Challenges Within Workplace Mental Health Support 

Workplace mental health has become a topic of increased importance in recent years as employers recognize the impact that employee wellbeing has on productivity and overall company success. Employee Assistance Programmes (EAPs) have emerged to provide support in this vital area. However, allegations surrounding one prominent EAP provider, Health Assured, suggest that these services may not always be providing the necessary level of care. 

The British Association for Counselling and Psychotherapy (BACP) has announced an investigation into Health Assured following a BBC File on 4 report. The report highlights claims that vulnerable callers were not always receiving appropriate support. In one particularly unsettling allegation, a caller expressing suicidal thoughts was simply advised to "go on a date" with his wife. 

Understanding Employee Assistance Programmes (EAPs) 

EAPs are designed to help employees manage personal difficulties impacting their mental health, and consequently, their work performance. These programs often include a helpline or access to short-term counselling. The UK Employee Assistance Programme Association estimates that around three-quarters of UK employees have EAP access through their workplace, calling them a "highly valuable resource." 

However, recent revelations cast a shadow on their effectiveness. File on 4 interviewed 15 current and former Health Assured employees, including counsellors and team managers. Their accounts paint a picture of an organization struggling with low morale, high staff turnover, and a system often unable to handle the volume of help requests. 

Callers Seeking Help Are Denied 

Amy (not her real name), a counsellor who began working at Health Assured last year, reveals a troubling practice within the helpline service. Despite callers expressing a range of serious mental health concerns like trauma, bereavement, anxiety, and even suicidal thoughts, many in need of deeper therapy were turned away. Amy explains that she was restricted in the number of referrals she could provide for structured counselling (only around 20% of calls) due to restrictive company targets. 

"Every time you put someone forward for therapy, you're stepping further and further away from your targets because the target is to put as few people through as possible," she says. 

Company Response 

In response, Health Assured has firmly denied that there are targets limiting referrals for additional counselling, emphasizing that they provided over 245,000 therapy sessions in the previous year. Yet, internal communications reviewed by BBC File on 4 indicate that weekly targets are, in fact, in place. These communications highlight a disturbing prioritization of brief call times and low therapy referral rates. 

Protecting Vulnerable Callers 

Health Assured claims a commitment to clinical excellence, citing various support methods and detailed assessments. However, Amy's account raises further concerns about counsellor qualifications. While her line manager was clinically trained, she asserts that this was not the case across the board, leaving some counsellors feeling under-supported in their roles. 

Nicola, a support counsellor with over two years' experience, recounts a chilling instance where a "non-clinical" manager hesitated to call an ambulance despite Nicola’s clinical judgment about immediate risk to the caller. "I'm on the call," says Nicola. "If I say we need an ambulance, I'm clinically trained, that should be enough. It's risking lives.” 

A Disturbing Call and an Investigation 

The severity of inadequate crisis response is underscored by the experience of Mikey, an emergency nurse practitioner working for the NHS. During a period of suicidal thoughts, he sought help through Health Assured. To his dismay, the counsellor flippantly recommended he "go on a date with his wife" and failed to refer him for structured counselling. It took Mikey three calls over six weeks before he was finally connected to a local face-to-face therapist. 

These disturbing allegations, along with various safeguarding concerns, were brought to the attention of the British Association for Counselling and Psychotherapy (BACP), the body responsible for accrediting Health Assured. In response, the BACP has launched a formal investigation, vowing to take "appropriate action" should "unethical behaviour or poor practice" be uncovered. The repercussions could be severe for Health Assured, potentially including membership restrictions or complete termination. 

A Trend Across the Industry? 

Health Assured insists that the pressures described by its former and current staff are a reflection of the widespread strain on mental health professionals in the wake of the pandemic, not a unique failing within its organization. However, others in the EAP industry aren't so sure. 

One industry source, speaking anonymously to the BBC, expresses skepticism about this claim. They point out that many other EAPs successfully managed the surge in demand without sacrificing service quality. Furthermore, concerns about Health Assured predate the pandemic, suggesting a potentially deeper-rooted issue. 

Dr Judith Mohring, a psychotherapist with experience working for several EAP providers, believes the problems often stem from a business model that doesn't prioritize client care. "They are sold to big organisations with promises that they will help increase productivity and reduce absenteeism," she explains. "But that emphasis on productivity can clash with the need to provide good psychological care." 

