Onsite Screening and Enhanced EAP Counseling Improves Overall Health, Depression and Work Outcomes: Four-Wave Longitudinal Pilot Study at Community Health Center in Vermont

Abstract

Over a 2-year period, patients of a rural community health center in Vermont were screened onsite for multiple behavioral health risk factors and if found at-risk, were offered no-cost counseling onsite at the health center. The treatment was delivered by two licensed employee assistance program (EAP) counselors highly proficient in an evidence-based Motivational Interviewing approach. Longitudinal data at four time points were examined: baseline; end of treatment (3 months); at three- and six-months post treatment. Tests of paired data of baseline versus each later time point found significant improvement for global health (PROMIS-10) in the total sample (N = 120); depression symptoms (PHQ-9) among subsample with depression as clinical issue (n = 68); and work presenteeism and estimated hours of lost work time among employed subsample (n = 46). Improvement in global health was significantly associated with improvement (reductions) in hours of lost work productivity at all later times (r = .33, .35, .50). Improvement in global health was moderated by level of household income (more improvement among cases at lower income levels), but not by clinical or demographic factors. Practical implications for behavioral health screening and intervention (BSI) in medical settings and onsite EAP counseling programs are discussed.