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Employee assistance programs underutilized by employees

Lack of information may contribute to perceived mental health stigma

Employee assistance programs underutilized by employees

Employee assistance programs can effectively reduce the adverse effects of depression, workplace stress and other mental health issues, but research shows that most EAP-based mental health services are underutilized by employees.

A mere 3% of employees used their employer's EAP counseling services in 2012, according to data compiled by EAP Technology Systems Inc., a Yreka, Calif.-based EAP analytics company.

A separate study, published in September by New York-based Towers Watson & Co., found that while 85% of employers of all sizes offer stress management services within their EAP, only 5% of employees had used those services.

Generally inexpensive and administratively unobtrusive, EAPs have long been popular among employers for their potential to reduce direct and indirect costs associated with employees' substance abuse and mental health disorders. The average annual per-employee cost of an EAP ranges from $12 to $40, representing less than one third of 1% of the average employers' annual per-employee spending on health insurance at the high end of the market, according to reports by the Employee Assistance Society of North America and the Kaiser Family Foundation.

However, EAP utilization for stress and mental health management has remained consistently low, primarily due to poor communication about the services available to employees and their families and also to stigmatization of EAP use and mental health ailments in general, several benefits and human resources experts say.


“One of the biggest problems surrounding EAPs is that employers generally don't do a very good job communicating with their employees about the program,” said Bruce Elliott, compensation and benefits manager for the Alexandria, Va.-based Society for Human Resource Management. “A lot of employees simply aren't aware that their company even has an EAP, or they've heard of it but they don't know who to call or how to use it.”

Experts said employees' lack of information on the full range of services their employer's EAP provides is a common deficiency.

“There still seems to be a pervasive sense among employees that EAPs are for very specific and discrete problems like substance abuse or management issues,” said Helen Darling, president and CEO of the Washington-based National Business Group on Health. “The message that EAPs really need to get across is that they're a one-stop shop where employees can seek out help no matter what challenge they're facing.”

In the absence of comprehensive information about the availability of EAP benefits and services, experts said it is easy for employee misconceptions to manifest as a negative perception of those who request counseling.


“A number of clients have told me that when they bring EAP counselors on-site, employees tend to assume that the people using those services must have a drinking problem or something like that, and that's simply not the case,” said Paula Andersen, a Louisville, Ky.-based director of Buck Consultants L.L.C.'s health and productivity practice.

Another frequent barrier to broader use of EAP services — particularly counseling services for depression and other mental health ailments — is employees' distrust or lack of awareness of privacy policies.

“A lot of employees tend to worry about confidentiality issues when it comes to using their EAP benefits, and they may not be aware of all the robust privacy protections they're provided” under the Health Insurance Portability and Accountability Act, Mr. Elliott said.

“I can't tell you the number of times I've had to tell employees not to worry about the confidentiality aspect because their information is protected by HIPAA. If an EAP vendor were to provide us with information about a specific employee's conversations with a counselor, not only would the vendor get sued, but we'd get sued as well, especially if we made any employment decisions based on that information,” Mr. Elliott said.

Beyond misconceptions, experts said use of EAP-based counseling services for depression, stress and anxiety has likely been dampened by a persistent stigmatization of mental health disorders in the U.S., particularly within certain industries and geographic regions.

“I've been told, for example, that people in rural areas avoid getting treatment at mental health clinics because they're terrified that their neighbors will see their car in the parking lot,” Ms. Darling said. “Outside of major cities, especially places like New York and Los Angeles, the idea that you might have a psychiatric disorder is still something most people — particularly men — aren't likely to admit.”