January 09, 2020

Global Employee Assistance Programs

As companies become increasingly global, employers are searching for ways to improve the health and productivity of their employees around the world by implementing employee assistance programs (EAPs) globally.

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While many large, global employers are interested in implementing an employee assistance program (EAP) worldwide, they are often unsure how to begin. The Business Group has developed a step-by-step guide to building a global EAP. This guide was written to serve as a roadmap for employers just stepping into this arena.

Determine Your Company’s Goals and Objectives

Employers roll out a global EAP for many reasons, including:

Regardless of what your reason is for implementing an EAP, it is critical that you know why you are doing it, so you can effectively develop your goals and related outcomes and ensure all stakeholders are on the same page. Consider the following:

• Do you want these goals and objectives to fit into your existing health and wellness strategies?
• Are the goals and objectives global in nature or do they differ by region, country or workplace?
• Who is responsible for meeting the goals and objectives?
• How will you measure whether the goals and objectives have been met? What metrics will inform you when you’ve achieved success?
• What is your timeline for meeting the goals and objectives? Will this be the same for all locations or do certain locations need more time because of cultural or other barriers?
• What will happen if the goals and objectives are not met?
• Will you include certain goals and objectives in contract negotiations with vendors?
• Will you add additional services to the standard EAP, if needed, to help meet your goals and objectives?

Conduct a Needs Assessment

Inventory of Existing Programs

Before moving forward with implementing an EAP, find out where an EAP or an EAP-like arrangement currently exists in your locations. This will help you determine whether you can leverage an existing partner more broadly to meet your needs worldwide or if you should be looking for more partner(s). It will also assist you in deciding whether you want to contract with a global EAP vendor or several regional or local vendors. For example, if you have existing, successful programs in the U.K., Australia and South Africa, you may choose not to disrupt those existing structures and either use global or regional vendors in your other locations or just use local vendors everywhere.

• The Survey Approach. A good way to find out what is currently being offered is to survey your company’s various locations. One employer set up a global health council to help him find out what benefits were being offered at his company’s locations outside the U.S.
• Hidden opportunities. Internal surveys or focus groups can also give you an opportunity to explore what the major issues are in each of your locations. Consider what other data and information would be valuable to obtain from your local markets for related initiatives. This allows you to leverage one survey exercise for multiple purposes.

Involve Local Leadership and Staff

By partnering with your local colleagues early in the process you can more easily obtain buy-in from local leaders. This is crucial as local support and perspective is one of the top keys to successfully implementing a quality EAP program.

Because cultural issues differ in each country, it is important that you get feedback from local leaders before designing and choosing your employee assistance program. Partnering with local leaders may also assist you in combatting any unknown biases or stigmas that exist in that culture. For example, in Asia, some employers do not refer to their EAP services as ‘counseling’. They may refer to it as coaching, relationship improvement or personal development instead. By working with their in-country staff to understand what would resonate with employees in that country, they have been able to package it and frame it in a way that works for that culture. It’s also important to identify employees who can serve as EAP or well-being champions within a country, and not just the leadership or senior executives. Peers can be incredibly important in influencing others to accept an employer program.

Decide on the Details

After you’ve finalized the goals and objectives of your EAP, it is time to determine the overall structure of the program. Some of the questions that need to be answered include the following:

Who is Going to Pay?

• Corporate - Some employers pay for the entire program at a corporate level. This allows for greater levels of decision-making at the senior leadership level and may also faciliate an easier buy-in process among local leaders.
• Local - In other companies, each individual division or country pays for their own employee assistance program. Corporate may or may not require the division or country to have an EAP depending on their goals and organizational structure.
• Hybrid - Still others have a hybrid system. For example, one employer kept the existing EAP structure in countries that already had an EAP, with those countries paying for the programs, and then paid at corporate for a global vendor to serve countries that did not have an EAP.

The payment question is a good first step toward determining the rest of the EAP structure because it affects many of the details that will follow.

Are We going to Have an EAP at All sites or Only Selected Ones?

