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Almost all businesses offer EAPs to support their employees, but the numbers using them remain troublingly low
Like so many good ideas, the concept of the employee assistance programme (EAP) began life in a bar. But it wasn’t a group of like-minded entrepreneurs coming together over a few drinks that led to its inception – it was the pervasive problem of white-collar alcoholism in 1940s US office culture.
Employers’ solutions became known as ‘occupational alcohol programmes’, which tackled the mental, emotional and financial issues created by problem drinking. Within a few decades, a broader focus was being developed to manage wider behavioural issues that affect performance at work – and this led to the fuller set of professional services that comprise EAPs today.
Legal and health information, and child and elderly health services, soon came on board. Today, EAPs can also offer face-to-face counselling, debt advice, trauma support and online services.
Their popularity really took off in the UK after 2002, following a string of occupational stress-related employment law cases that considered employers’ duty of care. These culminated in Sutherland v Hatton, where Lady Justice Hale said in her judgment: “An employer that offers a confidential advice service, with referral to appropriate counselling or treatment services, is unlikely to be found in breach of duty.”
Today, 88 per cent of organisations surveyed by the Reward & Employee Benefits Association offer EAPs, and a report from the UK Employee Assistance Professionals Association (EAPA) found that 13.8 million employees are covered by one, a figure that has increased massively since 2008.
EAPs are valued in particular for their confidentiality, which is why they tend to be outsourced to external providers that offer greater economies of scale by providing access to a pool of counsellors or specialists. As Clara McSweeney, HR business partner at MTR Crossrail, says: “The key factor for us is that the EAP is confidential and independent, so employees are confident that any issues they raise will remain outside the company.”
And yet, EAPs are not universally understood or valued by HR or the wider business. An EAPA report found that HR managers believe the programmes are primarily associated with mental health issues, which limits the use of broader EAP services and shapes attitudes to their use. The worry is that if employees are failing to take advantage of a potentially life-saving resource, they may be turning to the wrong place for support – or not going anywhere at all.
Between 2.5 and 16 per cent of employees use their EAP at least once in a year, with the average around the 5 per cent mark, according to research by Dr Zofia Bajorek at the Work Foundation. But as she points out: “It is quite a futile measurement because it depends on what the usage is. Is it a click on the website or a call to a counsellor? Does each individual call count or each individual problem? The definition of usage is subject to each organisation and each EAP.” Companies may also struggle to identify what percentage of employees who could benefit from an EAP’s support are using the service.
Despite the wide variance, Neil Mountford, chair of EAPA UK, believes that even if programmes aren’t being used, the very knowledge of their existence sends a strong message to the employee population. This view is reflected in Bajorek’s research: among the HR professionals she interviewed, the most common reason for implementing an EAP was that it was “seen as good employment practice”.
There were other reasons – among them reducing sickness absence and improving productivity – but few of them are ever measured. Just 37 per cent of employers that responded to the Work Foundation’s research said they measured sickness absence in relation to their EAP, and many noted that it was difficult to quantify a programme’s effectiveness when it was part of a wider wellbeing initiative. There was also a notable lack of pressure from senior leaders to justify the EAP or its cost-effectiveness.
That is a shame, says Paul Roberts, managing director of EAP broker Enlighten: “I have clients with a 43 per cent increase in utilisation year on year, but even with what is deemed to be ‘low’ utilisation people are still getting fantastic return on investment (ROI).” He puts this at up to £6 for every £1 spent, while EAPA says the average benchmark cost of a full-service EAP for an organisation of 100 employees is £14 per person, per year. This lowers significantly for larger organisations.
What’s more, EAPs are popular with staff. Respondents to Barnett Waddingham’s Workplace Wellbeing Index 2017 rated their effectiveness at 3.5 out of 5, which puts them above healthcare cash plans and onsite GP or gym membership, but behind carer support and health screening.
“When you look at what has happened to the cost of EAPs over the past decade or so, there has been a relentless downward trend,” says Mountford. “And there’s a strong feeling that given the value EAPs can provide to an organisation, they’re not valued as highly as they should be.”
Data may change that. A well-run and well-utilised EAP should throw up an array of information about how employees are feeling, as well as early warnings of recurring themes around either physical or mental wellbeing issues. “If you know that you have high instances of workplace stress [as shown in EAP data] then you know that is a risk the business should be focusing on,” says Laura Matthews, workplace wellbeing consultant at Barnett Waddingham.
