Why are employees with mental health issues being stigmatised again?

A recent trend in media reporting is encouraging a new form of stigma around people living with mental health issues, says Lisa McNally a Director of Public Health for Worcestershire County Council. 

In an opinion article for the Centre for Mental Health she highlights the rising number of media articles that question whether people are “gaming the NHS to get time off work” in the context of the UK’s high levels of long-term sickness and problems with economic inactivity. This has included the BBC surveys among GPs that suggested they rarely refuse any requests for sick notes for mental health concerns, and are often pressurised by patients.

Rage bait

Lisa McNally, who also an Honorary Professor at University of Birmingham, worries that the new form of stigma is the result of the media need for ‘rage bait’ for securing evidence of clicks and engagement.

“Reinforcing mental health stigma makes things worse for everyone. It can discourage people from getting help. It can stop them finding employment or housing. It can cause isolation and community tension. It can also lead people to lose trust in health professionals, making their jobs harder than they already are. Literally no one benefits from it.”

Stress or illness

EAPA UK chair, Karl Bennett said: “The nub of the issue is the difference between employees dealing with what might be considered ‘standard’ or common levels of stress and worry or low mood, that everyone experiences at times, and those who are suffering from serious, long-terms forms of mental illness which have a significant impact on their ability to work — and can lead to long-terms sickness absence.

“In recent years employers have demonstrated their recognition of the importance of wellbeing and mental health. But with NHS services under pressure and GPs unwilling to make judgments on the sensitive and complex cases that involve psychological health, who is taking responsibility for deciding what is ‘ordinary’ stress and what is an illness?

“Talking to an independent professional via an EAP is always going to be an important factor in terms of providing perspective for employees — for them to better understand their experiences and deal with underlying causes. And ultimately it will always be a matter of trust and relationships. Those employers with an open, supportive and positive culture are going to be more likely to have committed and engaged staff.”

Few GPs ever refuse a mental health sick note

In response to a BBC questionnaire, 540 of 752 GPs said they had never denied a sick note relating to mental health. 162 said they’d refused at least one (and 50 preferred not to say).

GPs highlighted how they didn’t believe they should have to “police the sick note system” — and how there were cases of patients becoming aggressive if a sick note for mental ill-health wasn’t issued.

Sick note culture

Last year, more than 956,000 sick notes were issued giving the specific reason of mental illness. But sick notes don’t need to include a reason, and another 72% didn’t.

The rapid growth in the issuing of sick notes for mental ill-health is central to the wider concerns in government at the spiralling cost of benefits provision.

A particular concern is around the attitude of younger adults to the workplace — supported by evidence from GPs in the BBC survey. One GP commented: “We sign off legions of young patients with anxiety and depression who are quite clearly not ill.”

Back to employers

EAPA UK chair, Karl Bennett said: “If GPs aren’t able to play a role in assessing mental health — it’s a reasonable point that it’s difficult for them to both offer support, be an advocate of patients, and also be a judge — then the responsibility appears to be drifting towards employers.

“A government pilot of a ‘stay in/return to work’ scheme is already running with 60 businesses, including Jaguar Land Rover, mainly focused on preventative health, exercise classes, health checks and access to counselling — and is a signal of things to come.

“But there’s a bigger question here, a serious one for the sector and employers in general, of whether a professional service like an EAP can be used to assess the extent of mental ill-health and the necessity for specific adaptations in terms of keeping people in work.”

BBC File on 4 Allegations – Outcome

Two years ago, the BBC raised concerns about confidentiality within an EAP provider. The EAPA Board reviewed the matter under our ethical framework.

Following that review, the Board concluded that a few aspects of the actions described did not meet the expected ethical standards within the EAPA Code of Ethics, particularly around confidentiality and informed consent.

While we are aware the provider has already demonstrated the changes they have made since the allegations, including audits with BACP and NCPS, EAPA UK Ltd has requested that the provider undertake a further independent external audit of its clinical governance and operational processes, which will be conducted by an independent EAPA UK Ltd auditor.

To be clear, subject to there being no unexpected findings from the independent review, EAPA UK Ltd does not intend to take any further action regarding this matter – we expect that to be the case.

The provider has worked constructively with EAPA UK Ltd since the allegations were raised to ensure its practices meet the required standards, EAPA UK Ltd would personally like to thank them for the way they have engaged with that process.

