That most famous of British clichés, the stiff upper lip, is fast disappearing, as the influx of American culture popularises personal counselling and self-help books. Seeking professional help in times of crisis is a growing trend, most notably in the workplace where stress-related absence is common. And to combat stress, some of the more sensitive employers are offering their staff a professional counselling service, usually known as an employee assistance programme (EAP).
Employee benefits consultant Towers Perrin recently surveyed 110 major UK employers about their healthcare programmes. Covering workforces mainly in excess of 1,000 staff, this report paints an interesting picture of healthcare at the dawn of a new century – and shows EAPs to be a small but interesting part of the mix.
According to the survey, half of employers offer their workers access to counselling, either in-house or through an external employee assistance programme. But how important is counselling to the health of the workforce?
A full EAP scheme will give employees access to a 24 hour telephone helpline staffed by trained counsellors, a legal helpline, plus a package of face-to-face counselling sessions if required.
The sort of problems expected and encountered range from everyday personal worries over health, relationships, family and finances, to those linked to anxiety, alcohol, gambling and drugs. EAPs also deal with work issues such as workload demands, fairness at work, working relationships, harassment and bullying, personal and interpersonal skills, stress, and coping with the work/life balance.
There is also an affinity market for EAPs where they are used as professional add-ons. Belonging to a fellowship body, for example, could provide access to a free legal helpline.
While EAPs can be bundled as fixed price schemes, they are usually negotiated as a core of standard benefits – such as the helpline – plus a flexible pick and mix range to be added according to the needs of the organisation.
Paul Roberts, a consultant at WorkingWell, a consultancy specialising in preventative healthcare, says: “There is always a fixed element because there are certain things that everybody wants. And then there are the variable things like trauma support which companies such as Shell would buy to cater for petrol garage employees who are held up during a robbery.”
As part of the employee benefit mix, EAPs are just one more thing to keep workers from going off sick or off the rails.
Keeping the health of the workforce at its best is a very 21st century thing to do, and mental health is an area which is increasingly being addressed. Most callers to an EAP line just need a little support or information. They may be going through a divorce or needing financial assistance, or even just feeling down at work and wanting to let off steam. But they might also be on the eight floor of their office block and about to jump off.
“Who answers the phone is absolutely key,” says Roberts. “As an adviser I would always find out who answers the phone.”
These services are not designed to be emergency helplines, despite the claims of some providers, but they are 24 hour a day, seven day a week support services, and it is vital they come up trumps when required.
In the past, most UK employees have been terribly British about counselling. But now, it seems, this market is really taking off. EAPs have, of course, come to us from the USA, where they are very big, but the UK market has grown dramatically over the last five years as a result of the initiatives of some very large employers.
UK Employee Assistance Professionals Association (EAPA) chairman Dr David Robinson says: “We estimate the current market as 1,500 UK organisations with externally delivered services. So around 1.3 million employees are covered at the moment. And the market is growing again after a period in the late 1990s when there was a slow down in growth. “Now with the stress issues, and awareness of harassment and bullying, there is much more interest again. There was probably around 20 per cent growth last year and I don’t see that stopping.”
EAPs are predominantly purchased by human resources departments. There are two reasons for offering any health benefits to staff: as part of a recruitment and retention package and to offer timely and appropriate treatment so employees lose as little time as possible from work.
Stuart Gray, the director of Taylors Independent Financial Advisers, says: “We see it as a key part of looking at the overall issue of absence management.”
The cost for the full mix of standard plus flexible add-ons is likely to be £26 to £28 a head, although £12 would represent a good average price and a token scheme can be arranged for as little as £3 a head. Some schemes pay commission, as much as ten per cent, but others do not and will be used as part of fee-based advice. And business, it seems, is good.
Gissings head of marketing David Royle says: “There is a big growth in soft claims – like stress, obviously, repetitive strain injury, mental and nervous conditions – where employees stay off sick for a long time. These can be very hard to detect.
“The UK, in particular, can be very poor at getting treatment for these people. So this must be a step in the right direction in terms of companies saying they would like to do what they can to help.”
The importance here is that any counselling must be completely confidential. It needs anonymity from the employee’s point of view but, at the same time, the employer should be getting feedback about overall use of the service.
This is important because any problem becomes work related once it has the potential to upset an employee’s working ability. With this degree of work impact, the argument for external counselling becomes a must.
The only area which might adequately be covered in-house is post traumatic stress counselling, for example, following a fire which has affected a number of employees. Here, a company may have its own programme or it may contract out to gain specialist help through an EAP.
Bupa head of corporate and voluntary consulting Ann Greenwood says: “Banks would be a good example. If someone comes in and puts a gun in your face it’s traumatic. The employee then needs help to work through it.”
But what of the employee who asks the legal helpline how to sue the employer? Greenwood feels that allowing bad feelings to fester is a far greater fear. Giving an outlet to an employee who cannot talk to a manager is a big plus point.
“The interesting thing is that most organisations buying EAPs are pretty enlightened and they want those sorts of things to come out, even though short term it might give them a problem,” she says. “They want those employees to have an outlet. Most organisations quickly get their head around that. We see it as almost a protection for the business, to avoid future litigation.”
Usage rates vary enormously and feedback statistics, a validation of the service, are global in order to protect employee confidentiality.
Quantitative usage may look like the prime measure but a good adviser will also be looking for qualitative information when selecting a provider. Some helplines work by leading on quickly to face-to-face interviews, while others answer the bulk of queries over the phone.
“There was one company which would answer 70 per cent of calls on the telephone, there and then,” says Roberts of his recent investigation into service providers.
“There was another company which answered 30 per cent but moved quickly to a face-to-face meeting. So it was really a fast track to a counselling service.”
So, depending on which company is used, it could be a leaflet information service or a gateway to full counselling.
Either way, an EAP is not a panacea for stress, it is just part of the mix, but it is a powerful release valve. If an employer has such a scheme in place and encourages the employees to use it, then it is mitigation against stress in any potential litigation exercise.
And an EAP can be a great deal more than a fancy counselling service. Promoted correctly it can also be a performance management tool, helping to control absence, optimise employee focus and improve output at the workplace.
In fact, EAPs are ready to take a giant step forward towards customised corporate consultancy.
PPP Healthcare employee support manager Tim Cuthell says: “We are now poised for EAPs to change beyond all recognition.
“The real benefit is in what the EAP can teach an organisation about itself from the experience of the users. Maybe bullying is an issue. We can then help an organisation look at its culture, see how it developed and see how it can be changed.”
This idea springs from analysing the EAP feedback, immensely valuable knowledge which a company can reinvest back into the workplace with the help of the provider. This development is still at the drawing board stage but exciting nonetheless. Watch this space, then, for the advent of custom made, second generation EAP.