What is an employee assistance programme (EAP)?

EAPs are primarily services that point people towards counselling, although they often include other bits too. They started out as occupational alcoholism programmes in 1930s America and have grown to become commonplace around the world.

In this section we’ll go through the basics of what employee assistance programmes (EAPs) are, why people might use them, and how they came into being.

What does EAP mean?

EAP is short for employee assistance programme (if you’re British) or employee assistance program (if you’re American).

What is an employee assistance programme?

There are two answers to this question, one theoretical and the other practical.

In an abstract sense, an employee assistance programme (EAP) is a service that organisations can pay for to give their employees access to short-term counselling and other professional guidance. In more literal terms, an EAP is a call centre. Employees of paying companies can call a hotline to speak with an advisor, who assesses their level of ‘need’.

In abstract terms an EAP is a service to provide employees with access to counselling; in literal terms an EAP is a call centre

In an abstract sense, an employee assistance programme (EAP) is a service that organisations can pay for to give their employees access to short-term counselling and other professional guidance.

In more literal terms, an employee assistance programme (EAP) is a call centre. Employees of paying companies can call a hotline to speak with an advisor, who assesses their level of ‘need’. Those who meet the eligibility criteria get called back later to arrange a set number of counselling or advice sessions, which take place either over the phone or in person, depending on the provider. Counselling and advice services are provided by independent “affiliates”, in the words of the EAP Association, meaning that the EAP advisor essentially refers the employee on to a private counsellor that it has a relationship with.

Interestingly, employee assistance programmes began life in the 1930s as programmes to help workers overcome alcoholism, but have since broadened their scope and now aim to help employees with all sorts of mental health issues, life events and legal issues that might be affecting their performance at work. According to experts, however, the vast majority of employees use EAPs specifically for the mental health benefits.

Why employees use an employee assistance programme (EAP)

According to one of the UK’s largest EAPs, these are the most common mental health issues and life events that employees contact an EAP about:

Source: Health Assured 2020

Although EAPs offer other services, the vast majority of employees use them for mental health reasons

The history of employee assistance programmes (EAPs)

Surprisingly, EAPs actually started life in America as offshoots from Alcoholics Anonymous (AA) programmes, which were founded in 1939 to combat the rise in drinking post-prohibition and began a shift in society’s view of alcoholism from moral shortcoming to physical disease.

By the 1950s, alcoholism at work had become a big problem: a shortage of male workers after the second world war meant that many companies had to hire people with alcohol addictions. It was surprisingly common for people to be drunk on the job, and this was causing problems for both employee and employer alike: employees in factories and other heavy industry jobs were getting injured more often (sometimes fatally), while employers were having to deal with people being drastically slower at work or not getting the job done at all.

With a shortage in talent, companies therefore had an incentive to rehabilitate any workers struggling with alcoholism, and this is why occupational alcoholism programmes (OAPs) emerged. OAPs mostly started out as internal programmes, set up and administered within organisations, and specifically focused on alcohol abuse. However, as OAPs grew in popularity throughout the 1950s and 60s, and expanded to cover substance abuse and other forms of poor mental health as well, they were rechristened as EAPs — and many organisations started outsourcing the admin of providing this service to an external EAP.

In 1970, the U.S. government passed the not-so-pithily-named Federal Comprehensive Alcohol Abuse and Alcoholism Prevention Treatment and Rehabilitation Act, which gave states and companies grants towards getting an EAP. It also mandated that all federal and military agencies had to have an EAP.

Is an employee assistance programme (EAP) mandatory in the UK?

No, EAPs are not mandatory in either the UK or the US. However, they have become practically ubiquitous: following 9/11 and the financial crisis of 2007-8, as well as the move towards external rather than internal programmes, EAP adoption rates jumped again, with 3 in 4 U.S. companies having an EAP by the late 2000s. With the advent of the internet and the spread of globalisation, EAPs moved from becoming a U.S. phenomenon to a worldwide one. Nowadays they are commonplace around the globe: 88% of all U.K. employers now have an EAP, and for bigger employers (those with over 5,000 employees) that figure goes up to 97%.

