With their wide array of resources and services, Employee Assistance Programs (EAPs) provide invaluable support to small business employees who are struggling with mental health or substance misuse. But what should you as a business owner do if your staff members are too intimidated to use your company’s EAP? In this episode, Gene Marks and special guest, Rich Jones of Youturn Health, discuss how small business owners can create a stigma-free environment that encourages their struggling employees to get the help they need. 

Executive Summary

2:50—Due to stigmas surrounding substance abuse, it can be difficult to get your staff members to actively engage in your business’s employee assistance programs. This reluctance is why some business owners need to consult an engagement expert.

3:39—Out of all the people who struggle with a substance abuse disorder, only 6% ever get help.

4:32—One way that small business owners can gently encourage employee participation in these programs is by offering an online platform where they can conveniently and confidentially access all the necessary resources.

5:01—In addition to your online resources, be sure to provide additional live support, such as certified coaches, for a human touch.

5:47—Remember that these services can always adjust their level of engagement to suit your company’s needs.

8:21—Even though younger generations are becoming more open about their struggles with mental health and substance abuse, our healthcare still has a very antiquated approach and only offers help once the individual’s condition has spiraled out of control.

8:55—46% of people who struggle with substance abuse can get better through moderation.

9:17—Substance misuse falls on a continuum and therefore, requires different levels of treatment depending on the severity of the condition.

11:42—Using “stress” as a conversation starter can open up the dialogue with your employees and  eventually, make them feel safe enough to disclose their substance abuse issues.

15:16—The most obvious signs of substance abuse are absenteeism; decreased work quality or productivity; and changes in mood, appearance, and speech. However, business owners also need to keep an eye out for the more subtle signs, such as presenteeism; frequent trips to the bathroom; and nervousness.

16:44—If we want to normalize the conversations about substance abuse, we need to change the culture around these issues. This shift will require our leadership to be onboard and maintain an open dialogue about these subjects.

17:37—Once you determine that a staff member is struggling, you need to have an honest conversation with them, but it has to come from a place of caring to prevent the employee from becoming defensive.

18:47—Depending on the company culture, either the business owner or a member of HR can initiate the conversation, as long as they do so in a compassionate manner.

20:16—Rather than reprimanding or threatening the struggling individual, try a non-intrusive approach and offer your employee some resources so they can course-correct

22:19—Rather than being so reactionary, we as a society need to be more proactive and preventive-oriented when it comes to mental health and substance abuse issues.



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Gene: Welcome to the Small Biz Ahead Podcast. We interview great experts and offer advice and tips to help you run your business better. Hey everybody, and welcome back to another episode of Small Biz Ahead. My name is Gene Marks. I’m really, really happy that you are joining us today. My special guest today is Rich Jones. Rich is the Chief Clinical Officer. Do I have that title right, Rich?

Rich: Yes.

Gene: I want to make sure that I’m describing you right. Good. At Youturn Health. And what we want to do is this whole conversation is about substance abuse, and if you’re an employer and a business owner and you’re employing people, there’s a lot of things that you need to know, that I need to know, about drugs in the workplace and substance abuse and all that. But before we get into it, Rich, tell us a little bit about yourself and about Youturn Health.

Rich: Yeah, and thank you for having me, Gene. Well, first off, what you just said is so important. Substance misuse, mental health. It’s one of those issues that we’re going to wind up talking about eventually anyway, because it’s getting so overwhelming that you can’t even ignore it anymore. My background, real quick. I’m a psychologist, a licensed therapist, a trauma specialist. I’m a certified EAP provider, employee assistance provider. And I’ve been doing this for about 25 years. But there’s another thing about my story that I always share. I’m also a person in long-term recovery myself. So, I’m in recovery from an opioid use disorder and an alcohol use disorder. In 1999, I was in a car accident and I walked out of an emergency room in Western Pennsylvania with 120 Darvocet. And Darvocet are opioid-based painkillers. And for a guy like me, it was a bad combination. And this speaks to the topic of what we’re talking about today.

Rich: I was a very high-functioning employee. I was not working in behavioral health at the time. My undergraduate degree is in business management. I come from a family of entrepreneurs. I was working in a recruiting company, actually, and just doing my thing, and nobody knew what was going on with me. My productivity level was probably 75% where it could have been. My health conditions and my health claims were just skyrocketing. And nobody ever said anything, because I didn’t look like the stereotypical person with this issue. And that really pushed me into the field, and it really pushed me, it motivated me to get a degree and become a clinician, but it also motivated me to try to find new ways to help people. And it comes from a different place whenever you’ve been through it, I guess.

