evidence-based workplace mental health risk management ......aggregate productivity loss than...

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Evidence-BasedWorkplaceMentalHealthRiskManagement:

Implica<onsforEAP

Mark Attridge, PhD, MA Attridge Consulting, Inc.

612 889-2398 / [email protected]

OpeningPresenta7on[2hours]29thAnnualIns7tuteEmployeeAssistanceSocietyofNorthAmerica(EASNA)Atlanta,GeorgiaMay10,2017

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Dr. Mark Attridge President of Attridge Consulting, Inc. Based in Minneapolis, Minnesota, USA Managed Research Department at Optum Led Data Cooperative at Watson Wyatt Past Chair of EAPA Research Committee 2009 Award from EASNA for Outstanding Service to EAP Field Created over 200 scholarly papers, presentations, and trainings Ph.D. Psychology (Social) from UniversityofMinnesotaM.A.Communica7onfromUniversityofWisconsin-Milwaukee(612)889-2398mark@a+ridgeconsul7ng.comWebsite:www.a+ridgeconsul7ng.com

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Welcome to Atlanta

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ABSTRACT

Thispresenta7onreviewstheglobalresearchliteraturetoiden7fytheevidence-basedbestprac7cesthatemployeeassistanceproviders

canusetobe+ermanagethebehavioralhealthrisksinthe

workplacestheyserve.

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SixThemes

1.RiskPrevalence

2.RiskBurden

3.RiskPreven7on

4.RiskIden7fica7on

5.RiskReduc7on

6.RiskRecovery

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Mark’sRecentRiskSCARYSTORY

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Photography by Mark Attridge

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Part1

RiskPrevalence

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Part1–RiskPrevalenceResearchonRiskPrevalence

Whoismostat-riskformentalhealthandaddic7onproblemsintheworkplace?

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StressinAmerica2014APAStudy–RandomSampleof3,068Adults

Source: American Psychological Association (2015). Stress in America: Paying with Our Health.

3in4AdultsExperience1+SymptomasaResultofStressinPastMonth

75%

TopSourcesofStress:64%Money60%Work49%TheEconomy47%Family46%PersonalHealth

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Life7mePrevalenceofBehavioralHealthDisorders

MentalHealth

AlcoholDrugs

MedicalHealth

1in3Life<meAffected

26%ofemployeesinayearhaveanxiety,depression,phobias,panicschizophrenia,orsuicide.Also,45%ofMHcaseshaveotherMHcondi7ons.

33%ofmentalhealthcasesalsohavesubstanceabusedisordersorbehaviouraladdic7ons.

45%ofmentalhealthcasesalsohavemedicalcondi7onssuchas:heartdisease,diabetes,chronicpain,andsleepproblems.

Source: Attridge (2008), Dewa et al. (2004), Frone (2006a&b), Kessler et al. (2005), NIMH (2008)

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Full-7meWorkersatClinicalLevelforBehavioralHealthDisordersinPast12-months

U.S.Na7onalRandomSampleEpidemiologicalInterviewData2012

8.0%

6.8%

6.0%

3.7%

20.0%

Substance Abuse

Adjustment Disorders

Mood Disorders

Anxiety Disorders

ANY Disoder

About1inevery5workersatriskeachyear

Source: Karg, et al. (2014, October). Past year mental disorders among adults in the United States: Results from the 2008–2012 Mental Health Surveillance Study. CBHSQ Data Review. SAMHSA.

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PrevalenceofSubstanceAddic7onsandHistoricalTrends:Canada

20 1915 14

2

Alcohol Tobacco Medica7ons Marijuana IllicitDrugs

AbusersinPastYearasPercentageofAdults(Canada)

Source: Attridge & Wallace (2009), Health Canada (2002)

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PrevalenceofBehavioralAddic7onsandHistoricalTrends:NorthAmerica

Addic<on Life<meRateinAdults Trend

Gambling 5%problem;2%pathological Increasing

Sex 3%to6% Increasing

Food/Ea7ng 5%women,<1%men Increasing

InternetUse Unknown(es7mated1%) Increasing

Workaholism Unknown(es7mated1%) Increasing

Attridge & Wallace (2009)

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MentalHeathDisabilityFacts

•  In most organizations, 1% to 2% of all workers have a mental health disability claim each year.

•  MH claims account for a third of all disability costs.

•  MH claims are difficult and more expensive to treat because of clinical and social factors that complicate recovery and RTW process.

•  Private organizations in Canada spent between $180 to $300 million on STD and $135 million on LTD for mental health and addictions in 2008.

•  45% of employers in Canada say these costs are increasing.

