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“HR people will be amongst the biggest people that they would want to go out to. There is lots of industry press that they could be in, or make themselves known in, and raise their awareness in. I now know that they go to the big health and wellbeing shows, but I think that they could think a bit more widely about who their customers are.” (Participant 9) Conclusion The results from HR Managers responsible for EAP contracts indicate that EAPs are predominantly implemented as part of an organisation’s health and wellbeing plan, to reduce sickness absence, and because this would fit into the organisation’s values of being a ‘good employer’. The majority of organisations in this research opted for what was often described as a ‘comprehensive survey’ (face-to-face, telephone and online advice) as this provided a range of methods through which EAPs could be contacted, as well as matching different employee needs. Work stress was reported as one of the most common reasons to contact an EAP, although through more in-depth interviews it became clear that in many cases the original intention for using the EAP may not have been the underlying cause of anxiety, and thus determining what EAPs are usually used for can be complicated. Similarly undertaking evaluations of EAPs were also reported to be very difficult, with the confidentiality of the service and the methodology used to undertake the evaluation being the commonly cited explanations.
None of the interview participants had undertaken a financial evaluation of their EAP, even though they frequently used terms like ‘our EAP is cheap, ‘our EAP is value for money’ or ‘I see the EAP as providing a cost-effective service’. EAP use was variable among the research respondents however a universal acknowledgement was the importance of improving the promotion of the service to all members of the organisation, with line managers often seen as having an important role.
HR Managers predicted that they would continue to use EAPs in the future, because removing the service would leave a health and wellbeing gap in their organisation, and there was evidently some need for a helpline, and organisations wanted to be seen as ‘wellbeing friendly’. Some managers had considered changing their EAP provider, but this was rarely cost related, but connected to service provision. Finally, the role of UK EAPA was discussed highlighting that increased visibility was required by the association to have the most impact with those who manage EAP contracts in organisations.
Results: EAP Providers
Alongside the data collected from HR Managers, an online survey was also conducted by EAP Providers to examine the use of EAPs by their clients. The research was interested in identifying the main EAP products and services offered; the patterns of EAP use and the approximate scale of EAP business being conducted in the UK. In order to collect the data from EAP providers a confidentiality agreement was produced between The Work Foundation and EAPA members to protect commercially sensitive data.
Eleven EAP Providers answered all or some of the survey questions, although one provider failed to provide any quantifiable data, however they did answer two questions about the type of EAP products offered and a question about the quality standards held by the company. Of the remaining 10 EAP Providers, the data supplied contained a high proportion of missing data, and consequently the number of respondents who answered each questions will be reported.
UK EAP Clients (Customer Organisations) When answering how many clients does your EAP provide services to, 10 organisations responded, with figures ranging from 14 clients to 1885 clients, with the total number of clients being 3,420. Following from this, the Providers were asked how many of these clients are directly managed by them (and not by some form of intermediary) only 9 of the providers answered this question, with the total equalling 2,057. Providers were asked to calculate the headcount from their total number of clients that they offered services to, which for the 10 organisations who provided this data resulted in 6,142,979 clients.
EAP Product Splits
EAP Providers were asked about the products that they offered their clients:
Of the 11 who responded:
• 11 offered EAP telephone information services, online services, telephone counselling and face to face counselling;
• 9 providers offered EAP telephone information services, online, telephone counselling;
• 9 providers offered EAP telephone and online services;
• 9 providers offered an EAP telephone helpline;
• 5 providers offered an EAP as part of an insurance policy contract with face-to-face counselling, and • 6 providers offered an EAP as part of an insurance policy contract.
Usage The EAP Provider survey aimed to determine the usage of the services they offered to clients, and questions were broken down into the separate services offered.
Online self-help The total number of clients that online self-help services were available, out of the 9 providers who answered the question, was 3,281 (96% of clients received this service). Out of the client population 155,799 individuals had used online self-help in the last full year of data (out of the 8 respondents who provided data), meaning that 2.53% of the client population used this service. A total of 3,798 online self-help sessions were recorded by the 9 providers who had the data available, however 5 providers recorded delivering no sessions at all.
Online counselling (chat room environment) With regards to online counselling, 10 providers were able to provide data, and a total of 548 clients had this service available to them (from a total of 4 providers), indicating that only 16% of the total clients had access to this service. Providers were asked how many of the client population had used this service in the last full year of data they had, which totalled 50 (from 3 providers).
How respondents measured the use of online counselling differed, with 4 providers measuring page clicks and 3 providers using total number of users (only 7 providers responded to this question).
Telephone usage Providers were asked how many clients the telephone service was available to. Ten providers were able to respond to this question, with the total being 1,539 clients. This means that 45% of the clients represented in this data had access to a telephone service.
Telephone counselling Of the 9 respondents who reported data for this question, telephone counselling was provided to 1,545 clients, with the number of individual clients using this service in the last full year of data collection being 32,739. However, once again there was a slight discrepancy with how telephone counselling is measured with 9 providers measuring the number of specific cases and 1 provider measuring the number of calls.
