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Employee Assistance Programs Among Fortune 500 Firms
Abstract
Since their inception fifty years ago, employee assistance programs (EAPs) have undergone fundamental changes. EAPs have widened the scope and deepened the intensity of the services they offer to employees. Currently many EAPs provide a wider range of counseling. As the number of EAPs has grown, their organizational structure has become increasingly more complex. By reviewing major trends, reporting on EAPs in Fortune 500 firms in 1997, and discussing the implication of the most recent developments, this article sets the stage for considering the EAPs as we move into the twenty-first century.
... Several of the classic cost-offset ROI studies for EAP conducted during the 1970s to 1990s [22] involved large employers in the U.S. in the manufacturing and utilities industries (Campbell Soup Company, General Dynamics, Virginia Power). Surveys of U.S. employers in 1990s [23][24][25] all found that EAPs were being used successfully at employers in the manufacturing, construction, utilities and wholesale trade industries. An EAP study in 2005 featured employees working in the manufacturing and utilities industries [26]. ...
This applied study explored the role of behavioral health issues among workers in the manufacturing industry in the United States. It features highlights of a previous much larger study in 2024 of eight different industries. The 29.3 million employees in the manufacturing and related heavy labor industries (construction, wholesale trade, maintenance/repair, and energy utilities) accounted for about 1 in every 5 workers in the total U.S. workforce in year 2024. Recent data on number of worker, number of employers, worker age, gender, private/public sector, union representation, compensation, and safety from the U.S. Bureau of Labor Statistics for 7 other industry categories was presented to provide context for this one industry. The study featured EAP data collected over a 7-year period from employee users of individual counseling or coaching from a single national EAP business in the United States (CuraLinc Healthcare). This full sample included 85,432 clients who worked at 2,679 employers. The EAP subsample for the manufacturing industry group included 17,389 employee clients who worked at 629 employers. Longitudinal data at 30-days post use was obtained from 9,063 cases in the full sample of which 2,342 were from the manufacturing industry. The manufacturing industry client sample was 56% men, average age of 40 years, 95% used the EAP for counseling (5% coaching), 95% were voluntary self-referrals (5% formally referred by manager at work), 64% used in-person office delivery (36% online video) and the typical treatment episode lasted about 7 weeks (48 days). Employees in the manufacturing industry used the EAP to address issues of mental health (43%), stress and personal life issues (24%), marriage and family issues (20%), work-related issues (5%) and substance use problems (8%). When starting to use the EAP many cases in manufacturing reported having clinical level symptoms on standardized measures for anxiety disorder (41% at-risk), depression disorder (29% at-risk), alcohol misuse disorder (15% at-risk) and low work productivity (50% at problem level). Among those cases initially at clinical risk status on outcomes in the total sample, over three-fourths recovered after use to no longer be at risk or to have a work productivity problem. Lost hours of work productivity changed from 64 hours lost per month per at-risk case to 23 hours. The hours of restored work productivity was estimated to be a $1,905 value per month per case who initially had this problem. Most of these same EAP risk rates and post-use outcome improvement results were also found at similar levels for employees in other industries.
... Three older studies from 1992, 1996 and 2001 each collected data from employees or managers in the U.S. working at employers in different industries. Each study focused on the market prevalence rate of having an EAP benefit or not at the company [67][68][69]. The results found that having an EAP was strongly linked with size of the employer (2 studies) and with the type of industry (all 3 studies). ...