Source: EASNA 2009

How does an employee assistance programme (EAP) work?

The commonality between how all EAPs work is through a hotline that employees call to access support of some kind. Different EAPs work in slightly different ways when it comes to the exact process of how that support is accessed and the hurdles and loopholes that exist along the way.

How do you access an employee assistance programme (EAP)?

The service provided by an EAP usually consists of a phone number that employees of a paying organisation can call to get advice or book an assessment for short-term counselling.

With some EAP providers it’ll be a trained counsellor (or another type of expert, such as a legal or financial advisor) who usually answers the phone, whereas with other EAP providers it’ll be a regular call centre worker, who might be called an EAP consultant or advisor. (If you’re looking to choose an EAP provider, it’s worth looking into whether your preferred provider has trained counsellors or call centre workers answering the phones.)

With some EAPs a trained counsellor will answer the phone; with others it’ll be a call centre worker

How do you use an employee assistance programme (EAP)?

If you’re using an EAP that has trained counsellors answering the phone, and if the issue you’re calling about doesn’t require a course of structured sessions, you can sometimes get support over the phone during the first call if you like. The counsellor will give you the space to talk through your concerns, and then might provide guidance or tips and techniques to help you out, or point you towards online self-help resources provided by the EAP. If you’d rather request a course of structured sessions, the next step is to do a clinical assessment.

If you’re using an EAP that has call centre workers answering the phone, or if all your EAP’s trained counsellors are busy at the time you call, you’ll need to do an assessment or request a callback before being able to use the EAP’s counselling services. Alternatively, you might be able to access online self-help resources if your EAP provides those too.

If you do an assessment (which usually also takes place over the phone and for some EAP providers takes around 20 minutes), you might then be referred on for a course of short-term counselling or another type of short-term support, such as a call with a legal or financial advisor.

How an employee might try to use an EAP

EAP services: what is (and isn’t) included?

All EAPs provide access to counselling in theory but end up turning a lot of people away from it in practice; some EAPs also provide other services like legal or financial advice, but fewer people use these.

EAP counselling

Access to short-term counselling for mental health issues is the core service that EAPs provide. All EAPs should offer this as standard. A scan through some of the most popular EAP providers’ T&Cs gives the consensus that a maximum of between six and eight counselling sessions per person per year seems to be the norm, with most providers offering counselling sessions over the phone or in person — although the availability of in-person sessions depends very much on where the employee lives.

Is EAP counselling included for all employees?

That’s an interesting question. Although all of your employees may have access to your EAP, that doesn’t mean all of your employees will be able to get counselling if they want it.

Whether a person is able to access counselling or advice depends on whether they meet your EAP’s eligibility criteria. Although some EAPs do publish example usage data for small subsets of their customer base, we couldn’t find an EAP that made its eligibility criteria or overall usage data public. (Spill, on the other hand, was available to just over 30,000 employees in 2022 and provided 26,000 therapy sessions to them during that year.)

Perhaps one of the reasons that EAP providers don’t tend to shout about these numbers is because they don’t actually provide that much counselling. Although about 10% of employees might typically contact their EAP in a year, according to an EAPA report, it’s estimated that only about a fifth of those who contact the EAP (so 2% overall) are actually offered counselling sessions, as an estimated 60% of callers are signposted towards self-help resources instead, based on the results of their assessment. And for those who are offered counselling sessions, many EAPs simply send over contact details for the counsellor and leave it up to the employee to book in the sessions, meaning it’s likely to be an even smaller number still who actually end up having them.

Which mental health conditions do EAPs help with?

EAP counselling is designed to help with most common mental health conditions, as well as broader work-related problems and adverse life events, including the following:

However, like with medical insurance, some EAPs have exceptions in terms of which cases they will grant counselling access to, and certain behavioural or learning conditions that classify as 'pre-existing' may not be covered.

EAP counselling exceptions: what an EAP won’t cover

EAPs aren’t crisis services, so if someone is at immediate risk of harming themselves or others, then an EAP isn’t the right place for them to get support and the EAP advisor will likely contact the emergency services or ask the person to do the same.

However, there are also some exceptions EAPs have that might come as more of a surprise. Most notably, similar to the physical healthcare insurance model, anything that resembles a pre-existing condition might mean get a person turned away from an EAP. When it comes to mental health, there can be a grey area with regard to whether something is a pre-existing condition: take the example of someone who has previously been on antidepressants but made a full recovery, but then years later has a bereavement and starts feeling depressed.

BUPA’s EAP service excludes all learning difficulties and behavioural or developmental conditions (like autism and ADHD), for example.

AXA’s EAP service says that “as with most private healthcare plans, there are exclusions and limitations” on what can be covered, and that access is “subject to medical history”.

Furthermore, each EAP decides what its own criteria are for assessing who gets access to counselling, and what level a person needs to score against those criteria. As these criteria and the required levels aren’t made public, we aren’t able to compare providers on these.

What services are included in an EAP apart from counselling?

Most EAPs provide counselling as their core service and then a selection of other services on the side as well. The exact services differ by provider, so we’ve put together a table of what all EAPs provide and what some EAPs provide, to make the distinction clear:

Services typically provided by an EAP
Services provided by some EAPs but not all
Services not usually provided by an EAP
✅ Access to a phone hotline for triage and assessment
🤷 Access to a phone hotline for immediate guidance from counsellors
❌ Support for employees with pre-existing conditions like autism or ADHD
✅ Short-term counselling sessions (over phone or video)
🤷 Short-term counselling sessions (in person)
❌ Longer-term therapy (beyond a pre-defined course of sessions)
✅ Access to legal and financial advisors
🤷 Access to an app or online portal with wellbeing content and tools
❌ One-off therapy sessions or coaching sessions, for milder poor mental health
✅ Access to legal and financial advisors
🤷 Access for immediate family members
❌ Emergency support for people at risk of harming themselves or others

Are friends and family covered by an EAP?

Most EAP providers cover immediate family members. One of the UK’s biggest EAP providers defines immediate family members as “spouse/partners and children age 16 to 24 in full time education, living in the same household”. It’s worth checking with your EAP provider (or potential EAP provider options) to make sure, though.

EAP benefits (and watchouts) for companies

EAPs offer a variety of benefits to companies: signalling benefits help strengthen the employer brand and attract new hires; usage benefits help to reduce sick days and employee churn. There are a few watchouts, however, as the usage benefits rely on people actually using the EAP, which often doesn't happen!

The benefits to a company of having an EAP fall into two categories:

1. Signalling benefits (to all employees and potential employees)

2. Usage benefits (to any employees who use the EAP)

Let’s go through each in turn.

The signalling benefits of having an EAP

These are the benefits the company accrues from having an EAP in terms of how it makes the company come across, and how it makes all employees and job candidates (or, at least, all those who know about the EAP) feel about the company.

With 88% of companies in the UK now having an EAP, you could argue that it’s now table stakes for a company in 2023 to have some kind of mental health support in place. Companies are shouting about their EAPs internally, in order to help their employees feel more cared for, and externally, in order to compete for higher-quality job candidates.

The usage benefits of having an EAP

If any employees do access and use your EAP’s services — and remember this is a fairly big ‘if’, as it’s estimated that only between 2 and 5 percent of an organisation typically uses an EAP within a year — then there are benefits to the company in terms of regained productivity and morale:

  • It might sound obvious, but it’s good to know that any employees who do complete a course of EAP counselling are likely to feel much better as a result.