Source: Attridge & Wallace (2010) – Able-Minded Report

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SecondaryEffectsofMentalHealthDisordersonOtherDisabilityCases

•  Mental health comorbidity can create undiagnosed hidden effects that exacerbate the treatment course and costs associated with other kinds of disability claims that do not have a mental health primary diagnosis.

•  Some employers and disability insurers now screen ALL disability cases for possible mental health and addiction symptoms as a standard practice in disability management.

•  20% - 40% of all STD claims involve diagnosed comorbid or secondary mental health and/or addiction problems.

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Yet,MostinNeedofCareDoNotGetTreatment

–  Socials7gma

–  Physicianmisdiagnosis(MDsarefirstplaceforcare)

–  Undertreatment(useofRxonly)

–  Notenoughprovidersofmentalhealthtomeetneed

–  Relapseandchronicissueswithmanyaddic7ons

Source: Dentzer (2009), Lipsey & Wilson (1993), Raistrick et al. (2006), Seligman (1995), Wang et al. (2005)

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A 34-page report written for a business audience that digests key findings and action strategies

from over 80 research studies.

HighPrevalence&LowTreatment=AQuietCrisisofMentalHealthintheWorkplace

Attridge (2008)

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Part2

RiskBurden

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Part2–RiskBurdenResearchontheCostBurdenofRisks

Howmuchdoemployeeswithmentalhealth

riskscostemployers?

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Source: Riedel & Lynch (2006). Benefits and Compensation Digest

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IncreaseinAnnualHealthCareClaimsCostsPct.BeyondAverageBaseAmountfor7RiskFactors

66%

54%

41%

16% 15% 11% 10%

0%

10%

20%

30%

40%

50%

60%

70%

Addi7onalIncreasein$

Based on % change in published research studies on different risk factors

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AnnualHealthCareClaimsCosts:USAverage(2015)of$5,141andAddi7onal$ByRiskFactor

Drinking DrugUse Depression Stress Smoking Exercise Nutri7onAddi7onal $3,414 $2,762 $2,087 $797 $745 $560 $514Average $5,141 $5,141 $5,141 $5,141 $5,141 $5,141 $5,141

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

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WorkplaceCostsRelatedtoMentalHealthandAddic7ons

•  Whenthecostsfrommentalhealthcondi7onsinavarietyareasforapar7cularemployerorganiza7onareconsideredtogether,themostcostly(70%ormore)areaisusuallyinworkproduc<vitylossesratherthanotherareasofhealthcare,medica7ons,ordisabilityclaims.

•  On-the-jobinjuriesare40%morelikelyforemployeeswithmentalhealth,alcohol,ordrugproblems.

•  Employeeswithmentalhealthandaddic7onproblemsusedisabilitybenefitstwiceasorenasotherkindsofhealthissues.

Quiet Crisis & Hidden Hazards reports

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PhysicalandMentalHealthareConnected

§  Injuredworkerscandevelopmentalhealthproblems,makingreturningtoworkmoredifficult(CarnideN,etal.2016,JournalofOccupa:onalRehabilita:on)

§  Performingrepe77vemovementsover7meincreasestheriskofdevelopingcommonmentaldisorders(KouvonenA,etal.,2016,EuropeanJournalofPublicHealth)

§  Individualswhoexperiencechronicworkplacestresshavea30%excessriskofdevelopingCHD(Steptoe,A.&KivimäkiM,2013,AnnualReviewofPublicHealth)

§  Highefforts–lowrewardsatworkcontributetoincreasedstressandelevatedriskofCHD,asdoesjobinsecurity(KivimäkiM&SiegristJ,2016,InWorkStressandHealthinaGlobalizedEconomy)

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It’sAboutPresenteeism

Presenteeism in the workplace:A review and research agenda

GARY JOHNS*

Department of Management, Concordia University, Montreal, Quebec, Canada

Summary Presenteeism refers to attending work while ill. Although it is a subject of intense interest toscholars in occupational medicine, relatively few organizational scholars are familiar with theconcept. This article traces the development of interest in presenteeism, considers its variousconceptualizations, and explains how presenteeism is typically measured. Organizational andoccupational correlates of attending work when ill are reviewed, as are medical correlates ofresulting productivity loss. It is argued that presenteeism has important implications fororganizational theory and practice, and a research agenda for organizational scholars ispresented. Copyright # 2009 John Wiley & Sons, Ltd.

