Surveying
Global EAP Trends
September 2006
Agenda
 Themes and Trends
Andrew Davies, Managing Director
ICAS Southern Africa
 Globalizing EAP Services
Janice Lenehan, Worldwide Director, EAP
Johnson & Johnson
 Discussion
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About the Independent Counselling & Advisory Services
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Established in 1987 in the United Kingdom
Extensive global experience in the field of behavioural risk management
Currently operating in 18 countries spanning all continents
Combining global strength with local knowledge and expertise
Multinational partnerships with world class companies
Covering 980 organisations and more than 1.5 million employees
ICAS Southern Africa
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Established in 1999
140 employees servicing 180 organisations and 350,000 employee lives
2nd largest in the ICAS International Group
Large infrastructure with extensive local and continental knowledge and
capacity
Strict adherence to global standards and ethics
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The South Africa Context
 A culturally diverse, middle-income developing country of 50 million
people
 A mix of 1st and 3rd world, with a large discrepancy between rich and poor
 Rapid social, political and economic transformation post-1994
 Increasing global competitiveness and a 4.9% economic growth rate
 Limited and inadequate community resources
 A young democracy grappling with:
• Rapid growth and radical change
• High incidence of violence, crime and trauma
• Rampant HIV/AIDS infection rate
This impacts negatively on the lifestyles of individuals, resulting in
high levels of stress, fear and uncertainty, heightened levels of
insecurity, and dysfunction.
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Core Components of an ICAS-SA EAP
The South African context demands EAPs that are comprehensive and capable
of addressing the complex range of issues and challenges confronting South
African society.
15%
Employee
25%
Managerial/Supervisory
Senior Management
COMPANY EAP
Not Given
15%
45%
Behavioural Risk
Management Audit
Counselling
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Practical
Assistance
HIV/AIDS &
Health
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Trauma
Management
ICAS EAP Themes and Trends
 65,000 cases managed per year
 Average EAP utilisation rate: 18.7%
 Utilisation rates are highest in the insurance sector, lowest in
the government sector:
Industry Sector Breakdown
Education
Finance
Goverment
Health
Hospitality
Industrial
Insurance
Media & Technology
Not classified
Parastaltatal
Regulatory
Retail
Security
Staffing
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EAP Needs Analysis Ranking (n= 38,000)
0%
5%
10%
15%
20%
25%
30%
Relationship Issues
Traum a
Legal
Loss Issues
Money Managem ent
Stress
HIV & AIDS
Childcare
Depression
Substance Abuse
South African employees’ ranking of critical issues that the EAP should address
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35%
Demographic Trends
Gender Utilisation
♂
♀
31%
Preponderance of
female users
Male
Female
69%
Language Utilisation
8%
15%
1%
1%
5%
1%
English
Sotho
38%
Afrikaans
English
Other
Sotho
Tsonga
Tswana
Venda
Xhosa
Zulu
29%
2%
Utilisation by Age
9%
8%
1%
32%
31-40
15%
19-30
31-40
41-50
51-60
61-70
Not Given
35%
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African Languages:
54%
English: 38%
Afrikaans: 8%
67% of EAP
service users are
under 40
EAP Service Utilisation
10%
7%
12%
71%
4%
Counselling
Legal Assistance
Money Management
Family Care
7%
Supervisory/Managerial Referral
Self Referred
Other
89%
The overwhelming majority of cases managed are self-referred
employees seeking counselling support.
