The history of Employee Assistance Programs and how they’ve coped with COVID-19

EAPs have a very interesting past and an extremely important future. When the pandemic first forced Australians into lockdown it didn’t immediately result in more employees reaching out to Employee Assistance Programs (EAPs). In fact, for the first two to three weeks there was a decrease in calls to their counsellors, says AccessEAP’s clinical services director Marcela Slepica.

“I suppose people were focusing on those hierarchies of needs. ‘Have I got a roof over my head, have I got food?’ That’s why they all went and ordered food and toilet paper, right?” she says. “People had a focus on day-to-day safety and health and wellbeing.”

But once the panic was over, they did begin calling. There were many issues, but everyone HRM interviewed for this article agreed anxiety was very prevalent. The anxiety wasn’t uniform, however. Some people were having difficulty adjusting to new routines. Others were frontline workers worried about contracting COVID-19. In industries severely affected by the global lockdown, people were anxious about possible redundancies, or already grieving a lost job.

Typically, the calls an EAP provider receives from clients are unique to them. One company is dealing with the emotional fallout of a merger while another is experiencing more typical day-to-day issues. During the pandemic however, the challenges were broadly the same across all clients.

Everyone was dealing with the pressures of remote work – juggling family responsibilities, video conference burnout and isolation – at the same time. The novelty of it wore off at the same time too. And when organisations began planning the return to work, people broadly reacted the same way.

“They want to stay at home,” says Slepica. There is a combination of reasons for this, and it varies from person to person. One of the main factors is not wanting to leave a place they felt was safe. But Slepica foresees problems if people stay isolated too long.

“It’s about balance. We need people, we need to connect with people, we need that social connection. People who are working only from home – finance people or IT people with very little connection – I don’t know that that’s healthy either.”

The pace of change during COVID-19 was also atypical, says Life Street founder Paul Flanagan.

“With COVID, what we were surprised by is how quickly peoples’ needs and moods shifted. It happened over a matter of weeks rather than months.”

One of the more interesting types of calls came from managers who needed help. Many EAP providers offer a manager support service that allows them to get advice on dealing with a worrying team member.

“Wellbeing is right up there on the list of priorities during this time,” says Flanagan. “Managers are asking, ‘How do I do this? I can’t see my team. And when I do see them, I spend minutes on a group call, it doesn’t tell me much. So how do I connect with each of them to know how they’re going?’”

This sort of news is promising. It suggests employees are getting the support they need during a trying time.

“In the past, if an employee was having mental health problems or they were struggling with something, people would just go to the EAP then they thought that was the end of it. Whereas now they’re much more interested in learning and understanding and what they can do,” says Slepica.

It’s a big transformation, going from seeing EAPs as memory holes – a place where emotional issues of all kinds are sent to disappear – to being proactive about mental health. Will it last? Some people think so.

Our New Reality: Predictions after COVID-19, a report from professional services firm KPMG, argues that the pandemic has permanently shifted peoples’ attitudes and will mean leaders play more of an active role in caring about the mental health of their employees.

It’s an open question though as to whether there won’t be regression once the pandemic is behind us – when the immediate threat fades and only individual anxieties remain. But to understand how EAPs might be used in the future, it’s worth looking at their past.

The origins of EAPs

If we are at the dawn of an era where organisations care more about wellbeing, it’s possible EAPs will be circling back to an earlier chapter in their history.

Their beginnings can be traced to the 19th-century temperance movement in the US. During the century, alcohol consumption went from being an open, ordinary work activity to a frowned upon an act that was linked to industrial accidents.

Of course, people still drank. But instead of being stigmatised, the diminished health and productivity of these people was something many companies felt they had a moral duty to fix. In The Evolution of Employee Assistance: A Brief History and Trend Analysis, a 2003 paper published by EAP Digest, William White and David Sharar writes that one of the earliest inebriate homes was started by a business owner who rehabilitated an employee by having them stay at his own house.

“Such efforts were part of the ‘rescue work’ that emerged within the American temperance movement and were aggressively pursued within companies whose leaders viewed themselves as the head of the company ‘family.’ The growth of medical and personnel departments [the precursor to HR] within American business and industry grew, in part, out of such paternalism.”

In this early form, employee wellbeing was the purpose and goal. It was perceived as a moral, even familial, responsibility, rather than a business benefit. The authors go on to write that in the 20th-century companies become more “depersonalised” and therefore more likely to just fire alcoholic employees.

In reaction, informal assistance from colleagues who had been through the Alcoholics Anonymous programs became common. These were then formalised into “occupational alcoholism programs” by progressive companies that wanted more staff to benefit. The programs gradually expanded their remit into other employee behavioural problems and began to be referred to as Employee Assistance Programs.

The turn to outsourcing these programs happened gradually but has very much become the norm. It has its advantages. Participants in a study published in the Australian HR Institute’s Asia Pacific Journal of Human Resources (APJHR) cited confidentiality as a primary reason to use an external program.