This applied study explored how workers in different major industries used employee assistance program (EAP) clinical services and examined the level of effectiveness of service use on common behavioral health and work-related outcomes. We used data collected over a 7-year period from employee users of individual counseling or coaching from a single national EAP business in the United States. Data was obtained from archival records of the normal course of business at CuraLinc Healthcare. The sample included 85,432 clients who worked at 2,679 different employers. Longitudinal follow-up data at Post use was available from 9,063 cases (11% of the starting full sample). Among those cases initially at clinical risk status on outcomes in the total sample, severity scores from Pre to Post were reduced by almost two-thirds for anxiety, depression, alcohol misuse and hours lost work productivity (change from 63.5 hours to 23.6 hours). In the total sample, a large majority of the cases who started EAP use at-risk on the specific measure later successfully recovered to no longer be at clinical risk at the 30-day follow-up: anxiety (78% of 1,105 cases recovered; hp2 = .77), depression (87% of 1,316 cases recovered; hp2 = .87), and hazardous alcohol use (74% of 788 cases recovered; hp2 = .74). Among cases with a work absenteeism and/or work presenteeism problem before EAP use, 88% of 3,636 cases recovered (hp2 = .74). These longitudinal results in the total sample were all large size statistical effects. Users were grouped into eight types of industries according to their employer: manufacturing and related heavy labor (20% of the total cases); healthcare (18%); financial and business (14%); transportation (12%); restaurants and retail trade (12%); education (9%); government and municipality (7%); and technology (7%). The gender mix of clients ranged widely by industry (from 44% to 80% women). The rare event of being formally referred into the EAP by a manager at work also varied by industry (from <1% to 6%). In the total sample, when starting to use the EAP many cases reported having clinical level symptoms on standardized measures for anxiety disorder (43% at-risk), depression disorder (30% at-risk), alcohol misuse disorder (12% at-risk) and low work productivity (50% at problem level). Only small or trivial size variations were found between the industry types in the service use characteristics and for almost all of the clinical risk rates. All of these clinical and work outcome improvement test results were found to be similar within each industry type (i.e., specific industry results only ranged from 5% better to 5% worse than the study average result). Comparisons with past research, study limitations and implications are discussed. This study is unique in providing empirical profiles of multiple industries using the same operational system and the same clinical and work measures collected longitudinally from large samples of EAP users working at thousands of employers nationally.
... Employees' at most large businesses today have access to an EAP. A survey of Fortune 500 companies in 1997, found that 92% of firms offered EAPs -a historic high level of market penetration among large employers (Sciegaj et al, 2001). Similar findings come from a 2000 Society for Human Resource Management Benefits Survey. ...
Employee assistance programs (EAP), work-life programs and wellness programs are three commonly provided kinds of interventions that have the goals of reducing healthcare costs, improving employee performance and fostering a healthier workplace culture. The integration of these kinds of programs is a recent trend that has the potential to offer additional synergistic benefits. New studies have linked comprehensive delivery services that support human capital needs with bottom-line financial success of the company. This evidence can be used to make the business case for offering EAP, work-life and wellness services in an integrated capacity. However, while promising, the scientific evidence thus far in this area has methodological limitations and there are critical aspects that require further study.
... Occupational assistance also emerged in the form of company towns with dry zones so that employed male labourers would not drink too much and as programs to properly acculturate newly arrived immigrants to a new continent and to the North American industrial work environment (Brandes, 1976;McGilly, 1985;Popple, 1981;Trice et al., 1988Trice et al., , 1985Thomlison, 1983). However, with the evolution of occupational assistance to broad brush EAPs, greater numbers of white collar workers and professionals have gained increasing access to this form of assistance through the latter half of the 20th century (Csiernik et al., 2001;Gladstone et al., 1999;Sciegaj et al., 2001). Nonetheless, it is still argued by some that the primary focus of occupational assistance programs remains on fixing individuals rather than examining larger organizational and structural issues that equally contribute to negatively affecting worker wellness (Csiernik, 1995b). ...
One component of a 2003 national cross sector survey of Canadian organizations with 100 or more employees was an assessment of whether occupational assistance programs were mechanisms of social control or additional employee benefits of those already economically privileged. Employee Assistance Programs (EAPs) were the most common form of assistance provided, followed by health promotion initiatives and drug testing programs, though only EAPs were found in the majority of workplaces studied. Organizations that scored higher in management control and employee involvement were significantly (p < 0.001) less likely to have an EAP and health promotion programming compared with those companies with greater scores in employee involvement. An inverse relationship between employee involvement and the establishment of a drug testing program was close to significant (p < 0.10). Organizations that employed a greater proportion of persons of colour and female employees were the least likely to have an EAP.
