Barriers to EAP Utilization: A Behavioral Economic Perspective

With the onset of the COVID-19 pandemic, work-related stress has become a prevalent topic of discussion in North America, with estimates suggesting that over 50% of North Americans in the labor force experience stress daily. With high work stress remaining a relevant issue in the workplace, organizations have made efforts to combat the significant levels through the increasing availability of the employee assistance program (EAP). Despite availability and studies on its benefits for both employees and employers, the EAP remains underused by employees for various reasons. Although previous research has studied the structural and demographic barriers to EAP utilization, there is a lack of diverse findings on the individual differences that hinder EAP usage. This project suggests that behavioral economics can be used to assess the dispositional barriers to EAP usage; specifically, this paper suggests that individuals who steeply discount the value of future goods and services will be less likely to utilize the EAP. This project will adopt a measure of temporal discounting to assess individual discounting values and study these values against a measure of EAP usage propensity. As the previous literature on dispositional barriers remains fixed on individual trust and EAP usage, this paper will also adopt measures of trust in confidentiality and efficacy to assess whether or not time discounting can explain the dispositional variance in under-utilization above and beyond the known predictors. It is expected that individuals with high discount rates will be less likely to report willingness to utilize the EAP.

Hello my name is Aparna Mathew and I am working with Dr. Lauren Kuyekendall to complete a psychology and economics project on barriers to EAP utilization in the United States. More specifically, I’ll be taking a Behavioral Economic Perspective to study these.

To get started on some key topics, the EAP stands for employee assistance programs. These are free of charge counseling services that address a lot of the things that private market therapy would address; things like stress, personal issues, and anxiety. Research suggests that the majority of full-time US employees will have access to the EAP in 2021 and there’s been a ton of research on associations between EAP usage and increased positive predictor outcome variables like productivity and functioning that increased as the outcome variables as a result of the predictor variable which is the EAP usage, as well as job and life satisfaction.

So even though there’s all this research on the benefits of EAPs and the growing availability, we do know that the EAP is relatively underutilized and there’s been a lot of research on why that is. So there’s been some demographic research, which is generally more mixed in the results, but some have found that minorities tend to be over represented. Gender minorities like women in the workplace or racial minorities like black individuals. A little bit less mixed is the structural research, so things about the specific workplace things like managerial support, awareness and promotion. We find that typically if you promote your EAP services, you show support and people are more likely to use it.

There has also been limited research on the dispositional barriers, so things about the individual personality that might affect people’s likelihood to use the EAP. The research really focuses on these dynamics of trust. The people who trust the EAP, trust their efficacy, trust that they’re completely confidential, those are the same people that are more likely to use the EAP in the future.

While we were digging through the literature, what we found is there’s a general lack of viable information on the other dispositional characteristics, so at the personality level what could be influencing decisions to invest in one’s mental health through the EAP when they know they could benefit from it?

So, to study these questions we are looking at a temporal discounting or time discounting model. This is a behavioral economics model, essentially there’s a phenomenon that individuals tend to discount the future utility of goods and services. So, the longer you have to wait for a reward, the longer you have to wait to see the benefits of a decision, there’s a general trend where the subjective value of that reward actually decreases overtime.

So what we actually hypothesize is that we know that the EAP is underutilized, we know about the demographic situations, we know a lot of situational barriers, but we really don’t know much else about the individual that will predict EAP usage. Knowing that research indicates people tend to delay mental health help-seeking and health treatment, something like 10 years between the onset of a condition an actual treatment. We also know that there’s a behavioral economics concept is kind of explains why people might put off things with longer-term benefit may be people who steeply discount the future and more quickly discount the value of future goods and services are the same people that don’t really want to put time into the preventative help or find themselves not doing that.

So what we actually hypothesize is exactly that: people with steep discounting rates, which means the value of a good/service is steeply declining for them, are the same people who are going to be less likely to want to use the EAP. So to study this we are submitting a survey via Prolific, getting full-time US employees to answer questions. They’re going to be briefed on the EAP — what it is, what kind of things it covers — and I’m gonna ask them the likelihood of usage. What’s the possibility that they might use in the future? I am also going to measure trust in confidentiality and trust in efficacy to improve the incremental validity of our study because this is the most commonly cited dispositional barrier. Of course will be allowing them to play a game to allow us to sort of identify their temporal discounting task and rate and after that we are planning to obviously analyze our data will be using a hierarchical regression model to see if the variance in willingness to utilize the EAP can be explained by the previous predictors in the literature and our new predictors and would like to see some associations form there

Thank you for listening, that is my project and I hope you enjoyed it!