Cutting out stress

The associated costs of an employee suffering from untreated stress is greater than one might think

Story by Lee Marie Reinsch

ASK THE NEXT 10 PEOPLE YOU SEE: “Does your job stress you out?”

Chances are pretty good you’ll hear “yes” more often than “no.”

With most Americans spending more time with their coworkers than they do their families, it’s really no huge shock that workplace stress exists. The World Health Organization called it a worldwide epidemic way back in 1992, and the U.S. Occupational Safety & Health Administration has deemed it a workplace hazard.

One area physician ranks it right up there with toxic chemicals, loud noise and dangerous equipment because of the havoc it can wreak on the body.

Cortisone and adrenaline, the two main hormones the body releases during times of stress, combine to increase the likelihood of problems with heart health, weight gain and depression, said Dr. Brian Harrison, occupational medicine physician with Menasha-based Affinity Health System.

“Stress is getting worse and it’s not likely to be getting any better,” said Harrison, who works with employers and their staff. “These are stressful times, and people are living and working in stressful situations.”

Affinity recently surveyed employees of 10 of the area’s largest companies and found as many as 60 percent of a company’s employees described their stress level as serious enough to affect their health.

In its 2007 “Stress in America” study, the American Psychological Association found that 74 percent of respondents cited work as the No. 1 cause of their stress.

No. 2 was money – which, for most hominids, tends to be closely related to their jobs. One out of three people rated their stress level as extreme, and one in eight said they spent at least 15 days each month in a state of extreme anxiety.

Blame the economy: The National Institute for Occupational Safety and Health (NIOSH) suggests that “downsizing, restructuring, dependence on temporary and contractor-supplied labor, and adoption of lean production practices” may be the impetus for increased workplace stress.

“Stress is increasing because of some of the downsizing that companies are doing,” said Gregg Brewer, supervisor of IntegNet’s employee assistance program in Fond du Lac, part of Agnesian HealthCare. “People are having to do more (on the job) with less.”

Plague and other P-words

THE THREAT OF PINK SLIPS, pay cuts and “performance improvement programs” – also known as probation – have led to a new kind of office contagion: presenteeism.

Presenteeism is like absenteeism, except the employees are not at home resting up for their enthusiastic return to work. Instead, they’re at their desks and on the company time clock, but for all they’re accomplishing, they may as well be home with the remote and a bowl of Cap’n Crunch.

“The person is (at work) but productivity isn’t as high,” Brewer said. “People are not as focused, so they get less done.”

Plus, they cost more: Brewer says stressed-out people generally rack up more in medical claims than their laid-back counterparts.

“From a healthcare cost perspective, we see that people with stress have 45 percent higher medical costs,” Brewer said.

If it’s not dealt with in a healthy way, stress can lead to all sorts of bad things: high blood pressure, heart problems, high LDL cholesterol, depression, headaches, digestive problems, acid reflux, eating disorders, alcoholism, substance abuse, overeating, chronic pain, Type-2 diabetes. The list could go on, but you get the idea.

So not only are stressed-out employees less productive, they’re causing your insurance premiums to rise because they’re suffering from stress-related conditions.

Here’s where safety comes into picture. Stress plays a role in musculoskeletal complaints because everything – muscles, joints, tendons – tighten up when a person is stressed out, Brewer said.

“They are more likely to have injuries on the job,” Brewer said.

And if they’re more prone to workplace injuries, that means employers are more vulnerable to headaches of the legal variety.

“People are not as focused, so they get less done, plus they cost more. If people are stressed out, it impacts their job satisfaction; morale isn’t as good. That creates issues with how people are working together, how they’re getting things done,” Brewer said.

The dominos start toppling over: Fred’s office is short staffed, so his boss expects him to cover the duties of the three poor schmucks that got downsized, while not missing a beat on his own job. Fred isn’t keeping up, so his supervisor threatens to demote him.

Fred feels angry when he gets home, and he can’t pinpoint why. His resultant troll-like demeanor ticks off his wife. Pretty soon, he’s seeking help for his marital problems in a pint of Smirnoff. Every morning, he drags his hung-over reverse-charisma back into the office to spread to his coworkers.

Soon the whole office is going home, shouting at their housemates and, if nothing else, keeping the local beverage distributor afloat.

Spend now, save later?

SIGNING ON TO AN EAP can actually be a money saver in the long run for an employer, according to Brewer.

