Delivering Employee Support Services in the Global Community

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Isaac Rich
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Delivering Employee Support Services in the Global Community EAP Drivers and Influences Projected Utilisation Though Employee Assistance Programmes (EAPs) are not yet the norm in the, the programmes

Given Czechs high level of familiarity with mental health counselling, and the popularity of social programmes in the, it is likely that EAPs will be viewed as a helpful resource.

1 Delivering Employee Support Services in the Global Community EAP Drivers and Influences Projected Utilisation Though Employee Assistance Programmes (EAPs) are not yet the norm in the, the programmes are becoming more popular and more frequently utilised. Given Czechs high level of familiarity with mental health counselling, and the popularity of social programmes in the, it is likely that EAPs will be viewed as a helpful resource. Fast Facts Population: 10,500,000 Capital City: Prague Political Structure: Parliamentary Republic Currency: Koruna (CZK) Time Zone: Central European Time (CET) The average cost of counselling services in a private practice ranges from CZK 950 to 1,750. The average length of a counselling session ranges from 50 minutes to one hour for an individual, while a couples counselling session generally lasts 90 minutes. Czechs are open to both telephonic and face-to-face counselling. Attitudes Toward Counselling As the birthplace of psychoanalysis pioneer Sigmund Freud, the is seen as having a rich history and tradition of psychology. Unlike most other Eastern European countries, which have focused mental health studies on a biomedical model, the has consistently produced more academic literature on clinical psychology than on any other mental health field. Though mental health disorders do hold some amount of stigma in Czech society, mental health counselling is generally understood and well accepted. In addition, community-based counselling, human rights promotion, and destigmatisation campaigns are major focal points of the s national mental health policy. Attitudes Toward Alcohol and Substance Abuse The has some of the highest rates of substance abuse in the European Union (EU). The most frequently used drug is cannabis, followed by club drugs such as ecstasy and amphetamines. The majority of illicit drug use occurs in the s urban areas amongst young males. Generally, drug use is viewed as a recreational activity and is not seen as a serious problem by the s younger generations. Addiction treatment is primarily delivered by public organisations, such as psychiatric clinics, specialised substance abuse facilities, and detoxification units. Though services offered in these facilities are free, these public clinics are often associated with stigma and viewed as a last-resort option. The Czech government has also contributed resources to developing school and community-based prevention programmes. Studies indicate that the level of illicit drug use amongst the general population in the remains stable. 1-7

2 Beer is an important part of the s culture and is commonly consumed by both men and women. It is common to have a beer with lunch or dinner, and to consume alcohol during most social celebrations and public events. Professional Clinical Qualifications There is not an organisation that oversees EAP accreditation in the. Minimum licensure and accreditation requirements for mental health professionals are overseen by the Ministry of Labour and Social Affairs as well as by the Ministry of Education, Youth and Sports. Requirements vary depending on specialisation area (social work, Gestalt psychology, psychoanalysis, etc.). General practice psychologists are required to hold a master s degree and one year of clinical experience in order to obtain licensure. National Delivery Systems Health Care The s health care system underwent fundamental reform following the end of communism in Under this new system, all Czech citizens are required to purchase a health insurance plan from one of several government-regulated health insurance companies. The rates and services of these health insurers are regulated by the government and subsidised by a national health insurance tax. In addition to this tax, Czech citizens are required to pay monthly premiums to the insurance company of their choice. Though some groups (low-income, elderly, handicapped) are exempt from paying health insurance premiums, average Czech citizens are required to pay 4.5 percent of their yearly income toward their health insurance. Though more comprehensive plans are available at higher rates, all health insurance plans are required to cover basic outpatient, inpatient, emergency, and preventive care. Depending on the level of coverage one chooses to purchase, there may be many procedures or medical tests that require individual co-payments. As of April 2012, a change to the public health policy removed all nonessential prescription drugs from the list of covered expenses. Now, only drugs that health care providers deem necessary and imperative are offered free of charge; all others require co- or direct payments from individuals. Key Professional Associations Czech-Moravian Psychological Society Kladenska 48 CZ Praha 6 Telephone: Website: Czech Association of Work and Organisational Psychologists Karlštejnská Praha 5 Website: Union of Psychologists Associations of the Kladenska 48 CR Praha 6 upacr@upacr.cz Website: php?lng=en&kap=about_us European Federation of Psychologists Associations of the EFPSA EFPA Head Office Grasmarkt 105 / 18 B-1000 Brussels Belgium Website: Alzheimer Society Simunkova Praha 8 Telephone: Fax: Website: 2-7

