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Established in 1961, the University of Maryland School of Social Work is one of the largest and most respected schools of social work in the nation. The University of Maryland School of Social Work is committed to excellence in education, research, community service, and innovation.
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EAP Evidence: Debunking Marketing Myths about the Purpose, Use and Effectiveness of Employee Assistance Programmes in South AfricaAs the demand has soared for workplace mental health support since the COVID-19 pandemic, billions of dollars of venture capital have flowed into many companies that are relatively new to this global market. These providers sell a mix of digital Apps and internet platforms. This presentation critically reviews the marketing trends that mischaracterize much of what EAPs do, how they are used, and how effective they are. It’s time to fact-check this propaganda against the decades of professionalism and research in our field. The evidence shows the true business value of employee assistance when properly delivered. Results of a 2023 survey of EAP providers in South Africa is featured.
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Occupational & Critical Incident Stress Management Services (OCISM) Moving from Moral Distress to Moral ResilienceUnderstanding Moral Distress Moral Suffering • Moral suffering occurs when nurses are exposed to pain and suffering on an everyday basis. • Has its roots in our concern for others and our intention to bring about beneficial outcomes, to relieve the pain and suffering of others, or to rectify an injustice. • Not being able to do this in every instance may be considered “part of the job,” but it is seen as the “cost of caring” and can lead to moral suffering. • Usually over situations or experiences that provoke confusion/uncertainty, or that do not turn out as hoped. • Can arise intermittently or over long periods of time Rushton (2018) / Papazoglou, Chopko 2017 Often healthcare professionals are unsure about what is the morally right way to proceed given the current situation.
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Navigating the Workplace Political MinefieldThat’s one of the more challenging situations Kelly Bunting has seen managers try to navigate when political discourse in the workplace—whether about an upcoming election, a Supreme Court ruling or a social protest—has gotten out of hand. Such situations can occur at a physical or remote office, a company function, or a social outing with colleagues after work hours. Bunting, a shareholder with Greenberg Traurig LLP in Philadelphia, says she’s never seen anything like the number or volatility of political debates in workplaces in recent years. “Employees feel much more comfortable voicing their opinions on everything, including politics, even at work,” Bunting says. “I think norms regarding respect for different opinions have also weakened, and employees will [now] say something out loud [when] before they may have just walked away. It seems it’s growing harder for managers to prevent these conflicts.” In SHRM's 2022 Politics at Work Study, 20 percent of HR professionals agreed there was greater political volatility at work than there was three years earlier. SHRM found that nearly a quarter of U.S. workers (24 percent) have personally experienced political affiliation bias, including preferential treatment or undue negative treatment based on their political positions or opinions, compared to 12 percent of U.S. workers in 2019. “It doesn’t have to be clearly over the line for a lot of people to say, ‘I’m fed up with this person, and I won't deal with them anymore,’ ” says Stephen Paskoff, a former litigator with the U.S. Equal Employment Opportunity Commission and author of multiple books on political discussions at work. “I started as a congressional intern in college, worked in D.C., and this is as intense as I recall it ever being. And I grew up in the ’60s. It’s not just, ‘Are you Republican or Democrat?’ It’s ‘What do you think about abortion, affirmative action, DE&I, gun control, gender identification?’ There are so many issues wound up in our politics, and none of them is just casual.”
