EAPs delivering improved mental wellbeing, productivity and turnover, says new research

Research among more than 15,000 employees in Southeast Asia has provided more evidence of the positive impact of EAPs [[https://link.springer.com/content/pdf/10.1186/s12889-025-21358-7.pdf]].

The study was carried out in countries where EAPs are a relatively new benefit, in Malaysia, Singapore, Philippines, Thailand, Indonesia, and Vietnam. Employees filled out surveys relating to their mental health, sociodemographic background, levels of productivity and intentions around staying or leaving their employer.

The value of awareness

The research found that less than 30% of the employees were even aware their employer offered an EAP as a benefit. Actual offerings in these countries included well-being and mental health webinars, talks and workshops, alongside the usual helplines and counselling.

But critically, among those employees who were aware of the offerings, there were significant indications of a positive impact in terms of their sense of wellbeing and attitudes to their employer. In particular, having access to regular mental health risk assessments and screening was found to be the most effective offering in these markets.

Professional first

EAPA UK chair, Karl Bennett said: “EAPs are such an established and proven form of support for organisations in the UK that measuring their real impact can difficult, given the number of factors involved.

“This study in new markets where EAPs are a fresh innovation is important in reminding us of the value of both access and awareness to services, and the ways in which an employer’s support has a real affect on their people’s state of wellbeing and outlook.”

Traditional first aid is now “dangerously outdated” claims St John Ambulance

The first aid charity St John Ambulance has shifted the emphasis of its operations towards mental health, calling in particular for workplaces to change their approaches to first aid.

First aid, St John Ambulance has said, is no longer just about treating physical illness or injury, or maintaining emergency first aid kits, but making sure there is a holistic response including attention to both physical and mental health first aid.

The changing focus comes in response to how almost half of all sick leave among UK employees is reportedly due to stress, anxiety and depression (16.4 million of 33.7 million days of absence between 2023 and 2024). Of the £21.6 billion cost of absence to employers during 2022-2023, £7.1 billion was the result of workplace injury, more than £14 billion to illness.

The new duty of care

With the changing landscape of employee health, HR teams need to be certain they are meeting the legal duty around ensuring employees are provided with a ‘safe’ working environment, one where reasonable care has been taken to prevent personal injury — which includes harm to mental health.

Lisa Sharman, Head of Education at St John Ambulance, said: “Workplaces that do not upgrade their approach to first aid to incorporate mental health first aid, and a focus on mental wellbeing, are in significant danger of failing to provide holistic care for their employees.”

Professional first

EAPA UK chair, Karl Bennett said: “The rise in the use of Mental Health First Aid — identifying signs of mental health issues and providing initial support and guidance to professional help when it’s needed — is clearly a positive development. It’s making it easier for staff to have a first conversation, and an early conversation, about any concerns, and to be signposted to advice from professionals like those available through an EAP.

“But, crucially, MHFAs have only been equipped with the training to provide that initial signposting and nothing more. MHFAs can only ever be one element in a package of measures that provide preventative and reactive support.”

Why 2025 means a battle to protect employee mental health

Employers of all shapes and sizes are looking at how to adapt to an age of higher taxes in the wake of October’s budget announcement on National Insurance — and looking to what can be trimmed from costs.

Business confidence has been shaken. The CBI’s Growth Indicator points to a 10% fall in activity up to February 2025; the Institute of Directors has signalled the lowest level of confidence in the economy since the start of the Covid pandemic. In particular, intentions around investment in areas like recruitment have been significantly affected.

Leaner and meaner?

Evidence so far suggests employers plan to take immediate action: by limiting wage increases, raising prices and job cuts. Most organisations plan to introduce a raft of measures to offset higher NI contributions, including improving productivity.

More employers are expected to look at cost-cutting — as the more efficient way to protect EBITDA (earnings before interest, taxes, depreciation and amortisation) — meaning scrutiny of any expenditure on benefits and activities considered to be not ‘mission critical’.

Certain ROI

EAPA UK chair, Karl Bennett said: “There are some fundamental contradictions here. Most of all the government wants growth, based on improved productivity and getting a much larger proportion of the economically inactive back into the workplace: young people, the disabled and those who have been long-term sick. This can only happen with healthy, supportive workplace cultures.

