An employee passes through the doorway to the Duke Personal Assistance Service suite at Erwin Square Tower. Photo credit: Megan Morr

Durham, NC - Dennis Kennedy Jr., a facilities plumber, couldn't see more than a few inches in front of his face after the power went out. He was in the basement of the Levine Science Research Center, and his friend and co-worker, Ray Cofer, was working nearby in a mechanical room.

Kennedy and another facilities employee tried to locate Cofer, but the heat and darkness made the task impossible. They later learned Cofer had died when a steam pipe ruptured.

After the May accident, Kennedy was overcome with guilt and began having nightmares. If it wasn't for Duke Personal Assistance Service, also known as PAS, he's not sure where he'd be today. PAS helped Kennedy and his family cope with the after-effects of the traumatic experience.

"Talking to people will put your mind at ease and help you," said Kennedy, 39, who is married with children and has worked at Duke nine years. "I've got to work in that building almost every day. If it wasn't for PAS, it would be a lot harder for me to work or go down to the end of that hallway where it happened and do a job."

Kennedy and the other employees featured in this article are like most PAS clients: silent success stories. However, they volunteered to tell their stories because they believe their experiences will raise awareness about the free counseling benefit available to Duke University & Health System faculty, staff and family members.

PAS provides confidential voluntary assessments, short-term counseling and referrals for a range of personal, family and work problems. Consultation is also available to managers and departments, and PAS responds to critical incidents, as it did last May after the steam pipe accident.

Like Kennedy, most Duke employees who received assistance last year reported improvements in coping ability, productivity and work performance, said Andy Silberman, PAS director. Last year, 1,088 individuals sought assistance through PAS, more than any year since the benefit began in 1984. Since then, nearly 18,300 clients have walked through its doors.

"PAS exists to help people," Silberman said. "Sometimes people don't realize what they're trying to sort through in terms of thoughts and feelings as they're talking because they're jumbled together. A counselor might be able to provide some feedback that helps them identify a concern. It's not that counselors have the answers. It's really that counselors help the individual find the answers that work for them."

Finding Answers

Several years ago, when Delores McNair was experiencing marriage difficulties, her co-workers could sense she wasn't happy. She didn't laugh as much and lost nearly 20 pounds.

"Are you okay?" co-workers asked at the time.

McNair, who works in the Clinical Transplant Immunology Laboratory, reached out for help. She logged onto the internet. "I just went out on the Duke HR website one day looking for help, not knowing PAS was going to be the answer," she said. "Two clicks, and boom; there it was -- Personal Assistance Service."

Finding answers starts with a one-on-one assessment with a PAS licensed counselor, who adheres to professional standards and ethics. Appointments are confidential, as part of strict legal regulations regarding privacy of health information.

Up to six, one-hour counseling sessions are available at no charge for a particular issue or problem.

"We don't want people to get confused and think, ‘Oh, I can only go to six sessions a year or six sessions over a lifetime,' " said Silberman, the PAS director. "We recognize that everybody has problems in life at some point, and they're not always spaced out in a neat, orderly fashion like once a year. "Things happen -- it's like the bumper sticker says."

McNair, who has worked at Duke since 1989, used PAS for support through a divorce and the loss of her grandmother over the span of a decade. Through PAS, she learned about a church support group and got access to literature and other resources that she shares with others at every opportunity. She has since happily remarried, she said, and with the support of her husband, volunteers to help the homeless and less fortunate in the community.

"It's like knowing your best friend lives in another state and you haven't seen them since high school, but you know you can pick up that phone and call them and they're still going to be there," McNair said

"And that's what PAS is like to me. It's that friend that you don't have to call everyday. You don't have to see them everyday, but when you call them, you can pick up right where you left off, and you know you're going to feel better when you hang up."

Improved Productivity

Most clients seek help from PAS for marital, family and relationship issues, followed by depression and anxiety and work concerns. Money worries and growing concerns about the global recession may fuel other personal problems, Silberman said.

"The state of the economy adds to the cumulative stress that people are experiencing in their lives," he said. "Life pours certain amounts of stress juice in our glass, and we all have a certain amount in our glass at any given time. If your level is already at the top, whatever gets added is going to make it spill over the top."

Most clients reported to PAS last year in anonymous questionnaires that their problems, productivity and work performance improved after they completed counseling sessions, said Silberman, who is encouraged by the results.

Last year, the 2,993 counseling sessions generated an estimated savings for Duke's health plan of $180,850, he said. That savings was realized because clients did not access their mental health benefit. And based on outcome data, PAS estimates the service saved Duke approximately $3.1 million last year by improving employee productivity.

"When employees are having personal problems that are affecting their work performance, the manager really doesn't, and shouldn't, try to decide why that work problem is occurring," Silberman said. "What they should do is recognize there is some issue that's getting in the way of whatever that work performance problem is -- let's say attendance, tardiness, accidents or errors -- and they'd want to encourage the employee to make use of PAS."

Yvette West, who was a Nurse Manager and then a Clinical Operations Director in Duke Hospital's operating rooms for 12 years, said she educated her staff about PAS. She told staff members private and confidential support was available if they needed help coping with the fast-paced environment, which, on any given day, involved anything from heart transplants to brain surgeries and gunshot wounds.

West left her role over the operating rooms last March and recently received an e-mail from a staff member, thanking her for the PAS recommendation.

"She e-mailed to say that was the best advice she'd gotten," said West, who is currently the director of Duke's Nurses Improving Care for Healthsystem Elders (NICHE) program. "We all have tension. We all have stress. We all have deadlines, and in that environment, it's non-stop, and everybody wants you to be at your best all day long."

 â€˜It's all right'

Kennedy, the plumber with Facilities, is back to a normal routine because of the service he received from PAS, he said. He's the lead singer in a rock band and enjoys time with his wife and children.

His counselor at PAS, Terry Nicotra, helped him remember and make sense of bits and pieces from the day of the steam pipe accident.

"Sometimes you put that macho facade on, and sometimes you've got to let down," Kennedy said. "And I'm glad I did. PAS let me know it's all right."