Positive experiences of employee assistance schemes are widespread – but how do these services stack up in terms of return on investment? Edmund Tirbutt investigates
There is probably more anecdotal evidence about the effectiveness of employee assistance programmes than about any other product or service in the group risk world.
Whether provided on a stand-alone basis or as add-ons, these confidential services generate countless positive reports of what they can do for employees or managers.
In addition to offering both telephone-based and face-to-face stress counselling, EAPs can include everything from debt or bereavement counselling and critical incident support to line manager assistance and advice on moving house or dealing with elderly parents.
Chase de Vere corporate advice manager Sean McSweeney recalls how a former colleague even used an EAP for advice on how to adopt a child from China. The service came back within 24 hours with details of all the procedures involved, and the individual concerned now has two teenage Chinese daughters.
McSweeney also had a client in central London with two employees caught up in the 7/7 terrorist atrocities of 2005. They were travelling through an underground station that had been bombed and witnessed horrific scenes involving body parts, which were hard to cope with.
McSweeney says: “The EAP was fantastic, using face-to-face counselling to get these people back to work in only a few days. It is hard to see where the employer would have turned without it because getting counselling via the NHS is very difficult. It can also take a long time to get debt counselling from other sources like Citizens Advice.”
Group Risk Development spokesperson Katharine Moxham also declares herself “a massive fan of EAPs both personally and professionally”.
In a previous role she used one herself for bereavement counselling when her father died, and she has directed team members towards EAPs for similar purposes and used them in her capacity as a line manager to seek advice on dealing with staff situations.
In particular, she recalls how a member of her team was killed in a car accident on the way to work.
“They brought in a crisis team and ran both group and personal sessions, which dealt with the emotion of it all.
A particularly effective practical step was setting up a remembrance book in which people could write their thoughts and memories. This was given to the parents of the colleague who had passed away. [The EAP people] were absolutely superb.”
RoI issue
But anecdotal evidence is of limited use in formulating a concrete business case and what EAPs conspicuously lack in the UK is any authoritative industry-wide data to convince employers that it is worth making the effort to promote them.
This contrasts noticeably with the situation in the US where, according to UK Employee Assistance Professionals Association chair Andrew Kinder, “there is a lot of evidence that EAPs return £4 for every £1 spent”.
At the moment UK data is limited to snippets from providers’ in-house surveys. For example, Health Assured reports that, in its interventions with people not in work, 62 per cent of employees return to work within five weeks.
Canada Life Group Insurance marketing director Paul Avis says: “Research we’ve seen from providers shows that 50 to 60 per cent of EAP users would have been absent without the service. We have also seen case-specific counselling result in reductions in GHQ [general health questionnaire] scores for anxiety and depression from 22/24, indicating unfitness to work, to below 5, indicating fitness to work.”
Fortunately, such fragmented pieces of evidence may soon be superseded by concrete industry-wide data. The EAPA has commissioned independent research from The Work Foundation to produce a definitive RoI figure and to ask people in HR and the corporate world why they have an EAP and what specific benefits it provides. In addition, those who do not have an EAP are being asked why. The results are expected to become available by the end of this year.
Promotional problem
Bringing an attractive RoI figure to the attention of employers may not make a huge difference to whether they decide to have an EAP because services embedded in other products are free, and even stand-alone ones tend to be relatively inexpensive – typically around £6 to £8 per employee per year. But it should help persuade those that already have an EAP to invest in actively promoting it.
Portus Consulting director of consulting David Dolding says: “If we had an RoI figure that could prove to an employer that there’s a value in promoting the EAP over and above the moral obligation, that would help it justify promotion through HR.”
Take-up rates for EAPs are typically as low as 2 to 5 per cent but can be as high as 20 per cent when a service is well promoted – and, because no more than a fifth of the workforce may in fact need the EAP in a particular year, 20 per cent could equate to optimum usage.
Aviva clinical and rehabilitation services manager for group protection Jon Blackburn says: “Lack of promotion is the key piece as promotion determines take-up rates. I think the employer should be promoting it, not the intermediary, although EAP providers can help with the process.
“Some employers nowadays are using impressive digital technology to promote EAPs and all their employee benefits. They can use Twitter and Facebook and promotional videos on YouTube.”
Promotion tends to be most overlooked when the EAP is a free add-on to another product because employers often regard the provision of it as merely a tick-box exercise. As the differences between add-on and stand-alone products have been disappearing rapidly, this is a problem that is only likely to increase.
Embedded versus stand-alone
Originally, stand-alone EAPs offered clear advantages over add-ons in terms of providing management information and joining up data from the EAP with that from occupational health and absence management services and, in particular, early intervention services provided by income protection insurers. But gradually the add-ons have caught up.
Capita Employee Benefits head of health management Alistair Dornan says: “Where a good-quality EAP is provided on a group risk or medical scheme, I would struggle to find a good reason to pay extra for a stand-alone service. Unum, Canada Life and MetLife in my opinion offer embedded services that are just as good as stand-alone ones.”
But Jelf Employee Benefits healthcare consultant Laura McLaughlin says a stand-alone service can give employees more confidence about maintaining confidentiality compared with IP rehabilitation support that may raise concerns about how their employer views them.
She says: “If the employer wants to just tick a box then an add-on is OK. But if it is committed to employee wellness, a stand-alone product can be more appropriate as it can have better account management support.”
McLaughlin cites two very similar clients, derived from the same industry sector and with similar demographics and employee numbers. The pair also have EAPs through the same provider.
But one has a stand-alone service and the other an add-on via a group income protection scheme. McLaughlin claims there is “a vast difference” in the service each gets.
“In my experience, it’s the level of account manager and day-to-day support they receive that makes the difference,” she says.
“The stand-alone service, which costs £5.50 per employee per year, is happy to provide line-manager training and promotional training and support, and it is achieving a staggering take-up rate of 32 per cent. But the company with the add-on is achieving a take-up rate of under 5 per cent.”
The fact that opinions can differ so markedly on such a fundamental issue is proof enough of the need for authoritative, objective evidence about EAPs as a whole. Hopefully The Work Foundation can provide this – so roll on the end of the year.
BEREAVEMENT COUNSELLING
Within the bounds of confidentiality, Canada Life tells how ‘Gillian’ benefited from the EAP attached to one of its group life schemes.
Following the death of her husband, Gillian had been struggling for several months to come to terms with losing a loved one. Daily routines, such as washing, had become difficult both physically and mentally.
Gillian needed advice on how to cope and decided to contact the EAP available at her late husband’s workplace, opting for telephone counselling as her preferred method of communication.
She was told that what she was experiencing was normal and that the grieving process could vary hugely from person to person. The key was ensuring she felt she was in a safe environment during her counselling sessions because this enabled an open and honest conversation.
Gillian was encouraged to offload all feelings, positive or negative, about her husband’s death. The more she conversed with the counsellor, the better she felt, and, after eight sessions, her mood and attitude had improved dramatically. She had learned how to control her pain and developed the confidence to regain some normality in her life.