The status of EAPs has been transformed over the past 20 years. Employees with worries about mental health have the confidence to reach out to their EAP; knowing, for example, that access to counselling is an immediate option.
The case of Hatton v Sutherland in 2002 prompted major changes. The case ruled that employers had a ‘duty of care’ in terms of employee mental health — and that employers who offered workplace counselling services with access to treatment were unlikely to be found in breach of this duty.
In 2003, data gathered by EAPA UK showed that the market size for EAPs was £32m. Since then, the combination of a need to demonstrate compliance, along with greater appreciation of the importance of employee health and wellbeing to productivity levels and organisational resilience, has led to market growth for EAPs of 368% (now £118 million) in spite of decreases over time in the average rate per capita.
This is one of the findings from Holding it together: UK mental wellbeing and the role of Employee Assistance Programmes, a report that sets out the latest data from the UK’s largest EAP providers and use of services between January 2022 and January 2023. Since 2003 there has been a growing recognition of the importance of employee wellbeing, mental and physical, to employers: wellbeing as a foundation of productivity and performance, motivation and engagement — and to overall organisational resilience. At 24.45 million employees covered, the data suggests that EAPs now provide cover for 74% of the UK working population (estimated at 32.84 million employees, according to Office for National Statistics, February 2023).
More open conversations and a willingness to look for professional support have been important and positive developments in terms of the state of the nation’s wellbeing. But the UK’s new world of mental health awareness has meant consequences for the NHS, EAPs and health services of all kinds.
NHS mental health provision has been overwhelmed by demand and continues to be a work-in-progress. A study by the Royal Society of Psychiatrists published in October 2022 suggested that one in four patients needed to wait 12 weeks before being able to start any treatment, and that many people were turning instead to A&E services.
In this context, EAPs have become a highly valuable resource to employees. Anecdotally, EAP providers know that GPs are increasingly encouraging patients with mental health concerns to contact their EAP if they have one. As the report data shows, this also means EAPs are being treated as a frontline emergency service and involved with complex, long-term cases of mental illness (68% of employees contacting EAP services in 2022 were offered the support of counselling (640,250 people used an EAP service, and due to their situation and symptoms, 434,250 were offered counselling). In 2022, EAPs in the UK provided more than 1.375 million counselling sessions. On average, 1.7% of counselling cases came with a ‘red flag’ (involving an immediate and serious risk of suicide). This translates to more than 10,000 lives at risk that EAPs support. Some EAP providers report red flag cases as being at levels above 3%.
The figure of 68% of people accessing an EAP requiring counselling is a telling one — and significant in a number of different ways. It’s another signal of the changes brought about by the pandemic years; concerns over the lack of timely access to NHS mental health services. But for the industry it’s also a very positive indication in terms of how services are being promoted and used. Employers are becoming more conscious of the hard value of EAPs in terms of employee wellbeing, productivity and absence.
A critical part of the future picture for EAP providers and employers themselves will be about managing this situation: the double-edged sword of a growing demand for counselling. It will be so important for EAPs to continue to be part of the landscape of mental health provision in the UK, to be a genuine source of added value via employers.
That means a shift in positioning for EAPs: taking on a more pro-active preventative role, ensuring there are earlier interventions among employees in order to avoid the need for extended programmes of counselling, a strong non-clinical service dealing with underlying issues such as the fall-out from a cost-of-living crisis, backed up by more training for staff around mental health.
The role of EAPA UK will be one of working with its member community to shape the most effective future for EAPs — drawing on insights into what works and what doesn’t — on the mix of clinical and non-clinical services and the supporting spine of codes of best practice and ethics which will come together to provide the best outcomes for employees.