Introduction

Absenteeism, generally defined as not showing up for scheduled work, has a long research history, duein part to its perennial cost to organizations and its status as an indicator of work adjustment (Harrison& Martocchio, 1998; Johns, 1997, 2008, 2009). However, it is only recently that presenteeism hasbecome a subject of interest. Although some definitional confusion will be addressed in what follows,the most recent scholarly conception of presenteeism involves showing up for work when one is ill.Excitement concerning the subject has been fueled by claims that working while ill causes much moreaggregate productivity loss than absenteeism (e.g., Collins et al., 2005) and by the idea that managingpresenteeism effectively could be a distinct source of competitive advantage (Hemp, 2004).

In this article, I trace the development of interest in presenteeism and review its severalconceptualizations. Then, I offer a definition to guide research that will contribute to bothorganizational theory and practice. The challenges involved in measuring presenteeism and relatedproductivity loss are considered, and organizational, occupational, and medical correlates arereviewed. Finally, a research agenda for studying presenteeism is presented. A prominent subtext is thatscholars in organizational behavior, human resources, organizational psychology, and healthpsychology have important theoretical and methodological skills that should be brought to bear instudying presenteeism.

Journal of Organizational BehaviorJ. Organiz. Behav. 31, 519–542 (2010)Published online 6 July 2009 in Wiley InterScience(www.interscience.wiley.com) DOI: 10.1002/job.630

*Correspondence to: Gary Johns, Department of Management, John Molson School of Business, Concordia University, 1455 deMaisonneuve Blvd. West, Montreal, Quebec H3G 1M8, Canada. E-mail: [email protected]

Copyright # 2009 John Wiley & Sons, Ltd.

Received 12 July 2007Revised 27 April 2009Accepted 11 May 2009

Source: Johns (2010), p. 530, Journal of Organizational Behavior

“Thereisconsiderableagreementacrossstudiesthat

presenteeismaccountsformoreaggregate

produc7vitylossthanabsenteeism”

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“Ourfindingthatstressanddepressionwereamongthestrongestcontributorstolostproduc:vity…isconsistentwithrelatedresearch.Thesignificantinfluenceofmentalhealthissuescannotbeoverstated.”

EmpiricalEvidenceoftheLinkBetweenMentalHealthandWorkProduc7vity

Source: Riedel et al. (2009). Journal of Occupational & Environmental Medicine, p. 9

StayWellHealthManagementStudy:Sampleof772,750employeeswhocompletedhealthriskappraisalsurveysat106employers

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$$$$$$$>$$$

Source: Boles at al. (2004); Burton et al. (2005, 2009); Goetzel et al. (1998, 2004, 2007), Integrated Benefits Institute (2004); Johns (2010); Kessler et al. (2004); Madras et al. (2009); Simon et al. (2001)

Lost Employee

Productivity While at

Work

Absence &

Turnover

Health & Disability

ClaimsAbout 70% of Total costs

Produc7vityLeadsCostBurdenofHealth-RelatedEmployeeProblems

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PercentageofEAPUserswithAbsenteeismProblematBefore(AVG=meanaverageweightedbysamplesizes)TotalN=141,693OverallAVG=27%

33%17%19%18%19%

43%48%

21%29%

44%28%

32%34%

23%59%

ComPsych2007(1,300)BDA2012Stress(11,608)BDA2014Anxiety(6,147)

BDA2014Depression(3,871)Careways2015(5,725)

AmericanBH2015(200)HMSA2015(248)

OptumHealthrecent(22,895)MorneauShepell2013(70,761)WOSfullscaleNORM(3,291)

WOSsingle-item(5,194)

WOSsingle-iteme4health(261)WOSsingle-itemNORM(5,194)

WOSfullscaleChina(1,707)WOSfullscaleNORM(3,291)

>halfdayAbsenceAVG=28%

UndefinedAbsenceAVG=19%

ZeroAbsenceAVG=40%

A+ridge(2016).EAPIndustryOutcomesforEmployeeAbsenteeismandPresenteeism:AGlobalResearchAnalysis.PresentedatEmployeeAssistanceProfessionalsAssocia7onconference,Chicago,IL.

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PercentageofEAPUserswithPresenteeismProblematBeforeAverage=56%12Studies(N=130,103)

29%45%46%47%50%52%

59%62%63%64%66%67%

OptumHealth"cutback"(21,413)ComPsych2007(1,300)

e4health2016(261)WOSfullscale(1,982)

AmeicanBehavioralH2015(200)WOSsingle-item(6,587)BDA2012Stress(11,608)Careways2015(5,725)

MorneauShepell2013(70,761)HMSA2015(248)

BDA2014Anxiety(6,147)BDA2014Depression(3,871)


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BusinessisMaking

Workplace

BehavioralHealth

APriorityIn2017

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Part3

RiskPreven7on

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Part3–RiskPreven7onResearchonPreven7ngRisks

HowcanEAPsbecomebe+erintegratedintootherworkplacehealthprogramsandorganiza7onallevelini7a7ves?

