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Interactive Screening Program (ISP): Evaluation of Workplace Programs

7/1/2019 – 8/31/2021

American Foundation for Suicide Prevention (C-0-001-19); https://afsp.org/

This study employs a mixed-methods design to assess utilization of and outcomes from using the Interactive Screening Program (ISP). The ISP is an online, anonymous screening platform that provides immediate feedback about mental health risk and well-being and connects users with an Employee Assistance Program (EAP) counselor, peer support counselor, or other authorized mental health professional. The counselor can then respond, but all communications between the counselor and ISP user are anonymous, unless the ISP user reveals their identity. ISP, which was developed and is maintained by the American Foundation of Suicide Prevention, is an innovative online program that provides employees with an opportunity to anonymously connect with a behavioral health professional and receive support designed to prevent suicide and encourage help-seeking. This is the first study to examine workplace ISP data from 21 work organizations.

BACKGROUND

In the U.S., approximately 20% of adults struggle with “any mental illness,” defined as a mental, behavioral, or emotional disorder (National Institute of Mental Health, 2019) that can severely impact their ability to function. Additionally, approximately one in 12 adults suffers from a substance use disorder (SAMHSA, 2017). According to the Centers for Disease Control and Prevention (CDC), suicide is the fourth leading cause of death among working aged adults, 35 to 54 years old (CDC; 2018). However, treatment

Young adult male looking at phone

gaps continue throughout the U.S. with approximately 50% of adult women and 56% of adult men with mental illness not receiving any treatment and 20% of adults with mental illness reporting that they tried but could not get treatment (Mental Health America, 2021; SAMHSA, 2019). Some of the reasons or barriers to help-seeking behavior include stigma and a fear among working-aged adults that admitting to a behavioral health problem will have a negative impact on their job status. Left untreated, depression, substance use and other behavioral health conditions can be fatal as we see resulting in increased risk for suicide (Brådvik, 2018). Addressing barriers to mental health assessment and referral to treatment is crucial to preventing suicide, while also being critical to improving access to care and quality of life for adults living with mental disorders.

RESPONSE TO THE PROBLEM

The ISP is designed to increase outreach and engagement to individuals, assess distress, connect individuals with referrals to providers, and encourage individuals to access and use referrals for mental health services. The program includes an online tool that provides individuals with a brief, anonymous, screening for stress and depression, and an interactive method of connecting with a mental health professional, peer support counselor or Employee Assistance Program (EAP) counselor. Given an opportunity to engage in dialogue with a trained mental health professional anonymously, ISP users are able to access support without having to be as concerned about stigma and other barriers that prevent help-seeking.

RESEARCH STUDY

The research team is conducting a mixed-methods research study to understand utilization of the workplace ISP in 21 work organizations. The research team coded over 7,500 unique ISP case files entered into the database over a 10-year period (2009-2018). The 21 work organizations represent diverse industries including university health systems and law enforcement agencies. Data analysis will focus on descriptive results about program utilization, presenting problems, and risk levels of employees who use ISP. The research team is also comparing proximal outcomes related to mental health help-seeking, including communicating with a mental health professional through ISP, ambivalence toward formal mental health support services or treatment, willingness to seek more formal forms of treatment, and requests for and acceptance of mental

Hands typing on laptop

health referrals. To better understand how the ISP is implemented and promoted among the worksites, the researchers are also conducting interviews with ISP administrators, site managers, and counselors. Questions included in the semi-structured interviews focus on initial implementation, ongoing promotion, outcomes evaluation, and programmatic or utilization changes observed during COVID-19.

Implications/Future Plan

The workplace is a natural, yet relatively untapped, setting for mental health and suicide prevention and early intervention. Given that the majority of adults in the U.S. spend a significant proportion of their time at work, it is critical that workplaces have evidence-based tools for risk screening and for encouraging employees to seek mental health services when needed. When employees do seek help through their Employee Assistance Program (EAP) or other workplace mental health resources such as peer support programs, they generally report high satisfaction with services; however, it is important that we reach out and connect with employees who are not ready or not willing to pick up the phone and call for help. Breaking through barriers to help-seeking, such as stigma and concerns about confidentiality are critical if workplaces are to be more effective in reaching out to and providing timely support to employees who are struggling with mental health problems and/or suicide. The ISP is one program designed to reduce barriers and encourage help-seeking behaviors, while simultaneously providing immediate crisis support to employees in need.

IMPLICATIONS/FUTURE PLAN

Results from this initial research study will inform behavioral health assessment and treatment engagement with working-aged adults throughout diverse work settings. If effective, the ISP can be scaled up and implemented nationally, in addition to being as well as embedded into EAPs and workplace peer support programs. Future research planned includes more extensive evaluation research studies examining the fidelity of implementation and continued provision of the ISP in workplaces, in addition to evaluating longer-term results focused on employee connection and engagement in short-term counseling, such as EAP, and mental health outcomes.

TEAM MEMBERS

Jodi Jacobson Frey

PhD, LCSW-C, Principal Investigator, University of Maryland School of Social Work

Dr. Frey is a Professor at the University of Maryland School of Social Work. Dr. Frey chairs the Social Work in the Workplace & Employee Assistance Sub-specialization, the Financial Social Work Initiative and she serves as Founder and Faculty Executive Director of the Behavioral Health and Well-Being Lab (BHWell Lab). Dr. Frey’s research focuses on workplace behavioral health, with an emphasis on translational research developing and testing programs to support working-aged adults and their families. A significant portion of her work has been dedicated to suicide prevention and depression, in addition to substance use and crisis intervention in the workplace. Dr. Frey serves as co-chair for the Workplace Suicide Prevention and Postvention Committee of the American Association of Suicidology and she has published over 60 articles and several books. Dr. Frey is regularly asked to present her work at national and international conferences.

Philip Osteen

PhD, Co-Investigator, University of Utah

Amanda Mosby

MA, Project Manager, University of Maryland

Rachel Imboden

MSW, Graduate Research Assistant, University of Maryland

Orrin Ware

PhD, MSW, Graduate Research Assistant, University of Maryland

Alicia Bazell

MPH, Social Work Research Assistant, University of Maryland

FOR MORE INFORMATION

Contact the research team for more information.

Dr. Jodi Frey, PhD, LCSW-C

Email: jfrey@ssw.umaryland.edu

Phone: (410) 706-360