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“It has either helped them get back to work quicker, or has prevented them going off sick because they have had counselling that they can access a lot quicker than they could if they went through their GP.” (Participant 2) One participant discussed how the decision to implement an EAP arose from input from their trade union, who suggested EAPs as a support mechanism through which staff could be further aided. Finally, a number of respondents insisted that as a service EAPs were so valuable that
organisations would be in trouble if they did not have it:
“I think the word on the street is and always has been is that you really have to have one. If you don’t then your organisation will be in trouble.” (Participant 3) Twelve per cent (9 organisations) had not invested in an EAP, with the most common response for not having implemented the service being a lack of information about EAPs (44%), followed by the organisations already using other wellbeing practices or initiatives (33%). Cost was indicated as a reason for not having an EAP by 22% of these organisations. When asked what might persuade these organisations to start using an EAP, evidence of their effectiveness was clearly needed, with both evidence of cost-effectiveness (33%) and evidence that they improve wellbeing and productivity (33%) most commonly reported. As in the previous question, respondents also noted that they would like more information regarding the services that EAPs provide before a decision whether to use an EAP is made.
If no (n=9): Why does your organisation not have an EAP?
Why does your organisation not have an EAP?
(Tick all that apply)
EAP Service Provision Organisations who did make use of an EAP were asked what ‘type’ of EAP they had (tick all that apply option). The majority of organisations (84%) had what in the qualitative interviews were often referred to as comprehensive EAPs, which included telephone services, online services and face-to-face counselling, 23% reported having EAP telephone and online services (although, in a number of cases in the qualitative interviews organisations indicated that they could pay for additional face-to-face counselling if required). A small number of organisations opted solely for telephone counselling (14%), whereas 6% of respondents had an EAP as part of their insurance policy.
What type of EAP does your organisation have?
Number of organisations
Survey respondents also provided information regarding the most frequent methods of contacting the EAP. Of the 57 responses, 84% indicated that telephone was the most common method, with 16% opting for the EAP website.
Many reasons were provided for why different types of EAPs were chosen, and why there could be different methods of EAP contact. The most common response referred to the accessibility to the service provided to employees, and organisations chose their provision method on the basis of enabling a range of options especially as staff in some organisations may not always have a regular digital connection or are based in offices, and versatility is needed to suit different access preferences. As such, offering a wide-range of services was often viewed as providing the ‘best support’ to employees. Respondents also commented that the immediacy of the response provided by having a range of service options was important, highlighting that the ability to speak to a qualified professional at any time of the day was a key decision maker when choosing service provision. The third most common response provided by survey respondents revolved around ‘cost-effectiveness’ and that the costs for the service seems reasonable for what the EAP would provide.
The qualitative interviews also highlighted the importance of having a range of services provided by the EAP. For example, having online facilities allowed for an added layer of confidentiality
that may not be available from phone services:
“The beauty of the service is that we have an online facility, so if you are in the office and you can’t pick up the phone you can do an online chat which is completely confidential, and they have strengthened this in the course of our contract…you can do that online with the counsellor, nobody around you knows what is going on, and you are getting some immediate support.” (Participant 8) Additionally, the interviews also indicated that the different modes of service provision could also serve different purposes. For example, a number of respondents commented that the online services were focussed on the health and wellbeing aspects of the EAP, whereas the telephone service could cover a range of topics. It was also inferred that there could be an age
difference in what services are used and by whom. For example:
“There is a 24/7 telephone service which covers everything from legal advice right through to elderly care…that would just be an interview on the phone. They can have up to six face-to-face counselling sessions…and then there is the health and wellbeing service online, and quite a lot of people just chose that, particularly the younger generation would use something like that.” (Participant 6) Survey respondents were also questioned regarding what services their EAP provides (once again, a tick all that applied option).
Of the 59 respondents who answered this question, 95% reported that counselling services were provided by the EAP, and the counselling was offered through a number of options: faceto-face counselling (92%), structured telephone counselling (83%), and Online CBT (Cognitive Behavioural Therapy) (34%). A range of other information and guidance was also provided by a majority of EAPs, including: emotional, work-life and workplace issues (93%); money/debt advice (92%); legal information/guidance (86%); health advice (80%) and child and elderly care information (76%).
The survey results also indicated that EAPs were an important resource for managerial information, where managers can contact an EAP to ask for support as to how to manage problems they may be having in the workplace (68%), management consultation (49%) and management information on employee and organisational interventions (44%). This specific manager service was highlighted as a welcome attribute to EAP services. In some cases the EAP service also came into the organisation to provide specific training for managers who may not have been fully equipped to help employees with a mental health condition or personal issue
that could be affecting their work, which was also seen as a beneficial service:
“There is also a specific part, a dedicated part for managers, so if there is a manager and they are dealing with a tricky situation, so for example, they are dealing with a redundancy or dealing with a member of staff who is suffering with mental health issues, there is a dedicated management support section which they can access as well.” (Participant 4) Some organisations (especially multi-national organisations) mentioned other methods through which an EAP has provided additional services including crisis management, where a country specific incident may have occurred. EAP providers, in some cases (and on a few occasions, for additional costs as it may not have been previously agreed in the service contract) could also come into the organisation to provide training after a critical incident had occurred and health and wellbeing training if/when an organisation was promoting the importance of health and wellbeing.