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BusinessRecognizesthePoten7alofPreven7on

“Employerscanhelpbyrecognizingthecauses

ofstress,urgingemployeestotake

advantageofemployeeassistance

programs,andmakingjobmodifica:ons.”

Source: Klachefsky (2013). Benefits (p. 36)

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Wellness&Preven7on

�  HealthRiskScreenings

�  PhysicalFitness,Nutri7on,WeightLoss

�  SmokingCessa7on

�  StressManagement

� Manyotherservicesandprograms

�  In2014,U.S.employersplantospend$594peremployeeperyearinincen:vestoencourageuseofwellnessprograms

Source: Fidelity Investments and National Business Group and Health (2014) – health care survey of 151 midsize and large companies

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WhatisaCultureofHealth?

ACultureofHealth“isthecrea7onofaworkingenvironmentwhereemployeehealthandsafetyisvalued,supportedandpromotedthroughworkplacehealthprograms,policies,benefits,andenvironmentalsupports.BuildingaCultureofHealthinvolvesalllevelsoftheorganiza7onandestablishestheworkplacehealthprogramasarou7nepartofbusinessopera7onsalignedwithoverallbusinessgoals.Theresultsofthisculturechangeincludeengagedandempoweredemployees,animpactonhealthcarecosts,andimprovedworkerproduc7vity.”

•  Source:USCentersforDiseaseControlandPreven7on,WorkplaceHealthGlossary.h+ps://www.cdc.gov/workplacehealthpromo7on/tools-resources/glossary/glossary.html

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Manyorganiza7onsnowpromo7ngconceptofcultureofhealthtodriveorganiza7onalsuccess

TrendsforCultureofHealth39

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GuardingMinds@Work

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ASSESSMENTTOOLSàOrganiza7onal

AuditàIni7alScan

àPSR-12EmployeeSurvey

ACTIONSTRATEGIESàRiskReportCardàAc7onResponsesàAc7onPlanning

Worksheet

EVALUATIONCRITERIA

àEvalua7onPlanningWorksheet

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EAP and Prevention in Canada 2013 National Standards for Employers to Maintain the

Psychological Health & Safety of Workers

Website:GuardingMinds@Work

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Integra7ngMentalHealthandWorkplaceSafety

Manyemployersalreadyhavesafetyculture–thuscanconnectwellnessculturegoalstothisongoingac7onandcompanycommitment

•  Leadingcorpora7onspromotebothhealthandsafety

•  Moresuccessfulfinanciallyascompanythantheirpeerswholackintegratedapproach

•  AnnualCorporateHealthAchievementAward-AmericanCollegeofOccupa7onalandEnvironmentalMedicine

•  CompanieswithhighscoresonbothhealthandsafetydimensionsincreasinglyoutperformedtheS&P500index

•  CaseExamples:Johnson&Johnson,IBM,Boeing,DowChemical,AmericanExpress

“…companies that integrate their health and safety efforts, building a culture of health and wellness along with a culture of safety, are likely to have a competitive advantage in the marketplace.” Fabius,R.M.,etal.(2016).TrackingtheMarketPerformanceofCompaniesThatIntegrateaCultureofHealthandSafety:AnAssessmentofCorporateHealthAchievementAwardApplicants.JOEM

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Part4

RiskIden7fica7on

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Part4–RiskIden7fica7onResearchonFindingThoseAt-Risk

Whatscreeningtoolscanbe

implementedtoiden7fyemployeesmostatriskformentalhealthproblems?

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Evidence-basedScreenerToolsforHigh-RiskBehavioralHealthCases

•  AUDITorAUDIT-C―alcohol

•  MAST―alcohol

•  DAST―drugs

•  PHQ-9―depression

•  PHQ-4―depressionandanxiety

•  GAIN-SS― mentalhealthdisorders andsubstanceabuse

Source: Herlihy & Mickenberg (2013)

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UnderstandingBe+erScreenerTools48

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EAPsDoPreven7on

Survey study with sample of 200 EAP professionals.

Half of EAPs offer prevention at their organization “often” or “frequently.”