Gene: So, tell me a little bit about what you’re doing at Youturn Health. Well, first of all, what does Youturn Health do?

Rich: Yeah, so Youturn Health, we are a behavioral health wellness company. So, we’re a non-clinical service. If we think about it in terms of other things that people know about, if people have ever heard about an employee assistance program, we are not replacing employee assistance programs. We are supplementing employee assistance programs. And quite frankly, the problem with all programs, not just employee assistance programs, it’s not the service. Everybody knows what to do with the service. Nobody knows how to get their employees to engage in the service. And that’s what we are experts at. We are engagement experts. We are retention experts. We use a coaching model rather than a therapy model for very, very strategic reasons. We have found that that’s an easier way to get people to start talking. And if you want to think about it, Gene, I can sum this up in one statistic. Out of all the people out there who have a substance use disorder, or are struggling with substances, only 6% ever get help.

Rich: So, you can see what the problem is. Yeah, the problem isn’t we don’t know how to help. The problem is nobody will come forward and get help, and that’s where we come in. We created an online learning management system. Like to call it Netflix for recovery. It’s anything and everything that you could think of related to substance misuse, stress, anxiety, depression, trauma, grief. Whole educational series that people can complete on their own time. Also a whole section of stories, people like me sharing openly about our experience. And then we have another section called Conversations, which is really our podcast.

Rich: Now, the reason we start with the platform, it’s a very non-threatening way to start the conversation. You can get this out to your employees without shoving it down their throat. You can get it out to them, and it’s a hundred percent confidential and a hundred percent on their terms. Whenever they want to get on their phone, they can check this out. They don’t have to do any kind of assessment or diagnosis. That’s where Youturn Health starts. The additional component is our coaching services, our professional coaching services, because we know no matter what, you need a human touch involved. So, we have professional certified coaches that back up everything that’s going on in the platform, if you will, and that’s where the one-on-one coaching comes in and the group coaching comes in.

Gene: So, your customers are mostly corporations. In my business, I have 10 employees, and if I wanted to offer a mental health benefit for my employees, I would sign up with you. You have different levels of service that you provide. And then basically, I could turn around and say to my employees, “Listen, to show our support, and it’s part of the benefit for working for my company, go to…”

Rich: Absolutely.

Gene: “You can get whatever help that you need.”

Rich: That’s exactly right.

Gene: Confidentially and privately, correct? Makes complete sense.

Rich: And we engage in whatever manner that the company wants us to engage. And what I mean by that, Gene, is companies go at it in different ways. There are some companies that really want us to be aggressive. I’ll do a lot of webinars. And then other companies have a different vibe. I think it might be the stigma. They just want it to be there, and they don’t want to, I’ve actually had companies say to me, “We don’t want to talk a lot about this.” Because it freaks people out, is what it is. People just get all up in their head whenever they start hearing the word, they hear the word alcoholic, right? Well, we don’t even use that word. We don’t even believe in that word. It’s a health condition. Let us us in, let us help. That kind of deal.

Gene: And there’s different levels of mental health issues that employees are dealing with nowadays. I mean, you’re talking about you’re, in a prior life, a substance abuser, and the opioid addiction, it’s a huge issue. I remember my son got injured in high school, and we were really afraid of him getting addicted to opioids. It happens. And I live in Philadelphia, and I’m not sure if you’re familiar with Kensington and Philadelphia.

Rich: I’m very familiar with Kensington. Very familiar.

Gene: I mean, it’s one of the worst areas in the world for opioid addicts. And when you hear some of that being interviewed, I’ve been addicted to this site called Soft White Underbelly, which is, maybe you’re familiar, with it as well.

Rich: I know that site.

Gene: The person who runs it, he interviews a lot of addicts, and they all come from backgrounds like similar to yours. Good, normal people, smart people, but to no fault of their own, they get addicted. So, employers have to recognize this. But that’s one end of a spectrum. Then the other end is just employees having just general depression and anxiety. Don’t you feel that the attitude towards mental health has changed? The awareness? I mean, I think it’s a younger generation thing. People are less afraid. Maybe it’s because of Naomi Osaka or Ben Simmons.

Rich: Simone Biles, yeah.

Gene: Yeah. They’re out there and they’re being very public about their mental health issues. And I find that more and more of my clients, their employees, particularly younger employees, are not afraid to say, “I do have some anxiety,” or, “I do have some depression.” And what has been your perspective on the changing environment for mental health awareness in the workplace?

