Thursday, May 27, 2010

Getting Spit On? Call the EAP!

Finally, I found an amazing and dramatic illustration of the topic I like to harp on most -- having EAPs identify and then make use of opportunities that suddenly and dramatically emerge in the workplace where the EAP solution can be applied. When EAPs do this, they grow their value and reputation, and if they are lucky enough, come in contact with major stake holders who have enormous clout. These stake holders -- property casualty insurers are one -- can elevate EAPs dramatically.

Can you guess how days the average bus driver in New York City took off last year after they were spit on by bus riding customers? The average time off was 64 days!!!!! One took off 191 days. No, these are not drivers to be disciplined for gross abuse of leave policies. They are getting paid by workers' compensation!

Amazing you say? Indeed. It's costing tens of thousands of dollars right out of the city coffers. And many of these drivers are claiming they need psychological help as a result of the pedestrian abuse they experience. Here is a link to the story.

What's the issue, and is there an EAP solution for the drivers, the public (indirectly), and the financial crisis associated with this workers' compensation nightmare? I think there is, or at least I hope you walk away from this blog with the idea that you can find untold numbers of opportunities to make yourself more useful and valued in the EAP setting. (And by the way, fear not, you won't have managed care competing with you for these classic applications of the core technology. It is off their "grid" entirely.)

Off the top of my head, the EAP should be included in a round table discussion with top management and review the data associated with these incidents. Specifically, what should be determined are patterns associated with everything from time of day these incidents occur, profiles of the spitting customers, antecedent and provocative events, worker profiles, and other variables that may point to behavioral interventions appropriate for the EAP.

For example - EAPs have skills or can closely coordinate with resources that have the skills to provide stress interventions for these cases, education on managing emotions, behavioral interface with customers, how to diffuse violence (which of course is what we are talking about when it comes to spitting). And, what about customer service? Dealing with angry and abuse customers? (see fact sheet).

How many bus drivers are depressed, alcoholic, or experience other behavioral problems exacerbated by these types of stressful incidents? What about anger management training or examining customer service issues that help employees avoid responding or provoking inappropriate behavior from people? There many more issues to examine here. Are more men than women assaulted. What's the difference? What about processing anger in groups and learning skills.

The violence of spitting on a bus driver surely is a crime. And law enforcement must play a powerful role. However, there are psycho-medical and dynamic behavioral issues at play with the larger problem, and of course, the enormous expense of workers' compensation costs demand a comprehensive attack on the problem.

The EAP is part of the solution. At least, this is much is true before I am willing to say there is not: Completely omitting any consideration of an EAP role in dealing with this problem is financially irresponsible.

Now, if the EAP is being considered at all, and no one has suggested, we need to ask why?

This problem lies at the feet of the profession. And here lies the answer to a new dawn for employee assistance programs. Am I wrong?

Thursday, May 20, 2010

Air Force Suicide Prevention Worked

Suicides are down and the intervention program worked. That's the conclusion of a research study just released by the University of Rochester Medical Center and published in the American Journal of Public Health. The program being proclaimed successful dropped the suicide rate by over 20%. The suicide prevention program with the U.S. Air Force began in 1994, but suicide rates were examined from the period 1981 - 2008.

Lessons from the study. To decrease the rate of suicide, the U.S. Air Force concentrated on four key components: 1) Encouraging members of the Air Force to seek help; 2) Promoting the development of coping skills; 3) Fighting the stigma associated with receiving mental health care; and 4) stressing the absence of negative career consequences for seeking and receiving treatment. The Air Force Suicide Prevention Program is included in all military training. Supervisor training is a key component of the program  with leadership getting instruction in how and when to refer subordinate personnel to help. If any traumatic events, especially those related terrorism occur, they are responded to rapidly to address acute and posttraumatic stress, a known major contributing factor to the risk of suicide risk. The number of suicides prior to the study going back to 1994 were 64 in that year. The program low during the implementation period of the program was 1999 with a total of 20 suicides. (Note: There has been no reduction in the suicide rate among the general U.S. civilian population since the 1940s according to the study.)