स्वास्थ्य देखभाल की सुविधा प्रदान करने में भारत सरकार के मूल कर्तव्य का परित्याग करने से निजी क्षेत्र की स्वास्थ्य क्षेत्र में प्रवेश करने की क्षमता बहुत बढ़ गई है। स्वास्थ्य देखभाल और चिकित्सा देखभाल के बीच अंतर महत्वपूर्ण है और इस पर ध्यान देने की आवश्यकता है। स्वास्थ्य देखभाल में सिर्फ चिकित्सा देखभाल, अर्थात् बीमारियों का निदान और उपचार ही शामिल नहीं है बल्कि इसमें पोषण, पेयजल और स्वच्छता सुविधाएं, अच्छे आवास और बहुत कुछ शामिल हैं। परिभाषा के अनुसार निजी चिकित्सा देखभाल तभी बच सकती है जब वह लाभदायक हो (70)/ "मुक्त-बाजार" के सभी गुणों के बावजूद, जिन्हें बढ़ा चढ़ा कर बताया जाता है। ये संपूर्ण निजी क्षेत्र सरकार द्वारा प्राप्त प्रत्यक्ष और अप्रत्यक्ष सब्सिडी के मेजबान के कारण संपन्न हो रहा है। यह विडंबना है कि एक सरकार, जो यह घोषणा करती है कि यह गरीबों के लिए "स्वास्थ्यवर्धक" स्वास्थ्य देखभाल को "आर्थिक सहायता" प्रदान करती है, निजी और कॉर्पोरेट चिकित्सा क्षेत्र को ऐसी सब्सिडी प्रदान करती है, जो विशेष रूप से अमीरों की जरूरतों को पूरा करती है(71)। इस प्रकार, बहुत ही मामूली लागत पर चिकित्सा शिक्षा प्रदान करने के बाद सरकार निजी चिकित्सा पेशेवरों और अस्पतालों को निजी अभ्यास और अस्पताल स्थापित करने के लिए रियायतें और सब्सिडी प्रदान करती है। यह देखा जा सकता है कि दिल्ली में अपोलो अस्पताल दिल्ली सरकार द्वारा उपलब्ध कराए गए सस्ती ज़मीन पर बनाया गया था! सरकार निजी दवा और चिकित्सा उपकरण उद्योग को प्रोत्साहन, कर अवकाश/छूट और सब्सिडी भी प्रदान करती है (72)।
स्वैच्छिक सहायता वाला क्षेत्र, जिसने स्वास्थ्य सेवाएं प्रदान करने के लिए भी कदम रखा है, केवल उन क्षेत्रों को ध्यान केंद्रित करने और प्राथमिकता देने के लिए मजबूर किया जाता है जहां अंतर्राष्ट्रीय सहायता उपलब्ध कराई जाती है - जैसे एड्स, जनसंख्या नियंत्रण, आदि (73)।
आज, पहली बार, हम चिकित्सा देखभाल क्षेत्र में पुरे संगठित कॉर्पोरेट क्षेत्र को प्रवेश करते हुए देख रहे है।जैसे-जैसे चिकित्सा का अभ्यास अधिक प्रौद्योगिकी गहन होता जा रहा है, चिकित्सा पेशेवर की भूमिका संकीर्ण होती जा रही है, और तकनीक की भूमिका बढ़ती जा रही है। इस कारण से पूरा कॉर्पोरेट घराना अब तकनीक पर ही निवेश कर रहा है ताकि मनमाने कीमत वसूल सके(74)।
सार्वजनिक स्वास्थ्य और नव-उदारवादी आर्थिक सिद्धांत के स्थापित आदर्शो के बीच स्पष्ट विरोधाभास है । सार्वजनिक स्वास्थ्य एक "सार्वजनिक लोक कल्याण " का विषय है, अर्थात् इसके लाभों को व्यक्तिगत रूप से आनंद या गणना करके नहीं किया जा सकता है, लेकिन उन लाभों के संदर्भ में देखा जाना चाहिए जो जनता द्वारा आनंदित हैं। इस प्रकार सार्वजनिक स्वास्थ्य परिणाम साझा मूल्य पर निर्धारित किये जाते है। और उनका संचय बेहतर रहने की स्थिति में ले जाता है।इन लोक कल्याण के विषयो के संग्रह से जीवन स्तर में सुधार आता है। मौजूदा आर्थिक नीतियां स्वास्थ्य को एक निजी कल्याण की वस्तु समझती है जो बाजार के माध्यम से पहुँचा जाता है। जबकि किसी भी सामाजिक कल्याणकारी निवेश में कटौती, सार्वजनिक स्वास्थ्य सेवाओं के क्रमिक विघटन के लिए जिम्मेवार है। सार्वजनिक संस्थानों में सेवा शुल्क लगाने से, गरीबों के लिए स्वास्थ्य सेवा पहुंच से बाहर हो जाती है।
स्वास्थ्य सेवा की जिम्मेदारी निजी क्षेत्र को सौंपना और सार्वजनिक स्वास्थ्य की प्रासंगिकत को कम करना है।दूसरी ओर निजी क्षेत्र केवल उपचारात्मक देखभाल पर ध्यान केंद्रित करता है। उदाहरण के लिए, भारत को स्वास्थ्य में अपने सार्वजनिक स्वास्थ्य व्यय को कम करने और अंतरराष्ट्रीय बैंकों द्वारा भारतीय उपयोगकर्ताओं से स्वास्थ्य सेवाओं की लागत वसूलने के लिए मजबूर किया गया।
अतः इससे एक बात तो सिद्ध होती है कि स्वास्थ्य के क्षेत्र में बाजार और उसको प्रोत्साहित करने वाली नव-उदारवादी नीतियां जिसकी शुरुआत वैश्वीकरण से हुई और आज चरम पर है आम जनता के लिए काम नही करती है। ओर इनसब नीतियों का निर्धारण राजनीति करती है इसलिए इसके पीछे की राजनीति को समझना अतिमहत्वपूर्ण हो जाता है। इसलिए जरूरी है कि हम अपनी राजनीति खुद चुने अन्यथा यह राजनीति हमे चुन लेगी और जिस दिन इसने हमे चुन लिया फिर हमें जिंदगी भर उसी के साथ रहना पड़ेगा और फिर हमारे पास न तो शिकायत के लिए ओर न ही सुनवाई के लिए भी कोई स्थान बचेगा।
