How EAPs are protecting the NHS

The number of referrals to NHS mental health services have hit their highest level for two years, signalling a new surge in cases.

The BBC’s Shared Data Unit figures from 117 Clinical Commissioning Groups and health boards across the UK showed around 300,000 people were referred to NHS mental health services in March 2021. This was a rise of 18% from the month before the pandemic struck. The biggest rises were seen in England. CCGs in Leeds, Redbridge and Greater Preston have seen referrals more than double compared to pre-Covid levels.

In response, the government plans to expand and transform mental health services with £2.3bn annual funding a year by 2023-24.

The need for early intervention

Most worryingly, the number of people actually receiving mental health treatment is lower than before the pandemic, raising concerns over the lack of access to timely interventions. Charities have flagged how people are being one long distances to receive support and care because of a lack of local beds, as well as an “acute rise” in numbers of people experiencing PTSD.

Geoff Heyes, head of health policy at MIND, said: “Had those people been able to get support earlier, be that through community mental health services, through talking therapies in their community, they may well have not got that unwell.”

EAPs step up

EAPA UK chair Eugene Farrell said: “EAPs are helping to ease the burden on NHS services, offering easier access for employees to mental health support, when and how it’s needed, and at an earlier stage.

“An EAPA study last year compared the use and waiting times for NHS services (via the Improving Access to Psychological Therapies programme (IAPT)) with EAPs. This showed an average waiting time from referral to treatment of 20 days through IAPT, compared with 8.8 days with an EAP. Clients who completed treatment with IAPT needed an average of 6.9 sessions; with EAPs this was four.”

How EAPs are protecting the NHS – EAPA UK

What is the talent going to stay for?

Around three in five employers expect to see an increase in resignations over the next 12 months, says a new study by XpertHR.

Other work by SD Worx has shown that of the staff who resigned during the pandemic (around one in 20 employees), the leading reason was to find better benefits.

The post-pandemic environment is believed to have created perfect condition for job-switching: a re-evaluation of work/life balance, the potential for WFH and re-location, alongside sudden skills shortages and furloughed staff looking for more security. All of these factors have led to what has become known as the ‘Great Resignation’.

Benefits under scrutiny

The XpertHR research has raised questions over the need for immediate action on benefits. It found that around half of employers only review pay and benefits packages once a year.

“The easing of pandemic restrictions has opened a massive pressure valve in the job market,” said Colette Philp, UK HR Country Lead at SD Worx. “With the ‘Great Resignation’ washing over industries, employers are scrambling to make their roles and organisations more appealing, and offering flexibility is key to ensuring job satisfaction in the current climate.

“Employers that don’t offer employees what they need are now in danger of losing ground in the war for talent. Senior leaders and HR teams will need to redouble efforts to make roles more attractive and competitive if they want to retain and develop their talent benches.”

Good work

EAPA UK chair Eugene Farrell said: “The pandemic experience has changed attitudes to work and working – and, as a result, to what makes for a ‘good’ employer and good working conditions and environment.

“Top of the list in terms of essential needs is support and understanding of wellbeing. Rather than a nice-to-have it’s become a basic requirement. HR should be looking again at their physical and mental wellbeing offerings and how they are perceived and communicated to staff, as part of recruitment and onboarding, as well as everyday awareness.”

Do you suffer from ‘pleasanteeism’?

More than half of UK employees say they feel under pressure to smile and hide their worries and concerns at work. According to Lime, authors of a new report Keeping up Appearances: How ‘Pleasanteeism’ is Eroding Resilience, the result is a ‘hidden mental health crisis’. Pleasanteeism just means a false sense of resilience and problems not being dealt with.

The report says 25% are concerned about whether they will be the ‘best version’ of themselves back in the workplace; 20% about whether their stress will be visible.

Mental health first

The survey also suggests that 26% of employees ‘aren’t coping’ with work; a third with everyday life in general. The research found that  just 16% feel their mental health is ‘well supported at work’. 81% want more. 40% said they would look for a new job if more help wasn’t offered around mental wellbeing.

“The long-term repercussions of the pandemic are likely to be felt for years to come, and it’s important we act now to be aware of and prioritise both our own mental health and that of those around us,” said Shaun Williams, CEO and Founder, Lime Global. “We know that employers have a lot on their plates and each workforce will require unique approaches for tackling mental health challenges. It’s only by drawing attention to and prioritising mental health in the workplace that we can support one another to be as healthy, resilient, happy and productive as possible.”

Open up to EAP

EAPA UK chair [https://www.eapa.org.uk/] Eugene Farrell said: “Inevitably employees put on a front at work. We step through the door and take on our professional persona. But as the Lime report points out, that’s no basis for resilience – particularly the level of resilience needed by organisations in the post-pandemic environment.