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Current Drug TrendsThis is an incredible presentation that reviews the 2021 SAMHSA National Survey of Drug Use & Health: In 2021, 61.2 million people (up from 59.3 million people in 2020) used illicit drugs in the past year, including 52.5 million people who used marijuana; 9.2 million people misused opioids. Past Month Substance Use (2021) • People aged 12 or older in 2021: • 57.8% (161.8 million people) used tobacco, alcohol, or an illicit drug in the past month • 133.1 million people drank alcohol • 54.7 million people used a tobacco product • 40 million people used an illicit drug (including marijuana) • 60 million people were past month binge drinkers (highest among 18-25 yos, then 26 yo+, followed by adolescents)
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THE NEXT PANDEMIC: Loneliness and the Power of Casual CollisionsThe sudden explosion of COVID-19 in early 2020 turned life upside down almost overnight. Lockdowns induced forced isolation, and employees transformed into either remote workers or essential, front-line workers at high risk of exposure to the coronavirus. As offices have reopened, remote work has been heralded as one positive outcome of the pandemic and as a solution to some of the ailments of Americans’ fast-paced lifestyles. While technologies such as videoconferencing and instant messaging have supported productivity, the reduction in unscheduled social interactions has the potential to harm employee well-being and engagement. While remote work can improve job satisfaction, it can also contribute to feelings of isolation, which in turn can lead to more serious conditions. Employees who are chronically lonely in the workplace receive poorer supervisor ratings of their job performance and have weaker feelings of emotional commitment to their employer. Ironically, although these employees crave social interaction, they also tend to distance themselves from co- workers, potentially undercutting workgroup collaboration. In addition, they miss an average of 15 more days of work per year than their nonlonely co-workers. Given these potential implications for the workplace, SHRM Research sought to explore the prevalence of employee loneliness and the importance of social interactions from the perspectives of both HR professionals and U.S. workers. There is a common perception of a permanent restructuring of the workplace in the wake of the pandemic. Findings from SHRM’s current study bear out these reports. Both HR professionals and U.S. workers reported similar degrees of change between December 2019 and December 2022. Whereas around 9 in 10 workplaces were almost entirely in-person before the pandemic, some 7 in 10 are now. Paralleling this decline are increases in the percentage of employers whose workers are permanently hybrid or remote. These shifts have potential implications for the nature of interactions among co-workers. A recent Morning Consult report suggested other implications as well. While 63% of workers in that study currently work in person, only 46% agreed this is their preferred work location, suggesting a sizable percentage of onsite workers want more work flexibility than their employers provide. Employees’ biggest reasons for preferring onsite work were being more productive in the office and maintaining greater separation between their work and personal lives.
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How the Harsh Realities of Work in Medicine Impacts Young PhysicianslesLeUnderstanding what younger physicians want and need is a key way for an organization to determine how to recruit and retain them. In our previous post, we reviewed what final-year residents want in their first jobs and what it takes to attract them, according to a 2021 survey by the national physician recruiting and consulting firm Merritt Hawkins. We've gleaned insights into how younger physicians (those under forty) feel after having been full-fledged working practitioners for a period of time. Medscape’s Young Physician Compensation Report from 2022 is mainly focused on what young physicians in various specialties are currently being paid, but it also assesses issues such as their workload and their satisfaction with the path they’ve chosen. Here, in a sample of the results, are four areas of concern. (Totals may not add up to 100 percent as respondents gave multiple options equal weight, or because not all response categories are included in the below overview). There is a definite shift in values among young physicians and their peers when reflecting on their professional lives. As reported by Medscape, “For young physicians, making the world a better place has gained favor over the past few years and patient gratitude and being good at their jobs have lost some impact (14%, 35%, and 27%, respectively, in our 2016 report).”
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Physician Suicide: One Family’s Story of Unthinkable Loss, Pain, Awareness and GrowthYou’ll see physician suicide statistics published online, or perhaps you’ll even hear them in conversations around you, but statistics don’t have the same impact as hearing a personal story. In late 2019, Dr. Matthew Gall was one of those physicians who tragically died by suicide, leaving his family and friends reeling to understand what happened. By all accounts Dr. Gall was a lover of life and happy guy. His suicide was an unexpected, heartbreaking and traumatizing event for his family and friends, that they continue to cope with today. This interview with Betsy Gall, Matthew’s wife, shares their story, the impact his death has had on their lives, and what they hope to accomplish by sharing it.
