Introduction: Suicide rates for healthcare workers, coupled with mental health challenges, continue to increase in the USA. This study aimed to assess how the Interactive Screening Programme (ISP) is being used by US healthcare employees and how ISP counsellors’ use of motivational interviewing (MI) techniques was associated with employee help-­ seeking outcomes. Methods: We used a retrospective one-­ group study to analyse secondary deidentified ISP interactive counselling dialogue (written communications between the ISP counsellor and ISP user) (time frame 2009–2019) from 5922 healthcare employees at 15 US workplaces. Help-seeking outcomes included referral requests, commitment to mental health services and improved willingness to seek mental health services. Key exposures included counsellors’ use of MI techniques. Results: 45% of ISP users scored in high distress on their ISP screening. Among ISP users in high distress, over 25% engaged in ISP dialogue and 63% of those who engaged in dialogue requested a referral. Bivariate analysis showed ISP users more likely to request referrals included women, younger employees, those with higher distress levels and those not currently receiving mental health services. Counsellors’ use of the MI technique, asking questions, was associated with approximately three times the odds of requesting referral (OR=3.12, p<0.001), higher odds of service commitment (OR=2.18, p<0.001) and improved willingness towards services (OR=2.21, p<0.001), compared with no questions asked during ISP dialogue. Asking questions also demonstrated a large effect size for all three dependent variables. Conclusion: Results support the use of the MI techniques, especially asking questions, with ISP dialogue to encourage healthcare employees’ mental health help-seeking.