Our EAP: Brigitte Kaviani, Programme Director – People Experience, South Yorkshire Integrated Care Board

Many other Integrated Care Boards in the UK have needed to stop their funding for an EAP — because of the idea that now the pandemic over, staff don’t need the support. But that’s obviously far from being the case.

In 2021 we commissioned a universal EAP service for the entire South Yorkshire Integrated Care System — we wanted to offer consistency of support around wellbeing, what would be the foundation to a culture of care for employees involved in delivering health services. Our EAP is available to more than 72,000 staff working not only in the Integrated Care Board but across the clinical commissioning groups in our region, the hospital trusts and primary care services, but also the health students in teaching hospitals and universities, local authorities, employees in care homes, hospices and the voluntary sector in neighbourhoods in South Yorkshire and Bassetlaw.

Some organisations might already have had access to an EAP, but with our new large-scale arrangement we were able to offer a way to bypass long waiting lists, a concerted programme of activities, 24/7 access to helplines and resources, and more immediate access to counselling (face-to-face, telephone or by video call) — a guaranteed six sessions that can start within seven to 10 days, with some employers in the System funding further sessions as needed.

It’s an amazing set of free services to staff. And as a Board we’ve found this to be a cost-effective way to provide a holistic wellbeing support service. On average we find around 250 people a month access the counselling offering, with many more taking advantage of the library of resources available.

Critically, we work closely with a Client Success Manager — the same person since the start of the contract, so they know the organisation and how it works — to help develop better forms of reporting. We have a set of monthly reports and annual reports on EAP usage, one for the whole ICS as well as by each employer sector, so we can see the trends in terms of usage: why the EAP is being used and when; along with the demographics of users.

This valuable data has been used along with staff surveys to inform our three-year health and wellbeing strategy from April 2024; to shape a series of evening events with speakers giving advice on the issues that were found to be the most common, so issues like stress and anxiety; and to target promotions and awareness campaigns around particular forms of support. The data is also important for demonstrating usage, the issues and the need for ongoing funding. One useful indicator of the quality of the support on offer has been the lack of any genuine complaints in the past three years of running the offering.

The EAP has been the focus for a wider package of support: short courses on mental health awareness, or more tailored for particular staff groups, such as a course on how to have difficult conversations for GP receptionists. Webinar resources have been developed to meet needs as they have been identified, forming a library of content for the ICS, such as dealing with anxiety, burnout, trauma, SAD. A particular example would be the interest in advice around work and the menopause, where a particular support service was developed and piloted from September 2023 and went live in April 2024 as part of the annual offer. A hugely valuable part of the EAP service is the wraparound of support, before, after and during counselling. People are looked after. The EAP stays in contact with staff who call in, they check-in ahead of any counselling and signpost to the resources they can access in the meantime.

Don’t suspended employees need access to an EAP?

When employees are suspended due to disciplinary action, they fall into a hole of worry and stress. And that means serious implications for their mental health — and risks for HR in terms of their duty of care.

ACAS guidelines are explicit about what’s expected. An employer needs to deal with any disciplinary case as quickly as possible; and be completely transparent about the process. That means making sure the employee knows exactly why they’ve been suspended, what the process is going to be, and kept updated on what’s happening.

But evidence from our work and colleagues in the EAP sector suggests this isn’t happening. Suspensions can often be a woolly, drawn out process, where support is limited. People end up being stranded: cut off from their colleagues and workplace routines, not given access to an EAP. Cases are dragged out for month after month — because they’re an awkward challenge for management to deal with, typically involving sensitive, personal situations and experiences. Uncomfortable and a drain on management time.

There are inevitable consequences for people undergoing a suspension in terms of their mental health. And let’s remember that these are employees who are yet to have been found guilty of anything, there’s just an accusation or a problem come to light. Very few cases involve intentional, malicious activity. It’s just been a mistake of some kind or another — and we all make mistakes.

