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.”