Many people who struggle with a substance use disorder or a mental health condition are employed. They show up, meet deadlines, and manage their responsibilities while carrying something their colleagues and managers know nothing about.
The gap between needing help and asking for it can last years, and the costs accumulate on both sides of the relationship.
For HR professionals and company leaders, this is where the Employee Assistance Program becomes more than a benefits checkbox. A well-utilized EAP is one of the most direct tools an organization has to reach employees before a personal crisis becomes a personnel crisis.
Substance use disorders and mental health conditions are among the most costly health challenges affecting the workforce, yet they remain among the least visible.
According to the Substance Abuse and Mental Health Services Administration’s (SAMSA) 2024 National Survey on Drug Use and Health, approximately 21.2 million adults in the United States had a co-occurring mental illness and substance use disorder.
Yet, organizations often don't recognize the problem until it has already affected performance, safety, or attendance. By that point, the opportunity for early intervention has passed.
Substance abuse and mental health issues often appear as behavioral and performance changes that build over time, rather than isolated incidents. Common indicators include:
Many individuals use alcohol or other substances to manage the symptoms of anxiety, depression, or trauma. Over time, that coping mechanism becomes its own problem. SAMHSA's 2024 data makes clear that co-occurring disorders are not the exception, but rather the norm.
An EAP referral that only addresses substance use without connecting the employee to mental health support may resolve one symptom while leaving the underlying condition unaddressed. Effective EAPs screen for both and refer accordingly.
Employees struggling with a substance use or mental health condition often do not seek help on their own. Stigma, fear of professional consequences, and uncertainty about where to turn are all well-documented barriers.
Offering an EAP is not enough. How it is communicated and reinforced determines whether employees use it.
HR's role here is facilitation, not enforcement. An HR team that positions the EAP as a confidential, no-strings resource builds a different kind of trust than one that deploys it primarily as a response to policy violations.
According to the International Foundation of Employee Benefit Plans' 2024 survey, 38 percent of employers identified employee fears about job security as the primary barrier to mental health and substance use support, with confidentiality concerns close behind at 33 percent. Addressing that trust problem is inseparable from facilitating effective recovery.
The EAP process begins with a single confidential contact that triggers an assessment. A trained counselor evaluates the issue, provides short-term counseling if appropriate, and connects the employee with the right level of care.
Employers receive only aggregate, anonymized utilization data. They never learn which employees contacted the program or why. Without that protection, participation would be negligible.
A well-designed EAP doesn't operate in isolation. Three legal areas deserve HR's attention:
Getting an employee connected to an EAP is the beginning, not the end. The EAP's most important function is often the referral itself: connecting the employee to the appropriate level of clinical care and maintaining support through each transition.
Organizations that see meaningful engagement have done deliberate work to build a culture where asking for help signals self-awareness rather than weakness.
Leadership visibility matters enormously, as does consistent, destigmatizing language in policies and communications. Referring to someone as a person in recovery rather than an addict sends a signal that accumulates over time.
HR's responsibilities during reintegration include coordinating logistics, confirming ADA accommodations, and ensuring the direct supervisor has been appropriately briefed without compromising employee privacy.
Effective returns are structured but flexible:
It's important to acknowledge that every situation is unique, but adhering to these best practices will help ensure that the organization is supporting employees' recovery.
Low utilization is largely an awareness problem. A single mention during onboarding does not constitute an EAP communication strategy. Effective efforts use multiple channels throughout the year: team meetings, newsletters, manager talking points, and targeted communications during periods of elevated organizational stress.
The message doesn't need to be elaborate. Employees need a clear, consistent reminder that the resource exists, what it covers, and how to access it confidentially.
Effective manager training covers three competencies:
Annual refreshers and scenario-based practice sustain that capability over time. Managers who feel prepared are far more likely to make an EAP referral early, when it is most likely to help, rather than waiting until a situation has escalated into a formal disciplinary matter.
An informal EAP mention differs from a formal management referral. The latter is appropriate when documented performance concerns are already established, and HR should be involved before the referral is made. The referral conversation itself should focus on observable work performance, not speculation about cause.
Employees must understand that participation is voluntary, and a refusal does not eliminate the organization's ability to take appropriate disciplinary action for documented conduct issues.
ADA and FMLA should be evaluated separately for each situation. An employee may qualify under one, both, or neither, and the obligations differ accordingly.
Medical information obtained through either process must be kept in files separate from the general personnel record and shared only with those who have a legitimate need to know.
Fitness-for-duty requests, return-to-work agreements, and last-chance agreements should be reviewed by legal counsel before being issued. Involve legal early rather than after a misstep.
The National Safety Council found that employers who support employees through substance use recovery save over $8,500 on average per employee through reduced turnover, lower healthcare utilization, and improved attendance.
HR should track absenteeism trends, retention rates, and healthcare costs among employees with EAP engagement, and request customized reporting from providers rather than accepting standard utilization summaries. Clinical outcome data and case resolution rates tell a more complete story than raw contact numbers alone.
Navigating mental health and substance use challenges in the workplace requires more than a hotline number. It requires a program with genuine clinical depth, responsive account management, and the flexibility to meet employees at different stages of need.
Ulliance EAP delivers face-to-face counseling, life coaching, and management consultation as core components, not add-ons. HR teams have access to direct support for complex employee situations, and crisis response services are available when circumstances demand an immediate, coordinated response.
When you partner with Ulliance, our Life Advisor Consultants are always just a phone call away to teach ways to enhance your work/life balance and increase your happiness. The Ulliance Life Advisor Employee Assistance Program can help employees and employers come closer to a state of total well-being.
Investing in the right EAP or Wellness Program to support your employees will help them and help you. Visit https://ulliance.com/ or call 866-648-8326.
The Ulliance Employee Assistance Program can address the
following issues:
• Stress about work or job performance
• Crisis in the workplace
• Conflict resolution at work or in one’s personal life
• Marital or relationship problems
• Child or elder care concerns
• Financial worries
• Mental health problems
• Alcohol/substance abuse
• Grief
• Interpersonal conflicts
• AND MORE!
References:
Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 National Survey on Drug Use and Health; SAMHSA https://www.samhsa.gov/data/sites/default/files/reports/rpt56287/2024-nsduh-annual-national/2024-nsduh-annual-national-html-071425-edited/2024-nsduh-annual-national.htm
Managing Employee Assistance Programs; SHRM https://www.shrm.org/topics-tools/tools/toolkits/managing-employee-assistance-programs-eaps
Mental Health and Substance Use Disorders: Employers Improve Response, but Employees Continue to Struggle; International Foundation of Employee Benefit Plans; Cara McMullin https://blog.ifebp.org/mental-health-and-substance-use-disorders-employers-improve-response-but-employees-continue-to-struggle/
The Role of Employee Assistance Programs (EAPs) in Substance Abuse Recovery; Compassion Recovery Centers https://compassionrecoverycenters.com/blogs/the-role-of-employee-assistance-programs-eaps-in-substance-abuse-recovery/
Substance Use Costs Your Workplace More Than You Think; National Safety Council https://www.nsc.org/safety-first/substance-use-costs-your-workplace-more-than-you-t