A New Approach to the Outdated EAP

In response to an intensifying mental health crisis, 90 percent of employers are increasing their investments in employee mental health. But are they making the most effective choice? Employee assistance programs are historically the first stop, but they’re increasingly not the last.

Plagued with problems like low utilization, limited care options, and poor quality, many organizations are supplementing or replacing their EAP programs with more effective solutions. We’ll look at how employee assistance programs work, consider some of the pros and cons, and explore alternatives to EAPs.

What is an EAP?

EAP stands for employee assistance program. An EAP is a program offered through work that helps employees resolve personal or work-related problems. Most employees use EAPs for mental health disorders such as depression, anxiety, and substance use disorders. Other EAP benefits may include support for:

• Physical health, such as gym memberships, or programs to quit smoking or lose weight
• Family/relationship issues, such as divorce, adoption, or a need for child, elder, or pet care
• Career transitions
• Financial problems and retirement planning
• Professional development
• Legal issues

EAP services are sometimes available to the employee’s immediate family members, as well as the employee.

How do EAP programs work?

Organizations typically offer one to three EAP sessions at no cost to the employee. For employees who need more support, the EAP makes a referral to another resource for more comprehensive care. Employees can start receiving EAP counseling by contacting the program directly, or a friend, colleague, or supervisor may recommend EAP services to the employee. Some of the most common types of EAP plans are:

The cost of EAP programs varies depending on the model chosen, the type of services, and the organization’s size, among other factors. According to the Society for Human Resource Management (SHRM), the average cost of an EAP per employee per month is between 75 cents and $1.50.

What is the purpose of an EAP?

EAP therapy services are designed to help employees cope with stressors and improve their well-being, so they can do their best work. Organizations typically offer an employee assistance program with the goal of realizing the following EAP benefits:

• Increase productivity and engagement
• Reduce absenteeism and presenteeism
• Reduce workplace distress
• Improve employee satisfaction
• Retain top talent
• Reduce health care costs
• Reduce workers’ compensation claims
• Address safety and security issues
• Avoid escalation of mental health challenges into more serious problems
• Help employees return to work quickly after a leave of absence

Most companies are bulking up their employee mental health resources, and for good reason. When employees lack access to needed mental health care, they’re less likely to work effectively and more likely to seek pricey medical care that may not address their needs. Employers bear the financial weight of inadequately treated mental health conditions, often without realizing it. For example:

• People with mental health disorders make six times as many ER visits and four times as many health care claims as the general population.
• Over one-third of disability claims are tied to mental health conditions.
• Untreated mental illness costs $300 billion per year in lost productivity and related costs.
• 50% of millennial and 75% of Generation Z workers left jobs in 2019 due at least in part to mental health reasons

Challenges with EAPs

The need to support workforce mental health is clearer than ever. What isn’t clear is whether a traditional EAP is the right kind of support. Is your employee assistance program solving problems as you intended, or are there hidden barriers and costs to care? Here are some of the challenges many organizations report with their EAP benefits:

Lack of awareness

Nearly all companies (93 percent) offer an employee assistance program, but only a little over half know how to access them. Because EAP services are often bundled with other products and poorly communicated, many employees don’t know they exist or don’t see how the services can help with their specific issues.

Poor utilization

The number of people looking for help with anxiety, depression, and other mental health issues has skyrocketed. Yet only about 4 percent of employees use EAP services. Why wouldn’t employees use a service that is so widely needed? Low EAP utilization rates are partly due to lack of awareness, but there are other factors as well:

• Stigma – The shame associated with needing mental health support can prevent employees from reaching out for EAP counseling services.
• Lack of confidentiality – Some people fear their EAP therapist may share their personal information with company leaders or co-workers.
• Lack of clarity or confidence – Employees may not know what an employee assistance program is or may question its effectiveness. Some people may avoid reaching out because they think they need special permission or a referral in order to use EAP services.
• Difficult to navigate – EAP features can be hard to understand and the process of getting care can be difficult to navigate. With traditional EAPs and even some newer solutions, people have to sift through a long list of providers without any context of their availability or specializations.

Long wait times for appointments

If an employee needs to see a mental health professional, it can take weeks or months to get an appointment. For example, the average national wait time for a first psychiatry appointment is 25 days. While they’re waiting, many people decide to pay out of pocket for care, or give up on treatment altogether.

Limited number of EAP sessions

Generally, the longer a person stays in therapy, the better the outcome. Research shows most people need between 15 and 20 sessions of therapy for their symptoms to improve. However, EAPs provide just 2.5 counseling sessions on average. This can discourage people from starting care. It can also interrupt the recovery process for those who do reach out since they have to start from scratch with a new provider after just a few EAP therapy sessions.

Insufficient service offerings

EAP services are often so broad that they don’t appeal to employees who need support for specific issues. For example, an EAP may offer a counseling session or two but this may not feel like the right fit for someone who needs to see a psychiatrist. As a result, the person may choose to find care elsewhere.