“EAP services needed to be front and centre of HR thinking and activity in this period. Because we know that while EAPs are listed as a benefit, there isn’t always the level of awareness and understanding of what an EAP is for – that it’s not just for people dealing with a personal crisis. EAP counsellors are an important outlet for staff with worries at all levels, a means of addressing small concerns early before they can turn into a major cause of stress.”

EAPs in the frontline of dealing with return to work anxiety

New figures from Towergate Health & Protection’s EAP show a 145% surge in the number of counselling calls in March 2021 compared with the previous year and the start of lockdown.

The rise in contact from the workforce was seen in both telephone and online access. Most calls were from employees worried about symptoms of anxiety, followed by low mood and then depression itself.

Towergate dealt with more than 33,000 calls and delivered 23,000 structured therapy sessions during April 2021.

Rush and tumult

“There may be many reasons for this, including the anxiety of returning to work and the stresses of resuming the rush and tumult of everyday life,” said Brett Hill, distribution director for Towergate Health & Protection.

“As a population, we have had to cope with a great deal over the last year or so. It should perhaps not be surprising that this has had a knock-on effect. We have been conditioned to become socially distant, and the return to busy offices, a hectic commute, and a gear-change in life in general are all likely to bring with them stress and anxiety. The good news is, there’s a lot that employers can do to make sure these problems do not escalate and affect working life. Support is available and employers should make use of it to ensure the wellbeing of their workforce.”

EAPs take the strain

“The figures from Towergate back up the anecdotal evidence we’ve been seeing from across EAP providers,” said EAPA UK board member Paul Roberts.

“Lockdowns led to different kinds of stress for employees from the disruption, the threat of losing jobs, taking on new ways of working or being furloughed. But there was also a break from routine, novelty, opportunities for home working and a better work/life balance. For some people that meant an escape from smaller worries, an easing of the usual work pressures and problems.

“The return to work period has seen a combination of ongoing concerns about job security and exposure to the virus along with a return to ordinary working life and expectations of productivity and performance.

“Again, EAPs have been up to the challenge. Counsellors have been able to provide professional support to the new waves of employees making use of services that will help them restore a sense of control and focus on their wellbeing.”

EAPs in the frontline of dealing with return to work anxiety

Do hybrid workspaces = better mental health?

More companies are transforming office spaces to suit their plans for hybrid working. A BBC survey of the UK’s 50 biggest employers earlier this year found that 43 planned to encourage working from home for two to three days a week going forward. A Leadership IQ survey has suggested that 91% of employees want at least some WFH.

Besides the potential for cost savings from smaller office facilities, there is the argument that an office space strategy needs to be ‘realigned’ with changing employees’ needs, leading to happier, more productive staff. A report from Envoy recently (UK return to the workplace) included the statistic that 70% of employees believe a hybrid working model results in personal benefits, with 34% saying it would improve their mental health.

WeWork campaign

The American commercial real estate company, WeWork, is promoting the idea of the need for flexible shared workspaces – not just for tech startups but for the mainstream of employers. In this way, they argue, HR is delivering more benefits to its workforce. Ashley Cope, Head of People Partners for WeWork in the UK, said: “Office visits are becoming more intentional – with employees coming in for specific reasons, and therefore office must fulfil a specific purpose. It must facilitate the in-person teamwork that has stagnated during working from home by being both collaborative and convenient.”

Cope adds: “Hybrid working can empower employees with more choice over how, where and when they work, allowing them to tailor their working days to their own personal schedules. This is something that employees have always wanted, and sustained periods of working from home and the trust built between employers and employees has shown how effective it can be.”

WeWork, with 1,200 employees across 24 countries, has introduced ‘collaboration hubs’ into workspaces to encourage “better in-work connection” along with the All Access scheme that allows employees to work from any office location in either the UK or Ireland.

Homeless?

“The move to hybrid work arrangements comes with a mixed bag of implications for employees,” says EAPA UK chair Eugene Farrell.

“It means revolutionary change to traditional practices. For all the potential benefits from incensed flexibility and work/life balance it has to be recognised that change is always unsettling. For many staff not having a fixed workspace, their own desk and chair, their things in one place, will be difficult. Not knowing when they will next see colleagues. The change in atmosphere. The need for more independence and self-reliance. Even a sense of isolation.

“For managers there will also be all the challenges of dealing with dispersed teams and all their different situations and needs. As the pandemic experience has shown, more flex can also lead to higher risk of the blurring of work and home life and more burnout. For HR in general there will be issues with engagement and loyalty among staff whose attachments to the workplaces are weakened.

“In this context, where there will inevitably be feelings of disorientation, support for mental wellbeing and an all-round sense of ‘belonging’ will be critical, and HR will need to be looking hard at how problems can be dealt with and relationships can be preserved.”

Do hybrid workspaces = better mental health? EAPA UK

Is return to work anxiety being taken seriously?