How many offer screening and/or training:

•  40% alcohol and drug

•  32% work team functioning•  25% depression

•  23% workplace bullying

Source: Bennett & Attridge (2008) Journal of Employee Assistance

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BeyondEAPBehavioralScreening

EAP BSI

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HowBSIDiffersfromSBIRT

Substance •  Alcohol •  Drugs

Smoking

Depression

EAP Work/Life Issues • Stress • Financial, Legal, Family, Workplace

1

3

2

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IMBVESTEAPVermontProject:NumberofHealthRisksPerPersonof7Assessed

52KAF=30CasesinStudy

52

PRELIMINARYFINDINGSNOTFORDISTRIBUTION

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EAP+Work/Life74%

EAP+Wellness50%

EAP+Any93%

EAP+Other27%

MBHO20%

EAPsCanShareBHScreeningToolswithPartnerProgramsatOrganiza7ons

Source: National Behavioral Consortium EAP Vendor Study (2013 JWBH) Attridge Cahill Granberry Herlihy

MBHO=ManagedBehavioralHealthOrganiza7on

Other:•  Training•  Addic7on•  Disability•  Coaching•  Specialty

services

5353

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“Integra2onInsights”ColumnbyMarkA+ridge-Startedin2015JournalofEmployeeAssistance

EAPIntegra7onTrendsEAP&Work/LifeEAP&CostSegmentModelEAP&Organiza7onalHealthEAP&WellnessEAP&DisabilityEAP&Pricing/Quality

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NurseAdviceLine

Disability

OnsiteClinics

MentalHealth

ChronicDisease

Work/Life

Occupa<onalHealth&Safety

EmployeeAssistanceProgram

Maternity

Leadership

WorkplaceIntegra7onPartnersforEAP

TheOrganiza7onalHealthMap

Addic<on

Benefits LaborHumanResources

Wellness

Self-CareMedia

GroupTrainings

eHealthWebsites

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Part5

RiskReduc7on

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Part5–RiskReduc7onResearchonRiskReduc7on

Howeffec7veiscounselingtreatmentofemployeeswithmentalhealthproblemsinareasofclinicalandworkperformanceoutcomes?

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GlobalResearchSupportforClinicalEffec7venessofTreatmentServicesforMentalHealthandAddic7ons

– Outpatient mental health counseling (CBT) – Rx medication for more severe cases – Combination of talk therapy and Rx – Workplace brief counseling – EAP – Prevention approaches (work culture) – Relapse and long-term model

Source: Lipsey & Wilson (1993), NICE (2008), Raistrick et al. (2006), Seligman (1995), Wang et al. (2005)

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•Telephonictherapyformentalhealthhasbeentestedinmorethan30researchstudies.•Thegeneralconclusionisthattelephonictherapyiseffec7veoratleastpromisinginmostoftheempiricaltestsconducted.Cogni7veBehavioralTherapy(CBT)hasbeenthemostcommonlyusedformofinterven7on.•Telephonictherapyservicesareeffec7vefor:

AnxietySubstanceAbuseDepressionTraumaPanicdisordersPTSD

Source: Hailey et al. (2007); Leach & Christensen (2006), Wang et al. (2007)

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Source: Anthony, Nagel, & Goss (2010), Griffiths & Christensen (2006), Reger & Gahm (2009)

•Internet-basedformsofpsychotherapy(e-mailandwebtools)alsoshowsini7alsupportinover20researchstudies;manywithRCTstudydesigns.•Onlinetherapyservicesandtoolsappeartoworkbestforcertainkindsofpa7ents,whenusedtosupportotherongoingtherapy,andforuseasself-careandrelapsepreven7on.•Posi7veclinicaloutcomeshavealsobeenobtainedwiththerapistuseoftheInternettointeractviae-mailforpa7entswithdepression,anxiety,socialphobias,PTSD,ea7ngdisorders,andpanicdisorder.

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Seeother2012&2014reportsbyVederetal.on

EASNAResearchNotes

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Thereissubstan7alevidenceshowingthatprovidingmentalhealthandpsychiatricservicesoffsetsorreducesthelateruseofmedicalcareservicesandtheassociatedhealthcareclaims.Reduceddisabilitycosts,avoidedfurtherabsencefromworkandavoidedemployeeturnoveralsoarefoundinmanystudies.

HighQualityResearchonCost-OffsetForMH/SAParetoCasesinGeneral

Source: Cartwright (2000); Chiles et al. (1999); Hudson (2008); Kessler & Stang (2006)

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WorkplaceCounselingWorks!2010LiteratureReview

“Thefindingssuggestthatworkplacecounsellingis

generallyeffec2veinallevia:ngsymptomsofanxiety,

stressanddepressioninthemajorityofworkplaceclients.”

Source: McLeod (2010), Counselling & Psychotherapy Research (p. 245)

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2011LiteratureReviewofEAP

“Tostateitassimplyaspossible,EAPsareeffec2ve.