EAPA UK will be at the Health & Wellbeing @ Work Conference next week

If you’re at the event too, come and say hello. We’ll be on stand 88b and look forward to talking all things EAPs!

Following the first day, our 2026 AGM will be held at the nearby Hilton Metropole Hotel and we have some incredible guest speakers lined up – if you’d like to join us for that, please contact info@eapa.org.uk

Workplaces weren’t designed for humans

Workplaces continue to be based on ideas from the 19th century and ideas of industrial efficiency, argue researchers from the University of Leicester and the Technical University of Denmark.

They point to how the ideas of the US industrialist Frederick Taylor, focused on using people as part of an organisational machine that can be measured and its performance optimised. As a result, they suggest, organisations are simply using up people’s resources for productivity, in the same way industries have used up other natural resources. While HR is now far more focused on engagement and wellbeing, it has tended to overlook the key issue of what happens when employee’s energy, and motivation and relationships with colleagues are all spent.

Using the circular economy model

As an alternative to the established attitude to the ‘human resource’, the academics propose a shift to a model based on the idea of a circular economy.

The model they call ‘circular work’ would stop employers seeing staff as a resource of time and energy to be ‘used up’ to meet short-term targets and build in opportunities for recovery and regeneration — the “rest, support and learning” that “help employees bounce back”. In this way, they say, work itself becomes something more sustainable and suited for long-term growth rather than constantly running on empty.

Humanising work

EAPA UK chair, Karl Bennett said: “Work has obviously been transformed by technology, the pace of everyday routines and cycles of performance targets have accelerated. It’s much easier and quicker to have meetings, to get tasks done. And now we’re impressed by the speed and efficiency of what AI can do.

“But maybe our attitudes to the role of people in work have lagged behind. We’ve tried to make people more like machines rather than considering whether that means work itself has become something inhuman. “Wellbeing programmes in themselves can’t just be used as a sticking plaster to cover up much bigger problems. Instead, the important services like EAPs, and their insights into employee health and experiences, need to be used as part of a wider strategy that looks at the design of work and job roles and their impact on wellbeing.”

EAPA UK Ltd Annual General Meeting 2026

The 27th Annual General Meeting of the Employee Assistance Professionals Association UK Ltd will be held on Tuesday 10th March 2026 at 5.30pm.

The AGM will take place in the Surrey Room, Hilton Metropole Hotel, NEC Birmingham, B40 1PP & Online via Teams.

Please register to attend by email to info@eapa.org.uk, stating whether you will be attending in-person or joining online.

Nominations are now open for Officer and Board roles

The following roles are available for a 2-year term:

• Officer: Secretary
• Board role: two positions

Members may nominate themselves by submitting the Board Nominations Form and Board Member Commitment Form to info@eapa.org.uk.  Only one person employed by or representing any organisation can become an Officer or Board Member. Nominations must be received by 5.30pm on 24 February 2026.

The ‘quiet crisis’ of men at work

“We’re told to toughen up, but a bit too much, and it’s toxic. We’re told to soften, but too much of that and it’s weak and unattractive,” writes George Bell in a new book, Be a Man About It: Building A Healthier Idea Of Masculinity.

The handed down version of masculinity, he says, has led to a version that stresses “emotional suppression, rather than expression.” And that’s at the core of reasons why men are three times more likely to take their own life than women — as well as being more likely to have a premature death, and to suffer from addictions, loneliness, homelessness and crime.

Too quick to label things toxic?

A campaigner on men’s mental health, Bell has himself experienced a slide into depression and suicidal thoughts.

“I was willing to trade my own life in order to preserve this notion of masculine pride. To get better, to recover, and to still be here today, I had to not only work through the mental health side but I also had to almost entirely deconstruct and then rebuild my sense of what it means to be a man…this isn’t about criticising or shutting down parts of masculinity that many men find so valuable. I believe we have gone too far in some discourse in recent years, too quick to label things toxic and shut down many parts of masculinity that men enjoy or aspire to have.”

EAPs for opening up

EAPA UK chair, Karl Bennett said: “All the experience of EAPs over decades backs up the data from the NHS showing how women are more likely to engage with their GP and other health providers and more likely to open up about their health concerns.

“In principle, EAPs are a perfect way to help more men. A professional and confidential service, accessible through their workplace, but independent from it. But more work needs to be done in raising awareness of when and how EAPs can be used, that they aren’t just there for when situations have reached a crisis point. Working together, talking to an EAP about mental health or root issues such as financial and relationship problems can be made to feel more ‘normal’.”

