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Conclusion Only 11 providers responded to the survey (despite a number of reminders), and within the responses there was a high level of missing data, therefore establishing any firm conclusions regarding the state of the market of EAP use in the UK is difficult. However, with the limited data that was collected, we were able to establish that how providers calculate EAP usage differs (some measure clicks, others measure cases), indicating that standardisation with regards to the measurement of usage needs to be developed. EAP Providers also reported that work demands and pressures resulting in work stress were the main work-related reasons for contacting EAPs, whereas non-work issues were themed around health and anxiety problems, relationship issues (e.g. divorce) and legal and debt issues. There was limited financial business data (i.e. income, expenditure and revenue) provided, and for providers who supplied data, there were a large range or revenues, thus the calculated mean were heavily skewed. Therefor it is very difficult for to provide any firm conclusions.
The research aimed to understand the state of the market of EAP use among organisations, and to highlight whether there is any evidence that return-on-investments are calculated or discussions of economic utility of EAPs in organisations occur. The findings have led to a number of contributions to the literature regarding the use of EAPs in terms of their use, their evaluation and how they can best be promoted in organisations. The research has also highlighted a number of difficulties in obtaining provider data to help determine the state of the market research. Finally, the role of UK EAPA as an associative body of EAPs has been discussed.
Previous literature has indicated that EAPs are implemented in organisations with the belief that the counselling and other associated services will improve employee productivity. The findings of both our quantitative and qualitative data suggests that organisations decided to invest in EAPs as this was part of their health and wellbeing plan, and provided an opportunity for employees to discuss issues (both work-related and personal problems) with somebody external and independent. It could be argued that as this would improve the health and wellbeing of their staff, the knock-on effects would lead to improvements in overall productivity, but the respondents were clear that being seen as an employer that considers the health and wellbeing of their staff was their priority. Implementation of an EAP to improve productivity was not mentioned per se, but could be inferred from a minority of respondents who indicated that EAPs were introduced to reduce sickness absence. As further evidence of organisations wanting to improve staff wellbeing, the majority of organisations provided ‘full EAPs’ (telephone, online and face-to-face service provision), which meant that staff had ease of access to the EAP through the mode of their choice (which was important for confidentiality in office situations or gave employees who worked in manual labour roles greater access to the service).
The use of EAPs varied between the organisations, and in the qualitative interviews when asked directly what average usage was, taking into account that there could be monthly variations, usage was reported to be 2.5-16%. The most common reason for employees to contact the EAP was related to work stress – which for some was not surprising as this was primarily how EAPs were promoted in organisations, and what HR Managers perceived employees assumed EAPs were focussed on. Personal relationship issues were also commented upon, with some managers clearly understanding that having the service available to deal with these issues was important, as there can be a cross over between personal stress and work which could have an impact on employee wellbeing and productivity. However, what became clear in both the HR Manager survey and in some cases from the provider survey was the discrepancy in how EAP Providers classify cases. Some used the umbrella term of ‘personal stress’ to cover issues such as divorce, bereavement, family issues etc., where others would have reported these as independent topics. Thus to gain a clearer understanding of why individuals use EAPs, there needs to be a clearer unified guidance as to how EAPs both measure and report this.
Discussions about service use often led on to EAP promotion and how this could be improved.
HR Managers often mentioned that they would like to see the EAP used more frequently by their members of staff, and thought how the service was promoted plays a really important role. All organisations used similar methods to advertise their EAP – posters, leaflets, the intranet, wallet cards, inductions etc. However, there was a universal acknowledgement that something more needed to be done, as managers would comment that the majority of their employees would not know the service existed, or would only seek it if they had a problem. Some managers acknowledged that only discussing the service at inductions meant that only new staff would know what the service currently provides, and suggested that launches of the EAP should be conducted every year. There was some evidence to show that there were still organisational barriers to service promotion, especially when discussing the intranet. Managers would like to have improved EAP visibility on organisational websites, and for the EAP to have the same organisational importance as other workplace initiatives.
The research highlighted that more could be done to promote EAPs in the organisation by two key stakeholders. A number of HR Managers in both the online survey and the qualitative interviews highlighted that EAP Providers need to take a leading role in helping to promote their services – either through a more dynamic literature campaign (better posters, leaflets etc.) or coming into an organisation on wellbeing days and visibly promoting the service. Some managers discussed having arranged this as part of their contract negotiations. However, others had the assumption that the EAP should provide this as part of their service de facto.
Thus, how EAP Providers consider this role could be of increased importance in the future. The other key stakeholder in EAP promotion was line managers. Line managers have an important role in organisations in developing a positive employment relationship with those who report to them, to assist in employee personal development and to be aware of the health and wellbeing of those whom they manage. Therefore how aware line managers are of EAP services plays an important role in service promotion. Although, some HR Managers argued that line managers already have extensive workloads, developing an employment relationship is part of this. An important role for the EAP industry to consider is how they can engage with line managers, thus improving the impact that EAPs can have through embedding themselves with their key audience in the organisation.
