Why EAPs Are Not Solving the Mental Health Crisis & What Really Works
The Mental Health Crisis, Explained
The current state of mental health in North America is often referred to as a “crisis”, and this is no exaggeration. Over 50 million Americans have a mental illness and more than half don’t ever receive treatment. Of those who do reach out and get support, nearly a third report that they didn’t get effective treatment.
Untreated mental health conditions lead to big costs for employers. According to the American Heart Association, it’s the single greatest cause of employee disability worldwide. Depression alone costs $9,450 per employer per year in absenteeism and lost productivity. Not to mention, individuals with mental health conditions are more likely to develop comorbidities like diabetes and heart disease, which lead to additional costs for employers.
In today’s changing landscape, where mental health awareness is growing, you would think the issue would be receiving more attention and effective solutions. However, statistics paint a stark picture: 68% of millennials and 81% of Gen Zers report having left a role for mental health reasons, and according to the World Health Organization (WHO), the incidence of mental health disorders has steadily increased over the past decade, reaching an all-time high.
EAPs: An Incomplete Solution to a Giant Problem
Ever since the 1940s, EAPs (Employee Assistance Programs) have been incredibly popular in the United States. In fact, more than 97% of companies with 5,000+ employees offer EAPs, and 75-80% of small and medium-sized companies make EAPs available to their employees.
The majority of employees use EAPs for mental health, which are provided to support employees with issues that impact work performance like family and relationship conflict, grief and loss, depression, and other mental health diagnoses.
But, are employers spending their money on EAPs wisely? Are EAPs really the BEST way to address the mental health crisis?
As the workplace continues to evolve, and levels of stress, anxiety, and burnout skyrocket, it’s becoming clearer that EAPs leave much to be desired. It’s more important than ever for employers to invest in personalized mental health solutions that prioritize the member experience, long-term health engagement, and catalyze a positive company culture shift.
What Makes a Mental Health Solution Effective?
EAPs typically offer short-term mental health support, which is only a small piece of the puzzle when it comes to solving the mental health crisis.
In order to experience a meaningful outcome, a mental health program needs to go beyond the short-term and address the complex and varied needs of individuals facing mental health challenges, as well as those most at risk of developing one in the future. This requires four key elements:
First, the mental health benefit needs to be easily understood by those who would benefit the most from it. Then, it needs to help the individual overcome the barriers to utilizing the benefit. When an individual has made it this far, the benefit needs to then offer relevant and effective therapeutic interventions. And lastly, it needs to lay out a plan for transitioning the individual from short-term to longer-term care (when necessary).
Let’s delve into each of these key points one by one.
1. UNDERSTANDING THE BENEFIT
The people who would benefit the most from the program need to understand what it is and its purpose.
According to the National Business Group on Health, the median utilization of EAPs is only 5.5%, indicating wasted resources for companies that invest in them. Why are these utilization rates so low?
Despite the widespread availability of EAPs, many employees remain unaware that they even exist. In a 2020 survey of 1,200 American workers, nearly half either believed their employer didn't offer an EAP or they were unsure.
Even among employees who are aware of their company's EAP, there's often a lack of understanding about how it operates and many misconceptions, particularly when it comes to confidentiality.
A Better Approach
Having a mental health issue is hard enough - someone shouldn’t have to do a lot of work or research in order to understand what’s being offered. An effective workplace mental health program should be easily understandable by the people it's trying to target.
For example, solutions can take a proactive approach to marketing and educating employees about its services, alleviating the burden on HR departments to promote mental health resources and leading to higher utilization rates. Mental health providers that identify and engage high-risk individuals early on by analyzing medical claims history are even more valuable to your organization.
2. REDUCING BARRIERS
An effective mental health benefit reduces or completely eliminates the barriers people face when reaching out for support.
The first barrier individuals face when it comes to getting help for their mental health is overcoming friction.
The process of reaching out for support via an EAP is cumbersome and unintuitive, often leading to more questions than answers. Common ones include, where do I even find the number to call? Will my employer know that I called? When I call, who exactly am I talking with? How will I be paired with a counselor, and what happens once I’ve had my allotted therapy sessions?
And if an individual does end up calling their EAP provider, the average wait time to get a first psychiatry appointment is 25 days, with many individuals understandably giving up prior to speaking with a provider.
A Better Approach
An effective mental health solution should simplify the signup process and minimize the friction to get started. Instead of employees needing to figure out where to reach out for help, providers should reach out to them with an easy-to-use enrollment process. Frequent and targeted communication using a variety of channels (email, SMS, flyers, mailers, etc) is the most effective approach to reach those in need.
