EAP Utilization Hack #15: Do Outreach with Post-Heart Attack Employees and Help Them Fight Depression to Prevent Premature Death

You have probably heard me encourage EAPs to look under every nook and cranny for real opportunities to identify unaddressed behavioral risk in organizations. New ways of applying the core technology can be spotted during the year if you pay attention and listen with the "3rd ear" while engaging with supervisors, counseling employee-clients, and participating in various work organization projects. Also, subscribe to a couple workplace wellness news feeds. Personally, I like Newswise.com -- it hits a lot of workplace related news that EAPs should pay attention to.
 
Today, I was scanning press releases on wellness, and spotted new research from Intermountain Medical Center in Colorado. Research conducted by this group shows that if you have a heart attack, your chances of dying over the next 10 years are higher if you suffer from depression after the heart attack, but rehabilitation can reduce this risk.

Can you guess what the opportunity might be for applying the core technology of EAPs to risk in this situation? The opportunity is encouraging employees and their family members to meet with the EAP after they leave the hospital following a heart attack. In your office, explain support services and screen for depression, encourage rehabilitation, follow up, and also refer them as needed to psychiatric help (med management) for clinical depression.

This is ripe territory for EAPs to make a difference, and the cost-benefit of this outreach can't be under-estimated in my view. So, I am declaring this an EAP Utilization Hack #15. (See prior posts for other EAP Utilization Hacks.)

In summary, the Intermountain Medical Center Heart research team (link shown below) compiled information from 7,550 patients who completed at least two depression questionnaires over the course of one to two years. These are patients who had heart attacks.

Patients were categorized based on the results of their survey as never depressed, no longer depressed, remained depressed, or became depressed. Following each patient’s completion of the last questionnaire, patients were followed to see if they had any major cardiovascular problems such as a stroke, heart failure, heart attack or death.

At the conclusion of the study, 4.6 percent of patients who were no longer depressed had a similar occurrence of major cardiovascular complications as those who had no depression at all (4.8 percent).

Those who remained depressed, however, and those who became depressed throughout the study, had increased occurrences of major cardiovascular problems — their rates were 6 and 6.4 percent, respectively. Treatment for depression resulted in a decreased risk of cardiovascular risk that was similar to someone who didn’t have depression.

So EAPs, the strategy is to talk more about depression, how's its treated, and educate people about this brain disease. Encourage self-referral, and follow up during the year. I suggest you read these heart-related research studies on depression and its impact on cardiovascular health. See if this avenue of EAP utilization improvement doesn't make your EAP one that has greater value, and hopefully one that is less easily contracted out to managed care. You may also save a few lives along the way.

Increase EAP Utilization Hack #19: Encourage DUI/DWI Court Programs to Refer to Your EAP

Employees of your company, or the companies you serve with your EAP, may get arrested for drunk driving. Establish relationships with the local courts, and specifically their municipal alcohol safety action DUI/DWI diversion programs to boost your EAP utilization rate. I've done it.
 
We're talking meeting with these professionals and discovering how you can help them with specific case management issues associated with clients who have eligibility to use your EAP. This could include family members.

ASAP or court-run alcohol-DUI/DWI intervention programs improve highway safety by reducing alcohol-related accidents and arrests. They are court-mandated programs for DUI and first-time drug offenders. ASAP evaluates those entering the program and recommends one or more of the following: driver education, alcohol/drug education, combination of education and counseling. All education is designed to prevent relapse and repeat offenses. By monitoring program participants, ASAP acts as a probation facility or diversion program for the courts. After completing the program, defendants either receive a certification of compliance or an order to return to court for noncompliance.

ASAP offices or similar services managing court referred DUI/DWI cases can use your services for assessment, follow-up, treatment referral, post-treatment monitoring, etc. And they have the power to make these referrals. Your EAP is voluntary, so the one caveat here is that the court can't force the offender to use your EAP, but a firm request will rarely be turned down by an anxious and cooperative client who would like to avoid going to jail. DUI staff counselors are swamped with cases. Many are difficult to follow up, and they experience frustrating communication with these court appointed clients, many of whom are alcoholic.

Some ASAP offices will accept the EAP's assessment, recommendations, and with the client's permission, allow the EAP to do the follow-up. As stated, most employees will readily accept a referral to the EAP when the ASAP counselor says, "You have an EAP with your company. We would like you to take advantage of its confidential services."

The chances are high that employees arrested for DUI are alcoholics, and this can further boost your alcohol-related EAP stats. There is nothing more valuable to an EAP than improving alcohol-related stats.

As you know, DUI and ASAP clients don't usually end up in treatment. And if they do, it is often poorly followed up--the most important aspect of treatment is follow up and aggressive participation in a program of recovery that does not dwindle. Many serious addicts get overlooked in DUI intervention programs, and your involvement may save lives on the highway if the alcoholic is motivated into treatment and properly followed up.

Call your court-run DUI/DWI intervention program. Meet to set up a cooperative relationship, and discuss how you might help them, help you. Synergy your efforts and boost your EAP utilization. Email me, and let me know how it goes.