published on May 11, 2017 - 11:54 AM
Written by The Business Journal Staff

When an employee breaks their leg or needs to see the doctor about a 102-degree fever, it’s easy for an employer to understand why they’re taking a sick day or medical leave of absence. When it comes to mental health, however, things are not as black and white.

In a society where a negative stigma is often attached to someone suffering from depression, anxiety or a myriad of other mental health issues, many people often feel embarrassed about seeking therapy to cope with even the most understandable life crises, such as the loss of a loved one. And when it comes to the workplace environment, most employees are uncomfortable divulging any mental health concern to their employer, and instead try to compartmentalize and “pull themselves up by the bootstraps.”

In many cases this approach isn’t the healthiest for the employee and if it causes a reduction in their productivity, it’s not good for the employer either.

“We want our employees to be healthy in mind, spirit and body,” said Bob Adams, the director of human resources at American Ambulance.  

Adams and American Ambulance’s Manager of Behavioral Health and Social Service Initiatives, Ken Katz, said there are several services their company provides to ensure employees feel comfortable seeking help after witnessing trauma.

First, Katz said each employee is given a card to carry in their wallet listing the number they can call in times of turmoil. At orientation, new employees also receive training in depression, anxiety and stress management, and throughout the year, Katz reaches out to various departments to remind employees of the resources they have available. As a first responder agency, there are also peer support groups set up and ready to assist when EMTs, paramedic and dispatchers get that inevitable traumatic call.

Katz said American Ambulance’s level of involvement when it comes to knowing what is going on behaviorally and emotionally with employees is unusual, but there are things all employers can do to assist employees going through traumatic and stressful situations.

One thing any employer can do is provide supplemental insurance or an Employee Assistance Program (EAP) emphasizing mental health.

Avante Health is one local company that offers employers these options.

While mental health is covered under all-encompassing health plans like Blue Cross or Kaiser, those plans don’t provide as many mental health resources since the majority of claims are for medical services.

“If you were to break down the PNL [profit and loss] financial statements of an insurance provider like Blue Cross, you would see that 98 percent of their expenditures are spent on medical and about 2 percent are spent on mental health,” Dennis Bourdo, the CEO of Avante Health said. “Any good business person is going to tell you that the focus is on your bread and butter—the money is going to drive the attention. So, while we believe Blue Cross has a great network, they handle mental health differently, and Avante feels like mental health should take a priority.”

Under a traditional plan, Bourdo said, an employee seeking mental or behavioral health services would call their insurance and be routed to a list of potential providers. Then, that individual would be stuck doing their own research and trying to decide which provider to see and if they have a bad experience, Bourdo said, it’s unlikely they’ll continue to seek help, which can have a devastating effect if the person does have a disorder or is suicidal.

“We truly believe that with mental health, we have one shot,” Bourdo said. “If all of a sudden you feel depressed and can’t get out of bed in the morning or are drinking too much and you decide to make the call it’s a really crappy experience where you feel like you’re getting the runaround, you may never call again.”

As a means to prevent a negative experience, those who call Avante don’t speak with a receptionist, they speak with a clinical professional who knows the providers and is able to ask the right questions and refer the patient to a relatable provider who specializes in the area they need help in.  

Many companies working with Avante, including American Ambulance, opt to offer an EAP. The EAP is no cost to the employee and is a fixed rate per employee per month for the employer. Though Avante’s EAP, each employee is able to access three free visits every six months and those visits can be used by the employee, their spouse, or any dependents in their household.

Dr. Herb A. Cruz, M.D., a board certified psychiatrist and medical director for Avante, said the EAP is equivalent to a medical alert bracelet for employees.

“Everyone wearing a medical alert bracelet isn’t allergic to peanuts, you actually have to read the bracelet to know and in many respects that is what the EAP is like,” Cruz said. “With the EAP, if an employee has any stressors, they let us know and if it is job related, we figure out a treatment plan and there may be a simple solution. If its something personal and the employee needs a longer course of treatment, at the end there is a referral out.”

The EAP is all about helping determine what each person needs.

“You don’t want everyone who develops a headache to go see a neurologist,” Cruz said. “That could be a six or seventh month wait. If you have stress or sinus headaches, you can afford to wait, but if you have a brain tumor, you can’t. At the same time, if all it is a sinus headache, do you really want to wait to see a neurologist for them to tell you all you really just need an ear, nose and throat specialist? The EAP tries to determine what is needed, similar to a primary care physician for mental health.”

The EAP model removes barriers, like cost, for employees, but it’s also a win for employers if even one employee benefits.

“From an employer standpoint, they want their employees to show up to work and, I say this all the time, the trade off is the employee works eight hours a day and every two weeks when they get that paycheck and they know exactly what they are getting and will say something if its 50 cents short. They want every penny and as an employer, it’s the same thing, you want every minute. That is fair,” Bourdo said.

“What causes employees to miss work? Depression certainly could, substance abuse could, and beyond that your wife’s depression could, your child’s truancy or ADHD or aggressive behavior on the playground could—all these things can take you out of work.”

By giving employees an easily accessible avenue to assistance to address these issues, employers are ensuring employees are able to get help so they are more focused and productive when they are at work.

Aside from removing the stigma of seeking mental help by encouraging employees to use an EAP, employers also need to assure employees that everything stays confidential between the employee and their provider.

“It is a huge hurdle,” Bourdo said. “In their minds, the employee is thinking, my employer pays the bill so obviously they must have access to see who used the benefit. But when you go in for a cold, your employer doesn’t get some kind of report from your doctor. It’s the same with mental health, the employer won’t know if you were seen and why. Everything is confidential and employees need to be assured of that.”

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