It is also important to consider the barriers to EAP use noted by HR Managers, and how these can be overcome. One of the key comments was how the advertisement of EAP services were most commonly concerned with tackling an employee’s mental health, and there was the perception that the ability to discuss personal or non-work related issues was not as well known. The idea that an EAP equated a counselling service was often mentioned, thus there is a clear need for EAP providers, HR Managers and anyone else involved in service promotion to improve the clarity of the message regarding the main functions of an EAP and the range of help that the service can give to organisations. Confidentiality was also noted as an issue as to why employees may not use the service. Once again, HR Managers provided examples of how they attempted to overcome this issue, but if there is a perception that EAP Providers do disclose personal information to the organisation, the industry and HR Managers need to find a way to clarify their stance on confidentiality and the importance of confidentiality throughout service delivery.
Determining the value of EAP services was very difficult for organisations to do. Although 60% of survey respondents reported to measure/evaluate the quality of the service provided, the majority of respondents and interview participants commented that this was most commonly measured through the usage reports or through anecdotal feedback from employees who had used the service. However, HR Managers understood that this wasn’t a ‘proper’ evaluation of the service, and that more needed to be done to understand how to measure ‘service quality’.
Another method through which evaluations were conducted was by looking at the feedback questions that EAP Providers asked their service users. HR Managers also questioned how useful these were as they were unsure about how many of the service users actually completed the feedback forms. Queries regarding the ability ‘to measure’ utilisation and evaluations of the service echoed what was found in the literature, regarding the methodological difficulties of calculating utilisations, problems regarding data confidentiality, and how to appropriately measure the intangible benefits of the EAP service. There were also concerns about using ‘sickness absence’ as a measure of EAP value, as this may not be an accurate measure of improved wellbeing, and it is also difficult to ascertain how much any improved wellbeing is as a result of the EAP over and above the other health and wellbeing initiatives organisations implement. Most organisations were interested to know how to measure service quality and conduct evaluations, and consequently the EAP industry may wish to develop this further.
The lack of evaluative measures was clearly demonstrated when asking whether any economical or financial evaluations were made. HR Managers in the interviews suggested that financial benefits were not important as they would have an EAP to be seen as a ‘good employer’ whether the EAP was cost-effective or not, and senior managers rarely asked for evidence of cost effectiveness. However, managers would justify their EAP as being ‘cost-effective’, ‘good value for money’ and ‘not very expensive’ if they were ever challenged about the service despite not having the evidence to show this. Some HR Managers mentioned that if a methodology to calculate return-on-investments were possible, then they would be interested in conducting an evaluation, especially if future budgets for such initiatives were reduced they would be able to highlight service value. However, some HR Managers noted that they can now negotiate good deals with providers and gain ‘added extras’ from their EAP, so services are becoming cheaper than they were, or in comparison to other initiatives that could provide similar wellbeing services. It is therefore important that quality and service evaluations are conducted to ensure that organisations are receiving value for money, and EAP Providers could use a return-oninvestment measure as a way to promote their service or differentiate their services from others in a competitive environment.
The provider data collected for this research highlighted a number of issues with undertaking state of the market research, and calculating any financial evaluations, many of which cemented the findings of methodological challenges found in the initial research literature. Engaging with EAP Providers was extremely difficult. Many providers who were asked for data were unwilling to take part in the research for fear of anonymity and competition between providers.
Additionally, amongst the providers that did take part in the research, the level of missing survey data made any significant data analysis difficult. Providers often mentioned that the data requested was either unavailable, the records were not up to date, or could not be calculated from their data sets. Further to this, although it was a small sample, we do have evidence that in some cases how provider’s measure utilisation differs, thus trying to gain a measure from providers about EAP market use proved difficult. If the EAP industry wants to highlight its true value to organisational wellbeing, then being able to demonstrate their effectiveness and value for money is of key importance. However, this will have to be calculated in a unified way, so organisations will be able to make a qualified judgement regarding who they would like to procure business from.
The research also suggests however, that costs are not the only reason for why a specific EAP is chosen to provide a service. HR Managers indicated that having a good working relationship is really important – especially with the account manager. If this relationship was honest, open, responsive and the account manager was clearly concerned with the individual organisation and not just seen as ‘one of many’, then this led to a greater likelihood of the HR Manager indicating commitment to the provider. When considering the likelihood of using EAPs in the future, HR Managers admitted that they could not envisage their organisation without an EAP, but service delivery and service quality was more important than the cost of the service in keeping providers. Thus although EAP Providers are clearly concerned with disclosing financial information in-case this hinders their competition, they must also consider how they provide the service and the ‘personal organisational relationship’. Consequently, developing methods through which service feedback can be universally measured and reported by the EAP industry could be an initiative to be considered.
Finally, the results highlighted that there is still work for UK EAPA to raise their awareness as associative body, and how they can improve the service they deliver.
Limitations and Future Research Although this research has provided interesting findings regarding the EAP industry in the UK, there were a number of limitations to the study. Although the online survey was promoted through a wide variety of methods (websites, articles, social media), the number of respondents were small, and may have only focussed on organisations who are already interested in HR/ wellbeing issues, the work of The Work Foundation, or those who have some connection with EAPA. In this way, we may have limited our outreach to specific sectors or organisations and skewed our findings.