In 2003, Employee Assistance Programmes were being offered by around 3,100 UK employers, meaning they were available to an estimated 4.9 million employees, outlines Eugene Farrell.

Now, around 105,275 employers offer an EAP to 24.45 million employees. EAPs have become a significant part of the UK’s mental health services, an option that is available to 75 percent of the entire workforce, compared with just 15 percent twenty years’ ago.

Holding it together: UK mental wellbeing and the role of Employee Assistance Programmes sets out new data from the UK’s largest EAP providers and use of services between January 2022 and January 2023. Figures that show a steep increase in both the availability and the use of EAPs, as well as more demand for counselling support around mental wellbeing, will be of no surprise to anyone.

Offering support is crucial

As levels of awareness around mental health have increased nationally, so have expectations around support. More open conversations and a willingness to look for professional help have been important and positive developments in terms of the state of the nation’s wellbeing. But the UK’s new world of mental health awareness has meant consequences for the NHS, EAPs and health services of all kinds. Mental health provision in the NHS has been overwhelmed by demand and continues to be a work-in-progress. An investigation by BBC News in January 2023 claimed that 418,000 calls to new NHS mental health helplines went unanswered in 2021/22.

The crisis lines, run by NHS mental health trusts, are said to receive more than 200,000 calls every month in England. In ten trusts, callers had to wait more than an hour for their call to be answered. Fewer than one in six trusts were able to confirm that crisis line staff were qualified mental health professionals. A study by the Royal Society of Psychiatrists published in October 2022 suggested that one in four patients needed to wait 12 weeks before being able to start any treatment, and that many people were turning instead to A&E services.

EAPs are a valuable resource

So EAPs have become a highly valuable resource. More employers have made the commitment to employee wellbeing; more staff feel able to trust their issues with an EAP. Anecdotally, EAP providers have pointed to how GPs are increasingly encouraging patients with mental health concerns to contact their EAP if they have one. As the report data shows, this also means EAPs are being treated as a frontline emergency service taking on complex, long-term cases of mental illness (68% of employees contacting EAP services in 2022 were offered the support of counselling (640,250 people used an EAP service, and due to their situation and symptoms, 434,250 were offered counselling).

In 2022, EAPs in the UK provided more than 1.375 million counselling sessions. On average, 1.7 percent of counselling cases came with a red flag(involving an immediate and serious risk of suicide). This translates to more than 10,000 lives at risk that EAPs support. Some EAP providers report red flag cases as being at levels above 3 percent.

What happens next? 

How do employers and EAPs continue to work together effectively, soaking up the increasing demand for mental health support? HR and wellbeing teams, working alongside their EAP partners, need to be in a position to manage the swell of demand and complexity — ensuring services continue to be an effective and viable option and employers maintain their growing role as a reliable source of mental health support.

One potential future route is for EAP services to take on an even greater role through programmes of counselling that go beyond the standard six sessions and see people through to a recovery stage, alongside a more psychological approach as a core offering with standardised clinical outcomes. But given how prices for EAPs per employee have been steadily decreasing, and the limited pool of professional therapists, this approach would need support from employers and via state funding.

More realistically, there will need to be a shift in positioning for EAPs. There will be a need for HR to initiate and develop a more pro-active and preventative role, using earlier interventions among employees in order to avoid the need for extended programmes of counselling: a strong non-clinical service dealing with underlying issues such as the fall-out from a cost-of-living crisis, backed up by more training for staff around mental health.

Whatever course the evolution of the EAP takes, the new figures are a stark illustration of why employer support on mental wellbeing is so important. Employers and EAP providers need to continue to share these kinds of insights into the changing levels and nature of demand, both to encourage awareness of the stakes and ensure the best kinds of collaboration and use of resources.


Eugene Farrell, immediate past chair, EAPA UK





Amelia Brand is the Editor for HRreview, and host of the HR in Review podcast series. With a Master’s degree in Legal and Political Theory, her particular interests within HR include employment law, DE&I, and wellbeing within the workplace. Prior to working with HRreview, Amelia was Sub-Editor of a magazine, and Editor of the Environmental Justice Project at the University College London, writing and overseeing articles into UCL’s weekly newsletter. Her previous academic work has focused on philosophy, politics and law, with a special focus on how artificial intelligence will feature in the future.