Employee assistance programs are usually pretty boring affairs. For a few decades now, employers have paid EAP providers to operate phone lines that their employees can call if they need help with personal problems. The idea is to provide short-term support, for example a handful of counseling sessions, to help staff deal with minor problems before they get worse.
But this year, EAPs have been faced with a rising tide of complex mental health issues brought to them by people with nowhere else to turn.
“We were never designed to be a crisis line,” says Bertrand Stern-Gillet, who runs Health Assured, the UK’s largest EAP provider with more than 80,000 clients. But he says “high risk” calls have now become commonplace, ranging from child or adult protection concerns to someone who “might have taken a significant number of pills, or might be standing on a bridge.” . The company is hiring more staff and managers to try to deal with the increasing complexity and emotional intensity of the job.
Andrew Kinder, head of mental health services at Optima Health, another EAP, conducted a webinar on grief for a client’s employees. He expected about 40 attendees, but 1,200 registered. “People were actually sharing a lot of experiences about what they had been through,” he says.
The use of antidepressants is also on the rise. In 2021/22, 8.3 million patients received at least one prescribed item of antidepressant medication in England, according to national health service data — 22 percent more than in 2015/16.
What’s going on? On the plus side, people are more comfortable talking about their mental health and asking for help. That’s an improvement on the past when “we had this undercurrent of need that wasn’t even talked about,” says Vicki Nash, policy director at mental health charity Mind.
But clearly that’s not the whole story. The loneliness, worry, pain and financial problems caused by covid-19 and the associated lockdowns appear to have damaged the mental health of people around the world.
In the first year of the pandemic, the global prevalence of anxiety and depression increased by 25 percent, according to World Health Organization. In the UK, young people are a particular concern: one in nine children aged 6-16 had a probable mental disorder in 2017; by 2021 that was one in six, according to national health service data.
At the same time, mental health services in many countries have been disrupted by the pandemic and have struggled with increased demand. In the UK, waiting for treatment has become so common that Greater Manchester has set up a service called “Waiting Well” to support people while they wait. But the longer people have to wait, the worse they tend to get. Nash says people can be turned away because they aren’t sick enough to qualify for treatment, “so they have to wait until they get dangerously sick.”
A study on the experience of people on waiting lists interviewed a woman who said: “I didn’t shower, I didn’t get out of bed because I thought in my head, I thought maybe if I stay in bed long enough someone will come and he’ll section me and then I’ll get help.”
Health Assured’s Stern-Gillett says some GPs tell patients to contact their EAP provider if they have access to one because they are “more likely to get some form of support faster than NHS routes”.
On top of that, the UK has now been hit with a severe bout of inflation and a probable recession. The people most vulnerable to a sharp drop in living standards are those with low and insecure incomes. They are also more likely to have mental health problems, problems that often exacerbate each other.
a recent report by the Joseph Rowntree Foundation highlighted the surprising link between antidepressant use and deprivation: in 2021/22, more than twice as many patients were prescribed antidepressant medicines from practices in the most deprived areas of England than in less deprived areas.
The problem with relying more on employers to provide mental health support during this time is that not everyone has access to such programs. People with low wages, insecure contracts, or no job are less likely to have that safety net.
They will need all the help the money-strapped state can provide. Some interventions do not have to be very expensive, such as integrating talk therapy with debt counseling. Other policies that would help are already on the table but need to be implemented, such as the government’s plans to make life in the rental sector less insecure.
Leaving people to fend for themselves will add up more problems, both for them and for the economy as a whole. Already, a growing proportion of people say they are too sick to work. Although those over 50 are the main drivers of this trend, there is also a worrying increase in inactive youth. For them, the main cause of long-term illness is mental illness, phobias and nervous disorders, 24% more than in 2019.
Money problems are hard on people at the best of times, and this is not the best of times. How well or poorly we handle this moment will have ramifications down the road.