    One EAP provider showed that its counselling "reduced symptoms of low mood and anxiety by 51%".
  • If an employee is on leave due to severe poor mental health, having an EAP can help them get back to work quicker.

    One study by a major EAP showed that 50% of people who were out of work at the beginning of a course of EAP counselling sessions were back in work by the end of it.
  • 65% of job leavers say their decision to quit was driven by poor mental health experienced while in the role.

    Helping these people to start counselling earlier allows them to get support before they reach the point of deciding to leave.

A few watchouts: why EAP benefits don’t always materialise

Realising the benefits of an EAP requires a few things to be true:

1. Employees need to know about the EAP

2. Employees need to take the initiative to contact the EAP themselves

3. Employees who contact the EAP need to actually get counselling support

As we’ve discussed in some of the previous sections, EAPs are great at remaining hidden: lots of companies have them, but not a lot of employees end up using them (for various reasons).

In order to make sure you’re getting the most out of your EAP, we suggest looking into the following to overcome these three watchouts:

1. Make sure everyone knows about your EAP: take a look at our 7 ways to promote your EAP internally.

2. Make sure employees take the initiative to contact the EAP themselves: consider running an employee wellbeing survey, and prompting those with low scores (automatically via the survey form) towards your EAP.

3. Make sure those who contact your EAP actually get counselling support: if you’re currently looking for an EAP provider, make sure you choose one that doesn’t exclude people based on severity or pre-existing conditions (BUPA and AXA Health’s EAPs definitely do this, for example). If you already have an EAP, look into what its policy is on this, and consider changing EAPs or looking for a modern EAP alternative if your employees have been turned away from support.

Are EAPs confidential?

EAPs are (mostly) confidential, in that they will not reveal a person’s identity to the organisation, with a few exceptions for cases where the law might be broken. It’s worth noting, however, that an EAP is only confidential if employees know how to access it: if they have to ask HR for information, they’re essentially forgoing their right to confidentiality...

EAP confidentiality is important at three different stages of the process. We’ll go through each of them one by one.

EAP confidentiality when an employee is contacting the service

✅ EAPs don’t share the names of any employees who contact the service of their own initiative.

👀 Some EAPs let managers or other employees refer someone else to the service who they think might need it. In this case, the EAP will tell the organisation that they have reached out to the person, and will also tell the organisation if they haven’t heard back.

👀 Accessing an EAP is only confidential if an employee knows what the phone number to call is and what information they need to access the service. If they don’t know this, they might have to essentially unmask themselves in order to use it.

EAP confidentiality when an employee is using the service

✅ Using the service includes speaking to an advisor on the phone, completing an assessment, or browsing online self-help resources. EAPs won’t ever share personally-identifiable details of these interactions with the paying company.

👀 Some EAPs record calls for training, and hold documentation of assessment scores and answers for future sessions.

👀 Some EAPs share overall insights with employers on which online self-help resources are accessed the most.

EAP confidentiality when an employee is taking part in counselling sessions

✅ As long as the EAP provider’s counsellors are registered with a member organisation, they’ll be required by the organisation’s code of conduct to keep sessions fully confidential — except for a few legal exceptions, like if the employee mentions money laundering, terrorism, or a plan to harm themselves or others. In these cases the counsellor is required to break confidentiality and alert the employee’s GP or the emergency services.

👀 The titles of therapist, counsellor and psychotherapist are unregulated in the UK, meaning that anybody can technically call themselves one of these things. However, most EAPs only work with counsellors who are registered a member organisation like the British Association for Counselling and Psychotherapy (BACP) or National Counselling Society (NCS). If you’re looking for an EAP at the moment, it’s worth checking that the providers you’re looking at do in fact use registered counsellors.

Are EAPs a taxable benefit?

