Government warned of the dangers of prioritising Mental Health First Aid

When MP Dean Russell first put forward his private members bill to make the training of Mental Health First Aiders a legal obligation, the move was welcomed as a means of “saving lives”.

Since January, former members of the board of Mental Health First Aid England have flagged their concerns over unintended consequences. MHFA should only be one part of the “jigsaw”, they say.

Ticking boxes

The board members have warned that using legislation to push employers to focus their energies and investment onto MHFA could lead to more of a “tick box exercise” around mental health. It would encourage organisations to train just a small number of people rather than look at broader support.

There would be issues of confidentiality around discussions of suicide, as well as a great deal of pressure put onto the First Aiders; and what happens after a case of mental illness has been identified?

Longer-term aid

EAPA UK Chair, Karl Bennett said: “Experience over the past decade or so has shown the value of having trained MHFA staff within the workplace. Peer relationships can make it easier for people to speak up and take the all-important first steps in recognising and talking about wellbeing issues.

“But employees need to know there is somewhere to go next with their concerns, more than being entered into the queue for overstretched NHS mental health support. As EAPA’s new report, Holding it together, has shown, more and more employees are relying on their EAP for immediate mental health support and counselling.

“MHFA is important for early interventions, but employers need to ensure they are thinking in terms of their specific needs and a mental health and wellbeing strategy — and avoid a dangerous situation where people are just being identified as having a problem.”

How EAPs have become an essential pillar to the UK’s mental health provision

Data from a ‘state-of-the-market’ survey among members of the Employee Assistance Professionals Association (EAPA UK) reveal how more people are turning to their workplace EAP.

Holding it together: UK mental wellbeing and the role of Employee Assistance Programmes points to huge growth in the EAP over the past 20 years, up to £118 million compared with £32.2 million in 2003.

An estimated 640,250 employees contacted their EAP in the period between January 2022 and January 2023 — of which, 434,250 (68%) were offered counselling as a result of concerns over their mental health. EAPs delivered 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 serious risk from suicide each year. Some EAP providers report red flag cases as being at levels above 3%.

Extended roles for EAPs?

Commenting on the figures, Sir Cary Cooper CBE, 50th Anniversary Professor of Organisational Psychology and Health at the ALLIANCE Manchester Business School said: “It’s critical that the Government, the NHS and other healthcare stakeholders, understand the role the EAP industry has been playing in supporting mental health, providing immediate access to counselling and professional assessment for millions of people every year.

“Given the limitations to NHS resources and both the scale and complexity of dealing with people’s mental wellbeing, more thought and discussion is needed around the place of EAPs — including how else they can help. Maybe there’s a need for extensions to EAP services, to ensure there’s provision for longer-term counselling programmes through to recovery.”

What’s next

EAPA UK Chair, Karl Bennett said: “EAPs have become a pillar of mental health provision for the UK, providing rapid access to professional support for the majority of the workforce, and delivering value-for-money for employers. The question now is what happens in the next 20 years.

“Sir Cary suggests that maybe there’s a need for an extension to EAP services, ensuring there’s provision for longer-term counselling programmes through to recovery. This would mean looking at the impact to providers and a model that adopts a more psychological approach as our core offering, with standardised clinical outcomes.

“Is this something we as providers are equipped to do and if so, is there the appetite to do it? I think once upon a time the answer to this would have been ‘yes’. But when the average cost of an EAP per employee has seen a significant decrease, and with the reliance on our services becoming much higher, I think the answer might be, how can we? If EAPs take on more of a role in supporting the NHS, how do we protect out resources, including our therapists, and what should our standard nonclinical EAP services be?”

A copy of the Holding it together 2023 report can be downloaded from www.eapa.org.uk

The cost of poor mental health at work reaches £28 billion in 2022

New figures from AXA UK and Centre for Business and Economic Research (Cebr) point to the vast financial costs to employers caused by stress, burnout and poor mental health.

The AXA Mind Health Study involved a survey of 30,000 people from 16 countries in Europe, Asia and the Americas. The UK, alongside the USA, was found to have the largest proportion of employees struggling with mental health issues: 21% were in a state of ‘emotional distress’; 26% had an ‘absence of positive wellbeing’. Compared with the previous year, there had also been an improvement in the numbers of people with very good mental health (up from 18 to 23%), pointing to a widening gap in experience between groups of employees.

Cost consequences

Previous studies have suggested that burnout leads to an increase in the number of sick days by 21%. At the same time, stress in general has been found to lead to reductions in productivity and performance, as well as an increase in healthcare costs for organisations.

