This past April I was standing in the lobby of The Westin Hotel for the 2012 International Law Enforcement Educators and Trainers Association (ILEETA) Conference, visiting with some fellow trainers, when I came into a conversation that both annoyed and worried me.
Several police trainers, some of whose expertise and responsibility it is to assist and educate LEOs on the existence, warning signs, and dangers of PTSD, depression, anxiety, and addictions, were talking about Employee Assistance Programs (EAP). Their collective commentary amounted to this: “Police officers should never go to an EAP because nothing is kept confidential.”
When I heard this I bristled and became slightly combative. Now, I often have this same reaction when someone criticizes a cop: When you unfairly criticize one, you criticize them all. I take it personally when someone says, “That cop didn’t know what he was doing, he didn’t even take pictures of my crushed mailbox… all cops are just out there to fill their quota because there is no crime in this town and they have nothing better than to harass citizens by writing useless traffic tickets… cops are lucky to get paid as well as they do for as little education you need to do that job” … etc.
As we’ve recently begun this series on overcoming complacency and building happiness, it seems that individual and institutional mistrust of a provided benefit that can directly and positively influence happiness and well-being is something we should address. If something is in the way of your happiness, at home or work, and there is a free benefit designed to remove those obstacles, having trust in using the benefit becomes rather important.
It’s often said law enforcement is both one of the most visible professions—and least understood—because citizens get most of their information about law enforcement from TV, movies and word-of-mouth, with little access to what really goes on in the mind and world of real-life cops.
The same is true about the profession of mental health, and my world as a mental healthcare provider. Most of what people know is from movies, television, and the rare but noticeable worst-case scenario stories. I take it personally when someone makes a blanket statement about my profession; for every bad therapist out there, thousands more are dedicated to the value we hold most sacred and the one that my profession goes to bat for every single day and guides every decision we make as a mental health practitioner—confidentiality.
I have no doubt there are LEOs out there with a “worst-case” scenario or horror story of a therapist, counselor, or an EAP that somehow revealed information to their bosses or employer that they’d shared in presumed confidence. In any profession the quality and talent of practitioners range from excellent to talentless. There are even those who carelessly violate ethical codes of conduct.
I’ve even found this to be true in cop world. Before Mike became a police officer my view of law enforcement was rather negative; on those rare occasions I came into contact with cops, it seemed I only ran into the kind who liked to bully or over-assert their authority when they had no real reason to. As Mike will tell you, I have an overdeveloped sense of guilt; if I do anything that seems to violate my morals, values, or ethics, I will tell on myself.
Breaking a law?! Are you kidding? I also grew up with a strong sense of hierarchy and respect for authority that borders on fear. So, needless to say, I’m not really the criminal sort and my run-ins with the law have been a couple fender-benders or the very occasional speeding violation. I’m one who admitted my transgression and never tried to manipulate the officer with flirting, a smart comment or making any statement implying, “You’re dumb and I’m smarter than you.” I’m the one with my hands at 10 and 2, my seatbelt on, asking permission to grab my insurance card out of my glove box.
However, even with a respectful demeanor, the few early encounters I had with cops had been negative and left me with a bad taste in my mouth. I unconsciously classified all LEOs as power-hungry bullies.
Of course, I’ve since learned this is not true. People who go into law enforcement have good hearts. They seek to serve others, make a difference in this world, put the welfare of others before their own, are willing to take charge in situations others walk away from, and are honorable. The same is true in my profession for, similar to you, the pay is not that great (and my profession has taken a serious pay cut this year with health care being revamped), hours are long, people want us to work miracles for them, the threat of getting sued is always present, and it is a profession that is often bad-mouthed by others.
Nonetheless, it still attracts professionals dedicated to the core value of confidentiality for our patients and clients. For those of us in the mental health profession confidentiality is sacred and, individually and as a profession, we constantly fight for your right to maintain your privacy.
For instance, if someone calls my office to seek information about one of my clients, unless the patient has signed a release of information for the inquiring party the response is always going to be the same: “I cannot confirm or deny we even know this person,” as dictated by HIPPA.
So let’s begin by looking at the purpose & definition of an EAP. The best written one I found is found states:
"An employee assistance program (EAP) is an arrangement between a corporation, academic institution or government agency and its employees that provides a variety of support programs for the employees. Although EAPs are aimed mainly at work-related difficulties, they can also help employees with problems that originate outside the workplace when such troubles impact work attendance or on-the-job performance.
"The concept of the EAP originated in the 1970s in an effort to reduce substance abuse and intoxication in the workplace. Since that time, EAPs have evolved to deal with a variety of issues such as marital problems, depression, anger management, anxiety and physical illness. EAPs can provide day care for children of employees and elder care for parents of employees. Legal and financial assistance may also be available.
"All EAP consultations and referrals are confidential and the services are provided at no cost. An employer with an established EAP can often attract and keep better talent than an otherwise similar employer without an EAP."
Although many employees may be covered by insurance provided either by their employer or self-purchased, there is an advantage to using the EAP for short-term assistance: The EAP does not require the co-pay often required by traditional medical insurance, so more employees have greater access to a health care benefit. An EAP is designed on a one-to-six-visit model; this means it is short-term counseling so that a mental health practitioner can treat people without accessing their medical insurance. Because this benefit is separate in most cases your medical carrier will have no knowledge of your visits, creating even greater confidentiality for the insured.
Another benefit of an EAP is there is an extra level of confidentiality not covered by HIPPA laws. When I see someone through the EAP there are traditionally two extra forms I need to have signed: the first is a form granting “Consent to Release Information” to the EAP for the purpose of coordinating treatment, and the second an authorization from them with a statement of understanding that acknowledges I gave them a copy of their “Notice of Privacy Protection.”
I always tell my clients to go over it and to know their rights. I tell them that if any of their rights are violated to definitely make a complaint and that this serves as their protection should their employer violate confidentiality. One of the benefits and protections provided through an EAP is when the employee is mandated to counseling by the employer, the counselor, by the contract we enter into with the EAP, is prohibited from contacting or providing any documentation to your employer. This even includes writing letters that the patient may request. This does not apply to Fit For Duty exams, which are different from counseling and are not subject to confidentiality laws. These exams will be addressed in later articles.
This introductory article’s main point is to stress the crucial importance of confidentially to your counselor and the mental health field. In our next article on EAPs and confidentiality we’ll look more closely at what confidentiality means, the questions you should ask your EAP counselor, how to ensure your rights are protected, and the potential limits on confidentiality when counseling is mandated by your department. We hope to clear up some misconceptions about, and clarify some of the benefits of, EAPs.