“I think that it is a very useful support mechanism, particularly in times of crisis or critical incidents or things like us for us as a business to be able to know that we can support our employees in those very difficult times. I personally see it as very important.” (Participant 1) Although all interviewees reported that they found their service comprehensive, there were also some suggestions regarding how EAP services could be improved. Overall, these comments revolved around how EAP providers could do more to promote their services in the organisation (which will be discussed in more detail later), so that employees could make the most out of the advice that was offered. The other two issues centred upon the EAP being able to tailor their services towards organisational needs, whether that be adapting the training provided rather than resorting to ‘off-the-shelf’ information, and getting back to organisations more swiftly.
The level of service provision and the ability to negotiate specific contract benefits (such as training, promotion activities, the ability to deliver services globally and having multi-lingual counsellors or health and wellbeing awareness days) were often given as reasons why certain EAP providers were chosen to deliver services in organisations. Both the survey and qualitative interviews indicated many organisations chose their EAPs having gone through a procurement exercise, often having to choose on the basis of the quality and price of the service offered.
One interviewee described how when deciding what EAP provider to use, their organisation
decided to alter the usual procurement process, to place a higher emphasis on service quality:
“What we have always done with this particular contract, is that we have always had the quality ratio higher than the cost one, so we would have a 70:30% ratio, whereas some other contracts are 100% price, or 80% price, this one we decided to get waivered so we could do it on a higher quality than price side, of things. So the evaluation panel would then look at the submissions, and we would also invite them for interviews in terms of for further questioning to the panel, and we would score based on those.” (Participant 7) The reputation of an EAP provider often had a large role to play in determining which service provider to opt for. If contract managers had experienced good service provision previously in terms of accessibility, customer feedback and had an excellent organisational legacy, these factors increased the likelihood of an EAP service provider having their contract renewed.
A number of respondents to the survey indicated that cost was a consideration, with one organisation reporting having conducted some cost versus benefit analysis from the information provided by EAPs during the tender process.
EAP Service Use An objective of the research was to gain an understanding of the issues pertaining to why employees (and employers) use EAPs. This is of interest as an EAP can be used for both workrelated and non-work-related issues, but both can have an impact on organisational productivity and sickness absence, and having knowledge about the main issues could help organisations improve wellbeing or management in these areas.
Survey respondents were asked to indicate what the top 5 issues employees present with. Work stress was the most common presenting problem, with 70% of the 54 respondents who answered this question selecting this. Depression (57%) and family events (56%) were also commonly reported. A number of workplace issues were also reported, but not as frequently as other life events. For example, difficulties with line managers received 20%, workplace restructure was reported by 15% of managers, and bullying was 6%. Other options for why the service was used by employees included legal and financial issues, bereavement and general HR issues.
What are the top five issues that employees present with? present with?
What are the top five issues that employees
Interview respondents were also asked highlight what they considered the top issues for contacting EAPs to be. Two of the participants were unable to answer the question as they had recently changed providers and so had not received the latest quarterly reports. Some other Piechart managers highlighted that reporting the top issues is actually a difficult task, as over the year the issues can vary dependent on what is happening at the organisation or in the individual’s private life. Additionally an employee may ring up not knowing the key issue they require support with, or they may be focussing on a different problem that is causing their underlying anxiety.
“Reporting the top three issues can be misleading, because some people will say right up-front that the issue is work related, when in fact when it is uncovered it actually turns out to be a relationship issue, maybe sort of socially or you know relationships within the family…” (Participant 6) At the time of the qualitative data collection the majority of managers confirmed the quantitative results by reporting that work stress was a major issue, although one manager clarified this finding with the reasoning that as this is what people usually associated EAPs with. Personal issues were also often commented upon – although there were some discrepancies in how these were reported. Some managers labelled all non-work issues as personal, whereas others broke down this category into individual issues – the most frequently reported being bereavement, divorce, relationship problems and concerns with child management. This is further clouded as all these issues could come under the umbrella of ‘personal stress’ which was another reported category for contacting the EAP. One manager had a usage report that divided the most common problems into work-related and personal issues categories, with work related issues being concerns regarding employer relationships, work demands, and organisational change, and personal issues being relationships, debt and general stress related problems.
Organisations also reported a large degree of difference between the level of EAP use, ranging between 2.5%-16%. Some organisations indicated that this may not reflect true usage, as in some cases there were known incidents were one employee had used the service more than once. Many were concerned that their EAP was not used enough, and organisations where the use was higher highlighted the importance of having an EAP, as it was evidently filling a wellbeing gap. One interviewee was concerned that their high level of EAP use meant that their
organisation was being poorly managed, but also reasoned that: