Leading EFAP Trends in Canada: Numerous Issues are Driving Changes

By Barb Veder, MSW, RSW


Over the past few years, there have been significant workplace changes in both mental health and in the role of Employee and Family Assistance (EFAP) programs in Canadian organizations. Recent developments in technology, changing attitudes and opinions of the public and employers, a 24/7 work culture, and other factors have pressured businesses to improve upon behavioral health and workplace well-being services for their employees. In Canada, nine basic themes have been driving these changes, areas that I will discuss in the remainder of this article:

* There is greater awareness about the importance of mental health among both the general public and business leaders.

Only one-third of individuals who need mental health-related services in Canada will receive treatment. As a result, great efforts have been made to increase awareness and promote the open discussion of mental health. Case in point, the Toronto Globe and Mail’s “Breakdown: Canada’s Mental Health Crisis” is a popular report that matches investigative journalism with human interest stories on mental health (Globe and Mail 2016).

Canadian speed skater and cyclist Clara Hughes discusses the importance of mental health during Bell Canada’s annual mental health initiative and Bell’s successful “Let’s Talk” campaign. While Bell has been a prominent leader in promoting mental health in the workplace, other companies are taking their own unique approaches. One such organization, The Great West Centre for Mental Health, provides free public resources to increase the knowledge and awareness of psychological health in the workplace, which turns knowledge into action with practical strategies and tools for employers (GWLCMHW 2016).

* Anti-stigma and social change campaigns for men’s mental health are emerging.

Men often delay seeking help for mental health issues like depression due to perceived stigma and gender norms. Organizations such as the Movember Foundation are committed to addressing men’s physical and mental health and actively supporting programs for social change, which are increasingly being driven by digital technology.

For example, the foundation has funded Queens University’s “The Caring Campus: An Intervention Project.” This led to the creation of an app to help male students’ self-monitor changes in substance abuse patterns and access resources for support (Movember 2016). It’s important to note that these “e-mental health solutions,” including online resources, social media, and mobile phone apps, are continuing to grow in popularity as tools to help males overcome stigma and access the proper mental health supports.  

* The voluntary 2013 National Standards for a Psychologically Safe Workplace is having an impact on employers.

Championed by the Mental Health Commission of Canada (MHCC), in collaboration with the Bureau de normalisation du Québec (BNQ) and CSA Standards, the National Standards for a Psychologically Safe Workplace (i.e. the Standard) was developed in 2013 to also help protect employees from psychological harm in the workplace and to promote psychological well-being.

Benefits to employers include reduced absenteeism, short‐ and long‐term disability costs, turnover, and risk of legal issues related to psychological harm to employees; enhanced recruitment and reputation as a favorable place to work; higher levels of employee engagement, creativity, and innovation; and lower rates of error and physical injury (Psychologically Safe Workplaces 2011).

To assess the impact of adopting the Standard, a three-year research study will document the progress of 40 organizations across the country. Led by Dr. Merv Gilbert of the Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, at Simon Fraser University, the study will commence in early 2017. The outcome will help identify successful practices, formulate programs, and develop educational tools and processes to help other organizations adopt the Standard and promote mentally healthy workplaces. 

Interim results are already promising, as early findings are suggesting that:
* An overwhelming 80% of participating organizations have already reviewed or updated their policies to account for psychological health and safety in the workplace;
* Nearly two-thirds (67%) already have a policy statement on psychological health and safety; and over 60% are taking action to create respectful workplaces, enhance psychological health and safety knowledge among workers, support work-life balance, provide stress management training, and build resilience among workers (GWLCMHW 2015).

* New university certifications pertaining to mental health are emerging.

Canada is also seeing select colleges and universities begin to offer courses on psychologically healthy workplaces, such as the University of Fredericton’s online certificates in psychological health and safety. Developed by Dr. Joti Samra, R. Psych., with the support of Great-West Life’s Centre for Mental Health in the Workplace, the Canadian Centre for Occupational Health and Safety, and the Mental Health Commission of Canada, these certificates are helping today’s leaders address potential negative psychosocial factors in the workplace and supporting employees who are experiencing mental health issues (University of Fredericton 2016).