In addition, there are typically large gaps in the type of care employee assistance programs can provide. For example, many do not include:

• Longer term counseling
• Virtual and in-person care options
• Specialized programs for complex issues like substance use disorders or suicidal thoughts or behaviors
• Support for managers
• Specialized care for children and teens

Poor quality

EAP mental health support is often poor quality. There are two main concerns:

Wasted spend

Most EAPs follow a per employee, per month (PEPM) payment structure. This means organizations pay a set fee per employee, regardless of how many employees use the EAP plan. In this model, the less the EAP is used, the more profit it makes.

Unfortunately, this structure disincentivizes connecting employees to the care they need, which often ends up costing employers more in higher health care costs, lost productivity, more disability claims, and higher job turnover. Employers have kept EAPs in their benefits packages despite their challenges because they’re relatively inexpensive, but it’s wasted spend if the service isn’t utilized and doesn’t help people get better.

Limited effectiveness

Proving the return on investment (ROI) for an employee assistance program can be challenging. EAPs are not required to validate their effectiveness or results. Most EAP programs don’t participate in peer-reviewed research to prove they help people get better. Few have robust reporting on clinical outcomes, productivity improvements, or health care cost reductions to help employers make a strong business case for choosing an EAP.

“Measuring the usefulness and value of an EAP can prove tricky,” says the Society for Human Resources Management (SHRM). “Many employers report dissatisfaction with their EAP use reports and the need to reformat those reports for internal use. Most often, EAP use reports are merely operational metrics, providing little value to the purchaser and offering little insight into the value or outcomes of the program.”

If challenges like these prevent your employee assistance program from fully supporting your employees, it may be time to rethink your investment.

Alternatives to EAPs

Employers across industries have recognized the need to elevate mental health benefits beyond traditional employee assistance programs. According to a SHRM survey, HR professionals believe offering mental health resources can:

• Boost productivity (88%)
• Increase ROI for the organization (78%)
• Increase employee retention (86%)
• Attract new talent (72%)
• Improve overall employee mental health (94%)

Recognizing these benefits, nearly half of companies either enhanced their EAP services or switched to a more robust offering, according to a 2019 Mercer survey. While employers believe they’re meeting the workforce’s mental health needs, employees feel their efforts are falling short. According to a Hartford survey:

82% of employers say their workforce has better access to mental health resources, but just 50% of workers agreed.

79% of employers say mental health has improved as a result of their greater investment in resources, compared to 35% of workers.

New EAP alternatives

Newer EAP models have emerged in an attempt to fill the gaps in traditional EAPs. While these types of EAPs typically have a stronger technology component, they continue to fall short in quality, global coverage, research, and the depth and breadth of their care offerings.

For example, few solutions effectively address complex or acute mental health needs such as substance use or suicidality. Instead, members get referred to other networks where the quality of care can’t be monitored. And most lack peer-reviewed research to prove their effectiveness, or have only a small number of studies that analyze one or two offerings, not the full range of care options.

In addition, the experience of getting care with newer EAPs can be frustrating. Many programs still expect people to recover in just a couple sessions, or require members to sort through a long directory of providers or go through care navigators to access care rather than having quick access to a coach or therapist of their choosing.

Finally, most mental health benefits focus on providing care to individual employees only, without tools to create a culture of mental wellness at the organization level. Employers are in an ideal position to help employees prioritize their mental health by providing development resources, training managers, and enhancing the work experience itself.

Organizations are expanding their mental health programs to provide better access through virtual visits and more sessions. “However, addressing mental wellness goes beyond access to care. It’s also about how employees are treated in the workplace,” said Steve Pemberton, chief human resource officer at HR tech company Workhuman.

Lyra’s comprehensive workforce mental health solution

Is your mental health benefit providing the level of support today’s workforce needs and expects? Many employers have partnered with Lyra Health because they were receiving complaints about long wait times, or weren’t getting data on symptom improvement, how long it took to get care, or provider availability from their EAP program.

In evaluating the effectiveness of a mental health benefit, there are three essential elements to look for:

1. An exclusive, high-quality global network of in-person and virtual providers verified to be available and proven to help members feel better
2. A concierge member experience that not only makes it easy to find and start the right care but also keeps members engaged between sessions
3. Organizational tools that help you make mental health a priority at every level of your organization, from employees and managers to your culture as a whole

Here are a few questions to ask to understand if a mental health solution will effectively support your organization:

Provider network

Member experience

Organization-wide support

A better solution for a new world of work

For too long, organizations have taken a “check-the-box” approach to workforce mental health. Employee assistance programs are a baseline investment that offers little value—and today’s workforce needs and expects more. The good news is there are more effective options. With Lyra’s comprehensive workforce mental health solution, employees and their families can quickly and easily access high-quality care that changes their lives and bolsters companies’ bottom lines.