While prevention strategies are vital to managing the risk of workplace violence, mid-market organizations also must prepare for the long-term impact on workforce mental health and productivity if an incident should occur.

Establishing a comprehensive and well-advertised employee assistance program can not only ease the mental and emotional burden of a violent incident after it happens, but might help prevent an incident from happening in the first place.

Besides providing one-on-one counseling to individual employees who may be victims of workplace violence, EAPs also can provide the group critical-incident response immediately after a tragedy, experts say.

Moreover, EAPs can train managers and employees on what behaviors to watch for in other employees that may give rise to a violent act, they say. EAPs also can be instrumental in helping a midsize organization develop a workplace violence prevention policy and action plan.

Unfortunately, while most large employers offer EAP services as part of their corporate benefit programs, small and midsize employers are less likely to offer them.

According to the 2011 Mercer National Survey of Employer-Sponsored Benefit Plans, just 27% of employers with fewer than 500 employees offer EAP services. The availability of EAP services is more common in the upper end of the middle market, with 81% of employers with 500 to 999 employees offering them. But this size employer still is less likely to offer EAP services than are employers with 5,000 to 9,999 employees. In that group, 94% of employers offer EAP services, the Mercer survey found.

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Oftentimes after a traumatic incident occurs in the workplace, such as an armed robbery or shooting, employers experience increased voluntary turnover rates and a bump in workers compensation disability claims, said Bob VandePol, president of Crisis Care Network in Grand Rapids, Mich., which provided critical-incident response services in the wake of the 2007 shootings at Virginia Polytechnic Institute and State University in Blacksburg, Va.

But research has found that when employees victimized by workplace violence receive professional support within two to 24 hours after a traumatic incident, it reduces voluntary turnover rates and workers compensation claims, he said.

Mr. VandePol cites the experience of Matthews, N.C.-based Family Dollar Stores Inc. as an example of the effectiveness of critical-incident response after workplace violence. The retail chain “gets robbed multiple times per day,” he said. “With minimum wage workers getting robbed at such an alarming rate, almost half of them quit after the robberies. The retailer engaged us to provide our service to them. After the first year, the stay-at-work rate jumped up to 84% and is now 91%,” he said.

At the same time, only 6% of Family Dollar's victimized employees now file workers compensation disability claims after robberies and, for those who do, claims are 15% less costly than they had been prior to the introduction of counseling, according to a study of the Family Dollar experience published by the American Psychiatric Foundation.

While the costs were a concern for Family Dollar—a Fortune 500 employer that had the financial wherewithal to absorb them—they could have far more dire implications for a middle-market employer, Mr. VandePol said.

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“Think of the turnover costs if half of your team quit,” he said. “Then there's recruitment and training costs” for new hires. “Family Dollar measures our success by the reduction in workers compensation costs per robbery. We're saving them a boatload of money.”

Kim Baker, director of account services at Chicago-based EAP ComPsych Corp., said employers often forget about using EAPs after a crisis.

“That's one of the most unknown but critical components to our service. When there is a crisis, we have a dedicated critical-incident stress management team. They are not part of our normal group of clinicians; they are specialized for these incidents,” she said.

Among other things, the critical-incident response counselors “will help us determine how quickly we need counseling on-site. Sometimes when folks are in shock, they don't know that they need services. But we'll have counselors out on-site not only for group sessions, which is how many employers like to handle these situations, but also for individual counseling as needed,” Ms. Baker said.

A group session often “is the best way to reach certain segments of the population,” she said, because “just seeing the counselor in a group setting makes people feel more comfortable about going to seek counseling on their own.”

In addition to responding after an incident has occurred, EAPs can be helpful in training managers and employees on prevention strategies, said Kathleen Greer, president of KGA Inc., a human resources consulting firm in Framingham, Mass., that specializes in EAP programs.

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“If you have a workplace violence incident, you can call the EAP and they will help afterward, but the whole point is prevention,” she said. “You can do direct training to heighten people's awareness. Managers and supervisors are in the best position to see something starting. A manager can see if something has changed with someone. If they have had any kind of orientation, they're going to pay attention.”

Among the clues to watch for, she said, are changes in attitude, changes in appearance or dress, bullying or confusion, especially if exhibited by a formerly clear-headed employee.

EAPs also can help organizations develop a workplace violence prevention and action plan, said Marina London, a licensed clinical social worker and Web editor for the EAP Assn. in Arlington, Va. “Ideally, you would have a representative of the EAP, an HR person and people in charge of security” collaborate on a plan, which would include directives such as when to call police or when to refer potentially volatile employees to the EAP for counseling, she said. “In conjunction with that, the EAP can train the managers and employees on the policy.”

“The most preventive thing an employer can do is to make employees aware of the availability of the EAP as a resource,” said Alan King, president and chief operating officer of Workplace Options, an EAP based in Raleigh, N.C.

Unfortunately, small and midsize employers are less likely than their big-company counterparts to offer EAP services to their employees as part of their benefit plan.

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“EAPs have less acceptance in smaller organizations. Part of it comes from people's perception that EAPs are a "touchy-feely' benefit for employees, but it is not,” he said. “On the management side, the EAP can be part of the toolbox that managers use to support their employees. An EAP can reach out to an employee a manager sees as troubled.”

Managers also can turn to the EAP to learn how to approach potentially volatile employees, Ms. Greer said.

“We all need coaching sometimes for difficult conversations. They may be concerned about getting too personal,” she said. “Large organizations may have corporate psychologists on staff, but not middle-market companies. HR managers are good at that, but having a good EAP can really help them go beyond where they're comfortable.”