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The recession and continuing high unemployment are taking a psychological toll on individuals.

The number and urgency of calls to employee-assistance programs have risen substantially over the past couple of years, providers say. In particular, there's been a startling increase in the number of calls regarding violence, psychosis and dementia in the workplace, including calls about suicidal and homicidal threats, program directors say.

"All of a sudden the economy tanked and we have had a big jump in the number of calls, and the variety of calls is very different from what we saw a couple of years ago," says Charles Lattarulo, clinical director of Harris Rothenberg International, a provider of employee and employer assistance programs.

Employee assistance programs offer workers and their families access to counselors via a toll-free telephone number or in some cases a Web site. Often, counselors are available 24 hours a day, seven days a week to help employees in an emergency.

A 400% Jump

Mr. Lattarulo says the number of calls to Harris Rothenberg's programs rose every month in 2009 from the previous year, sometimes by as much as 40%. There was a jump of 400% or more some months in manager referrals for suicidal, homicidal, or otherwise dangerous employees.

At provider ComPsych, calls about financial problems outnumbered calls for relationship issues for the first time last year, a spokeswoman says.

Financial pressures -- home foreclosures, bankruptcies and prolonged spousal unemployment -- are straining marital and family life, and contributing to behavioral problems in children and teenagers, Mr. Lattarulo says.

And a new concern: Depleted retirement funds are forcing many older employees to stay in the workplace longer, despite health problems or cognitive impairments. "For the first time ever, we are having multiple calls [from managers] because of people in the workplace with dementia," Mr. Lattarulo says.

Legal and Financial Help

Given these issues, some employee assistance programs are increasingly offering referrals to marriage and family counseling, legal advice and child and elder-care services. Some include access to financial planners, debt counselors and legal specialists.

People are now "calling for legal and financial concerns that are critical, like they are about to lose their house or have lost their jobs," says Ruth Donahue, a consultant and clinical social worker for human-resources consulting firm Segal.

Typically, there's no fee for the initial call and for up to eight sessions with a program's counselor, depending on an employer's contract with the provider.

Because so much of the anxiety stems from a job loss, some employers are continuing to offer free services to terminated employees for a few months, as part of severance packages, according to ComPsych. Some offer employee assistance to terminated workers even if they don't continue health-insurance coverage under Cobra, experts say.

For the unemployed or those without employee-assistance programs at work, the nonprofit National Alliance on Mental Illness (nami.org) can help you find mental-health services with low or sliding-scale fees, often through community mental health centers or universities.

State and local departments of mental health and substance abuse also list local resources

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