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The Difference of 20 Years

What's 20 years? In a hypothetical case involving assistance to a worker with an alcohol problem, those two decades indicate a very long journey.

Saturday, September 1, 2007
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Consider a hypothetical case, set initially in 1997, involving a worker with a drinking problem. Travel through time. The same scenario is reset in 2007 and 2017 and retold with sharply different outcomes.

Single, 35, Neil was a computer programmer for a large service company. His corporate information-technology department had paid a lot for him to learn new database management techniques. In 1997, late Monday arrivals at work brought Neil's case to the attention of his boss, Martha.

Signs pointed to alcohol, too much of which some co-workers felt he imbibed at an afterwork party. Martha herself noticed some slurring of words when Neil called from home. So when they met about Neil's performance, Martha asked, "Neil, will you call our company's employee assistance service?" Neil did not follow up. Nor did Martha.

Martha put Neil on a disciplinary regime. Several months later, with attendance unimproved, Martha let Neil go. She told human resources, "I had to let him go. I don't know if he did anything about his drinking." Cost to employer: $50,000 in lost productivity.

Since 1997, the counseling ranks in America have advanced their understanding of alcoholism. They are today more alert to other conditions that can go along with or perhaps precede substance abuse. Counselors know that having only a drinking problem is about as likely as spotting a white buffalo. They've started training supervisors on how to handle problem cases.

Clearly, celebrity memoirs about severe mental disorders and the mass marketing of mood-altering medications have rendered conditions such as depression less stigmatizing, more open to care.

Consider Neil's case again, in 2007. Martha has been tuned into her company's employee-assistance program through several telephonic coaching calls about dealing with employee personal problems. So Martha knows to phone her EAP contact about Neil: "I have an employee who is having problems getting in on Monday mornings. I think he drinks over the weekend."

The EAP asks Martha to step back from her well-meaning attempt to diagnose Neil's problem, and to make a concerted effort to induce Neil to call a counselor, which he does. At the EAP's suggestion, Martha specifies her performance concerns in a written memo, which also reminds Neil of resources he can turn to, such as his health plan, his human resource representative and the EAP.

The counselor meets with Neil and finds signs of both substance abuse and depression.

"Neil," the counselor says, "until you get help for both these possible conditions, the chances of more performance problems are very high."

Neil follows up and works in a dedicated way to use his new resources. His work improves. He holds onto his job.

Looking to the future, practitioners are counting on a world with better data; surer strategies for individual predicaments; and tighter, more integrated services. Predicting outcomes for troubled workers will become more fine-tuned and reliable. Fitness, counseling, and other work and life programs, today still rather scattered about, will merge into one available continuum of services, within the reach of a click.

Travel to 2017. After his third unplanned absence in two months, Neil receives an automated e-mail from human resources.

The e-mail cordially reminds him of the attendance policy and the impact of unplanned absences on his team. It also states the employer's understanding that personal circumstances occasionally disrupt the lives and work of employees.

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The memo reminds Neil that the EAP can not only help him with specific challenges but can also confidentially explain employer benefits that are designed to support employees through tough times.

Martha has received a similar e-mail that invites her to consult with human resources or the EAP's executive consulting service about how to address Neil's attendance with both authority and thoughtfulness.

The memo provides talking points that can help Martha remind Neil of company resources for maintaining a path to success with the company.

It dawns on Neil that he is drinking more, mainly to control feelings of loneliness and futility. He turns to a self-exploration module at his online benefits Web site, which he has been incentivized to use.

He reads that being both depressed and drinking more puts him on a bright-red path toward poor job reviews and even termination.

He clicks a button immediately connecting him to a live, warm counselor. In their 20- minute conversation, Neil admits that he has fallen into a daily drinking pattern and that his primary-care doctor is unaware of it.

He accepts the EAP's offer for a "chemical health assessment," as well as the counselor's invitation to transfer his call on the spot to a department that can explain the range of medical and personal leaves that might be available to Neil.

He takes a few days of sick leave for appointments with his primary-care doctor, a substance-abuse clinic and a consumer-credit group that will work with him to restore financial stability.

Neil starts going to Alcoholics Anonymous and taking physician-prescribed drugs. He also improves his physical fitness. The self-diagnostic module tracks his progress among his demographic cohorts.

Neil's 2017 scenario is predictable based on what is happening now.

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