EFAP providers are also joining forces with highly regarded educational institutions to push the mental health envelope. The Workplace Mental Health LeadershipTM certificate program, developed by Morneau Shepell in partnership with Bell Canada Mental Health and the Anti-Stigma Research Chair and Faculty of Health Sciences at Queen’s University, represents the first certification of its kind in Canada.

The program uses evidence-based and industry best practices (including the previously mentioned Standard) to help participants grasp the legal, ethical, and business concerns for mental health in the workplace. The program also supports the development of empathetic and solution-focused leadership skills, which can be transferred to a variety of professional settings and situations.

* Interest in, and use of technology to access mental health and educational services, is increasing.
As mentioned, Canadians are increasingly turning to their computers, tablets, and smartphones to access information and assistance about their health concerns. The benefits of visiting a website, using an app, or accessing online health services such as e-counselling, video counselling, or text messaging to access support are numerous. They include around-the-clock accessibility, anonymity, easy navigation of services, the ability to overcome barriers to traditional in-person treatment, and the ability to cater to learning differences and various lifestyles.

A research study by Morneau Shepell found that these benefits, along with 18 to 30-year-olds’ adoption of digital modes to gather information, is driving a shift in EFAP usage patterns across the country. It’s been proven that EAP providers who rely on digital technologies are better able to attract this younger, historically more difficult to engage demographic of EFAP services (Veder et al, 2014).

* EFAP providers continue to offer work/life and physical wellness services in addition to mental health counseling.

Business doesn’t stop at 5 p.m., so it’s no surprise that many people are currently experiencing high levels of stress, fatigue, and depression (WHO 2015). What may be surprising, though, is their inability to access treatment. Faced with a lack of available resources, limited access to professional help, prevalent stigma around mental illness, and/or insufficient benefit coverage, those suffering often aren’t able to receive the care they need. For this reason, many EAP providers are now including behavioral, mental health, and work/life services in their employee assistance offerings.

Programs such as Morneau Shepell’s Depression Care counseling—based on Cognitive Behavioral Therapy —help people develop the skills and resilience to recover from, or manage, depression. Studies show that employers who add these types of program to their EAPs can see a 4.8 to 1 return on their investment, proving that not only can they help their people break down the barriers of seeking support, and get healthier and higher performing employees, but it also makes good business sense (Veder et al. 2016).

* EAP business partnerships between vendors in the US and Canada are serving clients in both countries.

We’re also seeing an increasing trend among multinational corporations toward vendor consolidation. This arrangement allows for simplified procurement and administration processes, as well as increased purchasing power through greater economies of scale—leading to lower costs for EAP services. Such partnerships help harmonize benefits across borders, leading to the enhancement and greater consistency of employers’ employee value proposition on a global basis. Even within the mid-market segment, more and more companies have business activities that span both countries, with local employees in each jurisdiction. 

As such, EAP providers are increasingly required by organizations to provide a consistent level of access and support to individuals regardless of where they live. Therefore, multinational and global players are able to leverage their existing proprietary infrastructure (i.e., call centers, networks, account managers, etc.) and local market expertise. Conversely, for EAP providers with purely domestic operations, there is a need to cooperate (whether it’s through qualified referrals, sub-contracting, or more formal partnership agreements), to not only win new business, but also retain existing clients. 

* Collaboration is increasing between EAP providers and union or employee peer support groups to offer mental health crisis assistance and trainings in the workplace.

Peer support groups and EAPs can complement one another by providing different, though necessary support services during incidents or crisis situations in the workplace. Common in industries like mining, aviation, rail transportation, and major manufacturing; non-clinical mental health initiatives involve bringing individuals together who have shared similar experiences.

These peer support groups, facilitated by EA professionals, can raise individuals’ efforts in dealing with the challenges they face (Van Den Bergh and Hoffman 2012). They also augment traditional clinical care, and are growing in popularity across Canada (Speakers’ Spotlight 2016). 

* Better integration between disability management and EA professionals ensures a more effective return to work for employees on leave.

