Should we speak to the boss about our mental health?

A survey by The Global Business Collaboration for Better Workplace Mental Health (GBC) has flagged that levels of mental illness among employees may be higher than the usual estimates might suggest (with around 55% either currently dealing with a mental health challenge or have experienced a challenge in the past).

The study of a mix of 12,200 employees across 12 countries, also flagged the reason: that employees continue to feel a sense of shame, and are reluctant to speak up.

Shaming managers

Critically, of those who have been through mental health issues and opened up to their manager, 47% believed they had faced discrimination as a result. 57% thought they had been stigmatised by their co-workers.

As a consequence, half of those who felt their line manager wasn’t in a position to be supportive and have conversations around mental health, were feeling de-motivated. 35% were thinking about leaving their job. Only 45% of managers said they had training on how to have mental health conversations.

Around 80% of employees believed their organisations cared about their mental health when the senior leader openly talked about the issues, compared with 34% when they didn’t.

Safe talk

EAPA UK chair, Karl Bennett said: “It can only be beneficial for an organisation’s culture if there’s understanding and a sense of support around mental health. We all have to deal with feelings of stress and struggle to one degree or another, and need to believe there’s empathy.

“But the reality is that line managers, taking responsibility for performance targets and delivery, are not necessarily best placed to take on the role of mental health advisers. They can try to be sympathetic but there focus is always going to be on getting things done.

“No amount of training for line managers or leaders will help this situation. Employees need someone they can speak to in confidence, anonymously if necessary, without any worries about the implications for perceptions of them and their capability. EAPs are critical in this way, in always being there to listen, to start conversations and provide professional advice.”

EAPA UK Statement concerning the BBC File on 4 allegations – 12 July 2024

EAPA UK is extremely saddened to read the allegations brought to the public’s attention by BBC News on 12 July 2024 against one of our accredited provider members. As the representative body for the EAP sector, we set out professional standards which we expect our members to adhere to. We take alleged breaches to our standards seriously.

Each accredited provider is required to undertake a verification audit of our standards which is carried out independently. The audit and accreditation process requires that responses to the confidentiality and data protection questions must be positive, and that the auditors are satisfied that the provider’s confidentiality statements pose no cause for concern.

Confidentiality is the central tenet of an EAP service and creates trust from service users. It is at the heart of what we do, and a critical requirement. As such all EAPs must abide by this. It is imperative that users of EAP services can be confident and certain that all calls are fully confidential.

EAPA UK has commenced an investigation to understand from the provider the facts behind the reported allegations and if true, how this was allowed to happen and to get full clarification on the mitigations being put forward to ensure this does not happen again in the future.

It is important that our service users trust that EAP providers do not operate in the way reported and they should be confident that the only limitations to confidentiality are within the confines of safeguarding and UK Law.

It is essential that all EAPA UK members adhere to our professional standards at all times. Failure to do this may result in the members’ verification and/or membership being suspended or removed.

EAPA UK will report on the findings of our investigation once it has been completed.  

If you would like to learn more about the EAPA UK Standards, please follow this link: Resources

BBC allegations – UK EAPA statement

UK EAPA is aware of the recent allegations made by the BBC against one of its members. We take allegations of this nature extremely seriously and are reviewing at Board level.

Investing in mental health = better business performance, says Warwick Business School

Workplace mental health issues are estimated to cost UK employers £56 billion a year in sickness absences, employee turnover, and presenteeism (when employees are working when ill, or are routinely working beyond their contracted hours). As well as firm-level impacts, these issues have serious individual level consequences, with around 300,000 UK employees leaving their jobs every year because of a mental health problem [DWP: Stevenson/Farmer review of mental health and employers, 2017].

The Enterprise Research Centre (ERC) at Warwick University has been tracking UK employer experiences of workplace mental health with an annual survey since before the pandemic, uncovering some striking insights. For example, while the proportion of firms reporting some level of mental health related absence is currently stable at around 27%, presenteeism has nearly doubled over the past two years and is now reported by around 37% of firms. This may be related to hybrid working, which has also increased significantly since the pandemic. Around 30% of employers reported some level of remote working in 2024, compared to only around 11% before the pandemic.

Current research focusing on the effects of remote working suggests that working at home may make it more difficult for employees to psychologically detach from work. There is little doubt that it has also normalised working while unwell, as employees can be present at meetings without fear of infecting colleagues. This is a potential problem as research has linked presenteeism with stress and burnout in individuals, which inevitably impacts on firm-level performance too. As hybrid working continues to grow, employers will need to ensure that they are encouraging a good work-life balance for those working remotely.

More broadly, while nearly 80 per cent of employers believe they have a responsibility to address mental health issues in the workplace, the ERC’s data points to something of an ‘intention-action’ gap, with only around 56% offering mental health initiatives. We can also see a strong reliance on low-cost and no-cost practices, such as encouraging open conversations about mental health, which is reported by more than 90% of firms.

While such initiatives are an important element of workplace programmes to support mental health, they rely on line managers to deliver them. Yet only around half of employers surveyed in 2024 offered any training in workplace mental health to their line managers, which suggests that many may be relying on untrained or under-trained line managers for their mental health support programmes. In fact, only 22% of firms report that they have a budget for mental health initiatives.

We know that employers who have adopted initiatives to support mental health in the workplace often report improved firm-level outcomes. For example, in 2023, 53 per cent said that overall business performance had improved. In light of the apparently inexorable rise in workplace mental health issues, training line managers in dealing with them may be a wise and timely investment.

Dr Maria Wishart, Research Fellow, Enterprise Research Centre, Warwick Business School https://www.enterpriseresearch.ac.uk/themes/mental-health/

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

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?”