IntegNet’s EAP plan, for example, costs employers $20 per employee per year. So a company that has 100 employees would spend $2,000 on IntegNet’s EAP.

In return, all of its employees – plus members of their households – receive no-cost services, including psychological therapy, anger management, substance abuse counseling, stress management and many of the services of a mental health counselor. EAP counselors generally have degrees in psychology or counseling, Brewer said.

Employers can have EAP staff do on-site corporate training and topical workshops. In some EAPs, counseling services are unlimited and no charge to the employee.

Employee assistance programs have been around for years, but they’re hugely underutilized, said Brewer.

Because of their acronym, it’s easy to assume that in order to use their services, an employee’s problem must be related to their employment.

Not so.

“(EAP) is there for any issue you might be having,” said Stephanie Bellin, wellness educator specialist with Ingenuity First, a division of ThedaCare in Appleton. “It can be for marital problems, substance abuse, grief counseling, problems you are having with your kids or problems they are having. Maybe you are having difficulty with a coworker, but a problem doesn’t have to be work related. There is an endless number of possibilities and range of severities that EAP treats.”

In many cases, EAP benefits extend for a time even if an employee loses his or her job, Bellin said.

“Sometimes that can be when you need EAP the most – when you get fired,” Bellin said.

Another reason more employees don’t take full advantage of their EAP benefits is that they’re afraid it’s not confidential. It is confidential, Bellin said.

“We are bound by HIPAA laws. Those laws are there to protect people.”

Employees often think the human resources department gets an invoice saying ‘Johnny and Suzy and so-and-so were here and here’s why,’ but that’s not at all the case, Bellin said. Employers might get an aggregate of information, saying how many employees used the EAP services, so the employer could gauge whether or not it received its money’s worth on its investment, but names and reasons are never revealed, Brewer said.

The only instance in which an employer might know a specific employee went to EAP would be if the employer sent the employee to mandatory EAP counseling as a condition of continued employment. Say, for example, Fred’s Smirnoff habit affects his job performance. His employer could require him to go to EAP.

EAP could inform the employer whether Fred is complying with the employer’s mandate, but no other information would be revealed, Bellin said.

“It’s important for people to know that it is confidential. It is,” Bellin said. “A lot of people have the notion that HR gets an invoice. No, they don’t.”

How EAP works

EAP PROGRAMS CONTRACT WITH A BUSINESS for services, and it covers the employee, the employee’s family and members of the household – whoever.

But EAP differs from a psychotherapist’s office in two main ways. First, it can’t dispense or prescribe medicine; and second, it does training programs, corporate training, and comes to the worksite for crises – know as critical incident management – in situations such as the sudden death of a co-worker or a case of workplace violence.

EAP also may advise a company on cultural issues or organizational changes it feels should be made in order for employees to be more productive, Brewer said.

EAP contracts vary in coverage. Some limit the number of times an employee can come in to talk to a counselor. Some place a limit on a per-issue basis – for example, Ingenuity First allows up to eight counselor visits per issue (problem) per person. So if you have three issues, you could see them 24 times a year, Bellin said.

Our fictitious employee, Fred, could talk to a counselor about his job stress, his marital discord, and his drinking and learn healthier ways of coping with stress than tipping back a bottle. His boss could host an EAP session on mindfulness or meditation.

Brewer said IntegNet puts no limit on the number of therapy visits its clients can receive, although not all EAP programs are as generous.

Bellin likens EAP to “an initial push to get the door open and start talking.”

“We see people who are in critical crisis-management mode – at the end of their rope,” Bellin said. “But we prefer that people come to us before they get to that point.”

‘Death from overwork’

THE JAPANESE HAVE A WORD for the epitome of job stress: karoshi. It means death from overwork.

NIOSH says it’s not just that workers are stressed out and that stress is misery inducing, but their safety and that of others could be in jeopardy. NIOSH lists stress as the most common cause of worker disability and intimates that it could even be linked with workplace violence: “Long hours of work may increase exposures to chemical and physical hazards in the workplace, or night shifts may expose workers to heightened risk of violence,” NIOSH says on its Web site, www.niosh.org.

Harrison said an employee who files a short-term disability claim for a mental health issue and who fails to resolve the mental health issue is twice as likely to file an injury-based disability claim as someone who doesn’t.

An alumna of Ripon College, Lee Marie Reinsch is a freelance writer based in Green Bay