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EAP Problem Incidence:
Emotional and Practical
0%
5%
10%
15%
20%
Relationship Issues
Traum a
Legal
Loss Issues
Money Managem ent
Stress
HIV & AIDS
Childcare
Depression
Substance Abuse
Note: Low incidence of eldercare
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25%
30%
35%
EAP Problem Incidence: Physical Health (Top 20)
0%
5%
10%
15%
B ack Pain
Head ache
Hayf ever
Hig h B lo o d Pr essur e
D ep r essio n
Hear t b ur n
Sleep D iso r d er s
HIV & A ID S
Elevat ed C ho lest er o l
A st hma
A nxiet y
IB S
C hr o nic F at ig ue
Ecz ema
D iab et es T yp e 2
C o r o nar y Hear t D isease
D iab et es T yp e 1
R heumat o id A r t hr it is
Ost eo ar t hr it is
Inf er t ilit y
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20%
25%
Trauma Cases
0%
5%
10%
15%
20%
25%
Arm ed robbery
Carjacking
Assault
Rape
Violence
Hom icide
Fam ily Murders
Critical Incidents
Kidnapping
Cash in transit heist
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August 2006:
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154 cases of armed robbery
61 cases of carjacking
32 cases of assault
45 rapes
49 cases of violence
9 homicides
3 family murders
2 kidnappings
54 cases of domestic violence
82 other trauma cases
Also:
 140 HIV cases
 200 bereavement cases
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30%
ICAS-SA Local EAP Model
BRM Audit
HIV & AIDS Audit
Health Risk Assmnt.
}
To measure &
understand risk
PROACTIVE
ENGAGEMENT
Stress Innoculation
Healthy Living
Disease Management
}
To educate and
build resilience
GENERAL
INTERVENTION
EAP (on- and off-site)
Coaching
Health Screening
}
To reactively
manage risk
(24/7/365)
TARGETED
INTERVENTION
Trauma Mngt. Program
Resilience Training
Risk Countermeasures
}
To proactively
attenuate risk
(where indicated)
ASSESSMENT
(Indv. & Organization)
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“Every day in Africa a gazelle wakes up. It must run
faster than the fastest lion or it will be killed.
Every morning a lion wakes up and knows it must
outrun the slowest gazelle or it will starve to death.
It doesn’t matter whether you are a lion or a gazelle …
when the sun comes up you had better start
running.”
-Anonymous
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Questions
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Globalizing EAP Services
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 World’s leading healthcare products corporation
• 2005 sales of $50 billion; $100 billion by 2010
• 220 operating companies in 57 countries selling products in
virtually every country worldwide
 Three business segments:
• Consumer (17%)
• Medical Devices/Diagnostics (36%)
• Pharmaceutical (47%)
 120,000 employees worldwide
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55,000 in United States
40,000 in Europe/Middle East/Africa
15,000 in Asia Pacific
10,000 in Latin America/Caribbean
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Business Segments
Consumer
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Medical
Devices/Diagnostics
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Pharmaceutical
Healthy People, Healthy Planet, Healthy Business
Healthy People
Employee
Health
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Workplace
Safety
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Making the Business Case: Healthy People 2005
Improving Employee Health Outcomes
# Employees at Risk
20,000
15,000
8,740
17,940
Avoided Cost: $9.2MM
17,480
10,000
5,000
8,740
0
6,440
5,520
Smoking2,300
Tobacco Use
4,600
Blood Pressure
Above 140/90
J&J 1999 Health Risk Status
3,680
Cholesterol
Above 240
Inactivity
Less than 4 days/w k
30 mins/day
J&J 2005 Health Risk Status
Data extrapolated to J&J average population of 46,000 EE
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Health and Productivity Link
• Depression (WHO)
• 200 million days lost ($30-$40 billion)
• Leading cause of disability globally
• 4th leading health burden affecting humanity: 450 million people afflicted
with mental health disorder
• 1MM suicides annually; 20MM attempts
• Heart disease and stroke
• 50% of deaths (12 million annually) can be avoided
• Reduce major risk factors: high blood pressure, high cholesterol,
obesity, smoking
• Smoking related illness and premature death
• $92 billion in lost productivity
• Obesity
• Medical cost and lost productivity: $99 billion annually
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Main Causes of Death
Worldwide, All Ages, 2005
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The Threat Is Growing
Projected Global Deaths Over Next 10 Years (%)
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Workforce Challenges
 Mental health/stress-related disorders – two of the leading
causes of illness, disability, impaired productivity
 Speed of change
 Job demands/technology
 Work/family balance
 Globalization
 Complex social, economic, and political environments
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Multinationals With Global EAP
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Alcoa
American Express
Anheuser Busch
Chevron
Dow Chemical
DuPont
Exxon
FedEx
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Ford
General Electric
General Motors
J.P. Morgan Stanley
Kimberly Clarke
Novartis
Proctor and Gamble
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Local Considerations for Service Delivery
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Lack of regulation
Appointment scheduling
Costly
Limited expertise in workplace psychology
Inability to coach and support supervisors/managers
Lack of familiarity with J&J policies, guidelines, protocols,
and resources
No follow up with company regarding potential safety issues
or modified return to work
Community mental health providers do not consider the
corporation their “client”
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Global Health Objectives
 Develop worldwide programs and services addressing
employee well-being, including:
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Absence management
Employee assistance
Wellness and health promotion
Occupational health
 Provide injury and illness preventive strategies for
employees worldwide
 Support delivery of global health services
 Identify health standards with local consideration
 Establish performance metrics for the global health
community
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Employee Assistance Contributions
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Employee engagement and loyalty
Recruitment and retention of best talent
95% of Fortune 100’s provide employee assistance
Prevention and early intervention relieve employee
and organizational suffering
 Return on investment pre- and post-EAP ($4K per
person; $6MM in U.S. annually):
• Absence – decreased in 96% of EAP users
• Productivity – increased in 90% of EAP users
• Mental health status – improved in 78% of EAP users
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Employee Assistance
 24/7 confidential problem assessment, counseling, and referral
• Identification of qualified professionals and local resources
• Face to face, telephonic; on-site, off-site
 Education and awareness training
• Resilience, work/family balance, conflict and time management
 Management consultation and coaching
• Support for organizational change, complex employee concerns
 Critical incident stress management debriefing
• Natural or man-made disasters, terrorism, downsizing, traumatic death
 Organizational behavior risk analysis
• Stress audit to identify vulnerable employees/work units
 Trend identification and reporting
• Primary concerns of workforce
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The Process of Globalization
 Address challenges of decentralization
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Conduct Gap Analysis
 Demonstrate value and gain consensus of regional HR
councils
 Utilize existing J&J contacts (Operations, HR, Safety)
 Focus on business case; J&J focus on employee health
 Identify vendors
 Partner with Strategic Sourcing on RFPs
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Thorough investigation – call center visits; reference checks
 Establish relationships with existing vendors
 Create mechanism for global reporting
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Lessons Learned
 Build relationships with operating company
management based on trust; recognize what being
from “Corporate” means.
 Identify the most predominant workforce issues.
 Become familiar with socioeconomic, geopolitical,
and cultural context.
 Understand health prevalence trends and availability
of resources.
 Customize based on local culture.
 Ensure dedicated partners exist at each vendor.
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Lessons Learned (cont.)
 Educate and update continuously–vendors and
internal partners.
 Recognize that the real work begins after the
contracts are signed.
 Create a network of company stakeholders to
ensure sustainability.
 Promote the value of management consultations.
 Identify meaningful outcome measurements.
 Laud successes and inspire healthy competition.
 Create a personal definition of success.
 Prepare to be surprised.
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Then and Now
 December 2004
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10% of co’s OUS with services
No oversight of services
No international network of J&J EAPs
EAPs working in isolation
Absence of global report
 July 2006
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30% of co’s OUS with services
Corporate support of services
Quarterly international telephone conference
First international summit May 2005
Global report template
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Next Steps
 Continue to “Think Globally, Act Locally”
• Provide global standards/guidelines/policies
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Local administrative programs/procedures
 Build from existing programs
 Broader scope–reactive to proactive
 Provide guidance as to the “what” and not always the
“how”
 Health & Safety woven in business statements
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“The health of the organization is inseparable
from the health of the employees.”
- Russ Deyo, VP & General Counsel to the
Chairman
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Discussion
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Resources
 Janice Lenehan
jlenehan@corus.jnj.com
(732) 524-3139
 Andrew Davies
adavies@icas.co.za
+27 (0)11 380 6808
 World Health Organization
www.who.int
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