The AXA/Cebr study also showed differences in terms of the level of issues by sector. Public sector workers are more likely to experience work-related stress; health and social sectors are more likely to feel worried about their job, while higher earners are more likely to experience work-related stress and low moods. Just over half of workers surveyed felt their company provided good support to employees on mental health.

Looking to the positive

EAPA UK chair, Karl Bennett said: “The key stat in the report is not around the costs to employers but relates to the other side of the story. Employees who feel they are being actively supported with their mental health at work are twice as likely to be ‘happy’, and almost three and a half times more likely to be ‘flourishing’.

“Rather than seeing employee issues around mental health as just a source of rising costs — people as a problem and support as a cost-reduction measure — organisations need to think in terms of the positives of a healthy workplace culture, providing a better experience, demonstrating a genuine commitment and care for people, which all leads to benefits for everyone involved with an organisation.”

Sleeping for productivity

Dealing with cases of chronic insomnia would save the UK economy £34 billion a year, according to a study carried out by RAND Europe for Swiss pharmaceutical business Idorsia.

Research has shown that 80% of people suffering from insomnia — including lying awake at night, waking up several times at night and finding it difficult to get to sleep — reported that insomnia had impacted on their performance at work, including their concentration and ability to deal with stress. Employees said they would be willing to trade up to 14% of their annual household income for a regular good night’s sleep.

Wide-awake and unproductive

Calculations from the study point to insomnia leading to 11 to 18 days’ absence per staff member; 39 to 45 days of working while ‘sick’; and 44 to 54 days to lost productivity — meaning 1.31% lost productivity for the UK overall.

Marco Hafner, RAND Europe Research Advisor said: “Our findings point to the need for more timely diagnosis and management of insomnia to improve outcomes for patients and deliver better economic outcomes for the UK. This could include incorporating insomnia screening within routine clinic visits and enabling access to evidence-based, affordable, and cost-effective treatments for chronic insomnia.”

Culture alarm

EAPA UK chair, Karl Bennett said: “Sleep is fundamental to wellbeing — and to psychological health in particular, the times when the mind works on restoring its balance. Disturbed sleep is typically one symptom of stress and anxiety, of an uneasy mind, and is a consequence of a complex bundle of causes.

“To provide genuine support for employees around healthy sleeping, organisations need to be thinking about the bigger picture: the workplace culture and working routines and how they might be having an impact on states of mind. Issues like feelings of uncertainty and a lack of control around workloads and meeting targets.

“In this context, EAPs are of particular value in terms of helping people better understand and deal with underlying issues at home and work, take back more control and feel able to switch off when they need to.”

Revealed: how employers and EAPs have become an essential pillar to the UK’s mental health provision

Employers and their Employee Assistance Programmes (EAPs) have taken on a huge role in delivering mental health services to the UK population, according to new figures out today from EAPA UK.

Data from a ‘state-of-the-market’ survey among EAPA members has revealed how more people are turning to their workplace EAP over NHS services.

The new Holding it together: UK mental wellbeing and the role of Employee Assistance Programmes report suggests that EAP services are now available to 24.45 million employees working across more than 105,000 organisations (75% of the entire workforce) — compared with availability to 4.9 million employees at 3,139 organisations in 2003. An estimated 640,250 employees contacted their EAP in the period between January 2022 and January 2023 — of which, 434,250 (68%) were offered counselling as a result of concerns over their mental health. EAPs delivered more than 1.375 million counselling sessions.

The figures illustrate how EAPs — originally set up in the late 1970s as telephone helplines giving straightforward advice on financial and legal matters — are having to deal with increasingly complex and severe mental health issues in UK society. 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 serious risk from suicide each year. Some EAP providers report red flag cases as being at levels above 3%.

The UK EAP market is valued at more than £118 million compared with £32.2 million in 2003.

Project lead and immediate past EAPA UK chair, Eugene Farrell said: “EAPs are now a hugely valuable resource to employers and 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.

Karl Bennett, new EAPA UK chair, said: “EAPs have become a pillar of mental health provision for the UK, providing rapid access to professional support for the majority of the workforce, and delivering value-for-money for employers. The question now is what happens in the next 20 years. How will EAPs continue to take on an ever-increasing mental health role as society’s demands grow?”

Commenting on the figures, Sir Cary Cooper CBE, 50th Anniversary Professor of Organisational Psychology and Health at the ALLIANCE Manchester Business School said: “This is the stage we’ve reached, where figures relating to the mental health of the UK workforce are shocking but also unsurprising. Most worrying about the EAPA UK figures is the number of employees with severe depression, in crisis situations, now having to turn to their EAP. It’s critical that the Government, the NHS and other healthcare stakeholders, understand the role the EAP industry has been playing in supporting mental health, providing immediate access to counselling and professional assessment for millions of people every year. So not a matter of an employee benefit affecting the few, but a significant role in dealing with an urgent and long-term issue for society.