If you provide an EAP to your employees in the UK, you don’t have to pay tax or national insurance on it as long as people are only using the EAP’s counselling services to talk about topics that are classed under the government's definition of 'welfare counselling'. If your employees are using other EAP services, such as financial or legal advice, then tax and national insurance should be paid.

🇬🇧 In the U.K., benefits are taxable when they are acting as ‘benefits in kind’: in other words, they have a cash value and are therefore being used, like a salary would be, to compensate employees for their work. Income is taxed, and so benefits in kind are taxed as well. Employers need to declare any benefits in kind at the end of the tax year on a P11D form.

Does EAP counselling count as a taxable benefit?

According to HMRC, the provision of “welfare counselling services” by an employer to an employee is (in most circumstances) exempt from tax and national insurance contributions (NICs). This includes counselling services that help people with most common issues regarding mental health or adverse life events. HMRC gives this list of examples of the kind of topics that welfare counselling services might cover:

  • stress problems at work
  • debt problems
  • alcohol and other drug dependency
  • career concerns
  • bereavement
  • equal opportunities
  • ill health
  • sexual abuse
  • harassment and bullying
  • conduct and discipline
  • personal relationship difficulties

However, this doesn’t include the non-counselling services that many traditional EAPs also provide, including:

  • advice on finance
  • other than advice on debt problems
  • advice on tax
  • advice on leisure or recreation
  • legal advice

So, to be compliant with U.K. law, HMRC suggests that you split your welfare counselling services up from other services you might have to provide employees with financial or legal advice, for example by having two separate providers. If your EAP only provides limited legal or financial advice in the context of supporting a mental health issue, then your EAP can be exempt from tax. (HMRC and the EAPA released a joint statement on this, which includes a few examples of acceptable vs. unacceptable legal and financial advice.)

Your options for paying tax and NICs on your EAP

What does all this mean? That you’ve got a choice of three options:

1. Be above reproach: split your EAP into separate counselling services and advice services, and only declare the advice services for tax and NICs.

2. Be above reproach (but it costs more): declare your whole EAP for tax and NICs.

3. Operate in a bit of a legal grey area: don’t declare your EAP for tax or NICs, and ask people to only use it for the counselling services.

The business case for an EAP *

*or a modern EAP alternative, which we'll talk more about in section eleven.

Making the business case for an EAP is more about making the case for what could happen if you DON’T have one. We look at the legal, moral and financial reasons to have an EAP — or some other form of mental health support — in place.

Making the case for an EAP is tricky: like with insurance, most of its value isn’t released immediately, and instead pays itself back tenfold later on when someone on your team is going through a tough time (and we say when, not if, because one in six adults struggle with a mental health condition in a given year, so if you have six employees in your company then it's unfortunately a reality that you will encounter). However, unlike insurance, there are also legal and moral reasons to provide an EAP for your employees.

We think that the business case for mental health support involves three arguments:

The legal case for an EAP

UK companies have two legal requirements when it comes to mental health at work, according to the Equality Act 2010:

1. Employers cannot discriminate against any employee (or candidate) with a mental health condition that classifies as a disability. If someone has a disability, the company is required to make reasonable adjustments to their working processes.

2. Employers must carry out a stress at work risk assessment and take action based on the findings.

Technically, you don’t need an EAP in order to do either of these two things. However, many EAPs offer a legal advice hotline as part of their service, which can be used by HR teams as well as employees. This can prove invaluable when it comes to making sure you’re not discriminating against any employees with a mental health condition that classifies as a disability.

Making sure you have a proper mental health policy for your organisation is also important, and will ensure you have a plan in place before any instances of poor mental health happen.

The moral case for an EAP

Beyond those two bare-bones legal requirements, the U.K. government also says that employers have a ‘duty of care’ to employees when it comes to their mental health. This means that employers must do all they can to support their employees’ health, safety and wellbeing.

