It is a well-known fact that teaching is one of the ten most stressful jobs along with firefighting or flying a passenger plane in America. Let’s take a closer look at some statistics.
- According to a recent study, 61% of educators say that their work is always or often stressful, and over 50% say that they don’t have the same enthusiasm as when they started teaching.
- 58% of educators characterized their mental health as “not good” for at least a week out of the last month.
- Elementary school teachers are consistently found to be more stressed than secondary school teachers.
- About one third of all new teachers leave education within the first five years of their career, and the rate at which teachers leave the profession is significantly higher than the departure rate in other professions.
- According to researcher Richard Ingersoll, teacher turnover costs as much as $2.2 billion a year, money that is then not available for curriculum and instruction.
- There are negative correlations between emotional exhaustion in teachers and average student grades, standardized test scores, and school satisfaction.
- 75% of teachers have experienced psychological, physical or behavioral symptoms because of work, a significantly higher portion than the overall population.
The situation seems pretty gruesome, but are there indeed any ways to address teachers’ stress? To discuss that, I met with James Rascati, LCSW, partner at Behavioral Health Consultants (BHC) in Hamden. His organization provides Employee Assistance Services to the City and it is well equipped to tackle work related mental health issues including occupational stress.
Jim, I did a little bit of my own research before this interview and was surprised to learn that EAP started with Alcoholics Anonymous.
That’s correct. It started about 50 years ago because of drinking alcohol in the workplace. At that time the strategy was to bring people in recovery to the workplace to influence other drinkers. Today EAP services address not only alcohol abuse problems, but also stress, family issues, depression, anxiety and other mental health problems. It has become more professional compared to the time when the services started. Today, in addition to having people in recovery we also have mental health professionals delivering these services – LCSWs, PHDs, clinical psychologists, etc.
When was BHC founded?
It was founded about 30 year ago. Originally, it was called CT Psychological Group. Some 17 years ago the company split, and one of the branches became BHC (the other group is in the Hartford area now). I am one of the four partners. I have been with the BHC for about 15 years now.
What services does BHC provide?
There are two parts of our organization: first, anyone with health insurance can come and see a specialist. We treat all categories of population: elderly, adults, children, and with various problems – family, substance abuse, mental health disorders. We are a group practice. The other part of the company’s work is EAP and organizational services. We have 120 EAP contracts around the State. We work with many towns, with 58 police departments and 23 fire departments.
That many? How far away are your clients? Do their employees have to travel to Hamden?
BHC has four staff offices – Hamden (headquarters), Guilford, Orange and Fairfield. In addition, we are supported by 370 practitioners throughout CT. For example, one of our clients is the town of Greenwich and the Greenwich Board of Education. Greenwich educators do not travel to Fairfield. Instead, we have contracted providers in Greenwich who can deliver EAP services to them.
Which of the two parts is bigger?
The clinical part is bigger, but the EAP services are growing. The ratio is probably, 60/40.
Are the EAP services becoming more popular?
The employers become more knowledgeable about the mind-body interface and how stress impacts medical conditions. The other reason is that we still live in the stressful times because of the economy, the political polarization and divisiveness, state and city budget problems, fears of layoffs, etc. More and more people should be accessing EAP services. Across the US, regardless of the industry, EAP utilization is 3-7% of the entire workforce. That’s not a lot, especially if you think that one in every two marriages ends with divorce, that approximately 60 – 65% of all visits to a primary care provider or OBGYN doctor has a stress or other psychological component, that one out of ten Americans is depressed. It seems logical that people would seek help from mental health or EAP professionals in these situations, but that’s not the case.
My understanding is that people are biased, that there is a social stigma of a person with mental health issues. People are afraid that once their boss finds out that they had a visit to a mental health provider, they will be forever labeled as “abnormal” and face discrimination.