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An EAP Changed My LifeIt is not easy going through life as a man unable to fix a leaky faucet or tinker with a mechanical device to get it in working order. Nor, looking back on my childhood, is it fun being a kid who can’t climb a rope in gym or build a tabletop cart in woodworking class. Those failings made me feel worthless at an early age, compounding the fact that (unknown to me at the time,) I was predisposed to mental health issues given a family history of depression and other behavioral disorders.
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Managing Remotely: Seek More to Understand Than Be UnderstoodThe objectives of managing, whether it be remote or in person, is essentially the same. We still want engaged, motivated employees who are productive, efficient, and work well with their colleagues. The distance does create some new challenges and that invites us to adapt to be effective leaders. Some of the core issues to address include: good communication, appropriate supervision, helping people to feel a part of, project oversight and managing the distractions at home such as children, pets -- and even partners. As leaders, we need to provide clear direction, the necessary resources and information, some emotional support plus access for scheduled and impromptu meetings. Compared to managing in person, managing virtually has to be more intentional to be effective.
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Views A meeting of the minds: AI and employee mental healthOver the last few years, the shortage of mental health professionals has become a national crisis. As of March 2023, 160 million Americans live where the supply of mental health practitioners is less than half of what is needed. This has led to overburdened therapists, patient delays and frustration and a loss of confidence in a failing mental health system. Everyone deserves mental health care when they need it, not three months later, as is often the case. Employee Assistance Programs (EAPs), the rest stop for many workforce members grappling with emotional and work-life challenges, are seeking new resources to address this shortage. More recently, their quest has led to artificial intelligence. But to what extent can AI replace the functions performed by EAP counselors? This topic was explored at the 2023 Spring Conference of the National Behavioral Consortium (nbcgroup.org), a trade association of thought leaders from top-tier EAPs, behavioral health firms and partner companies.
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National Model Standards for Peer Support CertificationOn March 1, 2022, President Biden announced his administration’s strategy to address our nation’s mental health crisis as outlined in the 2022 Presidential Unity Agenda. This national mental health strategy seeks to strengthen system capacity, connect more Americans to care, and create a continuum of support –transforming our health and social services infrastructure to address mental health holistically and equitably. A primary goal outlined within this strategy is accelerating the universal adoption, recognition, and integration of the peer mental health workforce across all elements of the healthcare system. This included the development and implementation of a national certification program for mental health peer specialists1. To meet this goal, SAMHSA collaborated with federal, state, tribal, territorial, and local partners including peer specialists to develop the National Model Standards for Peer Support Certification, inclusive of substance use, mental health, and family peer certifications. These National Model Standards closely align with the needs of the behavioral health (peer) workforce, and subsequently, the over-arching goal of the national mental health strategy. SAMHSA acknowledges the nuances across the peer workforce and the communities being served, as states often reflect needs that are unique to their community within a certification. Further, SAMHSA’s National Model Standards for Peer Support Certification are not intended as a substitute for any state certifications but instead have been developed as guidance for states, territories, tribes, and others, to promote quality and encourage alignment and reciprocity across often disparate state peer support certifications. Since the 2015 release of the SAMHSA’s Core Competencies for Peer Workers in Behavioral Health Services2, the peer workforce has flourished, resulting in the implementation of state-endorsed or state-run peer certification programs across 49 out of 50 states3. The National Model Standards are designed to accelerate universal adoption, recognition, and integration of the peer workforce, and strengthen the foundation set by the peer workforce, reinforced by the Core Competencies, and implemented by our state, local, and tribal partners.
