1006 HR Magazine: EAPs for a Diverse World

Employers that provide culturally competent employee assistance programs show employees they care. 

Back when they started in the 1950s, employee assistance programs (EAPs) focused largely on alcoholism and mental health. But over the years they have evolved into one of employers' most comprehensive benefits.

In fact, EAPs now help employees handle such broad-ranging issues as legal problems, elder care, domestic violence and more.

"We're here 24/7, 365 days a year," says Zachary J. Meyer, senior vice president of Ceridian Corp.'s LifeWorks commercial division, which provides work/life services to 38,000 employers in different industries and 10 million individuals worldwide.

The importance and prevalence of this benefit in the American workplace is reflected in the Society for Human Resource Management's 2006 Benefits Survey Report, which found that 70 percent of responding employers offer an EAP.

Today, EAPs are being asked to evolve in new ways, ones that involve not only what they offer, but how they offer it. It is a change born of the demographic revolution taking place in this nation.

According to the 2000 Census, approximately 30 percent of the U.S. population belongs to a racial or ethnic minority group. The Census Bureau projects that by 2050, minorities will represent 40 percent of the U.S. population.

This growing diversity is bringing forth new needs among employeesincluding a need for information to address and take into account a wide variety of cultural experiences and perspectives.

For both employees' well-being and employers' bottom lines, it makes sense for employers to provide EAPs that are more culturally competentwhich means they refer workers to the most culturally appropriate providers. To do this, EAP counselors and case workers must take into consideration a range of characteristics about the employee, such as age, gender, race, religion and sexual orientation.

Putting Employees' Problems in Context

A culturally competent EAP can have a positive impact on employees' well-being and productivity by providing workers with a range of services related to work, personal, health, social and economic issues.

These issues can have distinct implications for minorities and in the way that EAPs serve them.

For example, although health indicators such as life expectancy and infant mortality have improved for most Americans, minorities experience a disproportionate burden of preventable disease, death and disability compared with non-minorities. According to the National Hispanic Medical Association, Hispanics are 1.5 times more likely to get diabetes than non-Hispanic whites and have a 40 percent higher death rate related to the disease. (For more information, see " Challenging Diabetes" in the June 2006 issue of HR Magazine.)

And the Centers for Disease Control and Prevention notes that Asian Americans with mental health issues are only 25 percent as likely as whites and 50 percent as likely as blacks and Hispanics to seek outpatient care.

These factors can result in lost workdays, declining work quality and spiraling health care costs for employers. Providing access for minority employees to a culturally competent EAP can help minimize these costs.

"A company's bottom line can definitely be affected by this, especially smaller companies," says Lesley Morgan, a senior manager with Business Health Services, a Baltimore-based EAP provider that focuses on workplace wellness and behavioral risk management solutions designed to reduce human capital costs, reduce organizational risk and loss, and support overall corporate wellness.

More Than Mere Translation

Mary Vasquez, president and CEO of Gurnee, Ill.-based VMC Behavioral Healthcare, which covers some four million people, says cultural competence is "the ability to understand and respond effectively to the cultural as well as linguistic needs of individuals and families.

"The changing dynamics of the workforce puts a renewed emphasis on the need to deliver culturally competent services, and this goes beyond just offering bilingual services," Vasquez says.

Indeed, language alone does not define an EAP counselor as culturally competent, notes Beth Remus, whose Chicago-based consulting firm Remus and Associates specializes in health care accreditation, quality improvement and cultural competence.

"Both a counselor and [worker] may speak Spanish, for instance, but the [worker] may be from a country with beliefs and values unfamiliar to the counselor," explains Remus, a registered nurse with advanced degrees in health care and other disciplines.

"Counselors must understand their [clients'] beliefs and practices, be able to demonstrate respect and caring within the context of the relationship, and provide culturally appropriate recommendations and actions without letting their own beliefs impact the worker," says Remus.

Gauging Cultural Competency

So what steps can HR professionals take to ensure greater cultural competency from their organization's EAP?

The first step, says Marina London of the Employee Assistance Professionals Association, is to make sure EAP professionals working with employees in need are properly educated, trained and credentialed.

To become a Certified Employee Assistance Professional (CEAP), counselors must meet certain experience requirements and pass a rigorous written exam, says London, who holds the certification.

Meanwhile, there are several hallmarks of a culturally competent EAP, according to Meyer and Vasquez.

They recommend seeking EAP providers that:

• Offer a culturally diverse provider network. For instance, Business Health Services EAP has a national network of licensed counselors and health educators, and the company works with partners to provide businesses with expertise on cultural competency issues "on a case by case basis," says Morgan. "We often work in partnership with our clients and others to recruit the clinicians to meet a particular need."
• Have counselors who are as knowledgeable as possible of the history, language, norms, traditions, beliefs and culturally influenced health behaviors of the cultural groups in your workplace.
• But counselors also should be able to acknowledge their potential limitations in understanding aspects of an employee's culture and language, and should encourage employees to let them know if they are unknowingly doing something that is upsetting.
• Have intake specialists ask employees if they would prefer to work with a certain type of counselorone that is Hispanic, black, female or homosexual, for instanceand encourage counselors to develop an initial rapport with employees.
• Offer "self-awareness" testing for their intake specialists to make them aware of any cultural biases they might have that might affect their interactions with employees. (For more information, see " Detecting Hidden Bias" in the February 2006 issue of HR Magazine.)
• Provide promotional materials that reflect the cultural fabric of your workforce and are willing to work with you to ensure that all benefits and educational materialsincluding wellness and disease management informationare distributed in multiple languages and visually reflect a diverse workforce.

Lasting Results

Vasquez says organizations must understand that becoming culturally competent is an ongoing process for EAPs, but the effort can produce lasting results for employers.

"You can often see it in the morale. People are happy to work for a particular company because they feel someone cares about themwho they really are. That's a benefit that can't be measured in dollars and cents."