the fact that medical/addiction and medical services typically fall into distinct “silos” in benefits administration and clinical service delivery. While it may be all well and good for EAPs to be incorporated into a broader spectrum of productivity and engagement-promoting services, Attridge emphasizes the need to break down those health silos.
He offers a battery of recommendations to make that happen, including:
- Require regular meetings between EAP and other benefits and employee support partners and vendors to encourage collaborative case findings and case management and prevention opportunities across the company;
- Include behavioral health and addiction screener items in all health surveys and intake processes for workers’ compensation, disability, and chronic disease management programs;
- Require all managers to get trained in EAP orientation and risk management;
- Encourage manager referrals into the EAP for troubled employees;
- Involve EAP in the on-boarding process for new employees so they know what it is about and that it’s OK to use the EAP; and
- Encourage EAP use for those employees with low work engagement scores on annual engagement surveys.
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Finally, Attridge urges employers to take the bold step of using the EAP to look in the mirror to determine the extent to which internal factors play a role in causing employees to need to use the EAP in the first place. An EAP representative should participate in exit interviews when employees leave the organization “to see what factors of management style… were factors” in the departure.
