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EAPs for start ups and small businesses

How to choose an employee assistance programme as an SME

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Mental health challenges in startups and small businessesThe benefits of outsourcing mental health supportEAPs for small-midsize businessesAlternatives to EAPS for mental health support

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  • Managing HR in small businesses and startups can be a challenge, especially when it comes to mental health concerns, which can significantly impact the wider team.
  • Small businesses and startups often face unique mental health challenges such as high levels of stress, struggling founders, and the impact of cost-of-living on mental wellbeing.
  • Mental health challenges in these environments are the result of difficulties understanding team morale, the promotion of inexperienced managers, burnout, a lack of impartial help, and the isolating effects of remote working.
  • Small businesses often outsource mental health support to external providers like EAPs because they offer access to qualified professionals, offer a private space to talk, save time and money, and free up HR resources.
  • When choosing mental health support, small businesses should consider cost and pricing models, accessibility, flexibility, and return-on-investment.

Running the HR department as a one-person band can be a lonely business. Between building out key policies, hiring, training – and in some cases, office management – it can be tricky to keep an eye on more abstract things like company mood, culture and wellbeing. 

But prioritising proper mental health support in small businesses and startups can be even more valuable, where just one person struggling is enough to affect the rest of the business, whether that’s by taking time off during a busy period or by unintentionally affecting the morale of everyone else in the room.

With smaller companies increasingly opting to outsource employee mental health support to external providers (usually an EAP), let’s take a look at why mental health challenges crop up in these environments – and what your options are for bringing in some external support.

The need for EAPs in startups and small businesses

Small businesses and startups face a unique set of challenges when it comes to mental health at work. The pressures on smaller teams to wear many hats and work long hours is felt the whole way through the business, from interns to CEO's:

👉 Four in five small business owners experience symptoms of poor mental health at least a few times a year

👉 69% of small business owners reported that the cost-of-living crisis is affecting their mental health

👉 65% of small business owners have experienced anxiety and over 50% suffered from depression

👉 30% of small business owners say that their employees reported a decline in their mental health over the course of the pandemic

Let's explore the reasons why small business owners and employees often struggle with their mental health...

An infographic highlighting five mental health challenges in startups and small businesses: high-productivity cultures, it's hard to tell if your team might be struggling, lack of impartial help, new managers might be less experienced, and the lack of connection due to remote working
Mental health challenges in startups and small businesses

It’s hard to tell how your team are feeling 

Around 1 in 4 people experience poor mental health each year in the UK. That’s a quarter of your team. If you don’t have a way to keep track of how people are doing, then you’re probably not spotting anyone who’s struggling early enough to help them before they feel properly unwell.

Shiny new managers

It’s common practice in startups and small businesses to promote team leaders internally rather than hiring experienced managers. Having younger people moving up the ranks quickly works well for lots of reasons, but there’s a drawback: they might be brilliant at managing KPIs, but have less experience managing people’s emotions. This can heap a lot of unexpected pressure onto new managers, and have knock-on effects for your overall team’s wellbeing. 

💡 In a recent Sifted survey, 50% of UK startup employees said they hadn’t been given the right emotional and personal support from their managers

High-productivity cultures

Burnout is a kind of emotional exhaustion caused by stress at work – and it’s behind 43% of all sick days taken in the UK. Between tight deadlines and small teams who feel personally responsible for delivering quality work on time, burnout is rife across small businesses and startups.

Lack of impartial help

Just 11% of employees feel comfortable discussing a recent mental health problem with their line manager. That could be down to old-fashioned stigma, or it might be because employees feel there’s no clear pathway towards getting professional help once they’ve disclosed an issue. HR leaders can deliver lots of things, but therapy shouldn’t be one of them. Outside of work, getting treatment for mental health challenges through the NHS can take a long time (and all the while your employee’s motivation, mood and productivity is likely to slide).

Remote working

Isolation is an important precursor to poor mental health. It can be easier for employees to socially withdraw when they’re not experiencing the kind of informal communication and collaboration that’s encouraged by working in the same room as other people. If you rarely see your team in person, it can be even harder to spot when a colleague’s showing signs of stress, too.

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Why do small businesses outsource mental health support?

Increasingly, smaller companies are opting to outsource employee mental health support to an external provider (like an EAP) rather than providing counselling services in-house. Outsourcing comes with lots of benefits for both employers and employees:

Get access to the pros

Outsourcing mental health support allows smaller teams to gain access to qualified mental health professionals who have expertise in dealing with a range of specific challenges like burnout, anxiety or ADHD.

Offer a safe space to talk

Having an external EAP provider can feel a lot more private and confidential than opening up to an internal member of staff, which might encourage more employees to seek help when they need it. The negative stigma surrounding mental health at work can stop people speaking up if they're worried that this might impact their career progression, so having external resource available draws a clear distinction between the two.

Save time and money

Outsourcing mental health support services tends to be much more cost-effective for small businesses than hiring, training and maintaining a dedicated in-house team. It also ensures that the counselling services provided are always of the highest quality, because EAP providers are continuously investing in training therapists and sharing the most up-to-date research and resources.

Free up HR resource

In a one-person HR team, it's simply not possible to have a weekly chat with every employee about their mental health alongside all of the other tasks on your list. Outsourcing mental health support services reduces the administrative burden on internal HR teams, freeing up their time to focus on other important initiatives.