The answer to this question may depend on where the need lies or may be based on the interest (or willingness to pay) of local leadership.

• Selective Approach - One employer said, “Business drivers play a big role and the presence in the market plays a big role—[we have EAPs] where we have concentrated populations, where we want to have key markets for attraction and retention purposes, and where countries could benefit because they have problems or issues. Ultimately our pay structure means that the country needs to support any benefits initiatives. It’s not funding from corporate. It’s the country wanting to engage and seeing the value on a priority list of other benefits.”
• All Sites - Other companies feel strongly that benefits should be equitable around the globe, so they either pay for a global EAP or require all of their countries and divisions to have an EAP.

How Many Vendors Do We Need? One Global Vendor or Several Regional or Local Vendors?

The answer to this will also depend on a number of factors, including your company philosophy and structure and how the program is being funded.

• One global supplier - One employer said, “You cannot manage 37 vendors to one standard. You haven’t got the time. We are spread so wide that we need one worldwide vendor...we wanted to be able to communicate our EAP with one message and one phone number. So that was a big factor for us [that the EAP be] centrally-owned and one enterprise-wide.”
• Multiple suppliers - In contrast, another employer said, “I find it hard to believe that any one vendor can really do a good job with the standards that we’ve set for what we want an EAP to be all around the world. So, where there are synergies, we’re going to go for them, but otherwise, let’s make sure we deliver the best program.”

For more information on global, regional and local vendors, see: Lessons Learned for Purchasing and Vendor Materials.

Identify Roles and Responsibilities by Stakeholder

Determine whether corporate staff, local leaders, or both will choose the vendor(s), manage the vendor(s) once implemented, and have responsibility for communicating the program to employees. This will differ depending on whether you have chosen to use a global, regional or local vendor, but the most successful programs include their regional or local staff in some capacity.

With regards to vendor selection, if you are using local vendors chosen by your in-country leaders, you may want to develop a list of minimum standards to which local staff must adhere. One employer said, “We set the criteria. We expect an in-person model with a minimum of three sessions and no more than 12 sessions. Management consultation has to be key. It has to be able to plug and play into our crisis management business continuity plan. We also have requirements around the levels of the providers but they vary by country. We’ve essentially put a stake in the ground and said, ‘this is what we have to have.’”

Also, who will monitor and evaluate progress toward the stated goals and objectives? Who will be responsible for communicating successes and challenges to the vendor account manager(s)? Outlining the answers to these questions clearly will establish ownership and accountability.

Which Services Do We Want to Offer?

Develop both an ideal list and a required list of services. Examples of services you may want to consider offering include the following, among others:

Select and Contract with a Vendor

After you’ve determined how your program will be structured, what your goals are and what services are most important, it’s time to select your global, regional or country-specific EAP vendor(s). This is also the time to outline expectations regarding requirements and ongoing measurement/ evaluation, including the reports that will be most useful in determining whether the program is meeting your company’s goals. Please see the purchasing and vendor sections of this guide for more information.

Begin a Communications Campaign

After you have chosen a vendor and are on the road to establishing your EAP, you can begin developing a plan for communicating about the program to your employee population. You will likely be most successful if you capitalize on both the expertise of your vendor(s) and of your local leaders to develop the materials. Below are some tips to keep in mind as you develop your communications campaign.

