The scale and depth of mental health support now available to employees via group risk products is virtually unrecognisable from how it was only a few years ago.
While employee assistance programmes (EAPs) – which offer confidential 24/7 stress counselling and a range of other useful services – still have a valuable part to play, they are just the start of what is
now available.
Dan Cockram, director at Partners&, says: “EAPs have for so long been seen as a silver bullet and as the focal point in the mental health puzzle, but they are now just one part. Other services such as stand-alone resilience training from specialist wellbeing providers are just as important.”
Cockram says: “Our experience with EAPs is also that they haven’t all been as effective during 2023 because unprecedented usage has increased waiting times. So, it’s very important for intermediaries to be able to advise on provider service levels.”
Some EAPs have now actually been absorbed into broader wellbeing apps offered by the same providers and, if this trend continues, it could help solve a major problem: namely, too much choice. With EAPs widely available on group life, income protection, private medical insurance (PMI) and cash plans, employees and employers can be confused.
David Williams, head of group risk at Towergate Health & Protection, says: “Around 10 years ago the EAP was the big add-on, but wellbeing apps started appearing just before lockdown and have grown and grown. It’s all part of broadening out mental health from just counselling.
“Some providers offer wellbeing apps attached to group risk products, and sometimes offer an EAP as well. Or sometimes the EAP is actually inside the app. Others offer stand-alone wellbeing apps.”
Some newer wellbeing apps can prove particularly valuable to employees and family members requiring assistance or self-help guidance not reflecting the severity of psychological distress that needs formal counselling or crisis support. Previously, those in this bracket enjoyed little in the way of support unless their condition worsened.
For example, Canada Life’s mental wellbeing myStrength app, launched in May 2023, offers content in over 150 genres. These range from issues like sleeplessness, anxiety, depression and mindfulness and extend to more inclusive content around subjects such as gender identity, sexual orientation, and neurodiversity.
These subjects might not have always been signposted or serviced adequately from traditional EAP services.
AIG’s Smart Health digital wellbeing offering, offers virtual mental health counselling. The provider reports that in the first half of last year 78 per cent of users of the mental health service moved from being in a state of medium/high distress to non-clinical/low level issues.
The EDI dimension
Mental health is an important area of focus for group risk providers through the lens of their equality, diversity and inclusion (EDI) agendas and across their core rehabilitation services, add-ons and general communications programmes.
Neurodiversity is a particularly hot topic at present, and Zurich has been prominent in arranging conferences and webinars to boost understanding of it.
Nick Homer, head of corporate risk market management at Zurich, says: “We want to ensure that utilisation is not just being promoted towards certain ages and demographics, and we know that supporting people with neurodiverse conditions like autism is key in the workplace, and can be a consideration with some claimants. Someone with a serious illness may respond differently to their situation if they’re also neurodiverse.”
EDI also crops up in the lion’s share of other recent insurer mental health initiatives. Legal & General makes heavy mention of it in conjunction with its publication this January of its inaugural chief medical officer report, which focuses on the notion of ‘good work’, the fact that mental health represents the crucial foundation, and the role of income protection in all this.
Key aspects of promoting EDI cited by Aviva include effective communication, collaborating with employee resource groups (ERGs), and encouraging employees to have open conversations about their mental health.
Unum highlights health and wellbeing reviews it has developed to support employers. Working in partnership, its experts create a roadmap to achieving better mental health outcomes for those in work, continuing to support them whilst embedding the changes, including those relating to EDI-specific wellbeing issues.
Choice challenge
Apart from services available on EAPs and wellbeing apps, other support offered by group risk providers relating to mental health includes menopause support, fast-tracked access to talking therapies, alcohol and drug addiction treatment and vocational rehabilitation – that examines and seeks to remove the barriers to employees returning to work.
So, lack of availability of relevant services is no longer the issue. Nor is achieving impressive results to illustrate their effectiveness for those who actually use them.
Although Group Risk Development’s (Grid) industrywide claims statistics for 2023 are not yet available, its data for 2022 showed that 62.6 per cent of those with potential mental illness claims were returned to work within six months. And recent data from individual group risk providers about their rehabilitation capabilities suggests the industrywide picture for 2023 will be no less healthy.
For example, Aviva reveals that, during the first half of 2023, 94 per cent of employees with a mental health condition who returned to work with its support did so within the deferred period. Legal & General reports that, each year for the past three years, it has supported a return to work of more than 9 in 10 people who have made an income protection claim due to a deterioration in their mental health.
But the real challenges for employers are getting to grips with what services they have available and promoting them in a comprehensible way to the workforce. And it’s not something that any organisation can afford to fail at.
Grid spokesperson Katharine Moxham says “Employers need to understand what they’ve bought and the wealth of support that comes with it, and then effectively communicate the benefits. Employees watch how others are treated, and it’s important to be seen as a caring employer.”
Hopefully, one day all group risk providers will roll up all their mental health support services into a single clearly signposted package. And with wellbeing apps beginning to swallow up EAPs, that day may not be too far away. Until then, however, understanding and communication are key.
BOX: PROSPERIS CONSIDERS ADVOCACY SERVICES
Prosperis had been looking at extending the group income protection scheme of a client with 130 employees to cover the entire workforce rather than merely the sedentary workers – who also have PMI.
Steve Ellis, associate director at Prosperis, says: “The remaining two thirds of the workforce, who work on the shop floor, have access to nothing other than an EAP bolted onto death in service. And the take-up for this is virtually nil, even though it has been promoted. But we are looking to create a more equitable workplace which reduces absence across the board.”
Unfortunately, however, the cost of providing group income protection for all was considered prohibitive. Because of a clear potential for claims, it amounted to around 1.2 per cent of payroll. So Prosperis is considering implementing advocacy services and to try and get employees treatment through the NHS for mental health.
Ellis continues “We are still at the planning stage but are looking at putting the advocacy in for a year, and if we can prove it is reducing the possibility and duration of claims we are going to ask the income protection insurers 12 months down the line to reduce the rate because of the organisation’s strategy.”