A Need for Transparency 

There are clear implications for those relying on EAP services. Employees – and the organizations employing them – assume these programs prioritize the mental wellbeing of their workforce. Dr Mohring suggests a greater need for transparency in the EAP industry. This includes providing greater clarity about what an EAP is meant to offer and what its limitations might be. 

The BACP investigation into Health Assured has the potential to serve as a catalyst for reform within the industry. Their findings could lead to updated standards and a renewed focus on the ethical and clinical obligations that EAP providers have to the millions of employees they serve. 

Beyond Health Assured 

While the spotlight is currently on Health Assured, it's essential to acknowledge that this may not be an isolated issue. Therefore, a broader look at Employee Assistance Programmes is necessary: 

Accessibility: Are these services truly readily accessible to everyone who needs them? Are there barriers in place? 

Capacity: Are EAP providers equipped to meet the rising demands for mental health support, ensuring timely care? 

Regulation: Are adequate regulatory mechanisms in place to ensure quality and consistency across EAP providers? 

These are critical questions that employers, employees, and policymakers should address as the role of EAPs in safeguarding workplace wellbeing continues to grow. 

The Hidden Cost for Employees and Organizations 

The impact of inadequate workplace mental health support extends far beyond the individuals directly seeking help. When employees don't receive the support they need, the consequences can ripple through entire organizations. 

One significant concern is the potential for increased absenteeism. Employees struggling with unaddressed mental health issues are more likely to need time off work. This can disrupt productivity and burden colleagues who must cover their workload. Furthermore, a study by Deloitte found that untreated mental health conditions cost UK employers an estimated £42 billion to £45 billion each year. 

Beyond the financial cost, there's the impact on employee morale and trust. When workers feel that their mental wellbeing isn't valued, engagement levels can plummet. This can lead to staff turnover, further impacting productivity and creating a drain on organizational resources as companies seek replacements. 

In the worst-case scenario, neglecting employee mental health can have devastating consequences. The pressure of unresolved psychological difficulties can contribute to a heightened risk of serious incidents in the workplace and even suicide. 

What Can Employers Do? 

Employers have a vested interest, both financial and ethical, in promoting mental wellbeing among their workforce. While EAPs can be a valuable tool, they shouldn't be the sole focus of a company's mental health strategy. Here are a few steps organizations can take: 

Lead from the Top: Company leadership should openly champion mental health support, destigmatizing the need for help, and fostering a culture where seeking support is encouraged. 

Invest in Training: Equip managers with the knowledge and skills to recognize warning signs of mental health distress and how to initiate helpful conversations with their teams. 

Offer Flexibility: Where possible, providing flexible work arrangements can help employees manage stress and balance their mental health needs with job responsibilities. 

Listen and Respond: Establish systems for gathering employee feedback regarding their mental health and wellbeing. Actively work to address areas of concern. 

These proactive measures have the potential to create a more supportive and understanding work environment, fostering employee loyalty, and ultimately contributing to organizational success. 

Changing Culture, Changing Lives 

It's important to remember that good mental health isn't merely about absence of illness; it's also about the presence of resources that promote resilience. Employers can play a key role in enabling their employees to thrive psychologically. 

The ongoing investigation into Health Assured carries the potential for meaningful change. But, ultimately, transforming mental health support in the workplace requires a collective commitment. Employers must move beyond simple checkbox compliance and prioritize the psychological needs of their most important asset – their people. 

Resources and Where to Get Help 

While workplace mental health reforms are necessary, individuals struggling with mental health challenges shouldn't wait for systemic changes. Here are some resources and steps to take if you or someone you know needs support: 

NHS Mental Health Services: The National Health Service (NHS) provides a range of mental health support services. Find information and access options on the NHS website . 

Samaritans: This confidential helpline offers 24/7 support to anyone struggling to cope and even considering suicide. Call 116 123 (UK) or visit https://www.samaritans.org/. 

Mind: This mental health charity provides information, resources, and local support services. Visit https://www.mind.org.uk/. 

Talk to Someone You Trust: Reaching out to a friend, family member, or a trusted professional like a GP can be a crucial first step in getting help. 

Employee Rights and What to Expect from an EAP 

When mental health concerns impact one's ability to perform their job, knowing their rights and what support they're entitled to is crucial. It's important to note that employment laws and protections may vary from country to country. Focusing on the UK context, here's some essential information: 

The Equality Act (2010): This legislation protects employees from discrimination based on disabilities, including mental health conditions. Employers have a duty to make "reasonable adjustments" to support employees managing a disability that affects their work. 