“So, more than ever, it’s a case of what’s most effective, focusing spend on the offerings that lead to a proven Return on Investment. With their emphasis on dealing with root issues, untangling the combinations of worries and issues, and providing immediate access to professional support, EAPs have a long and obvious track record in terms of impact and ROI. The most recent data shows that for every £1.00 spent on an EAP in the UK, employers have seen an average return on investment of £10.85.”

What are the implications of Get Britain Working for the mental health agenda?

A £240 million initiative, Get Britain Working has a target of an 80% employment, getting more young people, people with disabilities, and those with long-term health conditions back into the workforce and contributing to the economy.

The white paper — due to lead to a raft of policy innovations and projects in the coming year — has come in the wake of increases in the number of economically inactive people, now up to nine million, with 2.8 million not working because of a long-term sickness. Last year, 53% of these pointed to problems with mental health as the main reasons — a 40% increase from 2019.

Demands on employers

A consultation will include talking to employers, employees, trade unions and those with health conditions. But the expectation is that employers generally will be expected to play an even larger role in creating a ‘healthy’ work environment, and one that’s accessible to more people with different kinds of health conditions, including mental health issues: flexible working practices and supportive line managers.

The planned ‘connect to work’ scheme, for example, will offer voluntary employment opportunities to people with disabilities, health conditions or complex barriers to work, supporting up to 100,000 people a year at full rollout.

EAP partners

EAPA UK chair, Karl Bennett said: “Next year will see a sharp focus on work and mental health. How can workplaces be a positive force for both the existing workforce and for getting more people with long-term illnesses back into jobs.

“Supporting mental health, of course, isn’t something that comes with making ‘reasonable adjustments’. There has to be trust and a sense of psychological safety among people often dealing with difficult and complex combinations of issues around health and finances and relationships.

“HR teams need to be looking at how their EAP provider can step up with them to understand the challenges faced by the different demographic groups, the causes of stress, and the ways to find the best balance between support and flexibility, and the need for challenge and rewards.”

What can stop the snowball of long-term absence?

A study among more than 300 HRDs in the UK suggests three-quarters are struggling with rising levels of absence among their staff. 66% point to higher healthcare benefit costs; 34% to lower productivity. In 2023, CIPD figures showed that average sickness absence had jumped to 7.8 days per employee per year).

At the same time, 70% of the HRDs believed they were prepared and able to deal with the implications of rising absence. 22% wanted the government to spend more on the NHS to reduce waiting lists.

Getting proactive

In response, the study has pointed to the most common tactics being used by employers: the adoption of tailored wellness plans and increasing access to physical health resources (around a third of respondents); and investment into technologies to facilitate remote healthcare solutions (35%).

“These are serious and sensitive issues, impacting real everyday people, and they must be treated as such,” said Julia Turney, head of platform and benefits at Barnett Waddingham, the company which undertook the research. “If left unchecked, businesses may soon be dealing with faltering productivity, dissatisfied employees, and even financial losses.” She also highlighted the need for better data and ongoing tracking of wellbeing, health risks and needs.

Prevention mindset

EAPA UK chair, Karl Bennett said: “There will always be reasons for people’s absence due to issues with physical and mental health. But there are better ways to think about and manage absence, and long-term absence in particular.

“What HR and workplaces can do is encourage a positive culture and a mindset when it comes to both physical and mental illness. That means working to understand the context and environment for absence, the root causes — such as unreasonable workloads and targets — that can turn into a cycle of higher absence levels, of people feeling unable to cope.

“EAPs should be playing a central part in the strategic planning of HR departments dealing with rising levels of absence, both in terms of insights into what’s happening across different parts of organisations, as well as how to address the underlying problems.”

Revealed: better management of mental health leads to business benefits

Mental health training for line managers could save companies millions of pounds every year by helping to reduce levels of employee absence.

That was the headline finding from my work with Dr Juliet Hassard of Queen’s University Belfast — research that has attempted to improve understanding of the role of managers in supporting the mental wellbeing of their teams, and address the tangle of workplace issues around stress, mental ill-health and long-term absence.

With so many sensitivities and implications for productivity, relationships and costs involved, it’s clear that UK employers need more insights into what works, an informed approach to wellbeing strategy and where and why to invest budgets. Reportedly, one in six workers experience mental health challenges. 12.7% of all sick days are due to mental ill-health, which is now also the most common cause of long-term absence. The estimated cost of poor employee mental health to British employers is over £50 billion annually. Practical, impactful ways of supporting mental wellbeing provide a major ROI.

