Employees need to trust in EAPs for effective stress busting

EAPs may be affordable and help employers tackle employee stress, but staff need to fully trust the service, says Nick Golding

Advice lines that are set up for staff to call for help when they are suffering stress or bullying at work are an attractive proposition for employers as they cost from as little as £2 per employee per year, and can be effective in reducing sickness absence.

The perk has proven popular with employers as almost half (48%) provide an employee assistance programme (EAP) as a core benefit, according to the Employee Benefits/HSA Healthcare research 2007.

EAPs go some way to helping employers to meet their duty-of-care obligations around employee stress. However employers should not rely on EAPs alone to satisfy all their healthcare needs as the perk is most effective when it operates alongside a range of other health benefits.

John Dean, head of health and risk consulting at Punter Southall, explains: “An EAP has a limited scope of healthcare cover, it deals with stress and helps individuals cope with personal problems, but it’s limited when you think that it cannot offer treatments such as physiotherapy. It is useful but not comprehensive”

“An EAP should never be purchased on its own, it should fit into a company’s health programme and come as part of the package.”

Some providers even refuse to provide an EAP as a standalone product as they believe it should form part of a wider healthcare package and sit alongside an absence management programme, a healthcare cash plan or private medical insurance.

James Glover, member services director at Healthsure, says: “We don’t provide EAPs as a standalone product. It needs to be as part of an overall wellbeing programme that may focus on flexible working and other health benefits. It’s not just about saying ‘oh we set up this helpline for you and that should take care of all the issues’.”

Identify additional help
The nature of an EAP and the way it is delivered via a phone line restricts the care that can be offered. Staff can discuss problems with counsellors over the telephone, but actual medical treatment is beyond an EAP’s reach.

However, EAPs can help identify an employee’s need for additional help and direct them to other healthcare programmes such as face-to-face counselling or private healthcare so they can be treated quickly.

Charles Kydd, client manager at provider company Focus EAP, says: “Of course there is a limit to the amount of support an EAP can provide, and if the problem cannot be resolved between the counsellor and the employee, [for example] repetitive strain injury (RSI), we would suggest medical intervention.”

Westminster City Council is one employer that recognises the limits of an EAP service as well as its strength in helping to reduce sickness absence. It introduced a 24-hour EAP helpline in May 2006 and has since noticed a reduction in sickness absence rates from an average of ten days to eight-and-a-half days per employee. Although, Trevor Webster, strategic HR manager at Westminster City Council, admits: “An EAP can deal well with psychological issues, such as stress, but physical problems are more difficult for the EAP to resolve. The employee could be referred to the NHS, but the options can be more limited than with psychological issues.”

However, providers have taken steps to broaden the scope of EAPs offering face-to-face counselling as well as telephone advice with some now even providing advice services to help staff to resolve legal and financial issues. But while EAPs offering ‘welfare counselling’ are exempt from tax as a benefit-in-kind, the provision of financial and legal advice does not qualify for this status. HM Revenue & Customs is currently reviewing the tax status of EAPs and may decide to remove the tax exemption (see box).

Where these extra services are available to staff, Kydd fears they may not know that they exist and employers may be missing out on maximising the effectiveness of an EAP.

“Employers need to promote the service in many different ways, and explain how extensive the EAP actually is,” says Kydd.

Employers therefore need to make sure staff are aware of the perk and fully understand how it can help them deal with issues around stress and possibly legal and financial problems. Such a communication strategy should help boost take-up rates which tend to be quite low for EAPs.

Dean explains: “Take-up rates on the phone calls can be as low as 2% per year, EAPs are not generally well utilised.†

Picking up the telephone and discussing personal problems with a stranger poses problems for some employees, and many find it difficult to overcome the social barrier that still exists with talking to a counsellor.

However, UK employees are getting better at discussing problems of a personal nature, says Kydd.

“There is a kind of stigma attached to speaking with a counsellor, but I think it is diminishing. With the British psyche, there is still some stoicism that exists and employees think, ‘I don’t need to speak to a counsellor’,” he says.

Suspicions of anonymity
However, providers are adamant that this is a barrier that can easily be broken down by clear communication to employees on how an EAP is designed to help them and that its use is perfectly acceptable.

Employers may also want to make it clear that the service is confidential in a bid to reassure staff, who may be reluctant to divulge work-related problems over the phone through fear that they may get reported to their boss.

Westminster City Council’s Webster says: “People can be suspicious when an EAP first comes out, and people may not think that the information is as anonymous as the employer makes out, so employers need to address this issue.”

This confidentiality, though, does not prevent the reporting of general issues that have been raised by staff to their employers.

Webster suggests that employers should share this information with staff to maintain a level of trust and to show that they are taking the issues raised seriously.

“We share the information that we get back from our employee assistance programme provider with our [staff]. You have to be transparent the whole time to maintain the trust,” says Webster.

Whatever the limits of an EAP, is can provide a valuable service to staff and employers. It is just a case of making sure the service is properly communicated and forms part of a wider healthcare strategy for it to achieve maximum effect.


EAP tax position under review†

Services offered under employee assistance programmes (EAPs) that are defined as “welfare counselling” are considered to be exempt from tax as a benefit-in-kind.

Examples of counselling topics that are not liable for tax include stress, debt problems, problems at work, ill-health and alcohol or drug addiction.

However, in recent years, there has been a broadening of EAP products to, in some cases, include legal and financial advice services. These do not fall under the definition of “welfare counselling” and are therefore not exempt from tax. In recent months, employers have been hit by larger than expected tax bills as HM Revenue & Customs (HMRC) has questioned whether the EAPs provided are fully exempt from tax and, in one case, an employer received a back-dated bill for £1.5m.

The Employee Assistance Professionals Association (Eapa) is now lobbying HMRC and the government for clarification on what actually constitutes legal and financial services. It argues that the information and support that is provided through an EAP under the label of legal and financial is within the context of a mental health model and helps individuals to simply cope with their problems and does not provide them specific advice on how to solve their legal and money problems.

Case study: EAP proves to be capital idea†

Although Westminster City Council cannot attribute a fall in absence rates entirely to its employee assistance programme, it believes the 24-hour helpline has had an impact.

Since the EAP was introduced in May 2006, sickness absence rates have fallen from an average of 10 to eight-and-a-half days.

While Trevor Webster, strategic HR manager at the council, believes the monthly reports that its EAP provider sends back to the council can sometimes be useful, he thinks the fact employees are not identified limits the degree of action the organisation can take to solve any problems.

“Although [confidentiality] is a strength, at the same time, it has limitations. For example, if one of our employees called into the EAP and said they are being bullied, it can be difficult for us to do anything in that specific case, although we can review our policy when necessary,” says Webster.

However, he is satisfied that the council’s EAP is able to respond to issues raised by employees that it is not equipped to deal with, such as the need for treatment of physical illnesses, by referring staff on to the appropriate service provider.

“It depends on the provider, but ours is good at referring the problem on to others. It is important for an employer to know just what its EAP provider can actually do,” adds Webster.