May 8, 2012

How Behavioral Health Benefits Work Together

An effective behavioral health program should include an integrated mental health/chemical dependency benefit that includes inpatient and outpatient services as well as an EAP. This combination of relatively low-cost benefits provides a "safety net" for the wide range of behavioral disorders suffered by a worker population and its dependents. But a behavioral program's effectiveness relies on (1) employee and employer awareness of the program's services and value, (2) appropriate use of the benefits, and (3) how well the behavioral vendor and its network providers prevent and manage costly disorders.
Even when people access their behavioral benefits by calling for a referral, the "presenting symptom"—such as the need for divorce counseling—is often the tip of the iceberg.
A typical example is "Jim"—recently divorced, he is having excessive difficulty adjusting to the situation. Jim calls his MBHO and is asked a series of questions to ensure he receives a referral to appropriate services. Jim is referred to a specialist in marriage and family therapy (MFT). After an initial assessment the therapist determines that his patient is experiencing adjustment disorder with depressed mood. As therapy progresses, additional factors come to light. The therapist finds out that the primary reason for the marital breakup was financial—apparently Jim had been—and still is—abusing cocaine and depleting the couple's bank account to support his habit. The therapist calls the MBHO, and the licensed professional who takes the call refers Jim into a chemical dependency intensive outpatient treatment program. The MBHO case manager also recommends Jim use his EAP benefit for financial counseling. Fortunately Jim had access to a full behavioral program, because each one of his behavioral benefits was essential to a successful recovery.
Even seemingly obvious EAP situations, such as a need for referral to childcare, can turn into a need for more extensive mental health benefits. Often individuals will begin EAP counseling for this type of situation only to run out of visits. Take a look at how this can occur:
"Mary," a production worker in a large manufacturing plant, is divorced and the mother of two children, ages three and six. She is living paycheck to paycheck and works from 7:30 a.m. to 4:30 p.m. Monday through Friday. She has her childcare down to a "science." Before work she drops off her three-year-old at a day care facility near her house, then swings by school to drop off her six-year-old. Mary enjoys a reputation as a loyal, dependable and productive worker. Suddenly Mary begins coming into work late, is frequently absent and the quality of her work slips. When her supervisor confronts her, she breaks down in tears, confessing that her three-year-old has a recurring illness and the day care center will not watch her. She's been relying on the goodwill of neighbors, which is often sporadic. The supervisor recommends that Mary contact her EAP for a referral to a childcare facility that takes sick children, which she does. But her childcare issues are only the tip of the iceberg. Because Mary's an hourly employee and has missed work, her income has fallen and she is behind on her rent and other bills. In addition, the new childcare facility is expensive and adds to her financial problems, compounding her stress. She contacts her EAP, receives a referral to consumer credit counseling and also makes an appointment for emotional counseling because she is deeply concerned about both her daughter and her job. She forges a bond with her counselor and begins making progress.


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