This is the final installment of an exclusive four-part series on the importance and benefits of employee assistance programs. Read part one here, part two here, and part three here. If your employer is one of the increasing number of companies offering an employee assistance program (EAP) to support team members when they need help dealing with life events, workplace issues, and other personal problems and challenges, congratulations! If you are a manager in such an organization, you may be wondering what you can do to ensure employees access the program’s services to address issues before they intensify and endanger the well-being of the staff member, their coworkers, and the organization. Managers and supervisors have a responsibility to their staff and organization to act when an employee’s behavior changes. Everyone is entitled to an “off” day, but when the staff member is more “off” than “on,” it may be time to evaluate what to do. Understanding the types of behavior that may be indicative of a brewing crisis is essential to securing the proper resources for the employee. Indicators of crisis Dealing with an employee facing a personal struggle can be challenging for any manager. Whether it’s the death of a loved one, divorce, concerns about a child, a life-changing medical condition, legal and financial problems, violence at home, mental health issues, addiction, depression, or suicidal thoughts, these issues often spill over into the office and can affect performance. Initial behavioral changes may be minor, but if not addressed, can have devastating and far-reaching consequences. The warning signs Recognizing concerning behavior among staff members is the first step to getting them the help they need. According to Michelle Gonzales-Bryant, CVPM, president of the Veterinary Hospital Managers Association (VHMA), “Don’t disregard the small stuff! Often, the first signs of crisis are a few unusual—but not necessarily alarming—behaviors.” These include: Chronic tardiness or absenteeism, a pattern of Monday or Friday absences Increased irritability, including confrontations with coworkers, clients, and managers, or uncontrollable emotions Reduced productivity or deteriorating performance Poor personal hygiene or grooming Fatigue or lack of interest Inability to focus Failure to complete routine tasks Withdrawal These are just a few of the behaviors that may strike a manager as odd. It is not unusual for managers and colleagues to notice something amiss with the employee before he or she is aware they are acting differently. Early intervention When an employee exhibits unusual or uncharacteristic behavior that does not endanger themselves or others, a manager may want to refer the employee to an EAP. The manager, however, cannot mandate the staff member use the EAP unless it is outlined in the company’s policy. On several occasions, Gonzales-Bryant has recommended to staff members they explore the practice’s EAP services. “Personal challenges can bring a person down and the situation can quickly devolve into a crisis,” she says. Certain situations, she believes, warrant close observation because of their potential for life-threatening consequences. Consider the following: Surgery If an employee is scheduled to have surgery, there is a chance opioids will be prescribed to treat postsurgical pain. Recent studies have identified surgery as a gateway to persistent opioid use, dependence, and addiction. A report conducted by the American Physical Therapy Association (APTA) revealed 12 percent of patients who underwent soft tissue or orthopedic operations in 2017 reported they had become addicted or dependent on opioids. According to the study, higher dosages of opioids tend to be prescribed for total knee arthroplasty, total hip arthroplasty, rotator cuff repair, hysterectomy, hernia surgery, colectomy, and sleeve gastrectomy. That said, there are many common procedures and conditions for which opioids are routinely prescribed, including wisdom tooth removal, kidney stones, and lower back pain. Painkillers such as opioids can be effective in the short term, but without proper management, dependence can ensue, leading to opioid abuse and even overdose. Gonzales-Bryant advises managers keep an eye out for changes in behavior in the workplace following surgery. Postsurgical employees who become increasingly isolated, act nervously or erratically, miss meetings or have unexplained absences, are losing or gaining weight, and/or are unable to control their emotions may be exhibiting signs of drug dependence or abuse. Listen Gonzales-Bryant has one hard and fast rule: If an employee mentions suicide, get them help! “Too often, people think that when a person talks about committing suicide, either they are seeking attention or will not act on their words,” she says. “These are myths that need to be dispelled. Whether you hear an employee discuss suicide or an employee tells you of a staff member discussing suicide, take the threat seriously!” Gonzales-Bryant stresses that immediate action is vital. An EAP can provide help and resources, along with a referral to suicide-prevention resources. Know your staff Gonzales-Bryant believes the best way to prevent employees from spiraling downward is to know them. “Most behavioral changes can be traced back to something that is happening in a person’s life. When I note a change that is inconsistent with the employee’s personality, I will discuss it and recommend resources such as an EAP, if appropriate. Sometimes it’s nothing, other times there’s an issue. I’d rather confront the behavior before the situation devolves.” Are there other indicators? Erin Henninger, BA, CVT, VTS, CACVT, executive director at the Colorado Association of Certified Veterinary Technicians (CACVT) and a peer support specialist, admits it can be difficult to know when an employee is headed into a crisis. She encourages managers to focus on their employee’s behaviors and strive to become more comfortable talking about difficult issues. “Currently, we rely on warning signs and risk factors for clues an employee may be in trouble, but these are not foolproof. Managers should be aware people’s crisis response behavior does not always fall within the risk factors,” she says. If an employee’s behavior is raising questions and creating concerns, don’t ignore it. Address it with the help of the practice’s EAP. Careers in the veterinary industry are rewarding, albeit stressful, competitive, and draining. EAPs offer employees and managers the resources to deal more effectively with personal and work-related issues before they become debilitating. Increasing employee understanding and use of EAPs and enhancing a manager’s ability to recognize troubling behaviors help ensure these programs provide value to employees and employers. Beth Drost is a communication specialist who has worked on veterinary industry issues for more than a decade. She is a member of the Veterinary Hospital Managers Association’s (VHMA’s) public relations team and is collaborating with the National Association of Veterinary Technicians in America (NAVTA) to produce this series of employee assistance program (EAP) articles.