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Mental Health and Substance Abuse Issues in the Workplace

By May 10, 2018September 15th, 2025No Comments6 min read

By William Penney, DBH Candidate
Clinical Director – Counseling Care Associates

The focus of this brief article is to review how mental health and substance abuse problems impact employees in the workplace and to present several evidence-based recommendations for improving access for these troubling problems.  A review of research articles related to this topic indicates that employee-related mental health and substance abuse problems result in a reduction in worker productivity, create safety concerns for the employee and their co-workers, cause increased absenteeism and an increase in employee turnover.  Additionally, mental health and substance abuse issues can be a proximate cause of serious conflict among co-workers and result in increased stress on managers and human resource personnel.

In many cases, supervisory staff and human resource professionals are not fully equipped to deal with these types of workplace problems, especially when those issues result in staff-related conflicts.  Although the vast majority of larger corporations and companies offer Employee Assistance Program or Employee Wellness services in some form, there are systemic problems with how these services are utilized.  According to a recent blog published by the American Psychiatric Association (APA, 2016), less than 5% of employees who have access to Employee Assistance Programs (EAPs) take advantage of that service and nearly 40% of employees who work in a company that provides employee assistance are unaware that their company even offers that service.  This finding indicates that only a small number of eligible employees are utilizing this treatment option for self-referred mental health and addiction problems.

According to the APA, workers don’t utilize the services of EAP’s for a variety of reasons including the stigma associated with suffering from mental health and substance abuse problems and a fear that confidential information may be disclosed to the employer’s supervisor.  If an employee does not access their EAP during times of emotional stress and crisis, the employer funding devoted to this service is being wasted.  Aside from the individual being negatively affected by failing to receive help, co-workers, family members and the entire operation of the workplace may suffer as well.

As the director of an employee assistance program that provides counseling services to large municipal and county school systems, police forces and governmental agencies, my team and I have successfully addressed the barriers to employee utilization of this vital service using the following steps.

  1. Employees are provided with clear information about the manner in which the EAP functions. Periodic in-services and quarterly newsletters have increased clear communication of available EAP services and access pathways to all eligible employees.
  2. Employees are informed that all information shared with the therapist will be kept confidential and will not be reported to their supervisor unless written permission is given.  Employees are able to directly contact the EAP to make an appointment to discuss personal and/or professional conflict issues without discussing this directly with anyone else in the workplace. This results in the employee feeling relaxed and comfortable divulging the specific details of their personal issues without fear of this information being reported to their supervisor.
  3. Managers are educated to view the EAP as an advocacy service to assist staff members in times of need.  Managers are provided with a script to assist with making referrals for employees who are struggling with emotional and familial issues.  In cases where the employee’s performance is not currently being affected by an observed issues, managers are trained to ensure confidentiality of this referral.
  4. When mental health issues or substance abuse issues are directly affecting an employer’s performance, the employee’s supervisor or human resource manager mandates treatment with an EAP therapist.  Clearly, this is the most challenging type of case for both the employee and the EAP therapist.  When an employee is mandated to participate in mental health treatment, they often experience strong feelings of anger and fear.  The individual is angry that they are being single out for what they view as disciplinary action, and fearful that they may lose their job.  The employee frequently views the EAP therapist as being in a position of having control over their lives – if they don’t comply with the therapist’s wishes, the therapist will recommend further disciplinary action or termination.  In these types of cases, even though the therapist is working more in the interest of the employer rather than the employee, positive treatment outcomes can occur.  Utilizing a clear and straightforward approach helps individual confront their problem and formulate steps to alleviate these issues.  Establishing a collaborative contract and defining the specific parameters of treatment helps employees realize that the therapist’s primary objective is to help them save their job.  It has been our experience that if the individual believes the therapist is their partner in an effort to ameliorate the problem while preventing further disciplinary action from occurring, the employee uses the therapeutic services effectively.
  5. When an employee is mandated to attend EAP counseling for addiction problems, the level of initial resistance and distrust is in some instances less than in cases of referral for mental health issues.  If the addiction problem has gotten to the point where the employee’s supervisory becomes aware of the problem typically the employee recognizes that something needs to change.  However, convincing employees with addiction related issues to accept treatment at a rehabilitation center and to continue treatment after completion of the program is a difficult problem that is often met with resistance.  Treatment strategies for dealing with those types of issues are beyond the scope of this brief article.  However, our agency employs a Licensed Alcohol and Drug Abuse Counselor and seamless referrals to this professional are performed immediately on site.  This results in a significantly higher treatment compliance rate.  It is our strong belief that having an on site addiction specialist not only improves patient compliance with treatment recommendations, but also improves long-term positive treatment outcomes.

Employee Assistance and Wellness Programs can be valuable tools for helping employees who are dealing with mental health and addition problems.  However, employees must take advantage of the service for positive outcomes to occur.  When steps are implemented to ensure that managers and employees understand the value of the EAP service, as well as the pathways to access the service, the employer’s investment results in restored quality of life and employee productivity.

Testimonials

As a member of the AAPI community, I’m very familiar with the barriers to mental health services and the need to break through the glass wall of cultural stigma that prevents many from receiving potentially life–saving treatment. I was the only Asian American person in my master’s cohort, the only Asian American person in many of my clinical work settings, the only Asian American person to walk into many of the professional settings that I pushed myself to show up to. In my current practice, I’m constantly reminded by my patients of how difficult it is to find an Asian American mental health provider, though this reminder constantly informs me that more needs to be done for my community. Day after day, I read stories of Asian American people who die by suicide as a consequence of our culture’s avoidance of mental health topics. As a DBH, my biggest goal is to use my expertise in whole–person care to amplify the conversation around mental health and help my community understand that mental healthcare is not a privilege that we are not entitled to, it is a crucial part of our healthcare that will manifest differently in us than what many Western psychology or psychiatry textbooks will describe, and that our unique experience of mental health issues are valid, important, and is time to be part of the larger conversation.

Willam Chum, LMHCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - September 16, 2022

The Doctor in Behavioral Health (DBH) program has changed my understanding of the subject and career path. Before this academic journey, my knowledge of behavioral health was primarily theoretical, including essential ideas and methods. However, the DBH curriculum combined intense academic research with practical application, helping me understand behavioral health from multiple angles. Recognizing mental health as part of total health changed my perspective. The biopsychosocial model, which showed how biological, psychological, and social variables affect mental health, was stressed in the DBH curriculum. This comprehensive approach made me realize how complex human behavior is and how important it is to address mental health issues. Effective interventions must target the individual’s surroundings, relationships, and life experiences, not just symptoms. The curriculum also gave me enhanced evidence-based practice training to execute successful solutions. Studies methods and data analysis classes improved my critical thinking and allowed me to evaluate and apply behavioral health studies. This gave me the confidence to contribute to the field’s knowledge base through practice and research.

Dr. Rhea Hill, DBH, LPCDBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - February 17, 2025

This program will change how you present to the world, not just as a professional but as an individual. Understand this is work but the work is worth it and the journey is undeniably transformative. If you are seeking a doctorate for the title, this is not the program for you. If you are seeking a doctorate to interrupt and disrupt the course of healthcare, then this is the program for you. You won’t find a more supportive program with professors who are dedicated to your success and your education. This program is not about the regurgitation of information. It is about the appropriate applied application of knowledge and information to push forward and become an advocate for equitable and quality care for all.

Brandy K. Biglow LMHC, CCTP, QSDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - February 5, 2024

The Doctor of Behavioral Health (DBH) program has definitely transformed my understanding of behavioral health. Understanding the links between physical and mental health has taught how to make better treatment decisions. The DBH program has also given me insights that otherwise would not be possible and allows me to view individuals through a lens that I was previously ignorant of. This program has helped me grow into a more confident individual, provider, and parent.

Cory H. Cannady, BCBA, LBADBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 13, 2024

The DBH program has reinforced my vision of viewing behavioral health (BH) as an integrated component of the healthcare system rather than a siloed service. As a practitioner in the focused BH realm of substance use disorder (SUD) treatment, I observe on a regular basis how identifying and serving SUD patients is often missed, ignored and stigmatized in primary healthcare, despite the fact that early intervention at these check-points often has the potential to intervene earlier and lessen the negative SUD outcomes frequently seen by the time a patient reaches specialty SUD services. Reinforcement received in my DBH program has motivated me to promote integration as a leader in my workplace and is a primary factor in considering the long-term trajectory of my individual career path.

Kenneth L. Roberts, MPS, LPCC, LADCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - November 5, 2024

Graduating from the DBH program has influenced and enhanced my approach to addressing behavioral health challenges and making a difference in the field by preparing me to become a serious business owner. Through the DBH program, I understand now that becoming a business owner not only assists me in reaping the financial benefits of working for myself, but the program also offers me a sense of freedom to make a difference in an individual’s life.

Dr. Rebecca K. Wright, DBH, LBA, BCBA, QBADBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - December 18, 2024

I have always wanted to pursue a higher degree but never found a program that met my needs. When I investigated the DBH program, I can honestly say I was excited. It was a program that would expand my knowledge in behavioral health but also how it relates to physical health. The philosophy of treating the whole person was exactly what I was looking for.

Elizabeth Nekoloff, M.Ed., LPCC-S, NCCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - January 16, 2025

Prior to obtaining my DBH, I practiced behavioral health within the boundaries of behavior analysis. The DBH degree has given me the ability to broaden my scope of competence allowing me to provide a higher quality of care to my clients through a person-centered approach, while still staying within my scope of practice. I was in the beginning stages of opening my business when I enrolled in the DBH program which set my trajectory towards being a stronger leader. The program equipped me with essential healthcare leadership and entrepreneurial skills, allowing me to ensure high-quality services for my clients and foster a supportive work environment for our staff. It has also given me the confidence to expand my business and pursue other healthcare ventures, reaching a broader range of patients in need.

Dr. Pauline Tolentino Pablo, DBH, BCBA, IBADBH Alumna, Cummings Graduate Institute for Behavioral Health Studies - January 21, 2025

Although I have worked with many patients who have mental health diagnoses, or behaviors which make managing their medical diagnoses and day to day life difficult, the DBH program at CGI is broadening that knowledge and providing a deeper understanding of behavioral health and how best to help these individuals manage their health and improve their quality of life. This will allow me to provide and advocate for more meaningful and seamless integrated care, providing new tools for my intervention toolbox, and the confidence and skills to collaborate within and lead whole person focused interdisciplinary teams. I also anticipate building upon my knowledge as a nurse case manager and long time caregiver, as well as my personal passions and professional vision, learning about processes and operations, to be in position to start up and lead my own company one day, offering the services and care I know every person should have access to.

Hollie Wilson, MSN, RN, CCMDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - February 11, 2025

The DBH program will open opportunities for me to contribute to healthcare system innovation, particularly through trauma-informed care and integrated behavioral health settings. I will be better positioned to advocate for and implement holistic care models that improve health outcomes for underserved populations. Ultimately, this program will help me transition into higher-level roles, such as a director or consultant in behavioral health, where I can influence broader system changes and contribute to the future of healthcare delivery.

DeKyn Rashad Peters, MPH-CHES,BSW/BA,APCDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 4, 2025

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