“Given the limitations to NHS resources and both the scale and complexity of dealing with people’s mental wellbeing, more thought and discussion is needed around the place of EAPs — including how else they can help. Maybe there’s a need for extensions to EAP services, to ensure there’s provision for longer-term counselling programmes through to recovery. The EAP sector has coped this far with the giant swell of demand and more serious cases,    through training and recruitment initiatives, more online services and apps. But neither employers nor the UK as a whole can afford to see EAPs become overwhelmed.”

A copy of the Holding it together 2023 report can be downloaded here.

New EAPA chair sets out objectives for a stronger future for the sector

Incoming EAPA UK chair Karl Bennett has emphasised the importance of co-operation in order for the sector to deal with the growing pressures, and develop its role as a foundation to mental health provision nationally.

Previously a Director at Care first for 15 years, Karl Bennett is Wellbeing Director at employee benefits provider Vivup. He has been an EAPA member since 2005 and on the board since 2017.

Come together

“In the short-term we need to define more clearly what an EAP is, what it does, and how it supports our employees,” said Karl Bennett. “Not just now, but in the future. This should include parity around the management information EAPs provide to their customers, and clarity around the glossary of terms such as defining what is meant by ‘contacts’ versus ‘new contacts’, the issue types being reported on, and how we measure clinical outcomes. We will only achieve this by working together around a single goal. And that goal should be how we ensure our businesses are providing the right service to the right people at the right time.”

Expanded role?

In a forthcoming EAPA UK report looking at the growth of the sector in the context of limited NHS resources for supporting mental health, Sir Cary Cooper has commented that there is a need for an extension to EAP services, ensuring there’s provision for longer-term counselling programmes through to recovery.

“One conversation I’d like to start with you, our members, is: is this something we as providers are equipped to do and if so, is there the appetite to do it? I think once upon a time the answer to this would have been ‘yes’. But when the average cost of an EAP per employee has seen a significant decrease, and with the reliance on our services becoming much higher, I think the answer might be, how can we? If EAPs take on more of a role in supporting the NHS, how do we protect our resources, including our therapists, and what should our standard nonclinical EAP services be?

“There is certainly a lot of work to be done — but this is also an opportunity for us to drive change and improvement, working together as a community. Mental health is now a C-suite issue in a way that it just wasn’t pre-Covid-19, and establishing a role for EAPs and the value they provide needs to be a key focus for all of us in the months and years ahead.”

You can read the full welcome statement here.

Vivup’s Karl Bennett appointed to lead UK’s Employee Assistance Professionals Association

Karl Bennett, Wellbeing Director at employee benefits provider Vivup, has been elected to serve as the new Chair of the Employee Assistance Professionals Association (EAPA) UK.

He picks up on the role from Eugene Farrell, Mental Health Lead at AXA Health, who has headed up the national membership body since 2019, including the challenging years of the Covid-19 pandemic.

A Director at EAP provider Care First from 2005 until 2022, Karl Bennett has also previously worked as a radio broadcaster.

“I’m looking forward to continuing the amazing work being done by the members and dedicated board of EAPA,” said Karl Bennett.

“EAPs have always been seen as an employee benefit — but I believe we are now much more than that, supporting millions of people each year with counselling, professional assessments and psychological therapies, we have become the ‘go-to’ for mental health support for businesses. 

“As a sector we need to be encouraging a focus on the preventative elements of our services, adding more non-clinical services like Mental Health Coaching. As a respected body, working hard to promote and develop the employee assistance profession, we also need to lead the discussion around moving EAPs into a longer term assessment and treatment model, properly equipped with the best practice standards to be the alternative for employees to NHS mental health treatment pathways.”

Outgoing Chair Eugene Farrell said: “The past four years have seen a leap in terms of the intensity of demands on EAPs, more volume of calls, more challenges, more complexity as the norm.

“As a sector, we have stood up to those challenges. We’ve adapted to the changing context, introduced digital innovations and made progress on recruiting and training the professional expertise increasingly needed by our clients. Working with a board of committed EAP industry professionals, I’ve been proud to be part of the work being done.”

EAPA UK (www.eapa.org.uk) is a not-for-profit organisation that represents the interests of individuals and organisations concerned with employee assistance, psychological health and wellbeing in the UK. The body works to support and promote the EAP industry in the UK, promote the development of professionals and develop and maintain the highest standards of practice and ethics. Members include external and internal EAP providers, purchasers, counsellors, consultants and trainers working in the field of employee health and wellbeing.