We looked at anonymised survey data from several thousand companies in England collected between 2020 and 2023 by the Enterprise Research Centre at Warwick Business School as a part of a larger programme of research on workplace mental health and productivity. The survey covered mental health and well-being practices among the employers, including whether they offered mental health training to line managers.

The analysis suggested that employers providing mental health training for their line managers saw particular business benefits: there was improved staff recruitment and retention, indications of better customer service, and lower levels of long-term mental health sickness absence. (We used controls for the age, sector, and size of the companies to avoid skewed results).

So, equipping line managers with the knowledge, skills and confidence to better manage mental health at work appears to mean better business outcomes. And that’s important in terms of the business case for persuading employers to continue to invest in supporting the mental wellbeing of their workforces.

Follow-up research is now ongoing into what’s going on behind the headline: what kinds of training work best, what kinds of skills are being developed, and which are the most important?

Professor Holly Blake, School of Health Sciences at the University of Nottingham, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0306065

Our EAP: Leanne Matthew, HR partner at cable assemblies manufacturer GTK

We’ve seen how improving our internal culture in a number of ways has led to better employee wellbeing. An important platform has been making sure we’ve had an EAP in place — and the right kind of EAP for our workforce. Listening to actual needs and keeping up two-way communications on issues of health and wellbeing have been critical.

GTK recently changed its EAP because we recognised that it only focused on mental health but not any other areas. We also knew that uptake was low, a signal that the offering wasn’t meeting people’s needs. We take a holistic view of employee health and wellbeing and recognise that it goes beyond mental health. Physical health can sometimes be just as impactful, as good physical health can improve mental health, and vice versa. Then you have areas like financial wellbeing too. As well as offering professional advice and support, the EAP comes with above-and-beyond benefits, such as the offer of shopping vouchers, as a means of rewarding employee loyalty. We knew our previous EAP was good, but it wasn’t the best we could offer. Since we launched our new EAP, which covers all aspects of employee wellbeing, we’ve seen a 237.5% increase in uptake.

Early intervention is so important in making sure mental health issues are caught at stages when providing support is that much easier. Manufacturing is typically ranked in third place in terms of workplace stress (just behind hospitality and health and social care). We want our managers to be able to spot the signs of stress or poor mental health in their people. We’re building up a pool of resources for our managers — an employee handbook that includes a stress and mental health policy and a toolkit for managers, for example — to allow them to proactively support their people when they need it. They’re the first point of contact for their teams, so it’s important that they’re able to identify someone who may need more support. Sometimes, the hardest step a colleague can take is to open up about stress or mental health concerns. A lot of our managers report that their people come to them in the first instance when they’re experiencing difficulties, so that’s a testament to the environment we’re creating together.

Communications are at the heart of engagement and, ultimately, wellbeing. Whether that’s via regular one-to-ones, performance reviews, regular updates from senior management, or feedback on the EAP offering — it’s essential. If you don’t have it, your people might feel that they’re not important in your eyes.

What will the Employment Rights Bill do for wellbeing?

Employee health and productivity is clearly on the Government’s radar — as demonstrated by its high-profile plan to offer more access to weight loss injections as a means of getting people struggling with obesity back into work. But, as wellbeing professionals know, it’s critical that an employee health strategy is focused on dealing with causes of ill-health and not just symptoms.

Among the 28 reforms there are a number aimed towards increasing feelings of security. One proposal will remove the two-year qualifying period for protection from unfair dismissal; others ensure new recruits have the same rights from day one of their employment: access to paternity leave, parental leave, bereavement leave and statutory sick pay, as well as the right to ask for flexible working. People working on zero-hours or low-hours contracts will have the right to guaranteed working hours if they work regular hours over a defined period (with the suggestion that the qualifying period is set at 12 weeks). It was disappointing that announcements around the Bill have not included what would have been the most significant step forward: the planned ‘right to switch off’, to finally help address the impact of digital working and its pressures. Instead, there is expected to be advice and guidance rather than the kind of legislation introduced by Australia and Ireland.

