Workplace wellbeing and mental health have moved up the corporate agenda over the past decade. But despite this increased focus there has been relatively little innovation in recent years when it comes to the main tool for delivering this support service: employer assistance programmes (EAPs).
One company though is looking to be a more effective disrupter in this market. Spectrum Life — a Dublin-based company — has recently partnered with L&G to provide mental health and wellbeing services to UK corporates through its group risk products.
Spectrum Life has seen rapid growth since it was spun out of its parent company, Spectrum Health in 2018 as a stand-alone business.
At that point the company had around 20 employees and about €1m of contracts. Today, it has 225 employees, €15m of contracts and has recently attracted further venture capital funding to continue its expansion. In total Spectrum Life now provides health and wellbeing services to 4.3m members, through its 2,500 direct clients and 10,000 indirect ones – including the employees it serves through the
Spectrum Life CEO and founder Stephen Costello says he has seen considerable change over the past decade. “Ten years ago when I joined the business the corporate health and wellbeing market was relatively immature.” Spectrum Health had historically been focused on individual clinical services — be it physiotherapy, nutrition and mental health services. But with more multinationals locating in Ireland there was increased demand for corporate services — with many companies wanting to replicate the suite of wellbeing services that were becoming more commonplace in the US.
“So we started to develop our own programmes for these organisations, and developed and launched an EAP for a health insurer. This then became Spectrum Life.”
The company now has a strong footprint in the UK as well as in Ireland. As well as its recent partnership with L&G, it works with Benenden Health in the cash plan market, and also provides extensive mental health support services to many of the UK’s largest universities — including University College London, Bristol University, University of Birmingham and the London School of Economics.
So how does Costello see the company differentiating when it comes to EAP provision?
“It is certainly very competitive in the insurance market, and some of these products have become commoditised. In some cases there is very little difference in what some providers are offering in
terms of EAPs.
“There may be some innovation around the edge, but the core product is very similar across lots of different solutions.
“As a result of this the market tends to be very price driven. You can see this in the EAP space particularly when it comes to public sector tendering, where the price might account for 40 to 50 per cent of the scoring.
“This then puts lots of pressure on providers, particularly if they lose a big contract and then have to win back market share. As a result this can create a race to the bottom on price.”
Costello says that while the company is aware of price pressure it has tried to place more of a focus on service, and the key differential, he says is what happens at the initial point of contact.
“When someone contacts an EAP, particularly when it concerns mental health — which is what these services are primarily for — it is a big deal.” He says seeking help for stress, anxiety or depression can be a significant step, and something that an individual might have been thinking about for a considerable period of time.
“They have probably found a time that is suitable for them, a quiet space where they can talk without being overheard or interrupted.”
For this reason Costello says that all calls to Spectrum Life will be answered by fully qualified and accredited counsellors and psychotherapists. “Our target is to answers at least 90 per cent of calls in less than 60 seconds. At the moment we are answering around 80 per cent of these calls within just 6 seconds.
“We want this first call to be as impactful as possible. A lot of our members will essentially get a 45-minute counselling session there and then. Some may need a further referral to counselling but not all will.”
This, he says, contrasts to the standard practices at many EAPs where call handlers offer a triage service — and arrange calls back from clinical staff where appropriate. Costello says this can be unsatisfactory for individuals who have made the call but not got any initial help. It also leads to some calls falling through the cracks, possibly because the timing of these call backs may not be convenient.
How has it managed to achieve these high services standards? Costello says it is about putting adequate resources into staffing levels. “We have around 80 people, all fully qualified, now taking inbound mental health interactions.
“We are probably dealing with around 12,000 inbound interactions a month. Along with the rest of the industry we’ve seen a huge increase in people using EAPs since the pandemic — with usage, on a like-for-like basis up by around 30 per cent. But we’ve also seen the business grow as well over this period, so we have been able to invest in additional staff to meet this demand. Call volumes in total are probably up by around 500 per cent.
“Other providers may have had static member numbers but also seen increased demand for EAP services so this will put a pressure on either profit margins or service standards.”
Costello says that Spectrum Life has also put significant resources into developing its digital offering. This has in part been led by its work with universities, where they offer mental health support services to around 400,000 students.
“What’s really interesting for us is our mental health services are available via WhatsApp and live chat. People can talk to a qualified counsellor or psychotherapist over this services. And we see about 40 per cent of students making their first contact via WhatsApp or SMS, versus about 10 per cent in the employer market.
“Essentially by providing these services to the student market we are designing EAP and support services for the employees of the future, because it’s clear this generation are more likely to engage via these digital channels rather than picking up the phone.”
This doesn’t cover just UK-based students, but international ones too. Costello says that their work with multinationals has enabled them to provide counselling and mental health services in 35 languages.
Costello says that the ethos of the company has been to put the person at the centre of the process. This doesn’t just relate to how they first make contact, but how the engage with the broader health and wellbeing platform.
Costello says there has been an “app overload” in many parts of the employee benefits market. The company is trying to keep it simpler with the various services offered on one single platform.