3 Medical facilities are generally of high quality in the and fully funded by reimbursement from health insurance providers. Though some physicians have contractual arrangements with specific insurance companies, most accept all insurance policies. As a result, patients are free to register under any physician of their choice, and may switch providers after three months if they are not satisfied with their service. Patients do not require a referral from a primary care physician to see a specialist in the, and do so frequently using health insurance or fee-for-service payments where treatment is not covered. Behavioural/Mental Health Coverage and Care The s mental health care policy was established in 1997 under the Psychiatric Society of the Czech Medical Association, the organisation responsible for setting minimum standards for medical professionals and facilities. Under the 1997 policy, inpatient psychiatry treatment is defined as an essential medical treatment that must be covered by all public health insurance plans. In addition, the policy establishes the need for care that focuses on the social integration of mental health care, rather than treatment within psychiatric hospitals or inpatient settings exclusively. Part of this integrative strategy was a requirement that all district public health authorities ensure funding for added mental health facilities and professionals in non-psychiatric hospitals and in outpatient clinics. Over the past two decades, the s mental health care system has made slow but marked changes in response to these provisions. According to the Czech Republic s Institute of Health Information and Statistics, there were approximately 946 outpatient facilities in 2011, compared with 525 in The number of social workers, psychiatric nurses, and therapists who provide full- or part-time services in these outpatient facilities has increased as well. In 2011, the Ministry of Public Health s Bureau of Statistics estimated that 500,000 individuals received outpatient mental health care services. Though the trend toward less and shorter treatment in psychiatric and hospital settings has been a positive change in the, a fully integrated system of community-based treatment has yet to be adopted. The current shortcomings are partly due to limited financial resources. Currently only inpatient stays are covered by basic health insurance plans, while most social support and therapy-based interventions require co- or direct payment. In addition, mental disorders still face a significant amount of stigma and are seen as something that should be relegated to a psychiatric inpatient setting. Public education and training of medical professionals on issues of community-based care and integrative treatments for mental disorders will be an important step forward for expanding the s mental health care. Child Care and Parenting There is a range of both public and private child care service options in the. Though it is common for a parent or close relative to care for children younger than the age of three, a study by the Ministry of Public Health s Family Services Department estimated that up to 25 percent of children younger than the age of three attend some form of out-of-home day care. For children of this age, child care may be accessed in both public and private nurseries. Public facilities are typically established under municipal governments and may have different requirements based on local regulations. Private nurseries offered through churches or for-profit day care centres are also common in the, and can range in price between CZK 800 and 4,500 per month. Occasionally, companies may provide on-site nurseries or subsidise day care costs for their employees. For children ages three to six, pre-primary school education is available through a large network of public and private kindergartens. Public kindergartens are operated by municipal education boards and are provided at a low cost for the first two years and then for free for children who are in their third year. Private kindergartens for children of this age range are also readily available through private schools, foundations, or religious organisations. These private organisations have a wide range of costs but tend to be more expensive in urban settings. 3-7