It takes an entire team—including case managers, physicians, nurses, return-to-work coordinators, HR staff, rehabilitation specialists, mental health practitioners, supervisors, and others—to help employees on disability return to work. Increasing numbers of employers are integrating their employee assistance and short-term disability programs to better manage risk.

These programs work together to better understand the underlying and often interrelated behavioral and mental health aspects of disability claims, and to provide additional information and supports as early as possible. A combined program has the unique ability to be planned and implemented specifically to address issues along the entire continuum of health—from prevention through to recovery (Morneau Shepell 2016a). Some EAP providers have taken this idea one step further by creating specialty return-to-work programs to ensure that their case managers are “best-in-class.”

Summary
As we’ve seen, new legislation and certification, an increased demand for digital solutions, further acknowledgement of good mental health as a driver for business success, greater collaboration among EAP providers and vendors, and better integration among employee wellness and disability programs are just a few of the forces driving changes in EAP offerings across Canada.

As we move into 2017, we expect these trends to continue as mental health in the workplace remains a focus and business priority—both for employers and their employees.

Barb Veder is the Vice President of Clinical Services and Research Lead with the Canadian-based Morneau Shepell, considered a leading pioneer in delivering alternative EAP counseling modalities. Contact Barb at bveder@sheppell.com. 

References

Globe and Mail. (2015). Breakdown: Canada’s mental health crisis. Retrieved from http://v1.theglobeandmail.com/breakdown/

Great-West Life Centre for Mental Health in the Workplace. (2015). Psychological health and safety case study articles. Toronto, ON, Canada: Author.  Retrieved from https://www.workplacestrategiesformentalhealth.com/psychological-health-and-safety/psychological-health-and-safety-case-study-articles-october-2015

Morneau Shepell. (2016). Absence and disability management. Toronto, ON, Canada: Author.  Retrieved from http://www.morneaushepell.com/ca-en/absence-and-disability-management

Movember Foundation. (2013). Mental health funding. Toronto, ON, Canada: Author. Retrieved from https://ca.movember.com/news/view/?id=5705

Psychologically Safe Workplaces. (2011). National standard of Canada for psychological health and safety in the workplace – backgrounder and FAQ. Ottawa, ON, Canada: Mental Health Commission of Canada.  Retrieved from http://www.psychologicallysafeworkplace.ca/workforce-standard-backgrounder.pdf

Speakers’ Spotlight. (2016). Stéphane Grenier. Retrieved from http://www.speakers.ca/speakers/stephane-grenier/

University of Fredericton. (2016). Psychological health & safety in the workplace. Fredericton, NB, Canada: Author.  Retrieved from http://www.ufred.ca/online-programs/school-of-applied-occupational-health-specialties/centre-for-psychological-health-sciences/online-certificate-programs/online-certificate-in-psychological-health-and-safety/

Van Den Bergh, N., & Hoffman, C. (2012). Emerging trends for EAPs in the 21st century. New York, NY: Routledge.

Veder, B., Tian, A., Beaudoin, K., Bettencourt, L., Dunmarra, K., Fasciano, Y. ,Jankowski, H. (2014). Online EFAP service offerings: Re-examining user demographics and access patterns.  Toronto, ON, Canada: Morneau Shepell. Retrieved from http://www.morneaushepell.com/sites/default/files/documents/3187-online-efap-service-offerings-re-examining-user-demographics-and-access-patterns/8611/reportmorneaushepelldigital-research1114_1.pdf

Veder, B., Dunmarra, K., Bettencourt, L., Bourgeois, L., Wittes, P., & Fasciano, Y. (2016). Depression care: Helping employers help employees. Toronto: Morneau Shepell. Retrieved from http://www.morneaushepell.com/permafiles/63527/depression-care-helping-employers-help-employees.pdf 

Wang, J., Ho, K., Attridge, M., Lashewitz, B.M., Patten, S.B., Marchand, A., Merali, Z. (2006). Preferred features of e-mental health programs for prevention of major depression in male workers: Results from a Canadian national survey. Journal of Medical Internet Research, 18(6):e132. doi:10.2196/jmir.5685

World Health Organization. (2015). Mental disorders. Geneva, Switzerland: Author. Retrieved from http://www.who.int/mediacentre/factsheets/fs396/en/