Employee assistance programme

An EAP is the service behind the number on the poster in the kitchen. Someone rings it, or uses it online, and gets to talk to a person about something that is affecting them: work, money, a relationship, a bereavement, a legal problem, caring for a parent.

Most programmes combine a few things. There is usually an immediate conversation, available at any hour. There is usually a route into a limited number of structured counselling sessions where those are appropriate. And there is usually a body of practical information and referral on matters that are not clinical at all.

The word "programme" oversells the coherence of it slightly. Because there is no statutory definition and no market standard, two things both called an EAP can differ enormously in what they actually provide, how quickly, and to whom.

It is the benefit most often bought by employers who want people to have somewhere to go that is not their manager. That is a real need, and it is the thing an EAP does that an employer cannot easily do itself: a conversation the employer does not hear about.

It is frequently bundled, sometimes at no separate charge, with other policies such as group income protection or group life assurance. That is worth knowing before buying one separately, because a good number of employers are already paying for one without having told anybody it exists.

It is less useful as an answer to a problem the organisation already knows about. If work itself is what is making people unwell, a support line is downstream of the cause, and the regulator's framework points at work design rather than at individual support. That distinction is the subject of psychosocial risk at work.

Features that appear often. What is in a particular contract is a question for that contract.

• A telephone line, commonly available around the clock, answered by someone trained to have the first conversation.
• A limited number of counselling sessions, usually short-term and structured, where an assessment indicates they are appropriate. The number is set by the contract.
• Information and signposting on practical matters: debt, consumer and legal questions, childcare and eldercare.
• Online resources, and increasingly app-based tools.
• Manager support in some programmes: a route for someone managing a difficult situation to get guidance on handling it.
• Management information, usually aggregate usage figures. Ask what form these take and check that they are aggregate.
• Access for family members in some programmes, which is often unadvertised and often the most valued part.

The gap between what an EAP is assumed to be and what it is contracted to provide is wider than for most benefits, precisely because there is no standard definition to anchor expectations.

Worth establishing before you rely on it:

• It is not a treatment service. Short-term structured support is not the same as ongoing clinical care, and a programme will normally refer onward where more is needed. Where onward means the NHS, the waiting time is the NHS waiting time.
• It is not unlimited. The number of sessions is set by the contract, and what happens when someone reaches the limit is a question with a specific answer that most employers do not know.
• It is not an emergency service. Establish what the programme does when somebody is in crisis, and make sure whatever you publish alongside the number matches that.
• Confidentiality has limits. Every such service has circumstances in which it would break confidence. Know what they are, because you are the one promising confidentiality when you advertise it.
• Being available is not being used. Take-up is the whole question with this benefit, and it is the one most often left unmeasured.

Most EAPs are bought either as a standalone contract, usually priced per employee, or as an add-on included with an insurance policy. An EAP is typically a service contract rather than a contract of insurance, which means it usually sits outside the regulated insurance conversation, though what is bundled with an insurance policy is part of that policy's package.

The administrative footprint is small: the provider needs to know who is covered, and the employer needs to tell people it exists. The second of those is where programmes succeed or fail.

There is also a legal dimension worth understanding, because it is often misrepresented in sales conversations. In Hatton v Sutherland [2002] EWCA Civ 76 the Court of Appeal said that an employer offering a confidential advice service is unlikely to be found in breach of duty. That sentence has done a lot of work in benefits marketing since.

It is not the whole story. In Intel Corporation (UK) Ltd v Daw [2007] EWCA Civ 70 the same court held that counselling services are no panacea by which employers can discharge their duty of care in all cases, and found against an employer that had one. So an EAP counts, and it does not cover for the rest. Anyone selling you one as legal protection is overstating it.

The version that gets used is short, specific and repeated.

There is a number you can ring, at any time, and talking to it is free and confidential. Your employer is not told that you called, or what about.

You do not need a reason that sounds serious enough. People use these services for money worries, a legal question, a bereavement, caring for a parent, and for work itself. It is not only for a crisis.

If it turns out that talking to someone over several sessions would help, the service can usually arrange a limited number of those. If you need more than that, they will help you work out where to go next.

It is not an emergency service. If you or someone else is in immediate danger, that is 999, and if you need urgent help but it is not an emergency, NHS 111 is the route.

The questions that separate programmes are almost all about what happens after the first call.

• How many counselling sessions are included, and what happens when someone reaches the limit?
• How quickly does someone get from the first call to a first session, in practice rather than in the service standard?
• Are the counsellors accredited, and by which body?
• What are the limits of confidentiality, in writing?
• What happens if somebody is in crisis when they call?
• Are family members covered, and from what age?
• What management information do we get, and is all of it aggregate?
• What is take-up in organisations of our size, and how is take-up defined?
• Do we already have one of these bundled with another policy?

This is the benefit where communication is not a supporting activity but the entire value. An unadvertised EAP provides nothing to anyone, and it will still be renewed each year.

The things that seem to matter: put the number where somebody would look when they are not at their desk and not thinking clearly, which is rarely the intranet. Say what it can be used for in concrete terms, because "wellbeing support" tells nobody whether their particular problem qualifies. Say that the employer is not told, plainly, because that is the thing people are actually wondering. And repeat it, because the moment somebody needs it is not the moment you announced it.

Say who else can use it if family members are covered. That single detail often does more for take-up than anything else, and it is routinely omitted.

What not to do: do not present it as evidence that the organisation has dealt with a problem people have raised about the work itself. That is the use the courts have been least impressed by, and people notice it faster than any court does.

An EAP supports the person. If the question is what is happening in the work, the regulator's framework is the place to look: the six HSE Management Standards, and the psychosocial risk checker to walk them one at a time.

On the benefits side, an EAP is often bundled with group income protection, which is worth checking before buying one separately. For treatment rather than support, see private medical insurance.