After 16 months of working from home, 55% of UK professionals are reporting anxiety about going back to the office routine. But the survey by CV-Library among 1,100 people highlights how the roots of the concerns are less to do with the risks of Covid-19 than mental wellbeing.

73% didn’t want to lose the flexibility of WFH and all the benefits they’d experienced in terms of work/life balance and more time for family and friends. 44% felt they were more productive when they were not in the office. 33% were worried in particular about a return to office politics. Just a third flagged uncomfortable feelings around the risks from Covid-19.

Who’s helping?

In terms of support from employers the survey found a very mixed picture: a lack of awareness of what’s on offer (if anything), and an unwillingness among staff to speak with their manager about their concerns.

74% of the UK professionals said there was no mental health support on offer to help with the transition back into the office. Only 23% said they would feel comfortable with speaking with their manager.

Of those organisations that did have support available, 46% provided a staggered return to work and regular check-ins with managers; 40% offered access to an EAP; 29% to a ‘how to guide’ for preparing for the return.

The clash

“The lifting of coronavirus restrictions hasn’t meant a simple return to work and return to normal. Far from it,” says EAPA UK chair Eugene Farrell.

“And it has to be recognised that there’s a basic tension between the needs of businesses looking to maximise efficiency and productivity within its operations and the preferences of office-based employees who found WFH a boon to their wellbeing.

“It’s not a tension that employers can afford to ignore when it comes to engagement and retention. Particularly given the sudden opening up of the jobs market and more people looking for a move and better conditions. Employers need to make sure they are listening, keeping some levels of flexibility in mind – and make sure all staff are aware of the EAP services to help them find their own new normal.”

Is return to work anxiety being taken seriously? EAPA UK

60 seconds with …. Eugene Farrell, chair of EAPA UK 

1. What do you see as the biggest challenge now facing the EAP industry?

Digitisation has accelerated really fast, added to that it seems many counsellors may not want to return to face to face entirely. The EAP world has been a bit slow to respond to digital delivery and may get behind the digital curve. We see new digital providers entering the mental health and counselling space which present an alternative to EAP. Given the low cost per capita of EAP services, there has been little investment in the infrastructure of EAP services and providers. This may be the biggest barrier to moving the digital dial on. Gen Z’s are already digital in almost everything, while Gen Xers might be a mix of digital averse and digital adopters. Both are in the workplace so we can’t switch to fully digital. Choice of entry point and interaction is going to be essential too. 

2. Where are the biggest opportunities for expanding EAP services and relationships going to come from?

The spotlight on mental health has become more intense, there has never been a better time for EAP’s to really show their value and experience in helping employees and workplaces to assist with mental health. EAP’s have been doing this since the 1980’s, the industry had a boost after the Walker 1995 case and again after Hatton-Sutherland 2002, but nothing like this. Back then stigma was still an issue, it is much less so now and EAP’s have an essential part to play in helping employers with their mental health management and strategy.

The EAP industry bring years of experience and offer a wide range of support and treatments that can really help people. We have always done reliable assessment of mental health needs with onward referral to counselling, or mental health treatments. It shouldn’t be underestimated just because it’s so reliable and done efficiently. Overall, there is a wide offering from EAP that is an essential part of any mental health and wellbeing strategy. EAP’s also bring a wealth of additional services and experience, like training, mental health awareness, resilience and stress management. There is also an explosion of first aiders that need proper supervision and support that EAP’s can provide. 

3. What’s going to be the most important next trend in employee wellbeing?

It seems to me that data is the big thing, there are many aspects to wellbeing and data is disparate, overlapping, overrepresented or just unclear. Getting reliable data that properly identifies employee health risks and outcomes, is going to be really important. Otherwise, you are just sitting looking at reports thinking “so what is this actually telling me about the wellbeing of my people?” 

4. What should be the main priorities for EAPA in the coming years?

We need to set really high clinical and delivery standards to ensure that employees get real help when they need it. We are unique in having standards for providers, and this should be a huge comfort to organisational purchasers. But at this time, they are not well understood, so we need to work harder on that. Getting the standards verified is another challenge, we are working to resolve that right now.

5. What’s the most rewarding part of your job?

I truly believe we do good things to help people when they are in need, distress or crisis.

6. What’s your next big project at home?

We have two flat roof’s that need replacing, should I have ago or get a professional? I am pretty good at most things and with new rubber membranes I am tempted to do it myself. It might be sort of therapeutic doing a manual task, or it could turn into a nightmare where I need help.

Parliament EAP provides early warning system

The number of calls made to a 24/7 helpline, known by Parliament staff as the ‘harassment hotline’, have increased by 10% during the pandemic period.