The government’s 2017 ‘Thriving at Work’ report sets out some ‘core standards’ that it recommends all employers should have in place. The first standard is to have a plan in place for how to support people who may need it. Although this doesn’t necessarily mean that the employer needs to provide the support themselves (they just need to clearly signpost towards it), the fact that NHS waiting times for counselling were over 3 months long in 2022, coupled with the cost of living crisis putting private therapy sessions out of the price range of many people, is perhaps why 88% of employers feel that their duty of care extends to providing access to support themselves.

The financial case for an EAP

Without any mental health support in place at the company, it’s unlikely that an employee who is struggling with depression, anxiety, a bereavement, or some other work-affecting form of poor mental health will be able to get help quickly, unless they pay for it themselves out of pocket.

Therefore one of three courses of action will take place:

1. The employee stays in work but gets no support. They’re unlikely to be able to work productively, and may also decrease team productivity too, leading to what’s known as ‘presenteeism’: being physically (or virtually) present, but psychologically absent.

👉 For a private sector company, Deloitte estimates, presenteeism due to poor mental health costs £918 per employee (on average) per year. As this is the average cost, multiply it by your headcount to get the total cost of presenteeism. (If your organisation is a finance or real estate company, or you work in the public sector, then these figures will be higher: check the Deloitte report for exact numbers.)

2. The employee takes time off work but gets no support. According to the Health and Safety Executive, a U.K. government agency, the average time taken off work by an employee for a period of stress, depression or anxiety is 18.6 days: that’s more time off than for any other reason, including injuries, physical ill health or musculoskeletal disorders.

👉 For a private sector company, time off due to poor mental health costs £272 per employee (averaged out across all your employees) per year.

3. The employee gets no support and quits. According to Spill’s own survey of 1,400 employees, 29% of people have thought about quitting their job due to poor mental health.

👉 For a private sector company, the exit and re-hiring costs of someone quitting due to poor mental health costs £339 per employee (averaged out across all your employees) per year.

So, to get the total cost to your business of not doing anything to support your employees' mental health, do the following calculation:

EAP types and EAP providers

There are over 800 EAP providers in the U.K. alone, and thousands around the globe. We break them down into four types and list the biggest providers in each category.

There are four broad types of EAP:

1. External EAPs

2. Internal EAPs

3. Embedded EAPs

4. Modern EAP alternatives

Below we describe what each type of EAP is, and what kind of company or situation it's typically best for:

Type of EAP👇
What it is👇
Best for...👇
External EAP
What most people think of when they think of an EAP: a traditional off-the-shelf external hotline service
Companies with more than 50 employees who want to minimise time and effort to have basic support in place
Internal EAP
The do-it-yourself approach to employee mental health: find a private counsellor who can help when employees struggle
HR or leadership teams with time to spend on the logistics; teams where confidentiality isn't an issue
Embedded EAP
An EAP service that comes bundled in as part of a broader employee service, like insurance or perks
Companies who are already spending on these benefits or don't want to take on a separate service
Modern EAP alternative
Offerings that make mental health support far easier to access, often through an online booking system rather than a phone line
Companies with less than 50 employees (which most external EAPs won't cover) or those wanting to offer support that gets higher usage and payoff

There are hundreds and hundreds of EAP providers out there, so we'll only list some of the biggest and most well-known options in each category. (Except for internal EAPs, where providers don't really exist, as these involve setting up a one-on-one relationship with an individual counsellor. We'd recommend looking on the BACP register for a nearby or online counsellor to work with if you want to go for the internal EAP option.)

External EAPs

  • Care First
  • CiC
  • ComPsych
  • Health Assured
  • TELUS Health (LifeWorks)
  • MCL Medics  
  • Optima Health
  • Optum
  • PAM Wellbeing
  • Spectrum.Life

Embedded EAPs

  • BUPA
  • AXA Health
  • Perkbox
  • YuLife
  • Virgin Pulse

Modern EAP alternatives

  • Spill (!)
  • Modern Health
  • BetterHelp
  • Ginger
  • Unmind
  • Oliva
  • Plumm

You can jump straight to the section on 'modern EAP alternatives' if you're keen to learn more about them and how they work.