Rich: I think there’s a lot of hope, there’s a lot of progress, and I think you’re spot on with the generation coming up. They’re more open, they’ve been educated more on this. It’s definitely trending in the right direction. I will tell you, it’s not happening fast enough. And really, what the problem is, is our helping system is not keeping up with the changing in attitude. So, we have a very antiquated way of helping people with these issues. Everybody thinks that you have to hit bottom and then go off to rehab and go to AA meetings for the rest of your life. But what if I was to tell you that the truth is 46% of people who get better from substance use disorder, they do it through moderation, not total abstinence. There’s a misunderstanding and a myth that is perpetuated by some of the old school kind of thinking that is just not based in fact.

Rich: Here are the facts. Substance misuse falls in a continuum. It’s like any other disorder or disease. It isn’t the same for everybody. There’s stage five cancer and there’s stage one cancer. In substance use terms, it’s mild, moderate and severe. And the problem is, in our world, we don’t do anything until it gets severe. We don’t talk about it, we avoid it. You know what I mean? We may even unintentionally contribute to it, because it’s a shameful idea that a person might have alcoholism. It is a word that comes with so much baggage, that most people will just run the other way. So, our deal is we feel like that whole mentality needs to be challenged, and we need a paradigm shift. We need a mentality shift, because if the mentality shifts, the solutions will start to come at a more rapid pace. But we are still stuck in 1970 right now.

Gene: Got it. Youturn Health, though, just to be clear, I want to move into some questions I have about substances, but you would say that your platform, though, is for any mental health issues, correct?

Rich: Anything.

Gene: I mean, whether I have substance abuse problem or not, or an addiction problem, if I’m just suffering from anxiety or fears or depression or whatever.

Rich: Or stress. Or stress.

Gene: Or stress, or stress. Okay.

Rich: I’ll tell you something, Gene. I’ll share a story with you real quick. So, I’ve been an EAP provider for this one particular company for probably 10 years, I’ve had that account.

Gene: And what does EAP mean?

Rich: EAP stands for employee assistance professional. Employee assistance programs, that’s what most people think of when they think of getting help at work. These are licensed clinicians, and the company usually pays for three to five sessions, or something like that. And they come see me and I diagnose them and work with them. And it’s very, very low utilization, across the board. It’s two to 3% is the number of employees that will engage in this. So, I’ve struggled with that. I didn’t like that. Even though I technically made more money when people didn’t show up because I didn’t have to pay the counselors, that’s not why I’m in this business. I want to actually help people.

Rich: So, we sat down and said, “How do we get to these folks? They’re not going to show up for the drug and alcohol seminar, right? Nobody’s going to come down the hallway to the cafeteria to hear Rich talk about alcohol, because that’s too much.” So what we did was started a stress management program, and we started doing stress management seminars. We went from five people showing up to 65 people showing up. There was something about stress that was acceptable to talk about. And then, what happens was, this is a hundred percent true, people think I made it up, but when we were in the stress seminar, 10 people signed up for individual coaching after that, and all 10 of them eventually disclosed that their main concern was alcohol. Do you see what we did there? We went in the side window rather than the front door.

Gene: That is a great suggestion. I mean, employers themselves are looking for ways to deal and to identify people that might be having even substance abuse issues, let alone any mental health issues. Using stress as a, I don’t want use the word excuse, but using it as a vehicle to say, “Listen.”

Rich: Using it as a Trojan horse

Gene: As a Trojan horse, yeah. We’re going to pay for and sponsor a couple of online seminars or in-face seminars or whatever, just to talk about stress management. I mean, who doesn’t suffer from stress? And what you’re saying is-

Rich: It’s a badge of honor in our society to be stressed.

Gene: It really is. And that way, then, if you do promote that and you say to your employees, “We’d really like you to attend this, I’m sure you’ll do it on your own, because we all want to manage our stress better,” what you’re saying is that a lot of employers may find that other issues may come to the surface because of that.

Rich: And also what they’ll find is they’ll get help… So, think about stress in a different way. Think about stress like this. Stress, one of the main damaging factors about stress is it creates this thing called escapism. One of the ways that most people deal with stress is they have to take the edge off. And people do that in many different ways. So, we approach it like this. We go in and we say, “This is a wellness issue. Some of you folks are going to deal with stress appropriately, and you have some good coping skills, and we’re going to reinforce those for you. Others, it’s showing up in your life in self-defeating ways. Some of us eat 20 cookies at the Christmas party, others might drink a little bit too much at the Christmas party. Others might act it out in anger.” Do you see what we’re doing there? What we’re doing is we’re leveling the playing field, and it’s not about, “You evil alcoholics need to change.” It’s about, we all can work on something. Let’s get in there. Let’s figure it out.

