EAP Center of Excellence FAQ
Assessment, development of an appropriate plan, short-term problem resolution and client referral to appropriate treatment and/or community resources.
Specific situational events or presentations that warrant assessment and/or short-term problem resolution. Situational events may include: workplace/performance issues, family/relationship issues (e.g., divorce, parenting, conflict resolution), work-life balance and stress management, assessment of possible substance abuse, life transition or general V-Code issues.
The following are examples of when members should be referred directly to their behavioral health coverage: Recurring/active chemical substance use; current suicidal/homicidal ideation; severe mental illness; court-mandated referrals (unless other EAP clinical criteria are met); request for psychiatrist or medication evaluation; current, ongoing treatment with no break in episodes; request for psychological/neuro-psychological testing. If you are uncertain which benefit should be accessed, please contact the Member Service team for assistance.
EAP benefit designs are determined by the member’s employer. Some employer groups contract to allow a maximum number of sessions per eligible member each benefit year (e.g., up to three sessions). Others select plans which allow members to access their EAP benefits for different presenting issues, subject to assessment and approval by MHN clinicians. When you receive an EAP referral, the maximum number of available sessions appears on your authorization paperwork. Please note that it is inappropriate to use EAP sessions when your assessment shows that a higher level of care is necessary or that longer-term clinical care is needed.
Managed care benefits are for more intensive clinical treatment; EAP services are for assessment/referral and short-term problem resolution only.
MHN supports EAPA Professional Guidelines for Employee Assistance Programs and the EACC Code of Professional Conduct for Certified EAP Professionals (CEAP). EAPA guidelines state, "any actual or perceived conflict of interest among EAP professionals and service providers shall be avoided". MHN promotes client referrals to appropriate resources for the client. MHN has no general prohibition against a provider’s self-referral, when it is given in the context of multiple choices for the client and in consideration of the client’s mental health benefit coverage.