EAPsalsoincreasethewell-beingofthemajorityofemployeeswhoac:vely

par:cipateincounseling.”

Source: Csiernik (2011) Journal Workplace Behavioral Health (p. 335, 352)

Basedon42StudiesofDifferentTypesofEvalua7on

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NBCStudyofEAPExternalVendors:UserSa<sfac<on&Improvement

(%ofUsersSurveyed-BookofBusinessYear2011)

94% 86%

Sa7sfac7on Improvement

EAPVendors:5045

EAPUsers:130,981128,764Source: National Behavioral Consortium EAP Vendor Study (2013 JWBH) Attridge Cahill Granberry Herlihy

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INVESTEAPVermontStudy2016ClinicalExperiencefor120NCHCCases

67


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INVESTEAPVermontStudy2016Results:%Reduc7oninRiskFactorsCombinedSample

Basedon%change(pre-andpost-Tx)inat-riskgroupinstudy


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INVESTEAPVermontStudy2016Es7matedHealthCareAnnualCostSavingsPerPerson:ByNumber

ofHealthRisksinNCHC120Cases

69


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INVESTEAPVermontStudy2016Es7matedTotalSavingsinAnnualHealthCareClaimsCosts:

NorthernCoun7esHealthCarefor120Cases

70


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RESEARCHFACTS:EAPWORKPLACEOUTCOMESCountriesRepresentedinDataReviewStudy

AustraliaCanadaChinaGlobalDatabaseforWorkplaceOutcomeSuite(WOS)

NetherlandsSouthAfrica

UnitedStates


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Produc7vityLevelofEAPUseratBeforeCounselingHPQTypeSelf-Ra7ng0-100%PerformanceScale

IndustryAverage=64%(N=242,748)

57% 64% 61%

68% 59% 57%

72% 69%

55%

43%

54%

0%

20%

40%

60%

80%

100%

Optum 1999 (n=1,050)

Optum 1994-2002 (n=26,822)

DTC 2009-2013 (n=16,808)

Vanderbilt University 2016 (na)

FOH 1997-1998 (n=16,055)

FOH 1999-2002 (n=59,685)

Morneau Shepell 2010 (n=34,063)


FSEAP 2012-2016 (n=642)

WOS 1-item (n=8,369)


DirectRa7ng1-10or0-100%

IndirectRa7ngRecodedto0-100%

Average63%

Average64%


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Produc7vityLevelofEAPUseratAherCounselingHPQTypeSelf-Ra7ng0-100%PerformanceScale

IndustryAverage=79%(N=242,748)

81% 87%

75% 78% 78% 78% 83%

79% 79%

65% 70%

0%

20%

40%

60%

80%

100%

Optum 1999 (n=1,050)

Optum 1994-2002 (n=26,822)

DTC 2009-2013 (n=16,808)

Vanderbilt University 2016 (na)

FOH 1997-1998 (n=16,055)

FOH 1999-2002 (n=59,685)



FSEAP 2012-2016 (n=642)



DirectRa7ng1-10or0-100%

IndirectRa7ngRecodedto0-100%

Average82%

Average79%


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6479 84

0102030405060708090100

BeforeEAPUseIndustryAverage

ArerEAPUseIndustryAverage

Non-EAPTypicalEmployee

RESEARCHFACTS:GLOBALDATAONEAPOUTCOMESWorkProduc7vityLevelofEmployeeinPastMonth

Self-Ra7ng0-100%JobPerformanceScale

EAPGlobalIndustryAverageResultCombinedN=242,748

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13.04

6.444.00

0.00

5.00

10.00

15.00

BeforeEAPUseIndustryAverage

ArerEAPUseIndustryAverage

Non-EAPTypicalEmployee

RESEARCHFACTS:GLOBALDATAONEAPOUTCOMESHoursofEmployeeWorkAbsenceDuetoHealthinPastMonth


EAPGlobalIndustryAverageResultCombinedN=223,485

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CORE-10

Measures

ClinicalOutcomes

Research

forBHandEAP

IntheUnitedKingdom

h+p://www.coreims.co.uk/index.html

76

Barkhametal.(2013).CounsellingandPsychotherapyResearch,13(1),3-13.

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WorkplaceOutcomeSuiteWOS

The WOS was developed by Dr. David Sharar and Dr. Richard Lennox of Chestnut Global Partners in 2010 (published peer-reviewed research).