“The more effort an organisation puts into promoting the programme and driving engagement and utilisation, the better its data will be, and the more insight it will gain into the organisation,’ adds Mountford.
This also points to a central paradox for well-intentioned employers: greater usage of an EAP might seem positive, but it could be indicative of a toxic workplace culture given the role of the workplace in so many stress-related conditions. Conversely, reluctance to call in could, in some cases, mean everyone is happy, engaged and able to talk openly.
But perhaps the most common factor among employees who fail to use EAPs is lack of awareness. If the service is not proactively advertised – for example, in an internal message reminding employees they don’t have to struggle with personal crises on their own – it’s likely that the only touchpoint many will have with it is during induction or general benefit-related communications. It’s a danger McSweeney is acutely aware of. “We operate in quite a traditional environment, which means there may be reluctance to access the EAP,” she says. “It’s our responsibility in HR to champion it and ensure all colleagues are aware of the benefits and opportunities available to them.”
While Crossrail’s EAP – like the rest of the organisation – is still in its infancy, it will become a central plank of a forthcoming wellbeing strategy. McSweeney intends to use employee champions to highlight the service to others: “We are confident we have dynamic and effective systems in place – such as consultation, colleague feedback and strong contracts – which will mean the EAP can respond and adapt to our changing environment.”
Line managers, as ever, are key in the process of encouraging EAP uptake. Digital tools can also help. Roberts attributes successes among some of his clients to the growth of apps. “They are helping tremendously,” he says. “Apps are intimate – they’re in your hand and on your phone.”
Not only do they allow users to use services completely confidentially – without the concern of a colleague looking over your shoulder at your desktop PC – they can be accessed anytime, anywhere. “If you have a work-based phone, you can have the app pre-loaded, which helps get really good usage and ROI,” says Roberts.
Other providers are offering interactive online services that take users through a short questionnaire that will then signpost the right resource for their needs, be it a factsheet or a referral to a counsellor.
But technology aside, as the industry continues to move from a stance of illness to wellness, and tries to position itself as resource for life events rather than a crisis support tool, more will need to be done to communicate the benefits to staff.
As Mountford says: “At a time when organisations have never had a higher interest in the physical and mental wellbeing of their employees, they should be looking at the EAP and broadening their own perceptions of what it can do and how it can fit in with a wider wellbeing strategy.”
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I think it’s important, as a commentator within this article and Chair of the UK Employee Assistance Professionals Association, to respond to some of the points that have been raised.
Many of the points raised in the original article are being endorsed in comments about it; employers should look more closely at how their EAP can support their health and wellbeing strategies and they should invest more resources to promote the awareness of the EAP among its workforce, as well as among its line manager population.
EAPs are an important asset for employers to fulfil their duty of care to their people. Regardless of the factors that may contribute to an employee’s poor mental health, and acknowledging that these may be the result of both internal and external factors, the EAP has been proven to deliver interventions that are on a par with NHS outpatient mental health services, as well as delivering treatment in just nine days (on average), which is days ahead of current NHS service delivery times.
In specific cases, EAP clients may be dissatisfied with the way they believe the EAP is being ‘used’ by their employer to provide evidence in a tribunal case or tick a box to meet their statutory duty of care. However, a belief such as this relates much more to the wider cultural issues within an organisation rather than the purpose or function of the EAP itself. Such situations also point to a lack of awareness and understanding about mental health, having difficulty conversations and utilising the EAP on the part of the manager and HR.
EAP providers have an important role to play in reassuring employees when it comes to confidentiality and data protection. Data and information about a specific case is never shared between an EAP, its workplace counsellors and an employer. All EAPs will share anonymised data about trends and key issues arising from people contacting a service, but this is solely generated to contribute to strategic planning and identifying areas of concern within a business.
Research recently conducted by The Work Foundation on behalf of the UK Employee Assistance Professionals Association – as referenced in this article – confirmed that EAPs are perceived as an important channel to deliver a personal and professional source of support that, crucially, is independent from the workplace. EAPs are an important net with which to catch and support employees who are struggling with their mental health. In fact, of those people making contact with their EAP, 70% are doing so as a result of stress.