Face-to-face counselling Nine providers reported on the level of face-to-face counselling provided to their clients, and this service was available to 1,487 clients (43% of clients had access to this). In the last full year of data collected 13,732 individuals in the client population used the service. Only 1 provider measured the use of face-to-face sessions using the number of sessions received, whereas the other 9 measured use as the number of specific cases.
Legal information The number of clients that legal information was available to totalled 1,482 (from the 9 respondents who provided data), and 10,072 employees in the client population used the service in the last full year of data (from 9 respondents).
Financial information Nine respondents reported data regarding financial information, with a total of 1,486 clients having access to this source of support, and among this client population 1,362 employees used the service to discuss such matters.
Critical Incident Services The critical incident services were available to 1,489 of the clients covered by the service providers who responded (9 respondents), with 544 uses from the client population in the last year (from 9 respondents, with one respondent reporting 0 uses).
Total usage Ten respondents provided what they considered to be a ‘normal’ level of usage for a full EAP.
Percentage values ranged from 0-7%, with the calculated average at 4%, but the most common level reported was 5%. EAP providers described a variety of calculation measures they used to report what they considered to be this ‘normal’ level. A number of providers calculated this by using the number of clients who have used the service divided by the total headcount. However, there were discrepancies for whether this was for all those who has used the service regardless of access method, as some providers did not include online activity, others only included those who were ‘thoroughly embedded’ in the service and one provider reported that usage was based on the number of individuals who had called up and had a clinical assessment.
Other methods of calculating ‘normal’ usages included:
• Considering normal usage when 3% of eligible users contact the 24-hour helpline during any 12 month period;
• The calculation being based on the number of people using the service (be it legal, financial or counselling etc.) per 100 lives across the client portfolio; and
• The percentage of the total population that uses the helpline and the percentage of the total population that are referred to structured counselling.
This indicates that among the EAP providers who responded to the survey, there was no uniform method for calculating ‘normal’ usage.
Presenting problems EAP providers were asked to report the top five presenting problems from their utilisation
reports in a number of different categories:
Presenting problems for work issues: Work stress/work pressures was a commonly reported theme by providers (9 responded, although not all 9 provided complete answers) as presenting problems (including work dissatisfaction and work change); bullying and harassment and conflicts at work (both with an individual line manager or interpersonal conflicts) were
also frequently reported. A variety of work-related legal issues were identified, including:
contracting/redundancy problems; HR or grievance issues; and, compromise agreements. The final theme under presenting problems for work issues covered sickness absence/sick pay and return to work policies that employees needed help with.
Presenting problems for non-work issues: Once again the presenting problems provided (9 respondents, but not all complete) can be broken down into a number of distinct themes. The first theme is related to health issues with anxiety, mental health in general, sleep disruption and addictions all reported. The second theme relates to relationships (including issues such as marital difficulties, family issues, divorce), with the third theme covering legal and debt issues (such as property law, family law, financial advice and tenancy).
Presenting problems for work-related clinical utilisation: Only 6 respondents answered this
question and not all provided complete answers. Two major themes emerged from the data:
work-related mental health issues and stress as a result of the work itself (e.g. role stressors, stressful demands, anxiety and depression with relation to work hours/sickness absence, changes to work), and the second theme being work stress as a result of organisational relations (e.g. stressful working relationships, grievances, stress/illness resulting from bullying and harassment and stress as a result of redundancy or the threat of redundancy).
Presenting problems for non-work related clinical issues: Once again there were 6 respondents to this question (some with incomplete responses), with mental health (anxiety, depression and health) most commonly reported, sometimes in association with life events such as bereavement, divorce and relationships. Two providers reported that physical health was also an issue they had been asked about.
Providers were also asked to report other major services that they offered their clients that may not have been reported in the utilisation responses (7 providers answered this question).
Training and managerial services were most commonly reported, although wellbeing initiatives and advice were also given. Some providers offered mediation, vocational support, biometric screening, immunisations and consultancy as well (although these were less common).
Financial business data EAP providers were asked a number of questions regarding their business and the financial data they collect. In terms of the financial data collected, five respondents answered the questions with a variety of responses including: income and expenditure data; full GAAP accounts;
management accounts; turnover, costs and contribution and full monthly management costs.
All respondents reported that the financial data is collected monthly. For the majority of participants financial data was reported to senior management and the financial departments/ directors or business partners and the EAP business management teams.
Six of the EAP providers supplied data (although some was incomplete) regarding their full business data. One respondent reported their data in dollars (consequently excluded from calculations). Gross revenue ranged from £3,945 to £3,224,414 with the calculated average at £1,297,484 (although heavily skewed by two large revenues) with the median gross revenue at £649,000. Participants were also asked to provide details of any gross profit they received.
Profits ranged from £1,970 to £2,546,836. The calculated average of the gross profits totals £756,037 whereas the median is £592,000. Only three providers were able to report if they had a surplus. One provider said there was not, whereas the two other providers reported a surplus of £57,000 and £562,390.
EAPs were also asked whether their gross revenue differed from the previous year. Although only 6 respondents provided financial data regarding their gross revenue, 9 EAP providers responded, with 6 participants saying that they had an increase in gross revenue, with 3 indicating a decrease.