Our EAP: Southeastern Railway

A fresh review of an EAP offering — looking at how it works, who’s being targeted, the kinds of services available — can make a huge difference to usage and impact.

Southeastern Railway was having particular issues with long-term sickness absence. One in three rail workers has a mental health condition (compared with one in six in the UK population more widely), and levels of anxiety are one and a half times higher (according to the industry’s health and wellbeing performance indicators). At the same time, however, the established EAP at Southeastern, set up decades earlier, wasn’t being valued or used.

“When we actually looked at the recent numbers, we found that of the people who were entitled to receive counselling, only 20 had made it through,” said Alex South, Senior HR and Operations Executive.”

In 2025, Southeastern began trials of a new EAP service more suited to the needs of shift-based, frontline workers with 24/7 access to physical, mental health and safety support. “We knew we’d have to pay more than we were already paying,” said Alex, “but we were prepared to do so if we could guarantee getting more of a wraparound and holistic service that could be more easily accessed.”

The new offering has led to much higher levels of access: 21% activation of the app (more than 1,000 staff) and around a 50% conversion rate to counselling, and one on three reaching out to their GP.

How ‘social spending’ can reduce national worry

Dr. Lucía Macchia. City St George’s, University of London:

When governments think about protecting wellbeing, attention often focuses on what happens after people experience hardship — job loss, illness, or financial strain. But new research suggests that social policy also plays a crucial role before these events occur, by shaping how worried people feel about their lives and futures.

Our research examines “national worry” — the average level of worry reported across a country. Using large-scale survey data from Western European and OECD countries over the past decade, we study how worry varies over time and across societies, and how it relates to economic conditions and social spending.

The main finding is clear: countries with higher levels of social spending tend to have lower levels of worry across the population. This relationship holds even after accounting for unemployment and individual characteristics. Importantly, the association is not limited to those who directly receive benefits. Instead, it appears that living in a society with a stronger welfare state reduces feelings of worry.

This matters because worry is closely linked to poorer mental health, lower life satisfaction, and worse physical health outcomes. The study also shows that worry has increased over time in many countries, highlighting a growing challenge for population wellbeing.

The findings challenge the idea that wellbeing depends primarily on individual resilience or personal circumstances. Instead, they point to the psychological value of social spending. Welfare systems function not only as safety nets when things go wrong, but also as a form of collective insurance that provides reassurance and stability.

If policymakers want to improve wellbeing, reducing worry must be part of the conversation. That means recognising that wellbeing is shaped not only by individual choices, but by the social and institutional conditions that allow people to face the future with greater security.

How can EAPs scale support with AI without losing the human connection?

If you’re an EAP provider today, you’re being asked to do something deceptively hard: support more people, more often, on economics that don’t scale in the same direction. When demand rises but capacity and cost-to-serve don’t, it’s hardly surprising that AI starts to look like the only lever left.

The obvious worry is that introducing AI will “dehumanise” care. But if we’re honest, most EAP journeys don’t fail because they lack humanity. They fail because they hit the calendar.

Distress is rarely convenient. Anxiety peaks at 2am. A panic spiral happens after a meeting. The hardest moment to stay sober is Friday at 6pm. Yet the experience many employees have, implicitly or explicitly, is: “we can see you in two weeks.” That isn’t just a logistical delay, it’s an emotional signal: your problem is important, but not urgent. Help that arrives after the moment of need can feel like a fire engine turning up the next day.

This is where AI co-therapy becomes useful, not as a replacement for counsellors, but as the connective tissue between human touchpoints. Done well, it scales the parts of support that don’t require a human nervous system: guided skills practice, psychoeducation, structured reflection, and in-the-moment coping tools. It also helps people articulate what’s happening in real time, so the first human conversation starts further up the hill.

And the human element still matters enormously: trust, judgement, accountability, risk detection, and the experience of being understood by another mind. Co-therapy protects that scarce human resource by keeping clinicians focused on what only humans can do, while making support feel available when it’s needed.

So the answer isn’t “AI or human”. It’s AI for immediacy and continuity, with clinicians for care, meaning, and safety. That’s how EAPs scale without losing the connection that makes support work.

Sam Stern, co-founder, Affiniti AI. Sam will be giving a session and answering questions on AI and co-therapy at the EAPA UK Annual General Meeting on 10 March in Birmingham. Invitations to the event will be circulated in February.