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The Ripple Effect of Trauma in Medical Practice and How to Dampen the WaveThere is no doubt that practicing medicine today predisposes physicians to a tsunami of mental and emotional health issues. Certainly, there are predictable causes of stress that come from deep concern for the well-being of patients and there are added demands of time constraints, complex charting, burdensome bureaucratic tasks and more. Additional events that can precipitate traumatic stress reactions in even the most seasoned clinicians include medical errors, patient deaths, and increasingly, rude or violent reactions by patients or their families. Simply witnessing a cardiac arrest in the emergency room can be distressing for some. More covert trauma might come from leadership demands or organizational requirements that restrict one from providing the quality of care they believe in. This form of trauma leads to moral injury—the sense that one is violating their moral code. For female physicians and those from minority groups, micro-aggressions and subtle or overt signs of disrespect can wound and contribute to an ongoing cycle of trauma. The aftermath of such experiences may include grief, psychological, emotional, physical, or spiritual distress, rumination over the event or flashbacks. However, one’s response to trauma can be purposeful and allow for personal growth. Not everyone is traumatized to the same degree by a given event, but we all experience suffering. Over time droplet- sized traumatic events and other stressors add up, leading to the familiar symptoms of burnout—exhaustion, cynicism, a loss of sense of self and feelings of ineffectiveness or lack of accomplishment. However, one’s response to trauma can be purposeful and allow for personal growth. This growth is as much about how we manage suffering as how we help others walk through it.
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988 FactsheetIn 2020, Congress designated the new 988 dialing code to operate through the existing National Suicide Prevention Lifeline. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency, in partnership with the Federal Communications Commission and the Department of Veterans Affairs, working to make the promise of 988 a reality for America. Moving to a 3-digit dialing code is a once-in-a-lifetime opportunity to strengthen and expand the existing National Suicide Prevention Lifeline (the Lifeline). Of course, 988 is more than just an easy-to-remember number—it is a direct connection to compassionate, accessible care and support for anyone experiencing mental health related distress – whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. Preparing for full 988 implementation requires a bold vision for a crisis care system that provides direct, life-saving services to all in need. In pursuit of this bold yet achievable vision, SAMHSA is first focused on strengthening and expanding the existing Lifeline network, providing life-saving service to all who call, text or chat via 988. Longer term, SAMHSA recognizes that linking those in crisis to community-based providers—who can deliver a full range of crisis care services— is essential to meeting crisis needs across the nation.
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CMS Framework for Health Equity 2022–2032“As the nation’s largest health insurer, the Centers for Medicare & Medicaid Services has a critical role to play in driving the next decade of health equity for people who are underserved. Our unwavering commitment to advancing health equity will help foster a health care system that benefits all for generations to come.” The CMS Framework for Health Equity provides a strong foundation for our work as a leader and trusted partner dedicated to advancing health equity, expanding coverage, and improving health outcomes. This includes strengthening our infrastructure for assessment, creating synergies across the health care system to drive structural change, and identifying and working together to eliminate barriers to CMS-supported benefits, services, and coverage for individuals and communities who are underserved or disadvantaged and those who support them. Across our Centers and Offices, we are committing to taking an integrated, action-oriented approach to advance health equity among members of communities, providers, plans, and other organizations serving such communities, who are underserved or disadvantaged.