Without a doubt, there is an issue with a stigma of a person who sees a mental health provider. We treat mental health issues differently than medical, it is OK to take time from work for a medical emergency, but if someone is depressed, has marital or alcohol problems, such a person won’t take time off to see a psychotherapist. Stigma is less of an issue than 40 years ago, when I started my career, but the problem is still there. There are other obstacles that prevent people from using EAP: lack of knowledge about EAP in general and about the fact that their employer offers EAP services. There is a misunderstanding about confidentiality. People are worried that if they use EAP, and that their boss is going to find out, they will be discriminated. In reality, no one knows who uses our services. We only employ licensed professionals, and we advise patients that the only time the services are not confidential is when there is danger to yourself, danger to others, child or elderly care abuse – in these cases, the therapist has the duty to inform the appropriate authorities as required by law. In all other instances, our services are absolutely confidential.
Perhaps another reason is that there isn’t sufficient knowledge in society in general about behavioral health and psychotherapy. Psychology is not taught in public schools.
From what I know, in some schools it is offered as an elective course. I agree, we don’t do enough educating our citizens and schoolchildren about mental health issues. It’s changing though, and the fact that Employee Wellness program is offered in the New Haven district means that there is recognition of the fact that mental health and stress influence body. Hypertension, backache, obesity – a whole litany of medical problems are exacerbated by mental health issues. By the way, the New Haven City Employee Wellness program was prompted 13 years ago by a conversation the City controller had with BHC. The controller was looking at the pharmaceutical expenses of the city employees at that time (medications for lowering cholesterol and addressing mental health problems were a significant part of them). Behavioral Health Consultants suggested that the City start an employee wellness program explaining how mental problems affect medical. About a year later, the City issued a request for proposal. We were approached by St. Raphael’s occupational health to submit a joint bid. We did, and St. Raphael’s occupational health was awarded the wellness contract.
Recently, I read about a study on EAP efficiency conducted in England. The study showed that after psychotherapy male participants increased their income by 13%, female – by 8%.
I wonder why, perhaps the study looked at the work time saved by the EAP services. It is a known fact that people with substance abuse problems take a lot of time from work, so do their family members who take care of them. What I do know though is that medical cost offset research shows that individuals who received mental health counseling have less medical expenses than those who did not.
In my research, I also found out that in this day and age, there is not much hard evidence about EAP efficacy.
There is no rigorously designed studies that looked at efficacy of EAP. Part of the problem is that qualifications of the EAP providers vary greatly. The field is notoriously inept at having studies that demonstrate the efficiency of the services. There are plenty of case studies though.
Do you have any data on how the New Haven teachers use EAP?
Out of all the City departments utilizing our services, NHPS constitutes barely 1,5%. We are mostly utilized by firefighters, police officers, City Hall employees, but not by the city educators. Similar situation is observed in other school districts. New Haven is not an outlier. Every time I have to respond to an emergency situation in the school, I ask teachers or paraprofessionals: how many of you know about EAP? Less than a quarter hands would go up. Unfortunately, people don’t know that they have free services available not only to them but to their family members as well.
I would assume that educators are more intelligent and should know better!
Do you know what people say about people who make assumptions? We assume that educated people are more receptive. Maybe they are, but it does not mean that because of that they would be more likely to use EAP. I work with hospital personnel – their utilization is terrible too.
What are the ways to overcome these barriers and biases?
One way is certainly education. We need to tell people that EAP is not only for substance abuse, that we offer help in a broad variety of situations. There is a stereotype that people who use EAP services are either drunk or crazy. Although obviously we treat substance abuse and psychological problems that is not all we do. Teachers work in a highly stressful environment where they have to deal with students and parents from various backgrounds. To add to that, many of the teachers are parents themselves, and it can be stressful as well. Under these circumstances, schoolteachers should be using EAP much more than they currently do. .
Our recent survey on Employee Wellness Program awareness revealed that the number one problem our teachers have are high stress levels.
It was researched that the primary reason someone leaves the job is money and benefits. Number two – people leave jobs because of their relationships with their supervisors, they don’t feel supported. An inner city teacher is playing multiple roles – of a teacher, of a social worker, of a parent. Teachers have not been trained to cope with these roles. They feel overwhelmed, they feel frustrated. Certain things cannot be easily fixed, but there are other things that can be addressed to help teachers. I always say to my clients: I cannot change the circumstances of where I am working, but I can change my attitude to them, I can change my response.