It’s also worth noting that EAPA has produced a number of publications that are freely available on its website, including EAP Standards and Buyers’ Guides, whose purpose is to inform and educate both the industry and employers on the purpose, scope and correct application of EAPs. Reputable providers and responsible employers should ensure that their own policies and practices are aligned with these Guidelines at all times.
Whilst there will always be those who are sceptical about the independence of an EAP, it remains the case that they are a tried and tested solution to managing mental health in the workplace. They are a solution funded by the employer but with the objective to provide confidential, independent and professional advice for employees and should be used with the confidence that they can help employees to manage problems and concerns at any time of day, any day of the year.
I think the main reason for employees not using EAPs is lack of trust rather than lack of awareness - either a lack of trust in the impartiality of the EAP provider and the advice given, or a lack of trust in the employer’s reason for suggesting using the EAP.
I have personal experience of this. I left an employer (a large Japanese bank) due to work-related stress (PTSD and Adjustment Disorder). My ex-employer attempted to use the company’s EAP to absolve themselves of their responsibilities towards me. I was first made aware of the EAP when my manager took me into a room and handed me a phone number, saying ‘here, this is like the Samaritans’. As I hadn’t explicitly told him I was suffering from stress at this point (although it would have been obvious given the working environment), I was surprised that he hadn’t enquired about my wellbeing before. It seemed obvious to me that he had been told to give me this number by HR and it was just a way of the bank trying to cover itself without actually fulfilling their duty of care. My health problems stemmed from a hostile working environment caused by my manager allowing a colleague to behave in a hostile manner towards me at work without saying what the problem was. I explained to my manager that as I didn’t know what my colleague’s problem was, the use of an EAP was inappropriate, as the discussion needed to happen with my colleague. My manager agreed, saying that he should have given me the number, and took back the number.
I was surprised, therefore, when some months later I emailed my manager advising him that I was suffering from stress and he emailed me back the EAP ‘confidential helpline’ number (cut and pasted from somewhere else, as the font was different from the rest of the email). Given that we had already discussed the unsuitability of the EAP, it was obvious he was trying to shirk his duties, and that HR were trying to push the EAP as a way of washing their hands of me. The crass way in which I was told about the EAP and the obvious lack of concern for me actually greatly increased the level of stress I was under, as I realised how little my employer cared about me and how they were already trying to lay the ground for a defence against any future legal claim. I felt utterly trapped by the misuse of the EAP.
Sure enough, when I left the bank and later took the employer to court, the company tried to raise in their defence that they had made the EAP available, even although it had been agreed that the EAP was not going to help me. Although their use of this argument wasn’t sustainable (in terms of case law, it has been widely held that the existence of an EAP or confidential counselling programme is not a panacea, and the 2002 Hatton case mentioned in the article has been superceded to a large extent by other cases, notably Dickins v O2 in 2008).
Another area where employees don’t trust EAPs is when it comes to confidentiality/impartiality. In my case, even if the EAP had been suitable, I would have hesitated to use it as I felt that any information I provided might not be confidential and that any advice I received might not be confidential – I felt that advice would probably echo that given by the employer and that the employer might then use that fact to say that their original advice was correct. I know I’m not the only employee who feels like this about EAP programmes. It is important that these programmes are both neutral and seen to be neutral, and as such they need, in conflict at work situations, be capable of criticising the approach taken by managers/HR and even act as an advocate for the employee (or witness in court should matters escalate). As these EAPs are funded by the employer, there is a conflict of interest and I fear we are some way away from seeing a truly impartial service. In fact, I believe that it is feasible that an employee uses an EAP and the EAP then acts as a witness for the defence should the matter ultimately progress to court.
I am not saying that there is no use for EAPs, but I think it is important to realise their limitations and address their perception by employees. I realise that my situation was pretty extreme and certainly not best practice, and my situation related to mental health, which is only one of the uses of an EAP, but there are limitations in their use for mental health issues, and generally they are no substitute for good management. I hope that from my story it can be seen how a misused EAP can greatly increase work-related stress, and that this can be considered when designing and recommending these programmes. It breaks my heart (and causes me stress even now) when I see HR and even mental health charities touting these schemes as good mental health practice by employers when they are so often used as a box-ticking exercise or to cover up for bad management/HR. The law is clear that EAP programmes are not a panacea or get out of jail free card where an employer breaches its duty of care, and I would like to see them stopped being advertised or used as such.