Additionally, getting started with help should reduce friction as much as possible. For example, with Goodpath, members don’t wait to find relief from symptoms. Individuals in the Mental Health program at Goodpath receive their personalized, evidence-based program immediately, and it’s with them wherever they go (as long as they have their phone on them)!
And when it comes to wait times to see providers, there aren’t any. When a Goodpath member is assigned a therapist, they can set up an appointment with them within a week.
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The second barrier to getting mental health support is stigma, which is still a huge issue today despite growing awareness of the problem (in fact, 8 out of 10 workers facing mental health concerns say that shame and stigma prevent them from reaching out for support). Many people perceive mental health issues as a personal flaw, rather than a legitimate medical concern.
EAPs, while providing valuable support to individuals, don’t address this stigma, yet it’s one of the leading causes of untreated mental health issues within the workplace.
A Better Approach
Whole-person care solutions like Goodpath actively engage with organizations to educate them about mental health, promote cultural change and address systemic issues that contribute to mental health stigma and may be negatively impacting employee health. Employees that feel that their organization cares about their well-being are more likely to prioritize their mental health and therefore, get better, faster.
3. HIGH QUALITY CARE
The care employees receive through an effective mental health program has to be relevant and of high quality.
If an individual is able to overcome the barriers to accessing an EAP, and they actually meet with a provider, there are still several elements that can get in the way of clinical success.
First, is their care high-quality? With an EAP, it’s often the luck of the draw, since there isn’t extensive and consistent vetting among providers.
Secondly, is the treatment relevant to the individual? With such a restriction on the number of sessions per employee, it can be difficult to thoroughly assess needs and accurately diagnose a mental health issue, and therefore, an individual may be misdiagnosed and embark on ineffective treatment, wasting time and money.
A Better Approach
A benefits solution should prioritize personalized care, since mental health is never one-size-fits-all. For example, at Goodpath, members undergo a thorough intake assessment that assesses their risk and preferred methods for treatment, and they are then assigned a relevant provider alongside a program completely customized for them.
Their program includes a variety of evidence-based modalities (videos, educational documents, and one-on-one phone, video, or chat-based sessions with a coach and a therapist when relevant). Each provider is a discipline expert, and meets specific credentials to ensure consistency among all team members.
Goodpath also heavily emphasizes the importance of prevention; unlike EAPs, care is not only provided at times of crisis. Goodpath can identify high-risk individuals early-on, so they engage with mental health support before it becomes a severe (and more expensive) problem.
Plus, with built-in mechanisms for data collection, it is easy for providers to see whether a given individual is improving or not, and the Goodpath program can be adjusted accordingly. This data not only helps further personalize each person's care, but it also provides organizations with insights into how their investment is working for their organization and where their resources are most needed, something an EAP simply can’t accomplish.
4. TRANSITION PLAN
An effective mental health solution has a clear plan for transitioning from short-term to longer term care when clinically necessary.
EAPs can be effective in providing short-term care for people who need it. However, they don’t, at least not very effectively, address what happens next, after an individual completes their 3-5 allotted EAP sessions. This transition period is critical.
Many EAPs do refer out, however, it’s a disjointed process. Follow-up care can be expensive, and high-quality providers often have wait times. The result? Drop-off in care and unresolved mental health issues.
A Better Approach
Lasting outcomes in mental health require a well-thought-out plan for handling the transition to long-term care, a critical period when drop-off in care is common.
Goodpath does both short and long-term mental health care, in house, which makes the follow-up transition seamless. Members of the program are paired with a coach who monitors their progress every step of the way, ensuring continuity of care. And engaging high-risk members who have gotten off track is possible due to our AI capabilities that identify populations most in need of help.
Key Takeaways
In sum, EAPs are a good idea in theory, but as awareness of the importance of mental health grows, organizations are increasingly looking for more effective alternatives for improving employee well-being and reducing costs associated with the mental health crisis.
To improve utilization of mental health benefits and reduce the hefty consequences associated with poor employee health, organizations must move beyond reliance on EAPs as the sole solution for mental well-being. Instead, they should invest in comprehensive programs that not only follow individuals through the entire cycle of care, but also which address the root causes of mental health issues within the workplace.
By focusing on prevention, promoting cultural change, and implementing data-driven strategies, organizations can create healthier and more supportive work environments for all employees while also reducing healthcare costs.