Improving EAP Utilization Hack #24: Engage Hospital Emergency Rooms to Refer Employees

If you could sit in an emergency room for a week, you would discover that about 3.5% of admissions would be alcohol-use/abuse/ism related and diagnosed upon admission by the ER docs.

There are many more patient admissions to hospitals that are in some way related to addictive disease, but are not necessarily treated or addressed. Many are ignored. In this case above, I am talking about obvious injury or health problems attributed to alcohol use/abuse. 

Many of these patients are in an acute state of remorse--a crisis exists--and the opportunity to successfully motivate them to enter treatment is high. A referral for help is easier than it will be tomorrow. As a bonus, a family member or concerned friend often accompanies these patients, and they add leverage and influence in the referral process.

If an ER patient is an employee of a company that your EAP serves, an eventual referral of the patient to your EAP by the ER staff during the ER visit could be a way to boost EAP utilization and your alcohol-related stats--the most precious kind.

The key is having the medical staff AND the social workers in the hospital know that you are available via referral--and having them remember your EAP. It's tricky. They should also be encouraged to have the patient phone the EAP at the ER (24/7 if need be) and leave a message for you to get back to them. In other words, this ball should start rolling immediately. The patient should not be sent out the door with just an EAP business card or number on a post-it note. You can kiss this sort of referral good-bye.

ERs will love you for this help because hospitals must refer patients to appropriate resources in the community, and why not have this be you? You can help them avoid the time-consuming brokering role by making yourself available, do an assessment, and motivate the patient/client to accept an appropriate level of care.

You need to create a communication system to help ensure a busy 3-shift, high turnover ER department remembers you. I can't say I know exactly how to do this, but I have ideas. I have walked the walk on this post by the way, but I did not have the communication piece right. If I attempted this again, I would simply send a monthly newsletter like Frontline Employee with a message or specially not on it after doing an inservice that provide CEU/CME credit.

Think about this EAP utilization hack #24. Make it work, and you may increase the relevance of your EAP, save more lives, and keep your program from becoming MCD'd (Managed Care Demised)

*Source: Page 20-22 of
http://pubs.niaaa.nih.gov/publications/NEDS&NIS-DRM9/NEDS&NIS-DRM9.pdf

EAP Utilization Hack #25: Educate Employees with a Family Empowerment Model of Alcoholism Intervention

I phoned the National Association of Social Workers about 20 years ago and spoke with the General Counsel (top dog attorney) about doing interventions using the traditional Johnson Institute approach (the approach where a counselor sits and "lightly guides" a family in confronting a practicing alcoholic to motivate them to enter treatment using a planned meeting that does not include the alcoholic knowing its true purpose.)

The advice was: It's unethical.

Why!? The lawyer said at the time that it violates client self-determination principles because the alcoholic family member is unaware of the true nature of a surprise family meeting. This could get a licensed professional in the helping professions sued. Working for a hospital at the time, I decided upon a different route (you know how paranoid hospitals are) and developed a "Family Empowerment Model" as I called it. It was also an adaptation from Scott McMillan's work and Ron Rogers work with inpatient alcoholics and their incredible writings on addictive disease. The gist: Using influence and leverage that naturally exists in relationships can help family members be successful in conducting interventions with affected loved ones. The upside of the Family Empowerment Model is teaching others to do interventions more easily, being able to teach more people faster, and reducing risk to the intervention specialist who does not meet with the alcoholic at all. The other upside is teaching intervention skills and allowing the family members to make a paradigm shift to seeing the alcoholic as responsible for treatment and getting effective help, making it non-negotiable, giving up on making addict responsible for the illness. Once this shift is made, which must be routed in education about addictive disease and its bio-genic nature, then all family members become unified, as a runaway train to get the alcoholic enter treatment--and insist so strongly, that they use every incidental crisis that follows any failed attempt--to do it again and again until they are successful. Have you noticed after 50 year,s how few JI traditional "family interventionists" are in your community? I bet you can't name more than one or two, if any at all. Why? If the JI model is so effective, how come there aren't dozens of mental health professionals in every town practicing it? One reason: It's hell. This approach is stressful, time consuming, risky, and costly. It requires an inordinate amount of time and it is not reality based. Why? Simply put, 99% of drug and alcoholism treatment admissions to hospitals occur as a result of family members saying and doing, accidentally on purpose, what worked to motivate the alcoholic or drug addict to enter treatment. They used leverage (the power of resources possessed by one or more persons in the relationship with the addict) and influence (the weight of the relationship's value and what it truly means to the addict) as the key drivers or tools to motivating the alcoholic to enter treatment. If you made it this far in this post, here is what I want to say to EAPs: Teach this stuff to employee clients to boost your EAP utilization.

#family intervention  #alcoholism intervention

Employees Who Visit the EAP to Complain about the Supervisor

I would like to recommend again that you think about, and talk about ways in which your EAP protects the employer and serves as a huge, under-appreciated risk management "tool." My motivation of course is your survival! Here is one typical example, and you may want to be conversant with this example at the next board meeting. 

EAPs see employees who come to them for no other reason but to complain about the boss. It happens.

Whatever the case, we know that EAPs never tell the employee that they don’t handle these kinds of problems. Employees feel safe in coming to the EAP and know their concerns will be heard without prejudice. It is therefore not unusual for employees to visit the EAP complaining about the boss. After all, complaining about someone else is a common means of getting help for oneself, and it makes self-referral easier.