How to choose an EAP

Picking the right solution depends on identifying the problem you're trying to solve. There's no such thing as one ultimate EAP: instead, it's about ranking the criteria that matter to you, and then scoring alternatives based on those criteria. Then put in the due diligence to make sure you're getting beneath the marketing fluff!

Decide on your key criteria

How you make your decision depends on which benefits are going to be most impactful for your team. We think the best way to make an informed decision is to rank the below EAP criteria in your own order of importance, and then score different providers against your top criteria. (And don't worry, we've done the admin work for you: we have a free EAP evaluation checklist that you can download over on our longer guide on how to choose the right EAP.) Our suggested criteria include things like:

  • Speed of booking
  • Inclusivity
  • Confidentiality
  • Quality of therapy
  • Social proof and recommendations
  • Ease of getting started
  • Usage data transparency
  • Cost and payment terms

Ask the right questions

It's also worth having some hard-hitting questions up your sleeve if you speak with any potential EAP providers, so that you can make sure that the service you'll get is in line with your needs and expectations. Here are a few we'd suggest asking on a demo call:

  • How long is the average waiting time between someone contacting the EAP and having their first counselling session?
  • How do my team access the EAP? Are there online options as well as a phone line?
  • Can you share some average usage figures for your EAP?
  • When and how do you share usage figures with us? Can you show me an example usage report?
  • What are the payment terms? Is there a minimum length contract?
  • Are all your counsellors fully qualified? What are your minimum qualification and experience requirements?

Check out the reviews

Go one step better than asking the EAP provider, and look at what users of their service are actually saying about it. Here are links to the Trustpilot profiles of a few of the major EAPs and modern EAP alternatives:

EAPs vs. other options

EAPs aren't the only option out there when it comes to employee mental health support. We go through the pros and cons of some other main options, including health insurance and mindfulness apps, so you can make the best decision for your team.

If you're in the market for employee mental health support, that could very well mean you want an EAP — they're the most common option, after all — but it might be worth checking that there isn't another option that would work better for your team.

It depends on your goals and the problem you're trying to solve, after all. Do you need to boost your employer brand with a perk that stands out versus competitors? Maybe flagship health insurance would do that job better than an EAP. Do you have a lot of junior, inexperienced managers causing people problems? Perhaps your budget would be better off going towards bespoke coaching or training for them.

Here, we compare some of the upsides and downsides of popular alternatives to EAPs when it comes to supporting the mental health and wellbeing of employees:

  • Very, very cheap (i.e. free!).
  • If you have fewer than six employees in your company, you might not have an employee struggling with a mental health condition in the next year. (One in six adults typically experiences one.)
  • Poor mental health will cost the company money.
  • You aren't fulfilling your duty of care to employees.
  • Unless you're a very tiny company, we can't suggest this.
  • Something to offer to everyone (not just those struggling).
  • Looks generous on your careers page benefits list.
  • Not designed to help those really struggling.
  • Requires effort on your part to generate usage.
  • Best as an addition to, not an alternative to, an EAP.
  • Coaching is great for helping employees overcome work-related people problems or psychological challenges.
  • Mental health training, like Mental Health First Aid, can help managers to spot the signs of poor mental health in others.
  • Coaching isn't designed to help those experiencing severe or work-affecting forms of poor mental health.
  • Training schemes like MHFA were shown by an independent government review to have no evidence of impact on improving mental health at work.
  • Tangible support makes more of an impact than training and awareness.
  • Can be used for a wide range of issues.
  • Helps employees save time waiting for NHS appointments and treatments.
  • Very expensive: can be up to 30x more than an EAP.
  • Not a great option for supporting mental health: many insurers have a lot of hoops to jump through, and often turn people down with certain pre-existing conditions.
  • A solid all-round option if you've got the money, but not the best option for mental health support specifically.
  • Provides solid mental health support for those who need it. Available in a range of shapes and sizes, including more modern EAP alternatives.
  • Traditional EAPs can be hard for employees to access, with various callbacks and assessments to work through.
    They also can turn away those who need support.
  • The best option for employee mental health support. Although traditional EAPs can be very cheap, modern EAP alternatives are often better value as more people use them.