Employee Assistance Programs (EAPs) provide counselling and consulting services that focus on the prevention and/or remediation of personal problems experienced by employees, or members of their families. EAPs are currently considered one of the main vehicles for occupational stress management and are rapidly evolving into providers of holistic wellbeing programs in the workplace. This form of service delivery has, however, been criticised for focusing interventions at the individual rather than at the organisational level. This review examines the history and development of Australian EAPs, discusses issues unique to the delivery of psychological services in a workplace environment, and considers evidence for the effectiveness of EAPs. While research evidence is not fully supportive of the effectiveness of EAPs, data suggests that these programs do impact positively on employee mental health, and are perceived by employees as a desirable workplace resource.
Wells Fargo and Company's Employee Assistance Consulting (EAC) is an established and successful internal corporate-based EAP that delivers organizationally congruent services to a diversified financial services company with 80+ businesses and over 146,000 team members. While some elements of traditional EAPs are evident in the services provided by this entity, EAC also provides highly specialized and customized consultations to its corporate partners, business group customers and employees. Using a highly integrated service model that aligns closely with the specific strategy and operations of each Wells Fargo business, EAC is an invited guest at many of the company's most influential tables. EAC collaboratively partners with senior and line management, Human Resources, the Employment Law Department, Disability Management (called WorkAbility at Wells Fargo) and Risk Management, Corporate Benefits, Corporate Security, Learning and Development, and others to provide leadership and organizational influence on such wide ranging issues as threat assessment and management, business incident management, workplace trauma, health and productivity, and organizational and employee effectiveness. This article describes proven methods and strategies for maximizing organizational influence and positioning EAP consultants as effective business partners.
This article considers the commonalities and differences between Australian EAPs and their counterparts in the United Kingdom and the U.S.A. The unique characteristics of Australian EAPs are examined, including an account of the approach taken to the integration of EAP services and other employee services such as work-life and wellness. Three case studies illustrate the forms of integration presently being explored in Australia. It is concluded that efforts to engage in the type of “big picture” thinking characteristic of integration are apparent, even though there is little evidence of the type and degree of collaboration seen to be emerging in the U.S.A.
This study examines the prevalence, characteristics, and interrelationship of Employee Assistance Programs (EAPs) and managed behavioral health care insurance benefits (“carve-outs”). Based on our survey of Fortune 500 firms regarding 1999 behavioral health arrangements, over 90% had an EAP (typically externally contracted) and over one-third had a behavioral health carve-out. EAP arrangement (internal, separate contract, integrated contract) was associated with EAP benefit level. EAPs and carve-outs are interrelated in some important ways, though not in outpatient benefit levels. Both can offer substantial benefits to workers and their dependents, and are particularly important during this time of unusual stresses.
Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region.
A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%.
Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was 18.09, respectively.
EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.
Human services industries are defined as the sub-set of service industries that deal in the provision of services to consumers with the aim of bringing about beneficial change in those consumers. A number of characteristics of such services are discussed, including the influence of value systems and ideologies, their sources of finance, their heterogeneity and the issue of consumer choice. These and other characteristics are seen as crucial influences on human services management and organisation structure, service delivery technology and quality assurance.
This study compares internal and external Employee Assistance Program service models through utilization and cost-effectiveness at a nuclear power plant. The relationship of utilization rate to the presence of a part-time external EAP program and a full-time internal EAP program over a three year period is examined. The effects of the consumer'S grapevine will also be discussed. This study suggests that utilization and cost-effectiveness are significantly increased with the presence of the acculturated internal director via utilization analyses. Implications of these findings are discussed.
Discusses a methodology for evaluating the costs and benefits of employee assistance programs (EAPs). The methodology has 4 components: (1) a process description to understand the structure, operating environment, and the goals of EAPs; (2) a cost analysis to identify and estimate the full range of EAP costs; (3) an outcomes analysis to estimate the effectiveness of the EAP for the group of employees and the overall impact of the EAP on employee performance and workplace productivity; and (4) an economic evaluation to estimate cost-effectiveness ratios, cash benefits, and net benefits of the EAP. This methodology is based on the standard economic theory. It is concluded that as each EAP is unique, each evaluation must also be unique but all EAP evaluations should try to include the 4 components. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study examined diversity during the late 1980s in managed care programs for mental health, alcohol abuse, and drug abuse to identify ways in which research can generate more meaningful data on the effectiveness of utilization review programs.
Telephone interviews were conducted with representatives of utilization review programs for employee health insurance plans in 31 firms that employed 2.1 million people in 1990. Questions addressed qualifications of personnel, clinical criteria to authorize care, integration with employee assistance plans, penalties for not complying with utilization review procedures, outpatient review, and carve out of mental health and substance abuse review.
Large variations in utilization review programs were found. Programs employed a range of review personnel and used a variety of clinical criteria to authorize care. More than two-thirds did not carve out mental health and substance abuse review from medical-surgical review. Some firms' employee assistance plans were integrated with utilization review programs, while others remained unintegrated. Penalties for not following program procedures varied widely, as did review of outpatient services.
Because of trends toward even more diversity in utilization review programs in the 1990s, research that identifies the specific features of managed care programs that hold most promise for controlling costs while maintaining quality of care will increasingly be needed.
1. The history and development of Employee Assistance Programs (EAPs) can be traced back to the 1800s. There are currently over 10,000 EAPs in the United States. 2. Standards for program accreditation and counselor certification have been established for EAPs. The "core technology of Employee Assistance Programs" includes identification of behavioural problems based on job performance issues, expert consultation with supervisors, appropriate use of constructive confrontation, microlinkages with treatment providers and resources, macrolinkages between providers, resources, and work organizations, focus on substance abuse, and evaluation of employee success based on job performance. 3. Some EAPs take a broad brush approach, and incorporate health promotion and managed care functions.
Workplace drug and alcohol abuse imposes substantial costs on employers. In response, employers have implemented a variety of programs to decrease substance abuse in the workplace, including drug testing, health and wellness programs, and employee assistance programs (EAPs). This paper focuses on the relationship between enterprises' organizational and health insurance characteristics and the firms' decisions to provide EAPs. Using data from the 1989 Survey of Health Insurance Plans (SHIP), sponsored by the Health Care Financing Administration (HCFA), we estimated the prevalence of EAPs by selected organizational and health insurance characteristics for those firms that offer health insurance to their workers. In addition, we estimated logistic models of the enterprises' decisions to provide EAPs as functions of the extent of state substance abuse and mental health insurance mandates, state-level demographic variables, and organizational and health insurance characteristics. Our results suggest that state mandates and demographic variables, as well as organizational and health insurance characteristics, are important explanatory variables of enterprises' decisions to provide EAPs.