Utilized globally by over 400 EAP vendors and internal EAP programs to measure changes from before to after use of EAP counseling

Work Absenteeism hours

Work Engagement ratings

Workplace Distress ratings

Life Satisfaction ratings

Work Presenteeism ratings

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HOURSofWorkAbsenceinPastMonthforAverageUserofEAPCounseling

10.415.35

5.06

0

8

16

BeforeEAP ArerEAP Change

WorkAbsenteeism

ChestnutGlobalPartnersWOSGlobalDataset–Absenteeism5-itemScaleN=3,291from2010to2016–manyEAPvendorsSta:s:calAnalysisbyAWridge

Reduc7oninAbsenteeismPa

st30Days

ArerUseofEAP

49%

Significant***

Item:Fortheperiodofthepast30days,pleasetotalthenumberofhoursyourpersonalconcerncausedyoutomisswork.Includecompleteeight-hourdaysandpar:aldayswhenyoucameinlateorleZearly.Note:excludedoutliercaseswith160+hoursatPreorPost–absentforen7reworkmonth(3%oforiginalsample).

Lowerscoreisbejeroutcome


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PresenteeismMeanScoreinPastMonthforAverageUserofEAPCounseling

2.862.22

1.00

2.00

3.00

4.00

5.00

BeforeEAP ArerEAP

WorkPresenteeism

ChestnutGlobalPartnersWOSGlobalDataset–PresenteeismFullScaleN=1,948from2012-2016-manydifferentvendorsSta:s:calAnalysisbyAWridge

StronglyAgreeAgeeNeutralDisagreeStronglyDisagree

TEST:BeforeM=2.86(SD=1.24)vs.ArerM=2.22(SD=1.20),pairedr=.52pairedt(1,947)=23.52,p<001.Note:Excluded34caseswith160+absencehours(<1%allcasesinaggregatedsample).

Reduc7oninPresenteeismWhileatWork

ArerUseof

EAP

22%

Significant***


A+ridge(2016).WorkplaceOutcomesReview.PresentedattheannualconferenceoftheEmployeeAssistanceProfessionalsAssocia:on,Chicago,IL.

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WorkDistressMeanScoreinPastMonthforAverageUserofEAPCounseling

2.59 2.36

1.00

2.00

3.00

4.00

5.00

BeforeEAP ArerEAP(3months)

WorkDistress



TEST:BeforeM=2.59vs.ArerM=2.36,pairedt(1,598)=8.91,p<.001.

Reduc7oninWorkDistress

ArerUseof

EAP9%

Significant***

WorkplaceOutcomeSuite5-itemWorkplaceDistressScaleChestnutGlobalPartners-NormsN=1,599

ChestnutGlobalPartners.(2016).WorkplaceOutcomeSuiteAnnualReport2016:EAPsCanandDoAchievePosi:veWorkplaceOutcomes.Bloomington,IL:Author.AppendixB=25-itemScale.

80

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WorkEngagementMeanScoreinPastMonthforAverageUserofEAPCounseling

3.66 3.58

1.00

2.00

3.00

4.00

5.00


WorkEngagement


TEST:BeforeM=3.66vs.ArerM=3.58,pairedt(1,238)=2.41,p<.02

ImprovementinWork

Engagement

ArerUseofEAP2%

Significant

WorkplaceOutcomeSuite5-itemWorkEngagementScaleChestnutGlobalPartners-NormsN=1,239

Higherscoreisbejeroutcome


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LifeSa<sfac<onMeanScoreinPastMonthforAverageUserofEAPCounseling

2.853.17

1.00

2.00

3.00

4.00

5.00


LifeSa<sfac<on


TEST:BeforeM=2.85vs.ArerM=3.17,pairedt(1,599)=-4.86,p<.001

ImprovementinLife

Sa7sfac7on

ArerUseofEAP

13%

Significant

WorkplaceOutcomeSuite5-itemLifeSa<sfac<onScaleChestnutGlobalPartners-NormsN=1,600

Higherscoreisbejeroutcome


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55%

44%

25% 28%

57%

38%

10% 13%

24%

38%

Absenteeism(Hours>0)

Presenteeism(Agree)

WorkplaceDistress(Agree)

WorkEngagement(Disagree)

LifeSa<sfac<on(Disagree)


Sta7s7callySignificant(p<.05)LevelofReduc7onArerEAPUseYESYESYESNOYES

Reduc7onin%ofEAPUsersat“ProblemLevel”onWOSScalesatBeforevs.ArerUseofEAP:EmployerinGREECE-2016N=110FacetoFaceCases

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WhatisDrivingtheImprovementsinAbsenteeismand

Presenteeism?