Modern EAP alternatives

Modern EAP alternatives offer the same core service as traditional EAPs — access to counselling support — but through easier-to-use online booking systems or mobile apps. They often have better visibility into usage data and work better for global teams too. We list some of the biggest modern EAP alternatives and provide a set of criteria to help you think about them.

EAPs have been around since the 1950s and sadly haven't changed much since then: many traditional EAPs still offer some variation on a phone hotline that employees have to dig out of a document somewhere and call up to try and request support.

Especially in the last few years, with the pandemic forcing employee mental health suddenly up the organisational agenda, a raft of new companies have cropped up providing mental health support to teams — but designed to fit into how people actually work and communicate today.

Modern EAP alternatives tend to offer the following benefits over more traditional EAPs:

  • Easy online booking systems
  • A mobile app or an integration with communication tools like Slack and Microsoft Teams
  • Fewer hurdles and barriers to accessing therapy (i.e. no callbacks or phone assessments before booking a session)
  • More intuitive design and modern interfaces
  • Better visibility into usage data
  • Better support coverage for different languages and timezones

These are some of the biggest modern EAP alternatives out there and how they describe (in their own words) what they do:

  • Spill (!) — "give clinically-effective therapy courses to those who need them, or let Spill's Safety Net system survey your team's mental health and allocate therapy sessions based on those who are most in need"
  • Modern Health — "combines the WHO well-being assessment, self-service wellness kits, a global network of certified coaches, and licensed therapists available in 35 languages all available in a single app"
  • Ginger — "care from our on-demand mental health system is delivered through the Ginger app, available on iOS and Android, where members can conveniently connect with Ginger’s team of behavioral health coaches - 24/7, 365 days a year"
  • Unmind — "unlimited access to our vast library of wellbeing content. From stress-reducing exercises and menopause education, to immersive sleep stories and soundscapes – our tools help people work, rest and play"
  • Oliva — "proper therapy courses, coaching (the good kind), dedicated support for managers, and mental fitness classes—all led by a curated team of top professionals" 
  • Plumm — "access to on-demand mental health support through a global network of accredited therapists via 1:1 video and chat therapy, wellbeing courses, guided meditations and live workshops"

From those descriptions, the differences between those providers are quite difficult to see. Here's a simpler way of thinking about the modern EAP alternatives category:

Spill vs. EAPs

Spill was designed to provide the same core offering as an EAP, but without the barriers to accessing support that many traditional EAPs have. It has the added benefit of allocating therapy sessions fairly to those most in need, and is less of a financial commitment thanks to a monthly price you can set yourself and a cancel-anytime policy.

How does Spill differ to both traditional EAPs and other modern EAP alternatives like Modern Health or Unmind?

At a core level, there are many similarities: both EAPs and Spill offer a way for businesses to provide their employees with access to mental health support for a reasonable cost.

However, there are a few differences that mean EAPs are a better option for some companies or situations, whilst Spill is a better option for others:

EAPs 🐢
Spill 🐇
Provides access to 1:1 therapy support
Qualified professional counsellors
Proven to help employees get back to their best
Affordable cost
per month
Everyone who needs it
can get support
System for finding
those in need
Easy next-day
booking process
Ability to cancel
in 30 days

More questions about EAPs

If they aren't answered below, you can always email one of the Spill team on hi@spill.chat and we'll do our best to help out :)

Who can access an EAP?
Are EAP services free for employees?
Is Spill an EAP?
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