The global economic downturn has taken a significant toll on multinational companies and their employees. Increased worker mental health and substance abuse problems lead to performance problems and, in the worst cases, increased workplace violence or suicide.
As HR professionals seek out solutions, the economy has forced many companies to cut back on the very programs and benefits that target mental health problems. The challenge is in identifying a global employee assistance program (EAP) model that can deliver much-needed resources to the workforce while demonstrating real value for the company.
The decision to purchase an EAP is complex. While the vast majority of medium and large employers in the U.S. have an EAP in place, there is broad disparity around the world about the acceptance of EAPs and whether to invest financial resources in providing them.
Some factors surrounding the decision to implement an EAP are external to employers but influence their decision-making directly. Economic forces and tax schemes can impact the richness and structure of benefits packages. In developing regions, compensation and benefits strategies focus on limiting personnel costs. Considering that EAPs are still new to many such locations, employers might not recognize an EAP as a worthwhile investment.
Moreover, in some economically developing regions, despite overall low labor costs EAP providers might charge a premium because of scarce professional resources. In such areas, EAPs might make up a larger relative percentage of total personnel costs.
In some cultures, workers might be less comfortable openly addressing personal problems or mental health concerns, particularly in the workplace. Approaches to recognizing and addressing mental illness might differ from Western norms. Therefore, acceptance of an EAP might be slow, and a formal delivery system for service might be underdeveloped.
In spite of these cultural dynamics, a growing body of research demonstrates the global prevalence of mental illness and its impact on productivity and health care costs. Simply put, these are issues that are common, drive costs for businesses, and are not being resolved solely within the health care systems. EAPs remain a cost-effective tool to help mitigate these risks.
Crafting a Global EAP
Generally, purchasers of global EAP products fall into two camps:
• Those who seek to implement a single global EAP model.
• Those who manage a series of regional or local vendors around the world.
In theory, a single vendor model for global EAP is ideal in its promise of broad geographical coverage, ease of communication, centralized account management, and standard data reporting. The disagreement is over whether multinational EAP vendors can deliver a globally scaled program that meets multinational employers’ complex needs. There are doubts that a single vendor can manage complex contractual and legal issues across international lines, and skepticism that a single central vendor can have strong knowledge of local providers, approaches to mental health care and work cultures.
To counter those limitations, decentralized EAPs are organized around many local and regional agreements with those perceived as the best indigenous providers. However, those favoring a single global provider claim this “multi-local” approach is too cumbersome and difficult to manage by a central process owner. Multiple contracts across many vendors leave room for inconsistent and inefficient global programming. Communication and coordination of services when a multinational response is needed can create problems.
The debate boils down to knowledge and resources and the “build or buy” dilemma that many employers encounter routinely. Where HR has the time, budget, knowledge and volume of employees to essentially construct their own global network, the decentralized model has benefits. However, for those who are more resource constrained, relying on a vendor’s network and oversight might be the better path.
Regardless of the vendor model, there is broad consensus around critical EAP requirements, which include:
• High-touch account management.
• Legal compliance.
• Quality local services that are sensitive to language and culture, particularly during emergencies, critical incidents, and when training is needed.
• Quality and access as priorities over cost, particularly for services in remote locations or when expatriate services are involved.
• Phone-based services should not be the only method of service delivery.
• Electronic services should be provided only by native-language-speaking professionals, preferably in the country of the EAP consumer.
• Robust web sites and promotional materials should be customized to language and culture.
• Customized data reporting should be provided.
Reporting EAP Metrics
The performance of an EAP can be measured in many ways, and the reports coming from EAP vendors vary even more. Regardless of the model of EAP delivery, HR should require standard measures of program performance from country to country—perhaps even requiring reports that are written in a manner and language suitable for the local cultures.
Many EAP purchasers report dissatisfaction with their EAP utilization reports and the need to reformat them for internal use. Most often, EAP utilization reports are merely operational metrics, providing little value to the purchaser and offering little insight into the value or outcomes of the program. To remedy these shortcomings, EAP reports should:
• Be customized for the end-user.
• Provide useful operational metrics.
• Measure the variables that matter to the customer, such as clinical outcome, the EAP’s influence on productivity, and/or the impact on disability and health care costs.
The rapid shifts in the global economy and their impact on the workforce make a carefully crafted EAP more relevant than ever. HR needs to be a discriminating purchaser to help meet the demands of a complex global market that continues to evolve. For their part, EAP vendors need to deliver on promises of a quality product that offers well-measured value on a global scale.
Dr. John C. Pompe, SPHR, is the manager of behavioral health programs at Caterpillar Inc. David A. Sharar, Ph.D., is the managing director at Chestnut Global Partners, a provider of EAP services.
A New Measure of EAP Success, SHRM Online Benefits Discipline, September 2009
EAPs Target Mental Health Parity Costs, SHRM Online Benefits Discipline, August 2009
Guide Designed to Align EAPs with Employee, Business Needs, SHRM Online Benefits Discipline, March 2009
EAPs Face Upsurge in Calls from Stressed-Out Employees, SHRM Online Benefits Discipline, March 2009