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Work Absence

60%

ImprovedWork

Produc<vity72%

ImprovedHealth&Wellbeing

73%

+

++

Posi7veSignificantCorrela7onsBetweenClinicalImprovementandWorkAbsenceImprovementandWorkProduc7vityImprovement

AmongUsersofEAPCounseling(OptumN=1,050in1999)

r=.12* r=.26*

r=.?*

Source: Riedel, J., & Attridge, M. (2000, April). The relationship of employee health to presenteeism and absenteeism. Presented at the Institute for Health and Productivity Management, Orlando, FL.

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Absence 31%

ImprovedWork

Produc<vity61%

ImprovedHealth&Wellbeing

80%

+

++

Posi7veSignificantCorrela7onsBetweenClinicalImprovementandWorkAbsenceImprovementandWorkProduc7vityImprovementAmongUsersofEAPCounseling(FSEAPN=642in2012-2016)

r=.14* r=.35*

r=.29*

Source: Personal Communication, October 2016. G. Taylor. FSEAP. Vancouver, BC, Canada.

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Part6–RiskRecoveryHowcanEAPssupportemployeesreturning

fromworkareradisabilityclaim?

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Disability

WhenMentalHealthandAddic7onProblemsCannotBeManagedand

WorkisNoLongerPossible

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1.  AboutMentalHealthDisability

2.  TreatmentandReturntoWork

3.  MakingAccommoda<ons

4.  Preven<on5.  Resources

ReportavailableatnocostatthewebsiteforHomewoodHumanSolu7ons

A 36-page report written for a business audience that digests key findings and action strategies

from over 115 research studies.

Attridge & Wallace (2010)

Disability&RTW91

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ReturntoWorkArerDisability

Return to Work (RTW) support programs and employee-specific Workplace Accommodations are not only legally required but are crucial for gradually getting the person healthy again and back to work.

Partial or early RTW – while some treatment is still ongoing – gradually increases work hours and intensity of work tasks over time. This approach is is helpful for most mental health disability cases and is becoming a standard practice.

Source: Jacobs et al. (2010) – IHE Study

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Wasiak et al. (2007)

LeavePar7alMaintainAdvance1234

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EarlyReturntoWork–TheNewStandard

•  Par7alorearlyreturntowork–whilesometreatmentiss7llongoing-ishelpfulformostmentalhealthdisabilitycasesandisbecomingastandardprac7ce.

•  Apar7alRTWplanincludesgradualincreasesinworkhoursandintensityofworktasksover7me.

•  Watchfor“redflags”ofinadequatecareduringtreatmentphasesandstayincontactwiththeemployeeandothersontheclinicalcareteam.

•  Relapseorthereturnofsomeclinicalproblemscanoccurandisnormal–butcanbemanaged.

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WhyIsEarlyReturntoWorkEffec7ve?

•  Workitselfcanhavetherapeu7cvalue.•  Self-iden7tyandself-worthissuesareintertwinedwithworksuccess.

•  Posi7vesocialsupportsareorenfoundintherela7onshipswithothersatwork.

•  Incomefromworkalsoreducesfinancialstress.•  Simplybeingincludedagainatworkhelpstoovercomes7gmaissues.

•  Workismo7va7ngforcetocon7nuewithtreatmentandrecovery.

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GuidelinesforDepression-RelatedRTWCentreforAppliedResearchinMentalHealth&Addic7on

•  Ac7veManagementofDisabilityCases–  CaseManagement–  PsychologicalJobAnalysis–  PsychologicalFunc7onalCapacityAssessment–  Task/JobModifica7onandAccommoda7ons–  Voca7onalRehabilita7on–  IndependentMedicalExamina7ons

•  EncourageEarlyRTWProcess•  RelapsePreven7onStrategies•  EFAPCounsellingResourcesBilsker et al. (2007)

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WHENTO“CHECK-IN”withEMPLOYEEDURINGTHERTWPROCESS:

•  Ini7alIntakeforDisabilityClaim•  AssessmentbyMentalHealthProfessional•  DuringTreatment•  EarlyRTWandReintegra7on•  MaintenanceandRelapsePreven7on

GuidelinesforSuppor7ngRTWOccupa:onalHealthandSafetyAgencyforHealthcare

Bri:shColumbiaProvince

OHSAH-BC (2010)

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REVIEW:SixThemesfromToday

1.RiskPrevalence

2.RiskBurden

3.RiskPreven7on

4.RiskIden7fica7on

5.RiskReduc7on

6.RiskRecovery

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Thank You

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Seeotherfileforlistof

ResearchReferences

100

evidence-based workplace mental health risk management ......aggregate productivity loss than...

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