Gene: Got it.

Rich: That vibe.

Gene: Okay. Some specifics for you. I’m an employer, and let’s bear in mind, the average small business owner in this country is over the age of 50. I mean, that’s according to the Small Business Administration. So, kind of skews a little bit older. You’re a small business owner or mid-sized business owner. Give me some advice, Rich, on, first of all, identifying when there are potential either substance abuse or mental health issue. What signs should we be looking for? My follow-on question to that is going to be, once you’ve identified, what do you do next? Well, let’s talk about identifying first.

Rich: Yep. So, identification. It’s an interesting concept. So, there are signs and symptoms that anybody can look for, and it’s the standard stuff. Absenteeism increases, even their performance at work starts to go down and there’s no explanation for it. Mood changes. Sometimes you’ll smell the odor of alcohol from a hangover or from the night before. Sometimes you could tell literally by the person’s appearance and their speech. And sometimes, coworkers will express concerns or clients will express concerns. I had one guy who went out and he definitely had a little too much fun, and it got back to me. I was the EAP, I was the counselor for this company, and it got back to me because the client reported it. So, those come up and we’re pretty good as a society at identifying that stuff. What we are not good at is picking up on subtle signs, and we are horrible at talking about it.

Gene: What do you mean by subtle signs?

Rich: So, the subtle signs would be more what I would call classic presenteeism. The person who’s chronically distracted, and the person who is going to the bathroom 15 times a day, that type of thing. You would see it more, and they would be nervous. They would appear in a certain type of way. And the deal with that is somehow we have got to normalize the conversation about this stuff, because the problem we have right now is, anybody with an issue, I’ll speak for myself, I was super successful. I was working my way up the ladder. But I was terrified somebody was going to find out what was going on with me, and you were never going to get me to talk to anybody about it because of the fear. So, I think one of the other things that companies need to figure out is, how do you change the culture around these issues? How do you make it okay to talk about?

Rich: We believe that requires leadership, has to be on board, and it has to be a constant conversation. It can’t be just during mental health awareness month, which is unfortunately how we handle this a lot. And then, that’s kind of getting you to the problem, right? The second part of your question was, what do we do if we figure out that Joe is struggling? And here’s the deal. It’s okay to talk about this. You’re not getting in anyone’s business. We recommend that you lead with a positive statement like, “Hey, I care about you, man, I care about you. Is something going on? You’re showing up late. The other day when we were in a truck together, we were driving to the job and I could just smell booze. I’m not getting in your business, man,” but if you say it like this, “I care about you,” it’s hard for people to get mad at you whenever you say it that way. But it’s really hard to be the person to bring it up.

Gene: Yeah, with your permission, when you talk about even just talking to them about it, do you recommend that if an owner of a company becomes aware of a problem with a manager or a senior employee, do you think it’s best addressed that the owner talks to that employee about it, in the same way that you suggested, or that the owner has somebody else talk to them? Or is it an HR issue?

Rich: I think that’s great. It’s an HR issue from a best practices standpoint, in my opinion. There are labor laws and things like that that people will want to be aware of. But at the same time, I guess the best answer to this, Gene, is it’s very individualized, right? Because if you had the right type of owner and they were willing to get in there, man, that could be transformational in a lot of ways. But it would have to be the type of owner who’s truly coming at it from a caring place, not from a, “You’re getting over on me,” place. Does that make sense? How you approach that mentally is important.

Gene: Next question. Next question for you. You shared with me a story earlier, I said, “I have a story to share with you.” I have a client of mine, they’re located actually in central New Jersey. And they had a manager of the company that, the owners became aware of seemed to be coming to work drunk. Other employees were reporting that he seemed to be visibly drunk, and he had been known to have alcohol issues before in his past. So, the owner becomes aware of it, turns it over to HR, and their response to the employee was just basically just to give him a warning. “Don’t do that again, and if that happens again, you’ll be suspended or you’ll be fired.” And I was like, “I don’t know if that’s helping this guy.”

Rich: No, it’s not helping at all. It’s not.

Gene: Yeah. So, what would you do during that situation?