4 Child care providers working in public nurseries or in public kindergartens are required by the s Education Act (Act No. 561/2004) to hold a bachelor s degree in education and additional qualifications in early childhood or primary education. Credentials are not required for child care providers in private nursery or kindergarten settings; however, according to the Education Act, all private child care facilities are required to meet a minimum standard that ensures health and safety of children, their meals, and any other special needs. Babysitters, nannies or other in-home child care is also readily available in the. There are no requirements or licenses necessary for people who wish to work as in-home childcare providers, and no standard fee for this type of service. Elder Care The provides a pension to its citizens beginning at 65 for men and age 62 for women who have had more than two children. This pension is earningsbased, and typically equivalent to 7.5 percent of an individual s average monthly income during their wageearning years. The Czech government also establishes a minimum monthly pension that is allotted to all citizens over the age of 65, regardless of their lifetime earnings. As of 2011, this monthly minimum was set at CZK 2,240. In addition to a pension, all senior citizens are eligible to receive full or partial subsidies on their health insurance premiums. The level of financial support provided typically depends on regulations by local insurance funds and the financial need of individuals. At present, all elderly citizens in the are able to receive government funded home care, day care, and long-term institutional care. Home care may consist of in home nursing, personal assistance services, and integrated home-health assistance. All home care professionals must be certified by the Ministry of Health, and may be paid through public or private funds depending on the requirements and needs of the individual. As of 2007, there were 475 home care agencies providing care to more than 145,000 patients in the. In addition to home care, day and long-term care institutions are provided for elderly citizens at low or no cost. Municipalities and regions are responsible for organising these social and residential facilities according to their local needs; currently, there is no central body or policy governing long-term care in the. Nevertheless, municipal governments have made strong efforts to ensure availability and quality of care for the elderly. In 2009, the Ministry of Public Health s Bureau of Statistics reported that there were more than 75,000 available long-term care beds in elderly homes and nursing facilities throughout the country. Cultural Characteristics Language The official language in the is Czech, which is a Slavonic language (similar to Polish, Serbian, or Russian) and is spoken by 95 percent of the population. Slovak, which is similar to Czech, is spoken as a second language by approximately three percent of the population, while German and Polish are also second languages to two percent of all Czech citizens. English as a second language is present in the s urban centres but has a lower penetration rate than in most Western European countries. Ethnic Makeup More than 95 percent of the s population is ethnically Czech. Non-Czech populations include Slovak, Greek, Turkish and Italian immigrants who are primarily located in Prague, the country s largest urban centre. The also has growing Romani and Vietnamese populations. Demographic Trends The population of the has increased over the past two decades, with the largest portion of population growth coming from immigration. Most immigration comes from neighbouring countries such as Ukraine and Slovakia or from other EU member states. The is a fairly densely populated country, with about 340 persons per square mile, and more than 4-7

5 65 percent of the Czech people live in cities or towns of 5,000 or more. The highest population density is in metropolitan Prague, which has 1.3 million inhabitants. Other large cities include Brno, with approximately 400,000 people; Ostrava, with about 350,000; and Plzeň, with approximately 180,000. Lifestyle and Religion The majority of the Czech population identifies itself as agnostic or churchless, with only seven percent of Czech people stating that religion is important in their lives. According to the 2011 census, the largest reported religion was Roman Catholicism (10 percent of the population), followed by Protestantism (less than one percent). Typically, Czech people hold strong family values and maintain close relationships with their nuclear families. Though urban households tend to be small and are not commonly intergenerational, in the Czech countryside, many children live with their parents through adulthood. In these families, child-rearing tasks are shared amongst family members, and family support networks may be extended to aunts, uncles and first cousins. Communication Styles Czechs tend to be highly private and reserved people. Outward emotional expressions are usually reserved for family or close friends, as is first-name-based communication. Although always polite, Czechs may be hesitant to have in-depth personal conversations with individuals who are not part of their extended family or very close friends. Often, this changes as trust in relationships is built over time. Do not be surprised if individuals whom you do not know avert their eyes when passing you on the street or while on public transportation, as it is considered somewhat rude to interact with individuals whom one does not know Work Ethic The generally follows a 9:00 a.m. to 5:00 p.m. business schedule, with half-hour to hour-long lunch breaks during the day. Business typically slows during the month of August, when many Czechs take their holiday. Within Czech business culture, punctuality and regularity are highly valued and are seen as important points of respect in meetings. It is also respectful to schedule all business meetings well in advance. However, first meetings may be used more as an opportunity to get to know business associates, rather than to make decisions. It is normal to make some formal small talk and getting-to-know-you conversation before business is discussed. When presentations are made, however, formality and accuracy are expected. Business and Economic Characteristics Economy Though the s GDP remains below the overall average for the EU, it is one of the most stable and prosperous of the Central and Eastern European post-communist states. The principal industries are machine and electronic manufacturing, as well as iron and steel production. Currently the auto industry is the single largest industry in the and accounts for nearly 24 percent of all manufacturing. The also has a small but growing financial sector whose conservative fiscal policies have resulted in stable growth over the past two decades. Though the s financial sector was not as affected by the 2008 global economic crisis as other countries in Eastern Europe, the industrial sector proved more volatile and constricted significantly during this period. This resulted in a 4.5 percent reduction of national GDP. Over the last several years; however, the Czech economy has slowly recovered at a rate of 1.2 percent per year, and is continuing to grow. Workers Rights Legislation Workers rights are set and enforced by the Czech Labour Code, which was most recently amended in This code establishes all rights and minimum standard requirements that exist between Czech employers and their employees. The Labour Code defines the normal working week as 40 hours, with exceptions for professions that require hazardous or strenuous labour (these 5-7

