Humpday Hangout

 Editor in Chief Bobby Halton and FireRescue Editor in Chief Erich Roden talk to Frank Ricci, P.J. Norwood, and Jim Rascati about employee assistance programs (EAP) and mental health issues.

http://www.fireengineering.com/articles/2015/01/humpday-hangout-4.html

Employee Assistance Programs are more than just a buzzword…

Employee Assistance Programs (EAP) offers free and confidential counseling services for employees including members of their immediate family.   Immediate family generally includes the husband, wife or partner as well as children still on their benefit plan.  EAPs generally are prepaid services provided by the employer as an additional benefit.  The number of session can vary from 3, 5, 6 or more.  By far, the majority of EAPs provide up to three sessions.

Good EAPs should provide counseling not just for mental health and substance abuse but for any issue.  Although EAPs primarily focus on behavioral health issues they can provide counseling for a variety of matters, i.e. marital, family, children, school problems, job conflicts, career changes, stress, etc.   Even “happy” events like getting married, having a baby, buying a home, etc. can be anxiety producing. 

Cost

There is no cost of EAP services to the employee/family member as the employer pays a fee to provide the EAP as an additional benefit.   EAP fees can range from anywhere from $15 to $50 per employee per year.  The capitated rate is determined by the number of lives covered, how many sessions, how many locations to be covered, how many hours are included for employee orientations, wellness seminars, etc.

Confidentiality

As the fire officer it is critical that your members know that they can trust you. This means their issues will not be leaked as the latest rumor. EAP services are absolutely confidential except where the law requires disclosure.   Many EAP service providers are licensed behavioral health professionals like Ph.D. Clinical Psychologists, Master level Social Workers, Marriage and Family Counselors, etc., all of whom are mandated reporters.

The counseling services that are provided by an EAP are confidential with the exception of:

• Danger to self
• Danger to others
• Child or Elder Care abuse

Organizational Services

Some EAPs also provide organizational interventions such as:

• Pre-employment psychological screening
• Fitness for Duty Evaluations
• Management team evaluation
• Team building
• Executive coaching

EAPs can provide wellness seminars on a variety of topics, such as:

• Aging Parents     
• Attitude Training
• Burnout                       
• Communication and Conflict Management in the Workplace
• Managing Change                 
• Managing Diversity in the Workplace
• Parenting Adolescents           
• Stress Management
• Substance Abuse Education           
• Time Management

EAPs can provide training seminars on a variety of topics, such as:

• Diversity and Cultural Competency
• Prevention of Sexual Harassment
• Prevention of Violence and De-escalation
• Reasonable Suspicion of Substance Abuse
• Supervisor Training – Identifying Firefighters at Risk

Supervisor Training – Identifying Firefighters at Risk

Supervisor Training is vitally important so that Command staff can learn on how to identify work, behavior or other performance problems before they worsen.  The majority of individuals become supervisors through promotion or attrition yet very few have had specific training on how to manage people, especially those exhibiting work performance problems.  Supervisor training will provide command staff with specific skills and techniques to identify problems as well as firefighters at risk, and how to initiate constructive interventions up to and including supervisory referrals to the EAP.   This training also provides an overview of the following specific concerns for firefighters: stress, depression & suicide, and substance abuse.

A good EAP should also provide for ongoing and unlimited supervisory phone consultations.

Psychological First Aid/Critical Incident Debriefings

A good EAP should have availability to respond immediately 24/7 for any request for psychological first aid.  The behavioral health professionals responding should have a minimum of a masters-degree in a behavioral health field, training in psychological first aid/critical incident debriefing, trauma experience and, most importantly, understand and be familiar with the culture of first responders.

Recommended Protocols for Psychological First Aid/Critical Incident Debriefings

Our recommended protocol is that the Employee Assistance Program (EAP) be contacted immediately after a critical incident.  Depending upon the nature of the critical incident, the EAP may be requested by Command staff to go to the scene, the emergency room, or directly to the Fire Department and meet with the firefighters directly involved. 

On some occasions the defusing may be sufficient.  In other situations the EAP may recommend that within 24 – 72 hours from the critical incident an official CID meeting should be held at Fire Headquarters.   Psychological First Aid (CID) is facilitated by the EAP and we strongly recommend that attendance is mandated for all firefighters directly involved.  However, it is not required that anyone speak during this formal debriefing.   Our expectation is that only the initial first responders on the scene are requested to attend.  This is meant to be a psychological and not an operational debriefing.

Fire Department Peer Support

Some EAPs also provide Peer Support Development and Training.

Fire Department Peer Support programs were developed because historically firefighters and other first responders have been fairly reluctant to access EAP or psychological services.  And yet the professional literature shows that firefighters have:

• high levels of stress
• 2 –3 times the rate of substance abuse when compared to the general public
• high divorce rates
• high rates of suicide

The primary objective of the Fire Department Peer Support Program is to provide all employees with information and education with regard to the Employee Assistance Program, critical incident and other behavioral health and/or community resources. 

Another key objective of Fire Department Peer Support Teams is to decrease the stigma of seeking professional assistance.  This will be accomplished through education, information and by “word of mouth.”  The more that members of the department learn that there is help available, that their confidentiality will be maintained, that fellow firefighters have successful used EAP or other professional services, the more likely it will be utilized by more people.

How would I know if my Department offered an EAP?

If you are part of a municipality chances are very high that your City offers EAP services.  The Chiefs office should know whether or not there is an EAP.  If they do not, then a call to either Human Resources or the Benefits Department.   If you are part of a smaller town and there is no Human Resource Department you may want to call someone in the Finance Department.

If you are part of a volunteer Fire Department you may want to call the Mayor or Fire Selectman’s office to inquire whether the Town offers EAP services to your department.

In Summary

Offering Employee Assistance Programs makes good business AND financial sense.  Did you know that:

• 30% of all absenteeism is due to employee personal problems.
• 60-70% of all physician visits has either a psychological or stress related component.
• $23.8 billion is lost annually from absenteeism and lost productivity due to depression.
• 75% of individuals who use illicit drugs are employed.

For more information please contact:

James Rascati, Director of Employee Assistance Programs

Behavioral Health Consultants, LLC
3018 Dixwell Avenue

Hamden, CT   06518

(203) 288-3554, ext. 18

jnrascati@bhcservices.com

James Rascati, LCSW is a partner at Behavioral Health Consultants, LLC (BHC) in Hamden, CT and is the director of Employee Assistance Programs.   In this role he is responsible for EAP services for 20 paid and volunteer Fire Departments in CT.   He and his colleagues have trained and developed six Fire Department Peer Support teams.

In addition to his clinical, training and consultative work he also maintains an appointment as a Clinical Instructor in Psychiatry (Social Work) at the Yale University School of Medicine, Department of Psychiatry.