Blog Note: Currently the U.S. Army is undergoing service wide training in an effort to reduce the suicide rate among its ranks.

Suicide prevention education module in PowerPoint, PowerPoint with sound, Flash video, and DVD, with script notes for the PowerPoint formats can be found at, Suicide Prevention Training. (Used by many federal government agencies, Fortune 500 companies, the U.S. Senate, and smaller businesses.)

Monday, May 10, 2010

EAPs to the Rescue with Workers' Compensation Fraud?

One of my favorite subjects is business insurance. I like to watch news, press releases, and blogs reporting on the many aspects of this field. As I have often opined, business insurance is a stake holder of effective, core technology employee assistance programs. The only problem is, they don't know it. That's the fault of EAPs as a group.

Insurance protects businesses and producers sell insurance. Your bridge to meet these employers and establish yourself is one of following three professionals who know a business owner best: the lawyer, the accountant, or the insurance agent. Insurance agents are your best bet because of synergies associated with the their needs, business needs, and the purpose of EAPs are nicely melded. They must all be concerned about human behavior in the workplace that leads to risk and financial loss.

Who pays for the legal bills of employees sued for sexual harassment? Who pays for the workers' compensation costs associated with sexual harassment (yes, harassed workers have often collected money for sexual harassment) and who will lose money if lawsuits come for sexual harassment? The answer is business insurers. Of course, employers pay too, if insured, through high deductibles.

There are many types of business insurance and there are many behavioral risk exposures that business insurance is designed to address. EAPs interface with many of them.

So the logic is there to team up with this group. Get started. Start in Colorado, or at least follow this legislation to see where it goes an how much influence it carries. Here's the news.

One of the insurance writers I follow is Gary Boop. He writes for "". Gary reported today on a piece of legislation working its way through the Statehouse in the Colorado. The politicians there are focused on prohibiting workers compensation insurers from spying on or doing clandestine surveillance of employees injured on workers' compensation. This technique of finding employees who are stealing money from employers by faking injuries and collecting fat paychecks has been used for decades to reduce workers' compensation costs. Do you know the ramification of such legislation? They are potentially great and it means news skills and capabilities are going to be important to reducing costs. That's where you come in.

Consider this New Colorado bill H.B. 1012

What does this have to do with EAPs? I hope you see the connection, but let me spell it out clearly for you. Limitation of an employer's ability to investigate fraud means there must be some other way to find it, but even better, a renewed interest in preventing it will obviously be on the horizon.

Instead of ignoring injured employees and then seeking to discover criminal malingering to collect benefits, heading these problems off at the pass will get more scrutiny.

I predict that someday a business service will emerge that will be funded by workers' compensation insurers, and that it will play the following role. It will operate confidentially and
  • Meet with employees to assess the emotional impact of their injuries,
  • Do a family assessment to determine likely areas of distress and conflict at risk for protracting an injury,
  • Conduct an occupational alcoholism assessment,
  • Help an employee remain motivated and anticipating a return to work,
  • Resolve conflicts between an injured employee and the boss or coworkers back at the worksite,
  • Offer support for the injured employee during the period of time they are off work,
  • Offer guidance, tips, and support upon return to duty so employees experience reduced anxiety and conflict associated with return to light duty or full duty assignments.
I believe these activities would make a hell of a business opportunity to help reduce costs for workers' compensation managed care and employers. Specialists who would do such work would need the skills of employee assistance professionals. So, why can't EAPs get more involved now before such a service robs the field of an opportunity?

EAPs typically don't do these things now, but they could add these services to their continuum of activities and get enormous credit for doing so.

If you have entertained the idea of looking more at the EAP/Workers' Compensation interface, and you happen to service employees in Colorado, run don't walk, to develop your capabilities of servicing these employees with the goal of monitoring their care so they are less likely to fall prey to the temptation of malingering.

Of course, sometimes injuries are very real, except bogus injuries or injuries that were very real at the time become easy to lie about once their pain and debilitating symptoms disappear.

Any thoughts about this? See the drift?