The hotline has been available since 2014 as part of the EAP. Between 2019 and 2020 there were around 973 calls to the hotline, the great majority from House of Commons staff and a smaller number from the staff of MPs. In the most recent year this has risen to 1,073 calls. The actual figures are believed to be higher as the official figures do not include calls from other types of Parliament staff, including those involved with the House of Lords or MPs themselves.

Mental health signals

Rather than cases of harassment or conflict in particular, around half of calls have been from staff with worries about their mental health. A quarter were to do with legal queries.

Jenny Symmons, chairwoman of GMB’s branch for MPs’ staff, said: “Parliament has made huge headway in supporting MPs’ staff pastorally. As more effort has been made to publicise the EAP during the pandemic, more staff have made use of it. However, services offering mental health support are only treating the symptoms of cultural issues in Parliament – not the cause.”

Treating causes

“In a pressured, rough and tumble environment like the Houses of Parliament, access to mental wellbeing services is hugely important,” says EAPA UK chair Eugene Farrell.

“Yes the role of an EAP in this context is in treating symptoms – making sure people get immediate advice and help early on in situations. But it’s also only this kind of evidence of usage, and types of usage, that provides the necessary evidence for HR to plan a targeted response. In turn it’s the EAP that highlights the problems that exist and what can be done: allowing for steps towards culture change based on recognised realities.”

Parliament EAP provides early warning system EAPA UK chair Eugene Farrell

What’s happened to the cost of absence during the pandemic?

Sickness absence fell to 2.2% during 2020, down from 2.7% in 2019: an average of five days per employee compared with 6.4 days according to the XpertHR online resource.

The combination of staff being furloughed, WFH and people shielding is believed to be the reason for the falling rates – which are expected to continue as more staff opt for hybrid forms of working.

At the same time, however, there are concerns about how Covid-19 has made it more difficult for HR to record and understand the real impact of sickness absence on businesses. Fewer than two-thirds of businesses record the impact of absence, says new research from group risk protection body GRiD among 505 HR leaders in the UK. What’s been the real cost of disrupted teams on productivity and performance?

What’s being measured

The most common method for recording absence (among 44% if businesses) is simply to account for the number of lost hours or days. 40% calculate the cost of sick pay provision (statutory and salary). 36% look at lost productivity; 36% direct costs of temp or agency staff; 33% the indirect costs of colleagues covering work and management time.

The problem is, without a strong grasp on the full extent of the costs of sickness absence, how can HR make an informed case for investing at the right levels into wellbeing, early intervention support and other related benefits?

EAP ROI

“The headline figure for absence might be falling – but what is this hiding in terms of the range of costs from disruption, increased stress in the workplace, pressures and bullying?” asks EAPA UK chair Eugene Farrell.

“The need for more attention to the ROI from HR’s wellbeing initiatives led EAPA UK to compile the biggest ever data set on EAP usage, impact and financial returns in the UK (Financial Return on EAPs 2020: How Does Your Organisation Compare?). Based on 2,000 calculations made via the EAPA UK ROI calculator, we found that for every £1 spent on an EAP in the UK, employers see an average return on investment (ROI) of £7.27.”

What’s happened to the cost of absence during the pandemic?

Poor managers mean serious health risks says BMJ research

New research has shown an intrinsic link between inept management practices and problems with mental health among employees.

The study by academics at the University of South Australia, published in the British Medical Journal, suggests employees working in a ‘toxic culture’ are three times more likely to develop depression. There are also higher risks of death from heart disease and stroke. Where there is a lack of attention to employee wellbeing, it’s men who are more at risk of depression than women.

Problematic practices include making unreasonable demands, a lack of acknowledgment and rewards for good work and low levels of staff autonomy.

A problem shared…

Linked research has also found that a lack of a sense of ‘psychological safety’ at work is a predictor of bullying and emotional exhaustion.

Sometimes stress is a trigger for bullying and in the worst cases it can set an ‘acceptable’ level of behaviour for other members of the team,” said Professor Maureen Dollard. “But above all, bullying can be predicted from a company’s commitment to mental health, so it can be prevented. The global costs of workplace bullying and worker burnout are significant, leading to absenteeism, poor work engagement, stress leave and low productivity.”

What’s toxic?

“How do HR know when the workplace environment has tipped over into a dangerously toxic state?” said EAPA UK chair Eugene Farrell. “The business context might be challenging, management might have needed to make some tough decisions, demands on staff may have increased – but none of that means the culture is toxic. What matters is that management are keeping to the values of the organisation, working relationships are still good, people feel they are being listened to and wellbeing remains a priority.

“Tracking the use of EAPs can be a valuable source of anonymised data on trends, to look for patterns in terms of concerns over workloads, relationship breakdowns, bullying etc. This kind of early warning system is crucial for flagging issues with management, as well as for tailoring support via the EAP and other wellbeing benefits.”

Poor managers mean serious health risks says BMJ research