Taking on people with more rights, who are even harder to move on if they’re not working out, isn’t attractive. So some employers might well want to cut back on recruitment plans, and be far more cautious when it comes to who they recruit — meaning higher workloads for established staff, more use of AI and automation. Employers might well also feel they have to get tougher on performance and outputs, to make sure they are getting a fair return on all the extra rights they’re offering.

Organisations need to get to the root of problems. How aware are most employers of the detail of their wellbeing landscape? The reasons their staff are absent or not performing, which teams or areas are struggling with workload pressures, with questions over management styles, problems with relationships, or escalating worries over finances. Is their training for managers to hold constructive, productive return to work, leavers and 1:1 sessions with their team? How can people best be supported so that they feel part of something?

It’s in this context that EAPs can be used as an early warning system. More wellbeing services and benefits clearly haven’t been the answer. A tailored approach, with OH and HR working closely with their EAP provider and accessing its bank of insights to identify real needs can lead to the tangible outcomes needed, lower levels of stress and more engaged and motivated people.

Karl Bennett, chair, EAPA UK (Employee Assistance Professionals Association), www.eapa.org.uk

Fines and penalties for ‘unhealthy’ employers?

The Institute for Public Policy Research (IPPR) wants to see regulatory action taken against employers who don’t provide ‘healthy’ work conditions, those that have “unacceptable” levels of employee ill-health. Measures would include fines and public exposure.

The argument comes as part of the think-tank’s work on health and prosperity in the UK, and concerns around the cost of benefit payments for people not working because of long-term health conditions. What’s the point of the NHS trying to make employees well, when they’re just going to be sent back into places that make them sick again? The pressure on employers, says the IPPR, would help deal with problems with obesity and rising numbers of cases involving anxiety and depression.

Penalise or incentivise?

In his response, Sir Cary Cooper has called for more incentives to help organisations create healthier workplaces rather than more regulations on punishment for employers.

“There are 2.8 million people in the UK who are out of the workplace with long-term sickness and 53% of them are off with stress, anxiety and depression. These are the leading causes of long-term sickness absence, not only in the UK, but in every developed country.

“We could do what the IPPR is suggesting and impose fines on companies, but I think using positive incentives would be better,” he said. “For example, the government could reduce national insurance contributions for employers that support a healthy work environment, or encourage health insurers to offer them lower premiums. This makes it a bottom-line issue for businesses.”

Open up together

EAPA UK chair, Karl Bennett said: “Workplace wellbeing has become a major issue for the UK. It’s fundamental to national productivity, to the finances of the NHS, to society as a whole. That means we all have a stake in the wellbeing challenge, and need to be working together rather than looking to blame.”

“Workplaces are as much a source of rewards and fulfilment and motivation as stress and fatty foods. What’s important is honesty, open discussions and attention to the underlying causes of ill-health, physical and mental, and what might lead to unhealthy behaviours. EAP providers will increasingly be important partners in understanding landscapes of health and ill-health, raising awareness of what needs to be done, and introducing a more preventative approach.”

Campaign aims to get mental health patients back into work

Work and Pensions Secretary Liz Kendall has announced plans for a scheme where ‘employment advisors’ will visit mental health patients in hospitals to help them back into work.

The scheme comes in the wake of figures released by think tank the Institute for Fiscal Studies, which estimates that the costs of disability benefits to taxpayers are estimated to reach £63 billion by 2028. Coaches will help people with job applications, CV and dealing with interviews.

‘Dramatic results’

A trial of the approach, said Liz Kendall, had produced “dramatic results” in terms of returns to the workplace — and will help address the UK’s issues with its population of ‘economically inactive’ people (21.8% of 16-64 year-olds).

But mental health charities aren’t convinced. “It is ridiculous to try and turn a hospital, a place of care and support into a business setting,” said Mikey Erhardt at Disability Rights UK. “It is hugely inappropriate to be considering subjecting people who experience mental ill-health and distress to a CV check-up.”

Back to employers

EAPA UK chair, Karl Bennett said: “While we know that getting back to work provides important routines, rewards and a supportive social environment for most people, it’s not the solution to mental health problems in itself. The obvious reality is that work involves its own stresses and challenges.

“In other words, the Government needs to keep in mind that the greater challenge is for employers and their HR and wellbeing teams. Both in providing the right support and environment for returning workers, and to help maintain the balance of challenge and wellbeing for its staff, keeping them in work in the first place.”