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Life has been hell for Ginette Camolinos recently.

Soon after starting a new job at a Montreal law firm, she received a call at work from her distressed daughter, who was threatening suicide. Her son was arrested on drug-related charges and was sentenced to a six-month jail term far from home. And her husband of 19 years decided to move out. It all proved to be too much to cope with alone.

Fortunately, she didn't have to. Her employer has an employee assistance program (EAP) that provided counselling for her, family and parenting sessions and medical referrals.

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She kept working through most of the tumult, crediting her EAP counsellor for providing the support she needed to keep going. "What I like about the program is not just the therapy. Sometimes you just have a question to ask an objective third party. Sometimes a few sessions is enough."

Originally conceived in the 1980s to deal with alcoholism and drug problems in the workplace, EAPs have become a feature of benefits packages in thousands of workplaces over the past decade.

They provide third-party, confidential, one-stop shopping for the mental health and stress-reduction needs of employees. EAPs offer everything from limited one-on-one or on-line counselling for stress, addiction or other health concerns to information on child or elder care; from wellness programs to help with stress and crisis management; from conflict resolution to financial and legal advice. They might even provide career counselling.

The rationale is that a well-adjusted, healthy work force will be more productive on the job than workers pushed to the breaking point. But it's estimated that on average only 6 per cent to 8 per cent of eligible employees take advantage their companies' EAPs.

That business leaders should be actively concerned about the state of mind of their employees is a no-brainer, say policy experts, who cite the workplace itself as a primary source of angst for many.

The Canadian Mental Health Association reported last year that 51 per cent of Canadians describe their work as "a major source of stress." It said workplace stress and related illnesses cost the Canadian economy $5-billion a year.

"Getting help for a troubled employee is not just a social issue or a health care issue, it's a business issue," said Karen Seward, a vice-president at Warren Sheppel Consultants Corp., a Canadian EAP provider with 2,000 corporate clients. And that's just one EAP provider of at least a dozen.

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Never mind the brownie points, lost profit is a persuasive enough argument for providing some form of support aside from the ear of stressed-out human resources personnel. It's been estimated that 14 per cent of annual profits are lost to disability and mental health costs.

Almost every sector has signed on to EAPs, from manufacturing and high-tech outfits to the public service and churches. The size of the workplace is not important, said Ms. Seward, noting her firm tailors programs to companies with as few as five employees and as many as 30,000.

In all cases, the employer foots the bill, and they are increasingly willing to do so. That's because the cost of untreated psychological and family stress in the workplace is astronomical, say human resource specialists, who are turning to EAPs to put a cap on hours and money lost.

For example, it's estimated that the cost to employers of workers who must care for a family member afflicted with Alzheimer's disease is $9-billion a year in absenteeism, early retirement and working fewer hours. The number of people affected is expected to triple within one generation -- and that's just one disease, one stressor.

According to Statistics Canada, 50 per cent of the working population now provides care to children, older family members and those recovering from illness. That costs at least $2.7-billion a year in lost time, the Conference Board of Canada's estimates.

So why don't many employees use the programs?

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Ms. Seward said usage varies a lot among industries -- though it will rarely rise to above 20 per cent of employees.

Part of the reason, she said, is that not all companies promote their programs. Many employees just don't know the EAP is there or don't know how comprehensive the program is.

As well, employees might simply not recognize they have a problem, or they might fear the stigma of admitting it and seeking help, she said.

Research from the World Health Organization suggests that "20 per cent of people will be diagnosed with depression at some point in their life but only 6 per cent will access help," she added.

There's also a persistent fear that, despite safeguards guaranteeing confidentiality, management will find out who is using the programs and the worker will be branded.

"That's why it is so critical that employees are briefed appropriately on their EAP service," Ms. Seward said.

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The employer must never know which employee uses the service and why.

"If we didn't have complete confidentiality, we'd have no trust," said Don Paré, a psychologist and former McGill University professor who heads Donancy Consultants, an EAP with 800 mental health, legal and accounting professionals across Canada.

Safeguards are built into the system. When an employee calls an EAP, the intake counsellor, who works like a taxi dispatcher, takes down the identifying information, the cleint's location and problem and gives the caller an ID number and the name of a counsellor in her area. From that point only the therapist knows the employee's name -- every one else is blind to all details but the number.

Confidentiality can be breached only if a client threatens suicide or talks about injuring someone else, and then the therapist's ethical code requires that the risk be disclosed to authorities.

Otherwise, statistical reports that mask the employees' identities are given to the corporate client, which ultimately knows what type of services were accessed by how many, but not by whom.

"Unless there is an agreement between the employee and the employer specifically," Ms. Seward insists, "an EAP will not reveal names of employees who have accessed counselling."

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How much does all this cost? About $3.40 a month for each employee, Mr. Paré said. "You can cut it back to $2.50, but you get less service."

Whether the corporate client pays an annual fee, which works like an insurance premium, or pays on a fee-for-service basis, the costs are roughly the same. "In a good program, the average number of employees using it is 6 per cent. But there are some that go up to 18 per cent," Mr. Paré said.

Research indicates that every dollar spent on an EAP saves the corporation between $5 and $8 in costs related to disability and absenteeism, he added.

A third-party auditing company is often used to make sure the EAP actually provides the services for which it bills the client -- because due to confidentiality, the employer can't ask these questions.