• Use all available channels of communication. The more mediums you use, the more likely you are to reach a variety of people. “We use a variety of modalities in promoting EAP services: electronic and hard copy flyers, brochures, posters, newsletters, PowerPoint presentations, company intranet promotions, health fairs, training seminars and monthly or quarterly mailings,” a vendor said. One employer explained that they analyze and segment their workforce population based on job type and age and pattern their communication mediums based on those factors. “We analyze [whether] we have a manufacturing environment, a sales environment, a young population or an old population...so we’ve done everything from iPod downloads to a flyer attached to pay stubs,” the employer said. “It’s really geared toward what the [HR] person in the country is saying works and [what] has proven successful.”
• Have an ongoing plan. Your vendor should work with you at the initial implementation stage and annually to develop a detailed communication plan. EAP communication is not a one time occurrence at implementation. Utilization is strongest when communication is ongoing. One vendor said, “We believe that along with local stakeholder development, the communication plan makes the biggest difference in [en]suring awareness, trust and program utilization. We develop a continuous promotional plan that includes Web presentations, newsletters, surveys and other campaigns focusing on issues most relevant to an employer’s global population.” Simultaneously, you and your corporate and local staff are the experts of your own organization, so it is important that you have a lot of insight into what goes into the communication plan and tailor it to your own needs.
• Work with your partners.Push for cross-promotion with your other vendors and get local HR staff involved. “As much as we try to push it [EAP], a lot of the HR folks don’t think of [the value of] EAPs, so that’s something we need to work hard on -- trying to raise the visibility of its usefulness,” one employer said. In terms of vendors, many employers shared that they had good experiences with hosting vendor summits or conference calls to discuss the vendor’s role in communication, the employer’s future and existing health programming and how to best promote EAP and wellness services to employees.
• Adhere to local legal and labor requirements. You may need to engage with legal counsel and local labor and employee relations when implementing the EAP locally. Depending on contracts you may need to notify, inform or consult with unions or works councils before communicating and implementing. If you are implementing the program across several European countries this could trigger requirements with the European Works Council in addition to country and local work councils.
• Adjust your communications to fit local culture and content. Your communications should be flexible and culturally adaptable in order for them to be successfully received by the intended audience. One employer said, “The messaging is adjusted on all levels, all the way up. It starts with me and the regional managers and the senior account manager for our vendor, and then we push it down through each layer of the organization. We allow them the authority to adjust it so that the key elements of the message are maintained but they might shift what or how something is said in order to get the message out in a way that will cause the result we want.” If you have an EAP committee at your local sites, this might be an appropriate way to use their expertise.
• Use local champions to spread the word. Employees are incredibly effective at promoting workplace programs to their peers. As one vendor said, “It’s not about how great the program is at one company or another. It’s really about what type of culture the organization has that supports the use of the EAP as a clear resource for employees and family members to deal with the challenges of everyday living. Is the culture there so that when you’re sitting around the lunch table and someone says they’re having trouble making ends meet, does someone else say, ‘We’ve got a really good EAP and I bet they’ve got someone there that can give you financial guidance.’? You have to create a culture where every manager, every leader—whether they’re an official or an unofficial leader—takes it upon themselves to say, if someone’s hurting, I know a resource. That’s how you drive EAP utilization.”
• Realize that you may have to be a leader as well or appoint someone who is. One employer said, “A lot of times where utilization is low you’ll find out you have an HR person who is overwhelmed with work and can’t see their way clear to promote the EAP. We make sure the HR person understands what we can do for them so I have conversations with them. It takes a lot of frequent flyer miles because it does take someone who believes in it to listen and say, ‘What I’m hearing is that you have a lot of organizational change. How about if we come in and do some workshops?’ When EAP is really made part of the culture, people seek it out and say, ‘Can you come to this training and help us?’ Otherwise, you have a program that is dormant. You put it in place and aren’t checking up to see what types of posters they have, if they are participating in the health fairs, if they’re going to the national sales conferences, if they are having a family health day in China where everyone’s in the park together, that type of thing.”

Roll Out the Program

You should work with your vendor to develop a timeline for implementation with specific due dates and tasks listed. Depending on your organization’s needs, you may plan to roll out the EAP across all of your sites simultaneously or you may do it on a site-by-site basis. For example, one employer planned to coordinate the launch of the EAP with the launch of their wellness program in sites where the wellness program would exist; in the other sites, the implementation date was based on the preference of the local site and what other promotions were taking place in that time frame. Part of the launch should include orientations with managers about the value of the EAP and how they can promote its use among their employees.