Meanwhile this kind of stress over months can lead to anxiety and depression. There are feelings of shame and humiliation, so people don’t feel able to talk to friends or family about what’s happening, and the pressure keeps building up. Anecdotally there are cases where people have felt suicidal as a result of their situation — and this is only the tip of the iceberg, because EAP counsellors, in principle, only hear from employees who are coping and have reached out for support. What is happening to all those who don’t have access to an EAP and aren’t coping?

HR need to be mindful that they still have a duty of care for employees who have been suspended. Employees have a right to confidentiality, a clear process, ongoing contact and updates. Most of all — for the sake of employees going through an intensely difficult time, and for the relationship with their organisation — an EAP and its services needs to be signposted as part of the standard process of a disciplinary action and suspension.

Jayne Andrews, Clinical Lead and Counselling Services Manager, Smart Clinic

Notice of UK EAPA Branch Meeting

26 July 2024

13:30 – 14:15     Branch meeting  

• Welcome and Apologies
• Minutes of March meeting 
• Chair’s Report 
• Treasurer’s Report 
• Projects Update 
• PR & Social Media Activity​ Update
• EAPA International Update​
• Any Other Business 

14:15 – 14:30  Guest Presenter:  Dr Dale Masi

Dale A. Masi, PhD, is a Professor Emeritus, University of Maryland, where she taught for 22 years and directed the Employee Assistance Specialization. The author of sixteen books and more than seventy articles dealing with EAPs, evaluation, and various mental health issues.

Dr Masi will be discussing the development of EAPs throughout the world, the effect of the pandemic on the mental health of the world’s population, the unique characteristics of EAPs in various countries to addressing the pandemic and the effect of technology on delivering EAPs in 60 countries. This will be followed by a Q&A.

Members are encouraged to bring one colleague as a guest for this part of the meeting

REGISTRATION: info@eapa.org.uk

Keeping up conversations among staff with cancer

Around 890,000 people of working age in the UK are currently living with cancer. The ‘Window to the Workplace’ survey found that 25% of employees didn’t feel heard or listened to during their period of ill-health. 21% were unhappy with the level of communication with their line manager.

At the same time, 82% of line managers involved with the survey confirmed they believed in regular ‘check-in’ conversations with staff with long-term health conditions.

Using data to be proactive

With both increased numbers of cases of cancer diagnoses and higher survival rates, conditions such as cancer are affecting far more worker’s lives. More employees are dealing with periods of ill-health, regular medical appointments and treatments — and then returning to work. But in the meantime, relationships with line managers and colleagues have changed. Just 36% of employees, in particular, were satisfied with the mental health support being offered (and under 25% among the 55+ age group).

Only around half of the managers involved believed they had the resources and training to support a colleague with a long-term health condition.

“Open communication is crucial; employees need to be heard and line managers need to have the skills and the tools in place to both listen and act with confidence,” said report author Dr Julie Denning, managing director at Working To Wellbeing.

Prevention cycle

EAPA UK chair, Karl Bennett said: “Conversations about cancer and other forms of serious ill-health are difficult, sensitive and highly personal. The reality is that the majority of line managers are uncomfortable, they don’t have the specialist skills needed — especially when illness leads to issues around mental wellbeing. And for both the employer and the employee dealing with ill-health, there are dangers around the implications of those conversations, and basic lack of real communication. Loss of engagement and the potential for employees not to want to come back when their health recovers.

“It’s when employees are out of the workplace, at home, and perhaps feeling disconnected from work that communications with line managers are so important. EAPs become a critical form of independent advice and support, acting as a practical and sympathetic bridge with the workplace.”

Why Employee Relations are founded on mental health

Around 70% of the largest employers internationally believe mental health challenges in the workforce are leading to problems in Employee Relations (ER).

The survey was carried out by HR Acuity for its Employee Relations Benchmark among 250 organisations (representing more than 8.7 million employees globally and 20% of Fortune 100 and Fortune 500 companies). Organisations pointed to the role of aggressive ‘return-to-office’ policies and more employees being aware of the personal impact of stress and anxiety.

Poor mental health among employees was found to lead to rising numbers of cases involving policy violations, behavioural issues, discrimination, harassment and allegations of retaliation.

