By Mark Brown
Mental Health at work
In a world where we are encouraged to bring our whole self to work and where personal performance becomes more important than ever, what happens when you know that something isn’t quite right with your mental health? In the past, problems with your mental health were something you tried to keep quiet at work for fear of discrimination; sanction or even being asked to move on.
In 2013 47% of the working population were covered by an EAP
Luckily, approximately half of us will work in organisations where there are alternatives. Employee Assistance Programmes (EAPs) are services designed to improve and maintain the productivity and healthy functioning of the workplace and aim to help employees identify and resolve work and non-work related personal issues. According to the Employee Assistance Professionals Association in 2013, 13.79 million UK employees were covered by an EAP, which at the time was about 47% of the working population.
Elena, a social worker in her 50s accessed her employers EAP when a personal situation arose, going directly to the programme through a well-circulated telephone helpline: “When you've got your own stuff to be dealing with it's probably not a good mix trying to manage your own emotions and the emotions of others. I wanted to do face to face. Six sessions gave me the opportunity to explore some of the wider issues. It's cheaper for them to give you six sessions and make it easier than [for] you to fall apart at the seams because of the stuff that's going on in your life.”
Evolution of EAPs
"An employer who offers a confidential advice service, with referral to appropriate counselling or treatment services, is unlikely to be found in breach of duty.”
Employee Assistance Programmes have a long history, evolving in the US from ‘Occupational Alcohol Programs’ to a more general holistic work wellbeing services, spread across the world with the expansion of large corporations in the 1970s. They really began to grow in the UK in the wake of a number of high profile legal cases centring on employers duty of care related to employees mental health. One of the most important cases was Hatton v Sutherland in 2002, where four employers appealed against being found liable for employees’ - two secondary school teachers, an admin assistant and factory raw materials operative - psychiatric illnesses caused by stress at work. The judgement laid out sixteen principles of employers liability around stress at work, including a duty of care to employees regarding foreseeable stress. According to Lady Justice Hale’s judgement: "An employer who offers a confidential advice service, with referral to appropriate counselling or treatment services, is unlikely to be found in breach of duty.”
According to a survey by The Work Foundation of 78 organisations that provided an EAP to employees in 2016, the majority had a comprehensive offering including telephone counselling, online services and face-to-face support. Of 57 organisations that shared the methods people used to contact their EAP, 84% indicated that people most often instigated their use of the EAP via the telephone.
A need for access & confidentiality
"You need to know about it and be able to get to the service easily, and feel safe that your concerns are confidential and that it will be helpful.”
Chris O’Sullivan is Head of Workplace Mental Health at The Mental Health Foundation. “Even with these services on tap – in a lot of the conversations I have I heard that uptake of the service is low – far lower than the research indicates the need must be,” he says. “Two huge challenges are access and confidentiality. You need to know about it and be able to get to the service easily, and feel safe that your concerns are confidential and that it will be helpful.”
Work stress is the largest reason of why people use EAPs
When The Work Foundation asked employers why people used EAPs, work stress was the largest reason (70% of 54 respondents); followed by depression (57%); family events (56%); life events and anxiety.
Says Chris O’Sullivan: “Confidence is key – staff need to be absolutely sure that the conversations they have or the data they share through any work connected product are confidential and will not find their way back to the employer. This is a concern for conventional EAP products like helplines, but even more so, in terms of digital products. When we are most anxious, concerned, or ashamed, we are more likely to question confidentiality, so it’s important the feedback given to the employer and the data captured is clearly explained.”
A worker in their 20s who wished to remain anonymous had a less positive experience using EAPs. They looked to an EAP for support in two separate jobs for help around Post Traumatic Stress Disorder due to long waiting times for NHS support. Unlike Elena, their contact with the EAP was instigated through HR rather than through a confidential phone line. They were offered telephone counselling both times. Both sets of counsellors “were amazing. Kind, understanding, reassuring". The first time they “got to the point of desperation where all I had was the one hour telephone call with the counsellor. Then I got told I was too "sick" for them to help anymore.” In another job they asked for face to face counselling “as did a colleague on my behalf. My employer ended my contract and told the colleague I wouldn't accept the help that was given to me or help myself.”
Personalisation in EAP provision
Says Chris O’Sullivan: “With mental health services under strain, it can be hard for people who are apparently coping well (in work, and not in crisis) to access ongoing support. Whether it’s a work challenge, or a life challenge, it can be hard to get help for ‘regular issues’ like debt or discrimination from conventional services.”
"There is real potential for EAP service to provide support for self-management"
While often EAPs are often considered by employees to be counselling services only, there is potential for them to have a far wider impact. As Chris O’Sullivan says: “There is real potential for EAP service to provide support for self-management, and to look at things like coaching, career counselling, or assistance with life challenges to those with ongoing mental health concerns. There is not a single answer to addressing mental health at work, or reducing sickness absence due to mental ill health.” As an employee it’s worth checking what your employer offers, even if you don't think you need it right now. As an employer it’s worth examining your options if you have not done so already. In time where work and life is becoming more pressured and stressful than ever, more of us than ever will need help to keep ourselves well because none of us are superhuman and we all need a bit of help from time to time.