Rich: So yeah, if you look at most workplace policy, drug-free policies and alcohol-free policies, you’ll see that they’re a titrated system. So, they start, it’s classic stuff, you start at the lowest level with a recommendation of, “Hey, here are services that are available to you. Why don’t you check them out?” Now, depending on what services you have, that might be really effective or it may be really ineffective. If you have Youturn Health, that’ll work. I’m just kidding. But it has to be the right type of service. But if you have something, you can suggest it. So, the first recommendation would be, rather than coming at it from, “What’s going on with you? If you do it again, you’re done,” that kind of thing, it’s like, “Hey man, would you want to check this out? It’s called Youturn Health. They got a video platform. You could go on there and start watching these.”

Rich: Do it in a non-intrusive way, because you want to give people the opportunity to course-correct. And believe it or not, many people will. If it continues to climb the ladder, then you might get to a point, two rungs up, I would say, where, “Hey, either go get help or you can’t continue to work here.” Some people will take it to that level. I don’t recommend that. I feel like that’s just, we’re in a different world today. I don’t know if we need to be like that. But the scenario you described is really, really common, and that’s something that we really need to try to move away from. That’s how a lot of people would handle that.

Gene: Do you feel that mental health awareness, and we only have a few minutes left, so I appreciate the time that you’ve spent, but I’d like to get your thoughts for our audience on the importance of mental health. When people talk about benefits that they’re providing to their employees, they talk about health insurance, they talk about retirement, obviously remote working and PTO and all that is becoming important. To me, it seems like mental health is all a part of a company’s culture and a work environment. So, tell me about being proactive with that.

Rich: That’s a hundred percent true. I mean, everything you just said is really, you captured the problem, to be honest. We are a very reactionary society. So when something goes wrong, we’re going to step in and fix it. There’s no proactive measures. There’s no prevention. Think about it this way. Think about mental health no different than physical health. What do we talk about? Stay in shape. Why aren’t we talking about staying in mental shape? And I’ll tell you, I can answer that, Gene. It’s because people literally think the world is made up like this. They think that there are normal people and that there are crazy people. And what they don’t understand is, this is a statistical fact.

Gene: We’re all crazy.

Rich: Yes. That is a statistical fact. We are all crazy, just at different levels, at different times, with different issues. And when I say that, Gene, I literally mean it. There was a study done and what they found was 93% of Americans will report that at some point in time in their life, they dealt with an emotional crisis, a substance use crisis, or substantial grief issues. You follow me? It’s all of us. But I’m running around thinking that I’m the only dude dealing with this, right? I’m the only guy out here having these thoughts. No. We’re all in this together. I put the fault on that on my profession. I think the way we created our helping systems, we made them very difficult to access and we made them very intimidating. And somehow, we got to redo that. We got to redo that mentality. That’s where we think coaching can be helpful.

Gene: Rich Jones is the Chief Clinical Officer at Youturn Health. Rich, what is the website of Youturn Health?

Rich: Www.youturnhealth.com. Now, it’s real important. It’s spelled out Y-O-U health. Y-O-U-turnhealth.com. It’s not U-turn with the U.

Gene: Perfect.

Rich: Yeah. Yep.

Gene: And I have to tell you, just before we sign off on this, I mean, all the information you’ve been given is great, but what really resonated to me in this conversation is, and I’m going to talk about this when I talk to my clients, is that the proactiveness with mental health awareness is extremely important. I loved your idea about focusing on stress and stress management. I love that. And even just saying, as you’re an employer, listen, it’s very low cost to do two or three times a year, sponsor a stress management meeting or a seminar with a professional like yourself. Because that seems to me the way that you can really identify if there’s any of your employees that might be struggling with any issues, whether it’s substance abuse or mental health issues, and that can put you on the road to helping those employees and helping your business because of that. Rich, this is great information. Thank you so much for joining me. I appreciate it very much.

Rich: Thank you for having me. I love getting on here talking about this stuff. Anytime, anywhere. This is awesome. Thank you.

Gene: Yeah, we got lots more to cover, so we’ll definitely bring you back. You’ve been watching the Small Biz Ahead podcast from The Hartford. Thank you everybody. My name is Gene Marks. If you need any advice or tips or help in running your business, please visit us smallbizahead.com, or SBA.thehartford.com We will see you again shortly with another episode. Thanks again for joining us. Take care.

Gene: Thanks so much for joining us on this week’s episode of the Hartford Small Biz Ahead podcast. If you like what you hear, please give us a shout-out on your favorite podcast platform. Your ratings, reviews and your comments really help us formulate our topics and help us grow this podcast. So, thank you so much. My name is Gene Marks. It’s been great spending time with you. We’ll see again soon.

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