The COVID-19 pandemic. An increased number of mass shootings. Sizable layoffs at major employers.

Since early 2020, these and several other trauma-inducing factors have contributed to a worsening mental health crisis in the United States. The stressors have been so pervasive that the reported risk for post-traumatic stress disorder (PTSD) is 83% higher today than it was compared to pre-pandemic times, research suggests.

For individuals and families, traumatic events can lead to the disruption of their daily lives. For employers, they can do the same while derailing a workforce and impacting their bottom lines.

“As you can imagine, the level of disruption in the United States is not going down,” Jim Mortensen, the president of the behavioral health company R3 Continuum, told Behavioral Health Business. “It just isn’t.”

To help their employees prepare for, work through and recover from trauma, more and more employers are including trauma-support services in their employee assistance programs (EAPs). That trend has led to heightened demand for companies like R3 Continuum, which works through EAPs to deliver a range of behavioral health services to mainly mid- to large-sized employers.

With its roots going back nearly 30 years, R3 Continuum is the product of a three-way merger between Behavioral Medical Intervention, Crisis Management International and Crisis Care Network. Its core service line is disruption response and recovery, with additional services including workplace-violence mitigation, employee behavioral health support and leadership coaching that helps executives build a sense of resilience and mental well-being.

“[With EAPs], probably their highest-impact service is the service that we do,” Mortensen said. “Virtually all EAPs outsource most, if not all, of their on-site response work to us.”

Although R3 Continuum only has physical offices in Michigan and Minnesota, its network of roughly 7,000 clinicians delivers services to employers nationwide. After an EAP notifies R3 Continuum that it’s needed, the company’s clinicians can typically be on-site in a matter of hours.

“Pretty much anywhere in the country, we can be on-site with a counselor within two hours of getting a phone call,” Mortensen continued. “And we do about 2,500 [consultations] a month, in an average month.”

In times of crisis

When R3 Continuum clinicians visit a workplace, they do group briefings and one-on-one discussions to help employees normalize their response to traumatic events while also giving them the tools they need to recover. On an annual basis, the company works with about 200,000 people.

That number has sometimes felt much greater with how things have been going since 2020.

“It can be anything from an active shooter, sudden death of a co-worker, layoffs,” Mortensen said. “Lately, we’ve had a lot of what we call ‘facilitated discussion’ around issues like the George Floyd murder, Roe v. Wade, things like that.”

Over the past five years, R3 Continuum has seen its compound annual growth rate check in at about 15% for revenue. In 2022, that growth rate came in at about 42%, according to Mortensen.

A rise in the number of traumatic events throughout U.S. workplaces isn’t the only reason R3 Continuum has seen more demand. Similar to the general population, employees and their employers are more open about mental health and well-being.

Additionally, the tight labor market has meant employers place more importance on retaining their workers – and ensuring they can stay on the job.

Trauma in the workplace can mean absenteeism, task avoidance and loss of motivation, past research suggests. Workers exposed to traumatic stressors can also face heightened anxiety, anger, forgetfulness and more.

“What our counselors are largely doing is helping employees tap into their own resilience and their own support systems to work their way through [a traumatic event],” Mortensen said.

Since its formation, R3 Continuum has grown mostly organically. Still, it’s not opposed to a strategic acquisition or two in the future.

“We are always looking for new ways to grow and impact more lives,” Mortensen said. “Focusing on win/win strategic partnerships has been and will continue to be key to achieving this. … Diversified growth is always smart, especially given the enormity of the opportunity and need.”

Ground to be gained

Employers and EAPs in the past haven’t always prioritized services such as those delivered by R3 Continuum.

In a 2016 poll of working Americans, 53% of participants said they experienced a traumatic event while on the job. Within that group, however, less than half reported working for an employer that offered support to prepare for, respond to or recover from trauma.

And even with demand currently high, Mortensen believes there’s ground to be gained.

“We’re seeing a fair amount of activity,” he said. “Quite frankly, I don’t think we’re seeing enough activity, in terms of supporting the people.”

Looking ahead, an important consideration for R3 Continuum and its peers is the fact that many programs are changing what kinds of benefits are included in their employee packages.

In a WTW (Nasdaq: WTW) survey of over 230 employers, 55% of those offering well-being programs and services said they planned to make changes over the next two years, with 1 in 10 already having made a change in 2022. Of the employers providing mental health solutions, 37% said they’re planning to make changes to their mental health solutions, including EAPs and other clinical or pharmacy solutions, over the next two years.

As far as its business model R3 Continuum operates on a fee-for-service model, Mortensen said.

“Ours is a fee-for-service [mode],” he said. “So if you don’t use us, we don’t charge.”