Most SME (small- and medium-sized enterprises) employers and all enterprise employers provide EAP (employee assistance programme) support for employees. The programmes may differ slightly, but as part of the programme, there should be a component of mental health support for employees.

But our experience is that many employers have historically experienced low EAP utilisation, often below 1% and seldom higher than 5%. Infinit Care has conducted well-being assessments for tens of thousands of employees, and our data informs us that approximately 10% of all employees score in the lowest quadrant of the WHO-5 well-being assessment and most likely need mental health support. 

There are several challenges for the HR practitioner. Without diagnostics, it is difficult to understand the actual level of need in the organisation and, therefore, hard to make a case for investment in a more robust approach to supporting employees. The mindset of employers has been that the utilisation reflects the need and that no further action is required. The broader question of how to increase utilisation is also challenging. We observe that the reasons for low levels of EAP utilisation are typically a combination of the following:

• Complexity in the EAP availability rules
• Lack of awareness or understanding about the types of support available
• Barriers to access (via HR or Manager, or limited number of ‘free’ sessions)
• Organisation culture 
• Stigma
• Out-of-country support (global support vendors)
• Third-party counsellors (lack on consistent on-going support)
• Limited service delivery channels (only online or only phone support)
• “Sick-service” only

All of the above use cases are addressable but require the organisation to take a broad approach to seriously addressing improvements in employee well-being. The final point is also key in terms of how most EAPs are structured and, consequently, how most employers view mental health. The status quo for many organisations is a reactive one, whereby the employee needs to self-diagnose and then seek support, at which point they most likely already need urgent help. There is an opportunity to view employee well-being more holistically and also focus on prevention as well as treatment.

We have learned the following actions can create a step-change in employee well-being:

1. Build awareness. Training employees, especially those in supervisory and leadership roles, about mental health and wellness is probably the first step in creating the type of culture change required to bring about meaningful impact on employee well-being. Strong communication from the executive leadership can be a powerful part of the process.
2. Reducing Stigma. “Normalising” mental health discussion is an extension of the awareness effort. Creating an environment where employees are encouraged to discuss mental wellness is another important step, and there are a number of initiatives employers can deploy to support this. Note that these steps really incur little or no cost.
3. Deploy assessments. One of the greatest barriers to improving employee well-being has been the lack of data to support investment or actions. By deploying some assessment tools, either internally developed or via a vendor, HR teams can: provide a baseline for improvement; build a business case for investment in programmes; and isolate functions, locations, or demographics that require a specific, customised intervention. Employee assessments can be run periodically to measure the impact over a period of time or in cases where isolated interventions can be deployed.
4. Increase engagement. Engagement works at multiple levels. Telling employees about their EAP when they are onboarded will almost certainly not resonate with all employees and is likely to be forgotten. We have seen great results from running regular programmes and events for our clients around employee wellness topics, reminding employees how to get different types of support when it is required. Making support easy to access is the key to success. Ideally, partner with a vendor who has their own clinicians so you get the best possible feedback. Also, try to partner with a vendor who can provide end-to-end support for your employees. Handing employees off from counsellors to psychiatrists, for example, is a poor process that seldom provides the optimal experience for the employee.
5. Data collection. Collecting data from your own HR systems, your operations, and vendors and aggregating data for better understanding and transparency. Historically, employers have not had the data they needed to understand how to improve employee well-being. Today, it is much easier to access the type of data that can be a real game changer for employers.

These steps have proven to be highly effective. It should be noted that this may be a medium- to long-term project for employers. Depending on the “starting position” of the employer and their level of maturity with respect to employee well-being, it could be reasonable to map a 3-year horizon to bring about a fully realised culture change. But the benefits are now clearly understood:

• Improved retention
• Reduced absenteeism and presenteeism
• Increased employee engagement and increased eNPS scores
• Ability to attract the best employees
• ROI is typically in the order of fivefold but often much more

Mark Mackenzie is the CEO of Infinit Care.