Using data to be proactive

The report authors suggest HR need to focus on the triage of mental health issues — and to pre-empt problems by using employee data to identify patterns and implement targeted interventions of support. 90% of employers in the report were interested in adopting AI to transform ER, using the technology for data analytics and predictive modelling for ensuring compliance with policies.

Only 11% of the organisations involved were found to share anonymised information relating to the outcomes of ER cases, raising questions over transparency and trust.

Prevention cycle

EAPA UK chair, Karl Bennett said: “More employers are beginning to appreciate the impact of workplace culture on employee wellbeing — and how everything is interconnected. A people-friendly culture and ways of working supports good mental health and creates a virtuous circle. So it’s not just about reacting to the needs of individuals when they have problems.

“HR and EAPs need to be working together on preventative care, sharing data and insights in order to identify trends and issues, and tailor interventions together.”

Why staff are increasingly turning to legal action against their employer

A study by a global risk management firm, Gallagher, has shown how employee disputes have become the most common legal issue for businesses.

Over the past five years, three-quarters of firms surveyed (764 large UK businesses) had seen a growth in legal cases against them (28% had seen an increase of more than 40%). 38% were due to employee disputes, involving hundreds of thousands or even millions of pounds in costs for individual employers.

Litigious climate

The main causes for employees turning to employment tribunals and other legal action are thought to be the cost of living, economic instability and, in general, a greater willingness in society to look for legal redress. 60% of business leaders expect further growth in the number of cases over the coming year.

In addition to the financial costs, employers have also flagged the damage to reputation, operations and use of management time. The sectors most affected are said to be energy, scientific operations, IT, and finance.

Changing relationships

EAPA UK chair, Karl Bennett said: “Where there are good relationships within an organisation, feelings of trust and belonging, then people are far less likely to feel the need to turn to the law. They would much rather deal with conflict in an informal way, and will have enough faith in management to do so. “A sense of wellbeing, and of an employer actively supporting and being committed to employee wellbeing, is fundamental to relationships. Making full use of EAP services, making sure concerns and worries are dealt with at an early stage, is so important to defusing the levels of stress and tension that lead to an escalation of situations.”

What will measures to counter a “sick note culture” mean for EAPs?

Controversial new reforms have been announced by PM Rush Sunak to keep more people in work, including making “sick notes” harder to obtain. Sick pay has become “a lifestyle choice” he argues, particularly among a generation of younger people: with everyday forms of anxiety being given as reasons for long-term absence.

As part of a series of Government announcements criticising the UK’s “sick note culture” and an increasing reliance on benefit payments, the PM has now proposed new legislation. This would include some people suffering from anxiety and depression losing their disability payments; and GPs no longer allowed to sign people off work for certain conditions.

Objective assessments

In response, disability charities are angry that cost-savings are being made a priority over care and support, and that the Government’s statements are stigmatising people with disabilities.

Calls are being made for more professional, objective assessments by specialists to deal with “subjective and unverifiable” claims about mental health. The British Medical Association, in turn, has criticised the lack of access to mental health services to provide those assessments.

Who decides?

EAPA UK chair, Karl Bennett said: “It’s fair to say that work plays a very positive role in people’s lives, in terms of rewards and purpose and social contact. The core issue in the current debates is who decides who should be given disability support and benefits because of their mental health condition, and who might be better suited to staying in work? Where are the specialist resources of mental health professionals to make these critical, life-changing decisions?

“Without this clarity, more pressure is going to be put onto employees, fearful of being stigmatised; on employers in trying to deal with complex cases and situations involving mental health; and EAPs, already facing huge levels of demand. How might expectations change around what an EAP can deliver in terms of clinical outcomes and clinical decisions on who should be given disability payments?”

Is the sick note system encouraging people to leave work forever?

There has been almost a 300% increase in the number of sick notes being issued for stress-related disorders over the past 10 years, according to a new research paper from the think-tank Policy Exchange.

The report also highlighted what it has described as a “de facto system of self-certification” — how 90% of NHS doctors agree to sick notes, usually without any kind of diagnosis. GPs are simply too busy. Overall the number of fit-to-work certificates being issued has doubled over the last decade.

Never going back

Most worryingly for employers and the future of the UK labour market, Policy Exchange found that of those employees signed off for six months, 80% of them will never return to work.

The findings are being used as evidence to support the government’s new Back to Work Plan, which aims to encourage employees to remain healthy and re-enter the workforce rather than rely on support from welfare benefits. Secretary of State for Work and Pensions Mel Stride has continued to argue that “life’s ups and downs shouldn’t keep people off work”.

Workplaces for health

EAPA UK chair, Karl Bennett said: “Everyone agrees that more openness and acceptance of mental health issues is a welcome development. An unintended consequence has been the worry that some employees are seeing stress as an illness rather than a part of everyday life that can be managed in positive ways.

“Work is known to play a valuable role in good mental health and encouraging resilience, in terms of recognition, rewards and social networks. But we need ‘good’ workplaces where organisations and their HR teams are paying attention to employee experiences and the sources of stress, making use of insights from their EAP partners and the data available — and working in partnership with an EAP and OH to make the workplace a basis of good health.”

Mental ill health costs reach £300 billion a year — more than the cost of the Covid-19 pandemic

Research commissioned by the NHS Confederation’s Mental Health Network has looked in detail at the actual costs of poor mental health in the population of England.

The work, carried out by the Centre for Mental Health, found that economic costs were £110 billion (like unemployment, sickness absence, staff turnover and presenteeism); health and care costs were £60 billion; and ‘human costs’ (reduced quality of life and premature death) was estimated at £130 billion.

Constant Covid

The report The economic and social costs of mental ill health suggests that the impact was greater than the estimated costs of Covid-19 on the UK economy in its first year, 2020. But unlike the pandemic, mental ill health is an ongoing challenge with no vaccine.

To put the costs into perspective, they are almost double the entire budget of the NHS in England of £153 billion. The analysis also suggests that a third of the entire costs fall on employers.

The NHS Confederation’s Mental Health Network is calling for a comprehensive ten year mental health strategy.

Work matters

EAPA UK chair, Karl Bennett said: “For the majority of people’s lives, work plays a pivotal role in their mental health, providing financial rewards and a foundation to their sense of stability and security, as well as lots of other important benefits: a social network, friendship, feelings of belonging, of purpose and challenge.

“So when things are difficult at work, for whatever reason, there is a real impact on overall mental health and how people feel when it comes to coping with other issues around their health, finances and relationships. “It’s so important, then, for a national strategy to look at the role of work as a priority. How ‘good’ workplaces — conscious of how work demands and workplace culture affects people’s state of mind, and providing different forms of advice and support when it’s needed — are critical for the mental health of the entire nation.”

How micro aggression impacts on workplace mental wellbeing

Research among 2,000 UK workers by Mental Health First Aid England (MHFA) suggests around one in three have been the subject of micro aggression or discriminatory behaviour from their manager in the past six months. In turn, for many, this has led to negative effects on their mental health.

Younger people are more likely to be affected by — or pay attention to — these kinds of behaviours from managers: 66% of 18-34-year-olds, compared with 38% of those in the 45-64 age group. 47% of White British staff were affected; 57% of Asian and Asian British, and 72% of Black or Black British. 

Feeling picked on

Employees don’t feel able to bring their ‘whole selves’ to work. Most often, this is because of comments that managers have made relating to their age, their working patterns, mispronouncing people’s names, comment about their personal life, or even their physical and mental health.

The ‘exclusionary behaviours’ pointed to in the report include ‘not getting credit for work done’, ‘favouritism of other employees’ and ‘sarcasm.’

Improving cultures in practice

EAPA UK chair, Karl Bennett said: “When people feel able to be themselves in the workplace they’re going to contribute more — feel more motivated, more engaged, and a better sense of mental wellbeing. Discrimination or a sense of being unappreciated or disrespected is bad for everyone.

“Creating a more positive culture starts with understanding where the specific pressure points and issues are occurring. And that’s where a close relationship with an EAP is critical; for working together to identify underlying sources of workplace stress (among which specific groups, when and where), which can be used to make structural changes, provide more support and training.”