86% of our recent EAP 2.0 webinar attendees responded in our warm-up poll that demand from their employees for health and wellbeing support has increased since the beginning of the pandemic. And whilst 87% already have an employee assistance programme (EAP) in place, a whopping 41% are thinking of changing their provider, of which more than 50% are looking to make this change within the next twelve months.
Demand is high and change is clearly on the horizon, so it’s not surprising that the webinar panel was bombarded with questions from the audience.
Here, Suzanne Summerfield, Wellbeing Consultant with PIB Employee Benefits (who was one of the panel members), and Simon Miller, International Partnerships Director, Headspace (who sponsored the webinar), share answers to your unanswered questions. This is Part 1 – which answers eight of your questions. Part 2 will follow in the New Year.
Q1) We’ve had an EAP for many years with minimal utilisation. Is it time to change it?
Suzanne Summerfield: I would not advise any company to rush into changing their EAP (or any other provider) without giving it some proper consideration. If you change your EAP provider but are not willing to put in the resources to ensure that you embed the new provider and communicate with your employees about the services available then you are likely to get the same low take up.
There are many other people in your organisation that can also assist the benefits and wellbeing teams with the signposting to your wellbeing resources including the EAP – whether your existing provider or a new one. These include line managers, HR team, graduate support team, senior leadership, mental health first aiders, wellbeing champions, health and safety team, specialist interest groups, employee network group etc.
It is worth helping each of these groups to understand how they can communicate the support the EAP offers and highlight some of the services that might be of interest/ use for the colleagues they interact with.
However saying that it may be worth considering changing your EAP provider for several reasons if the new provider offers some or all of the following:
- More support services than your existing provider
- It makes financial sense and the provider can demonstrate the return on investment the company can expect
- The provider is proactive and willing to provide support with communications and can demonstrate that they can drive up engagement and utilisation levels
- The provider can provide better utilisation data or can demonstrate how they are able to engage with your population demographics or distribution (for example experience working with organisations that have employees in the field on the shop floor, with no or limited access to emails).
The providers in the wellbeing space, including EAP providers, are continually adding new services and changing their proposition (the developments Headspace have recently launched are a great example). So developing a good relationship and communication channels with your existing provider is important to ensure you keep up to date with what they offer.
It is also important to keep an eye on what is going on in this space. Brokers or intermediaries like PIB Employee Benefits can offer a lot of support for clients in this area as we keep track of the developments in the market and the feedback from the clients using the different services and providers. We can therefore advise what is available as standard in the market, the different propositions and pricing models.
Simon Miller: This is not an unusual challenge for employers and common with most traditional EAPs. So the question is not just do we change EAP, but how might we approach mental wellbeing differently?
An EAP needs to be part of a frictionless mental healthcare system that engages people when well, supports them when struggling and gives them the confidence, trust and direction to help them when unwell with the right level of care at the right time.
So in looking at your mental health support, ask yourselves:
- How you are supporting different types of needs across your population for different types of people?
- How are employees educated, engaged in and made aware of the support available?
- How easy and quick it is for them to access in-the-moment support?
- How is someone supported at the moment they might need more acute care?
- How are all the services you offer connected into one easy-to-use and understand pathway?
With that, also be clear on your objectives and the business case to support in investing to reach more people earlier in their journeys.
If your organisation is only prepared to fund like for like, then simply replacing your existing EAP with a similar but different one may only slightly nudge the needle on utilisation at point of need. As we know, this is often too late to make the significant impact on productivity, absenteeism and presenteeism that a proactive mental health care system approach can.
Q2) How will EAP providers expand their offerings to deal with the fallout from increasingly stretched health care from governments?
Simon Miller: A key aspect will be around ensuring there is really easy access to what we call “in-the-moment” clinical support. More comprehensive EAPs will connect you immediately with a clinical intake model that enables an employee to receive counselling there and then which makes a huge difference to drop-outs rates. In many cases this achieves first-time resolution.
Another area will be about developing continuous coaching models and CBT based guided programmes that enable individuals to immediately start with an element of non-clinical support and self-care while perhaps waiting for and in-between their in-person treatments via the NHS or other. And to keep them on track thereafter.
Finally, we expect increasing demand for platforms where there is easy navigation into an employer’s onward resources for additional clinical support they may need e.g. signposting or linking into their Remote GP provider, their PMI provision, their occupational health team or perhaps their employer’s physical wellbeing benefits.
The development of Application Programming Interfaces (APIs) – software that enables two applications to talk to each other – to be able to do this more seamlessly, will be key, along with employers taking a role in curating end-to-end pathways, experiences, and communications that help employees understand how they can be supported throughout in the absence of immediate NHS care. But also in some cases, reminding them of the excellent on-demand NHS resources available where GP referral is often not needed e.g. NHS Live Well and Digital Talking Therapies services.
Q3) What are the pros and cons of a global vs. regional approach when it comes to an EAP?
Suzanne Summerfield: Many of the largest global EAP providers now offer their services and information in a wide range of languages, and go one step further so the appropriate context for each country or location is also taken into consideration. This is known as localisation.