The benefits of outsourcing mental health support to an EAP

lAn infographic highlighting four benefits of outsourcing mental health support to an EAP: access to mental health professionals, show employees you care about their mental health, reduce absenteeism, and increase productivity
The benefits of outsourcing mental health support

Show people you care

Improve retention and attract the best new talent with bonafide mental health benefits

Lower absenteeism 

Reduce sick days by helping people to actively manage stress and maintain their mental wellbeing.

💡 The cost of sickness absence last year for UK small businesses was £5bn

Increase productivity and innovation

Get your team out of survival mode and free up their brainpower for big work challenges

We’re sure you’re looking into mental health support because you agree it’s the right thing to do for a happier and healthier workplace. But if you’d like a bottom line for your bottom line,  then a 2022 study by Deloitte found that an employee with poor mental health costs their employer an average of £2,646 a year in absenteeism, presenteeism and turnover costs. 😲

A traditional EAP provider will probably be your first port-of-call when you’re looking to bring in some external mental health support for your team.

Spill provides your team with access to qualified therapists in just a few clicks.

Learn more about Spill

Employee assistance programmes (EAPs) for small-midsize businesses

EAPs can be a good fit for small businesses if they align with the company's goals, budget, and employee needs. There’s lots to like about them, but they are fairly old school in terms of their approach. It's important to carefully weigh up the potential benefits and costs before implementing an EAP, and to choose a provider that offers the right level of support and flexibility.

Whether or not an EAP will suit your business depends on a few factors:

Cost and pricing model

The monthly cost of an EAP is usually between 40p and £1.25 per employee. If this sounds low, we agree. EAPs are budget-friendly because their price model is built on the fact that not everybody who needs support will get triaged into high-cost services like therapy. In fact, 60% of employees who contact an EAP are directed to self-help resources and only 20% are instructed to contact a counsellor.


EAPs are easy for small HR teams to implement, as long as you’re happy to spend some time regularly cheerleading their existence to your company. They’re often described as a “safety net” because they rely on your employees recognising that they’re feeling low and ringing a helpline themselves. And picking up the phone can feel like a big barrier when you’re struggling with your mental health. Employees will need to answer some questions about their circumstances to be referred to the right experts, which might not be an easy or immediate process.

Flexibility and scalability

For small businesses and startups, it's important to choose a provider that offers plans and services that can be tailored to the size of your business and can grow with you. Important questions to ask:

  • Are you locked into an annual contract, or can you easily freeze payments if needed?
  • Can you easily upgrade or downgrade plans and add or remove services?
  • As the business grows, can you easily add more employees to the service?

Return on investment

When the budget for employee wellbeing benefits is finite, it's important to crunch the numbers are understand if an EAP really represents good value for money. EAP's promise lots of benefits in terms of improving employee productivity, reducing sick days, and improving team morale – but if usage is typically below 5% of employees then most of the money you do spend could be wasted. That's why smaller teams are increasingly opting for pay-as-you-go therapy plans (like Spill's starter plan) to ensure there's zero wasted budget.

Alternatives to EAPs for small businesses

Traditional EAPs offer an easy way to implement basic mental health coverage. They’ll have a big, trustworthy brand name attached, but they generally don’t signal a progressive approach to mental health. If you’re looking for tailored, proactive support – or if you’d like to impress candidates browsing your careers pages – then you might like to look a little further than an EAP.

When comparing mental health support systems for your startup or small business, it’s always good to think about how you’d like your team to interact with the help on offer (if a phone line feels outdated, we hear you). One way to get more people the help they need is to sign up for a system that puts access to qualified therapists where your team already works: on MS Teams, or on Slack, for example.

Another consideration is how proactive you’d like your support system to be. Arguably the biggest limitation of an EAP is that it can only support your team once they feel unwell, and  therapy only happens once someone’s in crisis. If you’d rather focus on helping your employees to actively maintain their mental health so they can feel happier and healthier at work, making them less likely to need to take time off in the first place, then you might be in the market for an altogether more proactive kind of care. 

Maybe this is a predictable plot twist, but Spill’s take on corporate therapy offers three key things for startups and small businesses:

👉 Quick and confidential access to qualified therapists with 50+ specialisms and 10+ languages

👉 Flexible pricing plans, including our new pay-as-you-go therapy plan which is purpose built for smaller teams

👉 A check-in system that automatically detects signs or poor mental health and reaches out to support employees who are feeling low, relieving the emotional burden on smaller HR teams and making sure no-one slips through the net

💡 Typically, Spill will be used by 50% of your team – that’s ten times more employees than an EAP

Getting a bit of emotional heavy lifting done for you as a small HR team means you can get on with all the other important stuff you’re great at. Whether you decide to go for an EAP or a more proactive model, any mental health support platform will have its pros and cons for your small business. As long as you know what to look out for, you’re well on your way to becoming a more supportive and productive workplace.

For an easy way to evaluate your EAP offering, use our handy checklist 👇

A screenshot of Spill's evaluation checklist
Spill's EAP evaluation checklist
Why do employees in small businesses contact their EAP?
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Get our free EAP evaluation checklist

Make sure you're asking the right questions when buying an EAP (or weighing up the one you already have)

Spill is typically used by 50% of employees in a year. That means up to 10 times as many people get support vs. an EAP.

See how Spill stacks up against EAPs