At the end of 2023, we published Part 1 of our feature providing answers to the burning questions voiced during our recent EAP 2.0 webinar. This showed that a whopping 41% of the attendees are thinking of changing their Employee Assistance Programme (EAP) provider. 50% of these are looking to make this change within the next twelve months.
In Part 1 of our feature Suzanne Summerfield, Wellbeing Consultant with PIB Employee Benefits (who was one of the webinar panel members), and Simon Miller, International Partnerships Director, Headspace (who sponsored the webinar), addressed questions such as: “We’ve had an EAP for many years with minimal utilisation. Is it time to change it?”; “How will EAP providers expand their offerings to deal with the fallout from increasingly stretched health care from governments?” and “What are people’s ‘top tips’ on encouraging our people to use an EAP proactively to take care of themselves and their minds”.
Q1) When someone calls into the EAP helpline, what is acceptable / good practice for a person taking the call to triage to immediate counselling support, e.g. based on clinical need. This is something we are a bit concerned about now following a change of provider.
Simon Miller: We believe in an EAP model where the initial intake/triage is by a clinician who is able to effectively assess risks and triage accordingly if there is an escalated need – including in some cases arranging emergency support. But also to be able to support with immediate access there and then to therapeutic counselling (connected in under 30 seconds) with what we call “in-the-moment” clinical support. This sometimes results in “single session therapy” where the issue can often be successfully resolved there and then.
Without this you can see huge dropout if there is more of a call-centre triage model that relies on call-backs which can be very hit and miss and can allow issues to escalate amidst delay.
If providing global access, it’s also important that the initial intake is available in local language, not just translated.
It’s also important to understand the time taken in such calls. At Headspace we are proud that there is significant time devoted to understanding an individual’s needs in that initial intake (on average 24 mins per call) and a truly comprehensive initial counselling call undertaken in those single session therapy calls (on average 44 mins).
Finally, if there are escalated needs for more structured longer-term support, understanding the user journey and turn-around times to establish a referral and receive the first appointment session (in-person or remote). This is in under 5 days via the Headspace model and often determined by an employee’s availability and readiness rather than our therapists.
Q2) I’m conscious that EAPs often provide ‘mental health support’ and short-term, goal-focused counselling, alongside self support resources – rather than mental health ‘treatment’ per se (which is fair enough, of course). Do you think we are clear enough about how we talk about this to our people? I think sometimes discontent with EAPs is driven by people not understanding that.
Simon Miller: It is correct that an EAP is not there to replace longer term treatment for some diagnosed mental health conditions such as bipolar for example. However, the vast majority of employee needs are not at this end of the spectrum, or at least might not be if addressed early with a proactive and preventative approach to mental wellbeing. In fact, most “episodes of care” last about 7 sessions so the call for “longer term” therapy is not as common as one might think. The vast majority of members can have their immediate needs fully met within the scope of a comprehensive EAP.
But even for people with more acute needs, an EAP can play a really important role. Firstly, this may often provide a first step to engaging with a clinician to understand symptoms, build confidence and gain hand-held direction to appropriate onward care. Secondly, even for someone managing an existing diagnosed and possibly medicated mental health condition, short-term counselling via an EAP can still play a hugely important role in helping with the ups and downs alongside that condition. For example, managing a divorce as someone with bipolar. Unlimited access to a continuous remote coaching model can also play a huge role here in keeping someone on track in between scheduled long-term therapy sessions and being a trusted companion to reach out to 24/7 on demand.
So yes, while there are some limitations to an EAP model, helping educate about the role it can play in advance of or alongside more acute treatment pathways is key. If approaching your existing EAP, we’d certainly encourage a listening exercise with employees to better understand gaps in existing understanding of what is already available and why employees might not be engaging with that. Then ensure that your future plans effectively overcome those with a brand, user journey and education programme that helps overcome stigma, trust and accessibility issues in an inclusive manner.
Q3) Really interesting to hear about the challenge of triaging people to the wide range of services available. How is Headspace managing this as their service offer expands without overloading or confusing users?
Simon Miller: Firstly, meeting people early in their journey with the right level of preventative and self-care support is key. We see c. 70% of users in our system having their needs met in a sustained way through coaching and guided self-care content alone (measured by GAD-7 and PHQ-9 outcomes as well as satisfaction reporting).
Without that, employees would either default straight to a therapy model or not access any care at all. So providing this non-clinical level of support is hugely important in terms of both freeing up access of clinicians to those who need it (and escalating them quickly when they do), but also reaching a much wider population for those that don’t.
The second part of this is about providing access to a trained professional on-demand, 24/7 and continuously in an incredibly low friction way (we connect to coaches in under 2 minutes via live chat). This means we are available for people to present with how they are feeling at any time of the day.
People don’t usually know the right path to take, or say they need a specific type of therapist. Instead, they just know they are feeling, anxious, overwhelmed, down or depressed for example. Connecting them to a trained professional to help assess their situation and guide them to the right care at the right time is truly the task at hand. Having access to the coach to pick up on this and ask the right questions thereafter as part of a trusted natural human to human conversation is what then enables guiding people into the right type of care at the right time with trust and confidence.
Then if a clinical assessment is required at the next stage, the user is prepared with commitment and intent which results in much better first time resolution through short-term counselling, or much more efficient escalation thereafter into more specialist care.
Q4) Work related stress is one of the main drivers of sickness absence in the UK, with trends continuing to worsen since Covid. See HSE statistics: https://www.hse.gov.uk/statistics/assets/docs/hssh2223.pdf What can EAP’s do to help employees address work related stress?
Simon Miller: Coming back to some of the points made above, building a proactive and preventative mental health system that intervenes early and grants immediate access to care is paramount. But also creating a culture where leadership is constantly understanding and challenging the causes of stress in the workplace and adapting policy, process and procedure accordingly and measuring impact quantitatively and qualitatively.
Leveraging data from your EAP and wellbeing providers is key as well as leveraging the full remit of their resources. So don’t just rely on your EAP as a point of need phone number for mental illness, but challenge them on the resources they have to support everyday wellness and the training programmes they have to help transform a culture.
It’s important to also leverage their skills and experience to help you position and drive engagement in a way that users feel confident talking about their work stress via a confidential service provided by their employer who may be the very cause of their stress. Delivering a brand and customer experience that makes the service feel like that of the employee rather than that of the employer is key.
Q5) 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
Q6: The term “Employee Assistance Programme” seems to be a blocker to Associates using it. Anyone got any ideas for different names that really work for getting the services used?
Simon Miller: It’s a great challenge and we think this would be a great end of year survey/poll from the Make a Difference team to its audience.
Claire Farrow: We love this suggestion and will run a poll to gather some suggestions. Check back again in a couple of weeks for the responses.
Suzanne Summerfield: I would add that generally we need to look at the low rates of engagement with Employee Assistance Programmes especially when using this data to make decisions – it can not be used in isolation.
We need to help employees and their families, as well as line managers, HR teams etc. understand the wide range of support that Employee Assistance Programmes can provide, as well as where there are limitations. This insight can only be understood by gathering feedback and insights from demographic groups that are both users of the services, and those that have not engaged – as shown by the data.
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