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How the Rise of Women Physicians Impacts your Healthcare OrganizationIn 2017, for the first time in American history, more women than men were enrolled in the first year of medical school. In 2019, according to the Association of American Medical Colleges (AAMC), women made up the majority of med students.1 On the horizon: a medical profession in which women outnumber men. This very significant gender shift requires some major changes in policies, attitudes and procedures—because women in medicine today face daunting challenges and disadvantages, ranging from compensation to treatment by colleagues to family-centered issues and beyond. Addressing their well-being and satisfaction with the profession will be one of the most important responsibilities of healthcare leadership in the years ahead. What Medical Women Want One of the most important responses to the AAMC’s 2019 findings about med school enrollment was a survey made the following year by Medscape, “Women Physicians 2020: The Issues They Care About.”2 The researchers discovered that the 3,003 practitioners surveyed were most concerned about:
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EAP Evidence: Responding to the Challenge of Imposter EAPsThis is the first article for a new regular column in JEA called EAP Evidence. I will review empirical data and industry facts on central topics in employee assistance program (EAP) service delivery and effectiveness that are relevant to a complex and changing business climate. Since the COVID-19 pandemic, substantially more employees have experienced financial difficulties and behavioral health challenges and this increased prevalence of personal distress has encouraged more employers to ramp up their efforts to support the mental health needs of the workforce. As the social stigma has waned and demand for EAP has soared, billions of dollars of venture capital has flowed into many companies that are relatively new to this global market. These providers typically sell some mix of digital Apps and internet platforms with self-care tools, iCBT robot programs, artificial intelligence features, and online-only access to human support from peers, coaches, or counselors. This profit-driven context has generated marketing efforts that are directly confrontational with fictionalized versions of EAP. I frequently see examples of marketing that mischaracterize the purpose of EAPs, how EAPs are used, and how EAPs deliver results to the users and the work organizations they serve. I call these new businesses “Imposter EAPs” because they strive to replace real EAPs with technology-focused products that lack many of the core components of employee assistance
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Formal Management Referrals Compared to Self- Referrals to Counseling from an External Employee Assistance Program (EAP) in the United States 2017- 2023: Profiles of User Characteristics and Work and Clinical Outcomes at Before and After TreatmentThis applied naturalistic study examined the background and service use characteristics and also the work and clinical outcomes of employees who were formally referred by their employer to use brief counseling services from an employee assistance program (EAP) at CuraLinc Healthcare. The data was from 41,986 employees who worked at over 1,750 different employers located in the United States. The study period spanned 7 years, from January of 2017 through March of 2023. The majority of employees voluntarily used EAP counseling, with about only 3% of the total clients being formally referred to use the EAP by their employer – typically due to issues related to employee job performance or substance abuse. The two types of referral clients (Formal Management Referral or FMR n = 1,215 and Self/Other Referral or SOR n = 40,771) were similar or had only small differences on most of the profile factors. Factors with meaningful differences included the reason why the service was used (i.e., presenting issues of alcohol, drug, work stress and anger management were far more common among formal referrals than SOR; 77% > 13%), the gender of the client (FMR more males; 68% > 38%) and certain industries of the employer. All of the longitudinal test results found improvements in work and health outcomes at 30-days after the use of EAP counseling with large size statistical effects for both referral types, yet the FMR clients tended to have significantly greater relative improvement, which was due in part to their starting out at greater severity levels for work deficits and hazardous alcohol use than self-referral clients. More of the FMR clients were at a problem level at the start of EAP use for both work outcomes and they also had greater improvement afterwards (absence: FMR Pre/Post 46% to 1% > SOR Pre/Post 31% to 7%; productivity FMR Pre/Post 42% to 5% > SOR Pre/Post 35% to 5%). The typical FMR client reduced their average hours of unproductive work time per 30 days by more than the typical SOR client (Pre to Post change: FMR 56 fewer hours > SOR 39 fewer hours). The largest change was from 12.2 to 0.3 hours of absence on average per month for the FMR clients compared to 7.0 to 1.5 hours for the SOR clients. Referral types also differed on certain health risk factors. More of the FMR clients started EAP use at-risk for hazardous alcohol use and also improved more after use (FMR Pre/Post 30% to 5% > SOR Pre/Post 12% to 3%). However, fewer of the FMR clients started EAP use at-risk for mental health (anxiety and/or depression) and yet the FMR clients had greater improvement after counseling (FMR Pre/Post 22% to 3% > SOR Pre/Post 32% to 10%). An important implication of this study is that employers can be confident that when they make a formal management referral of a troubled employee to their EAP that the counseling will likely be successful, both in reducing absence from work and restoring work productivity to normal levels and also in recovering from the clinical problems that are part of the cause of the work-related distress history that likely prompted the referral. Companies that use their EAP for this kind of referral support can likely see results in better risk management of these kinds of common performance and behavioral health issues among their workforce.