Employee assistance programmes (EAPs) have been developing at such a pace that one could be forgiven for assuming that their race has already been run.
After all, according to Institute for Employment Studies (IES), access to them has increased by nearly 300 per cent in just a decade, with nearly half the UK workforce now covered. Some of the more eye-catching services that have sprung up during recent years have also now become standard industrywide features. For example, EAPs embedded into group income protection schemes as added-value features commonly extend well beyond the core telephone-based and face- to-face counselling to services like legal information, debt support and help with accessing a suitable care home or nursery.
But some EAPs are now going even further and providing the necessary governance for mental health first aiders and helping organisations involved with high-risk roles meeting their duty of care when employees are subject to trauma or abuse or have to deal with disturbing images.
Some are also now beginning to help with long-term support and chronicity, meaning that HR can get assistance in cases that are typically excluded from private medical insurance (PMI) schemes – such as employees who are bipolar or suffering from alcohol addiction.
Embedded EAPs have increasingly been springing up on group life schemes this year, and it has become the norm in the last couple of years for all EAPs to have web-based platforms offering employees the ability to access a wealth of material and information. MetLife launched its EAP for SME customers, targeting physical, mental and financial wellbeing, in October.
Axa PPP Healthcare mental health lead Eugene Farrell says: “Everyone has good, well- maintained websites whereas before they could be a bit clunky. Electronic supports are also emerging like live-chat via written messaging, which makes people less inhibited about their mental health as no-one can over-hear them.
“Perhaps the most stand-out development, however, is a big shift in integration with other mental health support. If a PMI client also has our EAP then there is seamless integration between the two.”
Providers have been increasingly measuring the effectiveness of their own performance and commonly refer to robust service-level agreements, satisfaction surveys and take-up or utilisation statistics.
Whilst the specifics of such monitoring arrangements are invariably considered too commercially sensitive to volunteer, the results they produce are not.
For example, Health Assured has achieved a 29 per cent year- on-year increase in call volumes handled and a 40 per cent increase in management referrals, while Care First says it has improved one client’s absenteeism rate recently by around 30 per cent a year.
One thing that hasn’t changed, however, is that effective communication remains the single biggest factor influencing take-up rates.
IHC consultant Paul Roberts says: “Uncommunicated EAPs, whether stand-alone or embedded, often get nil usage, but embedded ones don’t tend to be well communicated and the best take- ups rates I’ve seen from them are about 1 to 2 per cent.
“A well-communicated stand- alone EAP, on the other hand, will commonly achieve a usage of around 7 per cent and, if it has lots of wellbeing features, it can be as high as 20 to 30 per cent.”
Such provider data still falls well short of actual return on investment (ROI) information, but the UK Employee Assistance Professionals Association (EAPA) has been busy shedding important light on this area (see box).
One of the major developments around the corner in the field of employee engagement is commonly considered to be artificial intelligence (AI), and some impressive first forays into this are emerging.
Care First has started providing a couple of customers with Woebot, an AI product that can provide support over issues of low mood via an app. One trial showed that 20 per cent of employees had downloaded the app within a month of it being offered and that all of those who engaged showed improvement bar one – who was referred for counselling support.
Health Assured CEO David Price says: “Machine learning is altering human-computer interaction at an unprecedented pace, and natural language processing, goal-oriented dialogue systems and deep semantic similarity models of conversation are incredibly promising.
“Right now, our focus is on the human touch, but looking ahead, it’s likely that these technologies will begin to become more and more prevalent in every customer- facing online service.”
Nevertheless, a further trend for group risk providers to launch virtual health apps may have an even greater impact on EAPs as it could conceivably even threaten their existence.
Smart Health, launched by AIG Life this August, and Help@hand, launched by Unum this September, both offer a range of useful health and wellbeing tools, including mental health support and the ability to access GPs via video link. While they do not provide the same breadth of services as EAPs, there is significant overlap, especially in the area of mental health.
If, which would be no great surprise, all major group risk providers start offering these apps then EAPs could find themselves upstaged.
Towergate Health & Protection head of group risk David Williams says: “There are certain things these apps can do that EAPs can’t, such as offering access to a GP by video on your PC or phone, and I think they will start replacing EAPs as the primary wellness tool.
“EAPs should still have their place but these virtual health apps will do most of the signposting, and some might be to the EAP. Eventually the EAP might actually just become another part of the health app.”
But Care First business development director Karl Bennett says: “I think EAPs will probably start to include other elements to ensure customers are able to make comparable choices to those offered by the health apps. Eventually, I think every EAP may have to include a relationship with a virtual GP provider.”
Either way, EAPs look destined to undergo another very significant chapter in their development and, whatever ROI figures are currently being produced, they could soon become very out of date.
EAPS SHED LIGHT ON ROI
Following on from a study it commissioned from The Work Foundation in 2016, which showed that most EAPs at minimum covered their costs, EAPA requested the IES to build on this analysis and focus on the development and testing of an accessible, spread-sheet based ROI tool for employers.
A resulting October 2018 IES report found that most existing studies arrived at a positive ROI estimate, with a range of between four and 10 times return on investment. It also focused on the development of the ROI tool.
A draft tool was presented at the EAPA AGM in March 2018 and a working version placed on the EAPA website, with
employers encouraged to explore it and to submit their data. This data has been logged and aggregated and is being analysed by the IES.
EAPA vice-chair Andrew Kinder says: “The calculator will tell any potential buyer of a stand-alone EAP what their ROI will be. There is an awful lot of ROI data being produced in the US, so we needed to follow suit, and it has undoubtedly raised awareness.
“We are keen to refine the tool and are revising it to making it sector specific. Watch out also for the results of another IES study coming out in January 2020 which will shed light on the value of EAPs and workplace counselling.”