“This is where people can contact the EAP and mental health support. But there is also access to a range of other services and content. Members have access to digital gym classes for example, meditation tools, nutritional advice and mental health eLearning, which has clinician-led content on a range of issues from anxiety and sleep to financial wellbeing and parenting advice. It total there are over 2,000 pieces of content, including blogs, videos, podcasts webinars and articles.
“If the sponsoring company has events that are happening on site, for example mental health training for first responders, this will also be hosted on the platform. From an HR perspective this means they are not just marketing an EAP, but a broad health and wellbeing proposition that contains a EAP.”
Costello says that this broad range of services will soon include neurodiversity assessments as well. Currently, there’s the option for those seeking help to be referred towards counsellors with a neurodiversity specialism.
Having this information all in one place can drive usage and engagement, and Costello claims this has helped Spectrum Life’s achieve utilisation rates around 50 per cent higher than the market norm.
“The other key differentiator is that our services are white-labelled. We describe it internally as being high impact but low ego. We are not trying to push our own brand into the consumer space, but are here to empower the propositions and support our partners.”
As Costello points out while this approach is commonplace in Ireland it is less so in the UK, with many EAPs and digital GPs for example branded under the supplier’s name. He says that its partnership with Legal & General will see it offering the health and wellbeing platform and EAP services but all under the L&G brand.
When it comes to EAP and health and wellbeing, engagement has become a key metric, and an area of focus for intermediaries, insurers and employers. Allied to this is the importance of management information and data, to help identify and understand who is using these support services, and what they are being used for.
For intermediaries this can be an important sales tool and help when it comes to providing consultancy services, working with employers to devise more bespoke services and ensuring the full range benefits are being effectively promoted.
Costello says that often these discussions around engagement are focused on the front-end metrics, or utilisation of various services. “We want to broaden out this reporting to cover impact as well.”
As part of their reporting Spectrum Life now reports on a range of additional metrics to gauge the effectiveness of their interventions, all of which are shared with clients.
“These pre- and post- measures indicate that around 2 per cent of people who access our support services are healthy but this rises to 45 per cent after accessing our services. The reverse of this shows that around 11 per cent of people access the service are severely psychologically distressed, but this falls to just 1 per cent after using our services.
“As well as looking at these sorts of measures we can also report on other indicators like presenteesism, absenteeism, work-life satisfaction etc. I don’t think there is enough focus across the industry on measuring impact, and reporting on whether these range of services are delivering what they set out to do.
“You could compare all the utilisation reports from many of the big providers and they probably look very much the same. We are trying to give clients — and intermediaries — real time additional data to help them show the benefit of these services. We can imagine what a severely psychologically distressed person look like, but if we are reducing the incidence of this by over 90 per cent then that is demonstrating a real benefit.” This he says should enable a more frank discussion of the potential return on investment on such insurance, with a healthier workforce being
BOX A partnership approach to innovation: the L&G perspective
“The industry isn’t very good at communicating the benefits offered on group risk products,” says Legal & General’s distribution director — group protection, Colin Fitzgerald. “We need to be better at telling this story, and quantifying the value we are adding.”
Fitzgerald says he hopes partnerships with fast-growing start-ups like Spectrum Life, will help them not only improve the rich suite of benefits offered, but make it easier for the insurer and intermediaries to demonstrate the value added for employers.
From March 1 Legal & General has been offering Spectrum Life’s services on its group life, group income protection and group critical illness products – although all are through the L&G brand. Fitzgerald says that L&G had been looking to enhance its EAP offering, particularly with demand trebling since the pandemic.
L&G has offered EAP services for a number of years. So what is materially different about the services available via this new partnership? Fitzgerald explains: “What particularly impressed us was the way Spectrum Life deploys technology. This isn’t about how shiny and new the technology is, it’s about how you use it to deliver a high level of data across the whole book of business. The tools and services can be shown not only to increase engagement, but provide real-time reporting, demonstrating improvements in the general health of the workforce.
“From the employee’s point of view the technology integrates all these different apps in one place, so it’s easier to use. From an employer’s point of view they are getting excellent management information on the health and wellbeing of their workforce, and from an intermediary’s point of view this data tells a compelling story on the benefit of group risk insurance.”
This is key for intermediaries he says looking to expand the market for products like group income protection, particularly into the SME market.
Fitzgerald says this fits into L&G’s wider approach which sees mental health as being the foundation of the wellbeing model. “Good mental health is really the base that underpins physical, social and financial wellbeing. It can certainly help people deal with challenges in these other areas.”
L&G says partnerships like this fit into its broader remit to help employees “Be Well, Get Better, Be Supported”. Fitzgerald says the EAP and wellbeing services support the first part of this equation,
with L&G’s insurance benefits designed to help those who are off sick return to work, or provide help with longer-term conditions.
“Across the business we are looking to ensure employers and employees understand what products they have, and make it easier for them to claim. This means simplifying products, making smarter use of technology and demystifying communication by removing jargon. We also want to offer more innovative products, helping employers provide the services their employees need.”