Occasionally, other clinicians are called in to do random checks of the counsellors' files and to interview or send questionnaires to the employees regarding program effectiveness.

The program is well worth the cost, says Rita Apa, director of human resources at the Montreal office of McCarthy Tètrault, a law firm with 804 lawyers and 1,400 employees across the country, including Ms. Camelinos.

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"Everyone, staff, administration and lawyers use it, and it's available 24 hours a day 365 days a year," Ms. Apa said. "If people have a problem, they know the program is there for them."

For example, when a young, pregnant secretary was killed in a car accident a few years ago, "there was a huge reaction. People were crying in the office. People couldn't work. No one wanted to sit in her seat."

Ms. Apa called in crisis counsellors from FGI, the law firm's employee assistance program, to deal with the grief in the office. "A psychologist came in and ran a coping-mechanisms seminar." The seminar proved to be so helpful that Ms. Apa called in the psychologist again after the terrorist attacks on Sept. 11, 2001.

Although it's widely agreed that EAPs help reduce costs and are a humane response to increasing stresses on workers and families, there can be glitches.

Counselling is short term by definition -- on average about five sessions. Thus, more complex but common problems, such as substance abuse or major depression, are outside the purview of an EAP. The EAP counsellor can see the client and make a referral, but the contact ends there.

"The clientele is quite different because it's basically a short-term concept," Mr. Paré said.

Even if a client is willing to pay out of pocket to continue with the same therapist after the EAP sessions covered by the employer, most programs nix that option. The program directors cite the possibility of a conflict of interest, such as when "the therapist needs the client more than the other way around," Mr. Paré explained.

Yet registered mental health professionals already have ethical codes that prevent them from abusing the therapeutic relationship in this way.

Restricted access to the same counsellor can be a disadvantage to an employee who needs more help. It can affect the emotional investment and connection between client and therapist -- a phenomenon called the therapeutic alliance -- and can stop or stall the healing process.

To address the possibility that the stigma so often surrounding mental illness deters people from seeking help, many EAPs have added on-line self-assessment tools to help employees identify their problems on their own.

And provider Wilson Banwell offers what it calls a "wellness companion," which is an on-line self-evaluation program created by a subsidiary of the Canadian Medical Association. The program allows you not only to evaluate your health risks, but to store personal and family health information and to access a reliable database of medical information, including drugs, tests and medical procedures.

Despite the bells and whistles -- from on-line self-evaluation, financial advice and conflict mediation to on-line therapy -- one-on-one counselling is still the most popular service.

For some employees, such as Ms. Camelinos, it can make the difference between staying in a job or leaving.

Ms. Camelinos had read the pamphlets from human resources, so she was aware of her EAP benefits when she needed them. She accessed her requisite sessions of personal counselling, and when she found that five or six sessions weren't enough, she was given a referral to another counsellor "who was great also."

Of her EAP appointed therapist, Camelinos can't say enough good things. "I found her very compassionate. She was a sounding board. She guided me, helped me, and gave me tools," and called to check up regularly, recommending books and making other therapeutic suggestions.

Ms. Camelinos received help when it was crucial; she has settled into her job at the law firm, and her family life has stabilized. "Thank God for this program." A program primer

Difficulties with anxiety, depression, stress, alcohol and drug abuse, bereavement, marital or family conflicts? Your Employee Assistance Program (EAP) will provide a limited number of face-to-face counselling sessions with a psychologist, and referrals to outside therapists and support networks.

On-line counselling services allow an employee who may be geographically isolated or simply inhibited to log on and connect with a therapist in a convenient time and place.

Tragedies or crises in the office? An EAP will provide seminars to help deal with grief as well as traumatic events.

Difficulties with weight loss or smoking? Your EAP can help with a nutritionist, a referral to a physician and a support network.

If you're a wreck over a career transition or incapacitated by jitters before major presentations, some EAPs offer courses in self-confidence, resilience and "change management."

Financial or legal worries? EAPs now include a couple of sessions with a lawyer or a financial planner.

Child or elder care concerns? EAPs can find a day care centre or school for employees' children or will complete the time-consuming legwork and telephone research required when an ailing parent needs advocacy or home care.

Health and wellness programs, aimed at everyone in the workplace, can include lunch-time seminars on nutrition or yoga and health promotion newsletters. How to use the program

Call up the toll-free number given to you by your employer in its handbook or printout on Employee Assistance Programs, also called Personal Assistance Programs.

The intake counsellor will take down your basic information, the reason for your call and the service you request (this information is not shared with your boss) and use it to hook you up with a mental health, legal or accounting professional in your geographic area who has demonstrated expertise in your problem.

Or, browse the services available to you on the EAP provider's Web site, which usually includes contact information including an e-mail address. On-line services, such as courses or counselling, can be requested. Privacy and confidentiality procedures and policies are usually posted on the Web site. How to set one up

EAP companies are usually run by mental health professionals who have moved to providing corporate services after years in private practice or the public sector. The programs come as packages that are ready to implement or can be customized to suit a particular workplace.

For a list of accredited EAPs, contact the Employee Assistance Professionals Association at eap-association.org or 703-387-1000. -***** -*****

Correction

A list of organizations accredited for employee assistance programs is available through the Employee Assistance Society of North America at or 312-644-0828. Incorrect information appeared in Globe Careers on Dec. 11. Monday, December 16, 2002, Page A2)

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