For employers, the value proposition of an employee assistance program is driven by the understanding that employees with unresolved mental health and substance abuse problems often have troubles in their professional and personal lives that impact a company's bottom line. Historically, EAP providers have used a variety of measurement tools to illustrate their ability to resolve or mitigate these concerns, such as employee utilization rates, referrals to external resources or satisfaction surveys. While these metrics may be effective ways to identify the level of awareness an EAP has among employees, they don't truly address the impact the EAP had on the individuals who used the program.
A new study by my company, CuraLinc Healthcare, Outcomes and Impact: Maximizing the Utility of Employee Assistance Programs, suggests that EAP models with the proper construct and focus can facilitate meaningful and lasting behavior change that leads to a decrease in absenteeism, an increase in productivity and improved health from employees who presented with depression or alcohol use.
Data was collected from more than 1,900 EAP participants in 2013, using four screening mechanisms: the Stanford Presenteeism Scale (SPS-6) for employee productivity; the Workplace Outcomes Suite (WOS) for employee absenteeism; the Patient Health Questionnaire (PHQ-9) for depression; and the Alcohol Use Disorders Identification Test (AUDIT-C) for alcohol use. All EAP participants were offered the SPS-6 and WOS, but the PHQ-9 and AUDIT-C were only offered to those who presented with depression and alcohol use, respectively. After the assessment, the EAPs clinicians followed up at 30-, 60- and 90-day intervals to measure changes in the employees health.
Overview of results: productivity
Presenteeism, when employees show up for work even if they are too sick, stressed, or distracted to be productive, accounts for as much as 75% of lost employee productivity from U.S. employers (Health Enhancement Research Organization, 2012). While the Employee Assistance Professionals Association defines an EAP as a set of professional services specifically designed to improve and/or maintain the productivity and healthy functioning of the workplace, until recently, there was little empirical evidence to connect EAP utilization to a measurable change in employee productivity. This study confirmed an EAP can help reduce presenteeism among employees who use the program.
After using the EAP, the average SPS-6 score from EAP participants increased from 23.61 (assessment) to 26.15 (30 days) to 28.61 (90 days), representing a significant improvement in employee productivity. Further, the percentage of employees with low presenteeism scores dropped from 16% to 5% after 30 days; and 86% of employees reported high presenteeism scores after using the EAP, compared to 69% prior to using the program. The EAP had a meaningful and measurable impact on employee productivity, specifically among employees with specific presenting concerns, such as alcohol problems, depression, anxiety, and family issues.
Overview of results: absenteeism
Excessive employee absences particularly those that are unplanned can be detrimental to an organizations top and bottom lines. The U.S. Bureau of Labor Statistics reports that American businesses lose an average of 2.8 million work days each year due to unplanned absences, costing employers more than $74 billion.
After using the EAP, the average time away from work caused by the employees behavioral health concern(s) decreased by 8.87 hours within 30 days. From among employees who missed a significant amount of time due to their behavioral health concern(s) before using the EAP 40 hours or more only 22% reported any missed time at all after using the EAP; and the average improvement was 70.81 hours per employee. In short, an EAP does have the capacity to reduce absenteeism from among employees who use the program.
Overview of results: condition-specific outcomes
The study provided an illustration of the causal relationship between EAP participation and improved outcomes for employees who presented with depression or alcohol use.
A recent Gallup poll reported that workers in the U.S. who have been diagnosed with depression miss an estimated 68 million more days of work each year than their counterparts who have not been depressed resulting in an estimated cost of more than $23 billion in lost productivity annually. This study showed that an effective EAP can mitigate the impact of this problem by fostering a measurable improvement in 88% of employees who presented with depression during the initial assessment. Further, the percentage of employees with moderate, moderately severe or severe depression dropped from 32% to 11% after receiving services through the EAP.
The Substance Abuse and Mental Health Services Administration recently found that about 19.2 million U.S. workers (15% of the employed population) reported using or being impaired by alcohol at work at least once in the past year. The average AUDIT-C score for EAP participants who presented with signs of alcohol use improved from 4.71 to 3.71, which demonstrates a noteworthy reduction in employees abuse of alcohol after using the program.
What does this mean for employers? For one thing, companies that offer EAPs should leverage these programs as core components of their population health management initiative. While most employers utilize several different services to address the physical health concerns of employees, the EAP is the only benefit that is specifically intended to resolve the emotional problems that lead to absenteeism and lapses in productivity.
In addition, employers should select an EAP provider that is committed to implementing a company-specific strategy for driving awareness to the benefit. Although an EAP with the proper construct and focus can have a positive impact on employee health and productivity, these gains are minimized when only a small percentage of employees know that the program exists.
Fogarty is president of CuraLinc Healthcare. CuraLinc helps organizations improve productivity and decrease costs by providing an integrated suite of behavioral health and wellness services, highlighted by an innovative employee assistance program model.
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