I know that teachers resign when they are stressed, when they feel that they are not supported by the administration. Knowing that, we at BHC put together a proposal to address this issue. One part of it was to help teachers to deal with students. The other part was stress management for teachers.
Here is how Wikipedia defines occupational stress: “unexpected responsibilities and pressure that are not aligned with person’s knowledge, skills or expectations, inhibiting one’s ability to cope. Stress can increase when workers do not feel that they are supported, and when they feel that they have little control over the processes”. One thing catches my eye in this definition: “unexpected responsibilities”. Do we condition people to get only what is expected? Life is so unpredictable. Carl Jung who studied human psychology in depth said that conflict is inherent to a human individual. Humans will always have conflicts and will always struggle to resolve them. Conflict is inherent to human nature. When we talk about stress and stress reduction, don’t we instill the wrong idea that normal state of existence is peace and quiet?
That’s a good question. But I know that people in the district are pulled in a multitude of directions, and that they are not using help that is available to them. Quite frankly, what troubles me is the fact that people are ignoring the resources available to them – be it therapy sessions or workshops.
BHC counseled the police officers who responded to Sandy Hook events. They all returned to work. Treatment works, however, treatment does not work if people do not access it.
Going back to the question why people don’t use EAP. They don’t know about them, they forgot about them, they don’t realize that it’s for their families, they worry about confidentiality, about stigma – whatever the reasons are, they all can be addressed through education. We can educate people about EAP and they should use it.
It’s very rewarding to know that the work of my colleagues and mine yields positive results. I do a lot of police training, and often receive good feedback from the officers for the help my firm provides. Many times, I don’t even remember their names. I recall how some time ago at one of my trainings, an officer came up to thank me for saving his life. He said it was his hundred and umpteenth day of sobriety. All I did for him – I was on call the night he had a crisis, I listened to what his problem was – he was drinking a great deal. I never saw him. I counseled him and directed to the program specifically designed for cops, that’s all. I hear similar stories from my colleagues all the time. Just one of the recent ones was about a young teacher who could not sleep, was anxious all the time, overwhelmed. She was on the verge of leaving her job. Counseling helped her to stop and think: why leave if I love what I am doing, I love my students. We try to help our patients understand that they often cannot change the circumstances but they can change their response to them.
Thank you very much, Jim, for the information. How can district employees access EAP services? What’s the protocol?
EAP services are available 24 hours a day, 7 days a week through our toll-free hotline at 1-800-864-2742 or local (203) 407-1029. All you or your dependent family member needs to do is call this phone number to access services. We will inquire as to the nature of the problem so that we can refer the caller to the most appropriate resource or clinician to meet their needs, both clinically and geographically.
If you are unsure as to whether your problem or difficulty requires consultation, we are available for phone consultation to briefly and anonymously discuss the nature of your concerns and make recommendations for further intervention.
On our website www.bhcservices.com, we also offer self-assessment questionnaires that you can complete to help you better determine if you have an underlying problem that might require intervention. These questionnaires are meant as screening devices only and should not be considered diagnostic in nature. Only a trained professional can conduct a thorough evaluation and determine an accurate diagnosis. Here are the links to specific questionnaires:
During regular business hours, all calls come to our headquarters in Hamden, CT. After hours, the EAP hot line is answered by our medical answering service. Clinical coverage of the EAP line is handled by one of the four partners of BHC. Therefore, we always have a clinical staff person available for all urgent or emergency calls.
Here is a partial list of problem areas that we can provide counseling services for: substance abuse, depression, anxiety, sleep disorders/difficulties, post-traumatic stress disorder (PTSD), gambling, smoking cessation, Attention Deficit-Hyperactivity Disorder, eating disorders, elderly issues and dementia, chronic pain.
Interview by Liliya Garipova,