Employee assistance programmes – genuine fix or the illusion of a solution?

Employee assistance programmes (EAPs) are a popular employee benefit. Many companies provide them. But there’s a real problem: they’re massively underutilised, and frequently don’t deliver the expected benefits. If they’re needed, why is this?

I’m not going to dispute the case for EAPs. The money spent on them is well-intended. They offer support and services which can benefit employees. But the reality is that they are generally pretty ineffective.

They’re universally sold on a per-head, per-annum basis. This isn’t a utilisation issue, but it does mean companies pay regardless of the utilisation. A fallout from this is the way that cases are typically handled – the focus is on providing a service to the company, not to the individual. This isn’t just semantics. It’s at the heart of many utilisation issues.

For example, EAPs are seldom proactive. The person with the issue has to raise her or his hand to get help, something many struggle with. But people may not know that the EAP exists, or what they’re covered for. They may feel reluctant to talk about some issues. But it’s not just the first interaction: employees are almost always expected to manage their case and be responsible for driving it forwards. It’s a recipe for disaster. We know that even with state healthcare people fall through the cracks because they are expected to ‘report back’ after every intervention.

Services often position or advertise themselves as providing a solution, but the reality is they only contribute to it by helping with part of the journey. The table above shows how typical services contribute to the whole recovery journey.

Proactivity reaches beyond this. Many EAPs aren’t staffed by healthcare professionals. Employees are expected to effectively self-diagnose and the EAP, without challenging this, then refers them to what seems like an appropriate service. This means that people ask for help too late, or unwittingly ask for the wrong kind of help. Yet, in almost half of the cases on which we’ve worked, that initially reported condition was only part of the problem. We like to compartmentalise issues – and, with (say) a broken arm, sure, you can. But many issues are more complex. Physical conditions can be a manifestation of mental health issues. Or time spent off work from physical conditions can lead to mental health issues. Mental health issues such as anxiety can have complex causes – only solved by addressing workplace problems, or home life challenges. We’ve found that many cases have a mix of physical health, mental health, workplace, home and social issues.

You can see the problem. The reported issue is treated – but the actual problem remains. There is a real need to intervene earlier, get to the real nub of the problem and then ‘own’ the case on the employee’s behalf. Whatever they say, most EAPs don’t do this.

And there’s more. Healthcare services – which need to be navigated by the employee – operate in silos. Without external ownership, people get passed from pillar to post and get lost in the system. Data isn’t readily shared between silos and this frustrates progress too.

Even if the problem is fairly identified correctly, treatments may not work initially and need adjusting. Employees feel that they’ve ‘had their quota’ and tend to live with the issue, recovering over a needlessly long period.

We also know that many people aren’t compliant with their treatments. They skip physiotherapy. They come off medicines too quickly. They don’t maintain exercise regimes.

When they return to work, it’s assumed that they are ‘fixed’ and aren’t followed up, when they are possibly still struggling.

These issues – and more – result in EAPs suffering from ‘drop-offs’ in use which render them ineffective. The good news is that there are simple ways to address and overcome these challenges. It’s possible to put processes in place which don’t replace EAPs but rather work with them so that organisations get the expected benefits and value from them.

I’ve just written a detailed white paper on this topic: ‘Improving the effectiveness of employee assistance programmes’. You can download here.

And if you have any questions or comments, I’d love to hear from you – either here, or by LinkedIn message, or by contacting me directly. Feel free to connect. We’re building a comprehensive picture of employee well-being and EAP services and your experience may well be valuable to us.