Fit Notes: A GP can issue a 'Fit Note' advising an employer if a person is fit for work, may be fit with adjustments, or not fit for work. This information helps employers support staff returning after a period of mental-health-related absence. 

Access to Work: This government scheme offers practical and financial support for people with disabilities, including mental health conditions, to remain in or return to the workplace. Find information on eligibility and how to apply at https://www.gov.uk/access-to-work 

If you choose to use your workplace's EAP, here's what you can reasonably expect: 

Confidentiality: EAP discussions are meant to be confidential, except in circumstances where there's a serious risk of harm to yourself or others. 

Accessibility: Services should be accessible in a timely manner, with clear information on how to contact the EAP and how quickly to expect a response. 

Counsellors' Qualifications: Counsellors are typically expected to hold accreditation from a recognized professional body like the British Association for Counselling and Psychotherapy (BACP). 

Choice: Depending on the EAP, you may have some choice about the type of support you receive (e.g., telephone counselling, face-to-face, etc.). 

What an EAP IS NOT 

It's important to understand the limitations of EAPs: 

Crisis Service: EAPs are usually not equipped to handle urgent mental health crises requiring immediate intervention. In such situations, contacting emergency services or a crisis helpline like Samaritans is paramount. 

A Substitute for Long-Term Therapy: EAPs generally focus on short-term support. If you require ongoing therapy, you may be referred to external services within the NHS or private providers. 

A Guaranteed Solution: While EAPs can offer valuable help, they may not be the right fit for everyone or solve complex mental health problems completely. 

Section 5: Protecting Yourself and Taking Action 

If you feel your workplace EAP is failing to provide adequate support, here are some actions you can take: 

Document Your Experience: Keep detailed records of dates, times, and the nature of your interactions with the EAP, along with the outcomes. 

Speak to Your Manager or HR: If possible, discuss your concerns with a trusted manager or with your HR department, providing your documented evidence. 

Escalate Your Concerns: If an internal resolution isn't forthcoming, consider contacting the relevant professional body accrediting the EAP (e.g., BACP) or a regulatory body such as the Health and Care Professions Council (HCPC). 

Seek External Support: Don't hesitate to seek out mental health support from other sources like the NHS, independent therapists, or charities. 

Creating a Mentally Healthy Workplace for Everyone 

The ongoing investigation into Health Assured shines a necessary spotlight on the potential shortcomings of Employee Assistance Programmes. However, beyond this specific case, it opens a broader and vitally important conversation about mental health in the modern workplace. 

Creating a truly mentally healthy workplace involves a multi-faceted approach. Here are some key elements: 

Reducing Stigma: Openly discuss mental health, challenge misconceptions, and create an environment where employees feel safe to ask for help without fear of judgment or discrimination. 

Educating Leaders: Train managers to identify potential signs of struggle, offer support, and direct employees to appropriate resources, including the EAP or other channels. 

Designing for Wellbeing: Consider workload demands, job design, and workplace culture. Explore ways to minimize unnecessary stressors and cultivate a sense of autonomy and purpose for employees. 

Supporting Flexible Arrangements: Where possible, offer flexible working hours or the option to work remotely to help employees manage their work-life balance and mental health. 

Prioritizing Regular Check-Ins: Encourage open communication between managers and employees. Scheduling regular check-ins can provide an opportunity to address any concerns and identify support needs early on. 

Reviewing Your EAP (If You Have One) 

If your organization offers an EAP, it's crucial to assess its effectiveness. Consider the following: 

Usage Rates: How many employees make use of the EAP? Low uptake could indicate lack of awareness, mistrust, or that the service isn't meeting employees' needs. 

Employee Feedback: Seek confidential feedback from those who have used the EAP. Their experiences provide valuable insights into the quality of support offered. 

Contract Review: Examine the terms of your contract with the EAP provider. Ensure it includes clear standards on qualifications, response times, and data protection. 

A Call for Continued Vigilance 

Regardless of the BACP investigation outcome, the concerns raised about Health Assured serve as a powerful reminder that EAPs are not immune to problems. Employers and employees alike must be vigilant in upholding standards and demanding quality mental health support in the workplace. 

The journey to promoting mental health wellbeing in every organization is ongoing. It requires commitment, collaboration, and a willingness to adapt as needs evolve. By prioritizing the mental health of employees, we not only foster greater personal fulfillment, but we also create more productive, resilient, and successful workplaces for everyone. 

Remember: If you or someone you know needs support, don't hesitate to reach out to the resources listed earlier or seek professional help. Your mental health matters.