EAPs know this. It is always assumed that other issues exist beyond the primary complaint. These might include performance problems, personal problems, communication issues, poor coping strategies, mental health issues, and the like. Typically, employees are helped to better understand conflicts they are having with the boss and to resolve those conflicts in healthy ways through better communication skills or tasks associated with personal change. 

If it appears that an employee is a victim of an abusive supervisor, other internal resources are discussed. But never tell your employee to go get an attorney. This is about the dumbest thing you could do. It completely undermines the purpose of the EAP. The company, HR manager, owner, CEO -- they all deserve a whack at resolving the problem before the employee heads for the courthouse. Managing this type of case with finesse and maturity illustrates a priceless risk management role EAPs play. Whatever the problem, the EAP’s concern--your concern--should be for both the employee and the organization’s well-being (financial well-being). In nearly all cases, agitated employees voicing complaints about the supervisor are looking only to have a better relationship, so seek this as the goal. Do not align with an employee and inspire him or her to sue the organization--the one signing your check. You could end up without an EAP job, and I will lose you as a customer! In 30 years (actually more, but who's counting), I can think of no situation where an attorney referral to sue the company was better than a referral to the next level of management to resolve a problem.

#eap #employee assistance programs #

Claim the High Ground to Grow Your Program's Influence

I am all for "program creep," as long as it's saving lives, saving employers' resources, and helping workplace wellness and employee assistance programs flourish.
 
When you see the WorkExcel online E-Newsletter this week, you will learn about new research associated with workplace wellness, employee behavior, and supervisor training.

If you are paying attention, you will see a few ideas, or at least the thought process, about how to grow your influence to make a bigger splash and a more significant contribution with your employee assistance program.

During the year, you certain problems, issues, and risks in the organization(s) you serve. Always have your thinking cap on and consider how you can apply the core technology to the problems you are spotting, especially when no other part of the organization is tackling these issues.

If the timing isn't right to act on these opportunities, consider placing recommendations in your EAP Annual report in the form of an "emerging issues section. "

Connect the problems to the cost benefit of their resolution and argue your case.

Be a creep. See this weeks E-newsletters: http://www.icontact-archive.com/YAuysBsJ0Zzmn9lCXd4C99Hqer0z5WSS?w=3

EAPs: Say "People with Mental Illness", not "Mentally Ill"

This is not about political correctness. A new study says the most subtle differences in how mental health professionals refer to people who are mentally ill can affect how others perceive them and fuel stigma and discrimination. I believe it. When I was a student in graduate school, I worked in a half-way house residential setting for schizophrenics and severely mentally ill. The facility was an old Victorian home, with perhaps eight rooms. The program was hugely successful in behavioral contracting and getting people affected by mentally illness on their feet with jobs and proper med management. But, the culture of employees there was not conducive to de-stigmatizing (sp?) mental illness. Staff were absolute pros at their work, but they would use terms like "crazy" and make jokes about residents. This research goes much further that even this behind closed doors "gallows humor." Now research seems to address this problem in even more basic way, and I think EAP Employee Assistance Programs should read this research press release to help ensure they are setting the right examples in their work. For example, participants in a recent study were more likely to agree with the statement “the mentally ill should be isolated from the community” than the almost identical statement “people with mental illnesses should be isolated from the community.” Incredible. Here is the press release. Educate your student interns. Set the example, be a change agent regarding this problem.
#EAP Employee Assistance Programs

For EAPs: Press Release from American College of Cardiology (ACC)

I am going to start sending printable press releases to EAP Employee Assistance Programs and those who sign up on this blog, so if you wish to tell people about this blog, please do so they can get this content.

I subscribe to hundreds of news feeds, and when something comes through that's useful, I will pass it on to you.

This one is on Cardiac Health and Exercise. It was issued two days ago by American College of Cardiology (ACC). These press releases I post here can be printed and copied, and should be. You can distribute them to your employees and wellness customers so you add value to what you do.

PRESS RELEASE: EXERCISE CRITICAL TO CARDIAC HEALTH

Employment Practices Liability Education of Supevisors by (EAP) Employee Assistance Programs

Everyday, supervisors face the need to resolve difficult and critical people problems. Intermingled with their decisions in managing these situations are tripwires that can cause large legal problems for themselves and the organization. Serious and unintentional mistakes can lead to severe organizational crises of a legal nature. So, it makes sense to educate yourself as an EAP Employee Assistance Program about "employment practices liability", all the possible forms it takes, and consider claiming the high ground as an educational resource if no one else in your organization (or the organization you serve) is playing this crucial and preventative role.  Here's the bottom line: If EAPs (meaning true core technology programs, please!) are primarily responsible for consulting with supervisors about troubled employees, and within the organization are seen is the front line contact for such assistance, then EAPs also have the most strategic role for reducing risk of employment practice related lawsuits as consultants to front line managers. So, let me ask if you have a good, solid, in-depth book on supervision malpractices, employment practices liability, and the proper approach to handling the many different types of difficult people problems?  I recommend you getting Joseph D Levesque's book, "The Human Resource Problem Solver's Handbook." It is a thick, highly detailed book on tons of issues managers face. You don't have to be a heart surgeon to share healthy eating information with employees so they can have a healthy heart. Right? So the same is true for legal issues. Educate supervisors about improper and questionable supervision practices that can get them and the company sued. You don't have to hire an employment law attorney to do a seminar. You can educate yourself as an EAP about all the various supervision practices and related interactions managers experience with employees and help them steer clear of those practices that can get them in trouble.

#EAP employee assistance programs