Pros for a global approach:
- One contract can make it easier for contracting and onboarding and avoid duplication
- Management of the contract reduces the need to manage and renewal multiple contracts
- It may be more cost effective
- It provides one central source of information and support for employees which can make communication about the EAP and the support services easier
- Combined data showing utilisation in all countries and regions
- Not all global EAPs offer the same volume of content in each of the different languages, (some have more content in English than in other languages)
- You may find a local EAP could offer more support in some countries.
- Different jurisdictions have differing rules about the support available – for example the minimum age range for support for mental health for children differs between countries.
- One central management contract – may get less buy in from local stakeholders
Simon Miller: In addition to the points above, we are increasingly hearing employers wanting to provide one global consistent programme that they can throw their full weight behind in communicating as a single best-practice mental wellbeing journey for all employees. Thus ingraining it in their culture both as the go-to destination for support, but also as part of a consistent approach to how the organisation, leads, manages and acts as part of a compassionate culture.
So to this extent, it’s not just about a global solution, but a global engagement and communication programme including training and education at all levels, across all regions.
Q4) In our organisation, employees are asking for tailored support linked to their personal characteristics i.e. access to Black therapists; LGBTQ+ relevant support. Were there similar trends coming out of PIB Employee Benefits’ “Mind the Gap” survey? Should EAPs be providing this tailored level of support?
Suzanne Summerfield: This was not covered in the recent PIB Mind the Gap survey, but it is something worth watching out for. I think we should focus on the best clinician to provide the support for the individual rather than restricting the clinicians that can be allocated to an individual based on individual characteristics. Although I appreciate there may be some situations where a clinician’s personal experience may give them a different viewpoint on a situation. I’d be interested to hear the view from Headspace on this.
Simon Miller: This is hugely important and absolutely we feel this has to be part of a modern mental health proposition where carers can tailor their support based on shared identity and shared lived life experiences. It’s equally important that user journeys and content have been designed in an inclusive and accessible manner and deploy approaches that learn and personalise over time. For example, by being able to proactively suggest content relating to previous searches, engagement and conversations such as navigating injustice, embracing menopause or pride affirmations for example.
At Headspace, we are proud to have built a team of diverse coaches and therapists representing different ethnicities, ages, identities, faiths, cultures and other characteristics to help us match individuals with the most effective care for them. This is recognising that the most important factor in successful therapy is the therapeutic rapport that is developed and many members feel they are better able to connect with a provider with shared life experience.
Q5) Is there an HMRC effect on offering EAP to family members?
Simon Miller: Technically the government advice is that welfare counselling services are only tax exempt for the employee and issues that might affect the employee in their line of work. This can cause some grey areas around dependent cover where a mental wellbeing impact on a loved one may impact an employee. It is also dependent on the nature of the services being offered. The government position can be found here but we always advise you to seek your own personal tax advice on such matters.
Q6) Is it possible for a small company (25 people) to access an EAP?
Suzanne Summerfield: It is possible for a company to have access to an EAP for a small number of employees and even for companies of less than 25 employees. However, the amount of utilisation data will be very restricted due to data privacy and confidentiality as providers usually need a minimum number of interactions before they can provide reporting to preserve anonymity.
Simon Miller: At the moment, Headspace’s complete mental health solution (Headspace Coaching+Care+ EAP) is only available to companies with over 600 employees. We are however looking to partner with benefits platforms and providers to open up wider access to this important segment of the market where there is significant need for such benefits, particularly if an organisation does not have access to other resources through say health insurance or occupational health resources.
Q7) What are people’s ‘top tips’ on encouraging our people to use an EAP proactively to take care of themselves and their minds (that’s as opposed to reactively, when they’re struggling or having difficulty)?
Simon Miller: It will always be hard to proactively engage someone for everyday support in a clinical service that is associated with being a workplace support programme. That’s unless it is redesigned and positioned as more of a holistic resource to support people everyday, not just with issues but to help them optimise and be their best.
So the top tip would be to take a step back and look at how all of your mental wellbeing services (from wellbeing apps to EAP, virtual GP, occupational health and health insurance) come together to provide one connected and coherent programme, where employees know what to access when, for what and how. This may be hard to do if you have lots of disparate and overlapping parts in which case that might be time to reevaluate your core programme. Take time to listen to employees in focus groups, look at data and model user end to end scenarios to really challenge yourself on how accessible, intuitive and supportive the journey is.
Be sure to road test your pathway both in terms of employee feedback on the perception of it and how it works in practice. Sometimes the smallest things can be the cause of confusion, lack of trust and low engagement e.g. wording that might suggest it is a manager referral service rather than an elective employee service. Sometimes it might be more structural barriers. For example a solution that requires someone to complete a full 360 degree wellbeing assessment before they can access any services.
At the end of the day, think of your employees as customers of a service and design their comms and user journey as a consumer centric brand might. Then ensure your service providers deliver on that too, as one bad experience can lead to immediate negative word of mouth across a whole team which is very hard to undo.
Q8) What data does Headspace share re. usage with companies?
Simon Miller: We deliver insight driven reporting on population level mental health and wellbeing utilisation and outcomes:
- Average time to care
- Member enrollment
- Member engagement
- Member satisfaction
- Member retention
- Key areas of member need
- Nature of content engaged in
- Depression outcomes (PHQ-9)
- Depression outcomes (PHQ-4)
- Anxiety outcomes (GAD-7)
- Stress outcomes (PSS)
More answers to your questions from the webinar are in Part 2 of the feature here.
You might also like: