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That request can be made at a job interview or 10 years into employment, she says. While Boswell acknowledges there is still a risk of being stigmatized, many employers feel more upset when they are kept in the dark and don’t learn about an illness until it has become a major problem.
Footing the Bill
Paying for mental healthcare is a significant issue for both patients and their employers. And that cost may keep those who need treatment from getting it. Harrison says Utah has some of the highest mental health deductibles in the nation. If people are unable to pay for proper mental health treatment, many will resort to “Band-Aid” fixes to get by.
For example, many employers would rather send an employee with dysthymia to get Prozac instead of paying $120 an hour for cognitive behavioral therapy (CBT) with a psychologist, Harrison says. Medications are not effective for all, or even a majority of patients, and getting good treatment can be key to getting permanent positive outcomes, instead of a quick fix.
Parity laws have made it so employers must cover mental health at the same level as they cover other illnesses, unless they choose not to provide mental healthcare at all, Glather says. That’s an option too many business people have taken, she says, because they don’t understand that in the long run, untreated mental illness will cost them more than thorough insurance coverage.
“It makes good business sense to care about mental illness,” she says.
Many companies in Utah participate in Employee Assistance Programs (EAPs), which provide free counseling and other mental health services to employees. “EAPs have been around for a long time, but their importance is just being recognized,” says Terry Flint, director of employee health services at Intermountain’s Employee Assistance Program.
Under these programs, counseling is available to all employees and their immediate family members. EAPs also include crisis services that provide immediate help in the aftermath of a workplace accident or death of an employee
Flint says she thinks one of the most important ways EAPs have changed mental health services is by normalizing counseling. Intermountain tries hard to remind managers of the programs in place. “We advertise to say, ‘Come when you’re stressed, before you’ve gotten really ill.’”
And she says EAPs are seeing good results, with 30.7 percent of people who come for counseling reporting they had “much improved” the highest rating—function at work—and 37.9 percent saying they would have missed three or more days at work had the counseling not been available. Additionally, 40.2 percent say their home life is “much improved” after EAP help.
However, EAPs have their drawbacks. While Employee Assistance Programs provide valuable help to those who may not have had it before, Harrison says they ultimately are linked to the employer, and so their first loyalty is to the company not the patient.
“Their job, then, is to keep you functioning in your job and get you back to work as soon as possible instead of treating you. They’re trying to save corporate America money instead of trying to treat you,” he says. “I’m glad EAPs exist, but they are looking at can you go back to work, not what is the problem, or is the job the problem?”
A Dose of Compassion
Beyond providing comprehensive coverage, Glather would like to see employers be more understanding if someone does experience a mental health problem. This takes a lot of communication and trust between an employer and employee, but she says it’s ultimately mutually beneficial.
She gives an example of a NAMI employee with depression. The employee missed work without calling, so coworkers went out to visit this person only to find the person was having a crippling depressive episode. With proper help and care, Glather says her employee was back at work quickly.
Too many employers would rush to fire such an employee, but Glather says that’s a mistake. The cost and time lost of hiring and training a new employee is greater than proper care for the current employee. And being concerned and helpful is just the right thing to do, she says.
Employers should also choose to see the qualities that come from someone’s mental illness as a benefit, rather than liability. Harrison says because of depression, someone may be more compassionate and is an asset to the company in that way.
Flint hopes that more people talking about mental healthcare in the workplace will make others feel more comfortable talking about mental illness and seeking help. Having a safe working environment where people are not afraid of being stigmatized helps everyone.