NICE recommends mental wellbeing apps to reduce NHS waiting lists

In response to long waiting lists for accessing talking therapies, NICE has made initial recommendations for eight digital technologies that help people with common mental health issues such as depression and anxiety, as well as PTSD and body dysmorphia.

Together, the apps have the potential to help around more than 40,000 people at any time — given that one in six people report experience mental health problems each week in England, according to NHS Digital. Patients, first of all,  need to have a formal assessment with an NHS Talking Therapies therapist before app access is provided.

Subject to consultation, the apps are due for “rapid deployment” across the NHS.

Rapid value

NICE believes digitally-enabled therapies will provide faster access to help, more flexibility around time and location of treatment, and good value in terms of NHS resources.

“Digital technology could transform the experience of people living with mental illnesses,” said Elizabeth Mullenger, a lay specialist member on the NICE committees involved. “It can be incredibly isolating to be on a long waiting list for in-person treatment. You might know that help is coming, you just don’t know when.

“Having access to a digital therapy could help prevent this lonely feeling. Sometimes people need support most in the middle of the night, or after a busy day at work, and it’s hard to know where to turn. Having access to digital therapy, can give people the help they need, when they need it.”

Human contact

EAPA UK chair, Karl Bennett said: “Online resources and apps have become an established part of the toolkit for supporting people with mental health concerns — having immediate access, 24/7, can be vital in terms of early intervention, and helping people not ready to talk openly about their experience. Many people are reluctant to talk to their GP, let alone their employer, about common issues like anxiety and depression.

“Our experience with EAPs shows that, ultimately, employees need the reassurance of a human relationship. A sense of isolation, of being stuck with only digital, artificial relationships, of not being listened to, is so often part of the problem.

“That’s why the offerings that employers put in place via an EAP, their commitment to offering individual attention, empathy and a human voice is so valuable and valued.”

Finance and mental health: TV’s Peter Komolafe at the EAPA UK AGM dinner

Dinner guests joining the EAPA UK AGM dinner on Tuesday 14 March will have the chance to meet and hear from Peter Komolafe, finances expert for Channel 4’s Steph’s Packed Lunch, Lorraine on ITV, and host of the Conversation of Money podcast.

Money in mind

EAP providers have reported steep increases in the number of calls relating to financial worries — the practical issues relating to debt, credit and contracts. But the bigger concern is the anticipated next phase, when money problems start to affect relationships at both home and work, with the potential for more complex and ongoing mental health problems.

“Studies have shown that if you are worried about money you are four times more likely to suffer from depression, and also four times more likely to suffer from anxiety. Financial literacy and money management are key skills that speak directly to how confident we feel about tackling both difficult and simple financial decisions,” said Peter Komolafe, who experienced a period of being homeless before becoming an executive at a Fortune 100 company and a regular media commentator on personal finance.

Send your completed booking form below to info@eapa.org.uk to secure your ticket for the EAPA AGM dinner.

https://www.eapa.org.uk/wp-content/uploads/2023/02/Dinner-Booking-Form-EAPA-v5.docx

Is the four day week the ‘cure’ for poor mental health among employees?

Research into the impact of the first major trial of four day working in the UK has concluded that the schemes have been a success: benefiting employee wellbeing and staff retention levels in particular.

The pilots, organised by 4 Day Week Global, ran between June and December 2022, involved 61 employers ranging from a software firm to a fish and chip shop.

Good results

56 of the employers now plan to keep the arrangements for the time being, where staff work four days but continue to receive full pay. 18 said this would now be a permanent change.

“We don’t have a firm handle on exactly what happened to productivity,” said report author Juliet Schor at Boston College. “But we do know that on a variety of other metrics, whether we’re talking about revenue, [workforce] attrition, self-reports of productivity, employee well-being and costs, we had really good results.”

Time out?

EAPA UK chair, Eugene Farrell said: “In our age of anxiety, any steps taken by employers to support employee wellbeing are a positive development. On the surface an extra day off for time at home and relaxation sounds ideal. But the situation is complex.

“One of the assumptions of the UK pilot was that employers expected staff to continue to deliver the same levels of outputs and productivity. When people under pressure and feeling the stress of their role are given more time off, it can only serve to increase negative feelings: they’ve got more to do in less time; a ‘day off’ can be just more time to feel anxious.

“As was evident from the Covid-19 pandemic when so many people were working from home, more time at home doesn’t suit everyone anyhow. For many, the workplace is where they socialise and get their sense of purpose and fulfilment.

“Employers need to be aware of the combination of factors involved in affecting wellbeing — like work design, workplace culture, alongside challenges at home.”