One vendor described their implementation process as follows. “Typically, each country will have local requirements for implementing an EAP. We provide a welcome letter template in the native language for the client contact in each country to distribute to employees. We recommend that the client organization follow up with a series of presentations and leaflets, which we provide in the local language, to explain the service in more detail. We consult with our partner throughout the implementation process to ensure that the communication method is appropriate for the culture in each country. We formulate an effective plan for each customer based around budget, number of employees, language and cultural nuances.” This vendor described the major components involved in implementation as follows:

• 1 | Develop a communications plan to introduce the benefit to all employees and family members.
• 2 | Determine a schedule for employee orientations and supervisory trainings.
• 3 | If appropriate, gather medical benefit plan information to utilize when making referrals for ongoing counseling and in rare instances, such as in-patient treatment.
• 4 | Obtain other benefit plans offered by the client organization that our counselors may recommend to callers. These could include more comprehensive legal coverage, adoption benefits, other benefit programs, etc.
• 5 | Review relevant HR policies that we should reference when expediting management referrals.

Be Patient, Be Creative, and Be Persistent

Change doesn’t happen quickly, and biases against mental health treatment are very ingrained in some areas of the world. As one employer said, “It took me two years before I got my first EAP case in Indonesia. We have a great vendor there who is well-known and well-respected, but we couldn’t get anyone through that door. Finally someone came in and cracked it and we run about 5.5% to 6% utilization annually in Indonesia, which is huge in that culture...basically I run over 5% utilization in every country in the world. I run about 33% in Brazil and 11% consistently in the U.S. and through Europe. I point to that all the time as evidence that our model is working because we have a local ownership concept. People really believe that the program is a valid and valuable resource so people will use it and we’ve demonstrated that.”

Some vendors and employers report that local stakeholders have to actually see the value before they will be on board with the EAP. “We were working with a company that did a good job of involving their regional stakeholders around the globe during the process of identifying and selecting a supplier, yet a key HR representative was clearly not on board with the global EAP,” one vendor said. “Following final presentations for the EAP in which this HR leader was involved, we were notified by corporate of an industrial accident at a facility in another country where a worker was seriously injured. We provided consultation to the operations manager at the facility and an on-site debriefing was conducted for employees and the plant manager. The debriefing supported the employees...and overall, it served to strengthen the work team. The feedback provided by the plant manager to the HR representative resulted in gaining [the HR rep’s] strong support for expanding the benefit.”

Use all opportunities at your disposal – monthly webinars on topics of interest, to meet the employee where they are in a non threatening way can be great to keep the EAP program front of mind for employees as well as break the ice for engagement. Many providers offer webinars on a library of topics to choose from.

Review and Make Changes as Needed

The implementation process doesn’t stop with the launch of the program. You (or the appropriate resources from your company) and the vendor account manager(s) should plan to meet regularly to continually review and evaluate the success of the EAP. Company representatives should include those who have direct roles and responsibilities related to the EAP. This could include you, benefits or well-being colleagues, local HR or leadership, supplier management. One vendor said, “On an ongoing basis, the account manager proactively meets with the client manager to understand how the current program is working, provide recommendations for program enhancement and understand other employer initiatives that might affect the program.” If this isn’t happening in your current relationship with your EAP vendor, don’t hesitate to ask for it and also consider including it in your RFP or contract negotiations during the next purchasing cycle. See the Evaluation section of this guide for more information.

Conclusion

Implementing an employee assistance program outside the United States requires persistence and determination. “The thing about international EAP is, it really doesn’t matter if you’re the employer or the vendor, you have to have a level of passion and a level of fortitude to really take it on and do it well,” one vendor said. “You have to be committed to the idea of doing it. If you do it to check a box because your company has done it for the last 20 years, you’ll be disappointed internationally. It takes a passion and commitment.” However, many large employers have seen great success and rewards, and substantial utilization over time. Working with your local leadership and employee champions, partnering with a strong vendor, developing an effective communication plan and being flexible enough to make changes as needed will lead you further down the path of success.

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