6 are typically defined as between 35 and 38 hours per week). All employees are entitled to rest lasting at least 12 hours between the end of one shift and the beginning of the following shift, as well as one uninterrupted period of rest lasting at least 35 hours per week. In addition, employers are required to provide all employees with four weeks of paid leave per calendar year. Communication Almost all companies, households and hotels in the have a broadband or DSL connection available. Wi Fi connection is also commonly used in the and can be accessed through laptops or smartphones in many cafés, hotels, and other public places. Female employees are entitled to 28 weeks of maternity leave (or 37 weeks for mothers who give birth to two or more children at the same time). Typically, this maternity leave is required to start between eight and six weeks before the expected due date. The Labour Code also states that employers must grant parental leave to male and female employees if so requested. Unpaid parental leave may be granted to mothers upon termination of maternity leave and to fathers of children younger than the age of three. Status and Influence of Work Councils and/or Unions The s labour movement has been heavily influenced by the country s communist history. Following the political transition of the government in 1989, the adopted a nonpartisan union system, with workers and trade confederations in almost all industrial sectors. The largest of such organisations is ČMKOS, a multi-sectoral confederation of works councils, which had almost 500,000 members in At that time is was estimated that the total number of unionised workers in the was 800,000, although precise numbers are not published by all union organisations. However, this number represents a significant drop in participation from the early 1990s, when the labour movement began; in 1995, ČMKOS had 2.45 million members. The decline in union participation is due largely to a decrease in political support. Workers union rights groups have reported that the Czech government takes a mostly perfunctory stance on labour disputes and has limited workers right to strike. It is likely that this trend toward a more centralised labour system will continue as the navigates a tightening economic climate. The has a well-developed mobile telephony market, which has penetrated even the most rural areas of the country. Nevertheless, most businesses and many residents in the still primarily use a landline system. The largest telecom company in the is Telefónica, which offers both mobile service and landlines and is considered one of the leading telecom providers in Eastern and Central Europe. Overall, the has an excellent telephony system with available toll-free numbers, SMS texting, and universal international freephones. Confidentiality Issues In the, the right to protection from unauthorised interference with privacy and personal data is regulated and enforced by the Personal Data Protection Act (2001). Further information on this act may be accessed at the following website: aspx?menu=4&submenu=5&lang=en Support for International Assignees Embassies British Embassy Thunovska Prague 1 Telephone: Fax: prague.consular@fco.gov.uk Website: Embassy of the United States Tržiště Prague 1 - Malá Strana Telephone: Fax: Website: 6-7

7 Schools The International School of Prague Nebusicka Prague 6 Telephone: Fax: Website: The British International School of Prague Podolská Prague 4 Telephone: Fax: mainoffice@podoli.bisp.cz Website: Additional Resources for US or UK Citizens Employee Assistance and Work-Life Snapshot LOW MODERATE HIGH Acceptance of counselling EAP awareness in business world EAP and work-life utilisation Population of English speakers Telephone availability Internet access 7-7 Copyright 2013 Workplace Options. All Rights Reserved.

Delivering Employee Support Services in the Global Community

Delivering Employee Support Services in the Global Community EAP Drivers and Influences Projected Utilisation The Arab culture will influence the likelihood of EAP utilisation and the means of service