But there is a flipside to this. Being outside the organisation can mean being assigned the dirty work. By the end of the eighties, drug testing and zero-tolerance policies saw some EAPs take on a role that was the reverse of their original intent.

“Employee assistance professionals who had long played a role in the ‘rescue and recovery’ of substance-impaired individuals within the workplace now found themselves participating in the exclusion and extrusion of these individuals from the workplace,” write White and Sharar.

External EAPs are also used for their cost-effectiveness, the APJHR study found. That’s not surprising. Organisations became their ‘customers’. This shift also led to the diversification of EAP services. They began offering training, mediation, consultation and a variety of other services that were aimed at prevention and proving their worth to leadership, rather than just addressing the wellbeing crises of individual employees.

In a 2018 paper published in the Journal of Workplace Behavioural Health, researchers drew on qualitative interviews with employee assistance practitioners to find out what caused EAPs to be successful, at-risk or eliminated. They arrived at several themes that seemed determinative. Except for one, they all touched on the tension business viability creates between organisational and individual outcomes.

Tying wellbeing to an external service makes it easier to switch it off – the organisation can stop being a customer. Under the theme ‘organisational culture’, the research paper quotes a practitioner as saying: “We can be empathic, we can be understanding, but we also need to be able to present in a way that people get [that] we understand this is a business. We have shareholders.”

In other words, while caring for an individual is good, it is not sufficient. You need to be able to tie it to a bottom-line benefit. The links between wellbeing and organisational outcomes have to be argued freshly each time.

Under the theme ‘organisational structure and change’ a different practitioner spoke of the difficulty of using certain analytics to get buy-in.

“Here’s the fundamental question: even if you get a nine per cent utilisation, isn’t it fair to ask what you are doing for the other 91 per cent?”

This suggests that, for some companies, only helping some employees is not sufficient to justify the cost. This is a world away from the business owner who rehabilitated an employee in his house. The most pertinent quote from the study came from a practitioner who was referring to the best way to get organisational support: “In order to make the program successful and sustainable, unfortunately, you need a tragic or a big event.”

It could be argued that every organisation in the world has just experienced such a thing. So how have EAPs been affected?

Permanence or regression?

There is data that shows wellbeing has become a common company investment. A Gartner survey of HR leaders around the world found that two-thirds of organisations had introduced at least one new wellness benefit by late March 2020.

Flanagan believes employers collaborating with their EAPs and committing more seriously to the wellbeing of all their employees is a trend that has been accelerated by COVID-19.

“I think it’s a journey that leaders and businesses have been on over the last few years,” he says. “And I think the benefits of that are seen in how they’ve responded to this crisis. They’ve realised they need to engage people and be on the lookout for them.

“As things go on, they’ll see a need for a more holistic program that looks at employee wellbeing in a broader sense, not just for people with problems, but to help improve and support the wellbeing of all employees. That includes things such as helping employees manage their own wellbeing with online tools and programs, as well as professional support.”

Slepica agrees the pandemic has meant employers have a greater focus on the mental health of their staff, but she is more circumspect about whether this will last.

“I think they definitely have become more aware. They absolutely recognise and acknowledge that it’s important. I think the next step is, do they understand that it’s important all the time and not just because there’s a pandemic? Once the pandemic is over, will they revert back to ‘normal’?”

One hopeful sign that the change might be permanent has been the proactive steps organisations have taken as they move through different stages of the pandemic.

“A lot of organisations are in that phase of transition back to the workplace, and they’re reaching out to us beforehand,” says Slepica. “They’re asking, ‘How can we work together?’ They want to collaborate before things happen, rather than saying, ‘This crisis has occured. Can you look after all of our people?’”

Flanagan has seen a similarly collaborative attitude from his clients.

“We’ve worked with companies to put on sessions to address manager capability more proactively. So they’ve had online sessions where they’ve talked about managing and supporting their employees. HR might do a session to do with work, management issues and communication. Then, as their EAP provider, we talk about mental health risks and what managers can do to look after their own and their team’s wellbeing” he says.

In the APJHR study, respondents felt there were tremendous benefits to making sure an EAP partner was fully integrated with the company. A telling example: a government organisation that did this found that employees who had received counselling from their EAP tended to pass on the advice. Wellbeing had become a cultural norm.

The biggest beneficiary of embedding an EAP might be HR professionals, as the pandemic proved.

“All of a sudden their role was 24/7 focused around dealing with pretty difficult issues from lots of employees,” says Flanagan. In response to this, he worked with his clients to help give HR resilience training and other mental health support.

“When we talk about wellbeing in organisations, often it’s the HR people themselves that are right in the middle of it.”

Confidentiality remains important, but Slepica agrees that if EAPs are going to benefit organisations they need to be a true partner, offering a range of support across the employee lifecycle.

“It’s about working with your EAP, not handing things over to your EAP.”

A version of this article originally appeared in the August 2020 edition of HRM magazine. Managing your stress – and your employees’ stress – is paramount during a crisis. Gain tools and techniques with AHRI’s wealth of wellbeing resources.

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