Employee mental health services have become a multi-billion dollar industry. New employees, once they've found the bathrooms and signed up for 401(k) plans, receive a panoply of digital wellness solutions, mindfulness seminars, massage classes, resilience workshops, training sessions and apps for sleep.
These programs are a source of pride for forward-thinking human resources departments, proof that employers care about their workers. But a British researcher who analyzed responses to a survey of 46,336 workers at companies that offered such programs found that people who participated in them were no better off than their colleagues who didn't.
The study, published this month in Industrial Relations Journal, considered the results of 90 different interventions and found a single notable exception: Workers who were given the opportunity to do charity work or volunteer work seemed to have improved their well-being.
In the large study population, none of the other offerings (apps, coaching, relaxation classes, time management or financial health courses) had any positive effects. The resilience and stress management trainings actually seemed to have a negative effect.
“It's a pretty controversial finding that these very popular programs were not effective,” said William J. Fleming, an author of the study and a member of the Center for Wellbeing Research at the University of Oxford.
Dr. Fleming's analysis suggests that employers concerned about workers' mental health would do better to focus on “core organizational practices,” such as scheduling, pay, and performance reviews.
“If employees want to access mindfulness apps, sleep programs and wellness apps, there's nothing wrong with that,” he said. “But if you're really trying to boost employee wellbeing, then you have to focus on working practices.”
Dr Fleming's study is based on responses to the Britain's Healthiest Workplace survey in 2017 and 2018 from workers in 233 organisations, with a slightly over-representation of financial services and insurance workers, younger workers and women.
The data captured workers at a single point in time, rather than tracking them before and after treatment. Using thousands of peers from the same workplace, he compared the well-being measures of workers who participated in wellness programs with those of their colleagues who did not.
There may have been selection bias, as workers who enroll, for example, in a resilience training program may have lower well-being to begin with, Dr. Fleming said. To address this, he separately analyzed the responses of workers with pre-existing high levels of job stress, comparing those who participated and did not participate. But among this group, too, survey responses suggested that the programs had no clear benefit.
The findings call into question practices that have become common in all work sectors. But researchers said it was not a surprise.
“Employers want to be seen doing something, but they don't want to look closely and change the way work is organized,” said Tony D. LaMontagne, professor of work, health and well-being at Deakin University in Melbourne. Australia, which was not involved in the study.
Mental health interventions in the workplace can send the message that “if you do these programs and you still feel stressed, it must be you,” LaMontagne said. “People who don't have a critical view might internalize that failure: 'So I really am a loser.'”
The corporate wellness services industry has exploded in recent years, with thousands of providers competing for billions of dollars in revenue. Companies invest in the interventions in hopes of saving money overall by improving worker health and productivity.
Some research supports this expectation. A 2022 study that followed 1,132 workers in the United States who used Spring Health, a platform that connects employees with mental health services such as therapy and medication management, found that 69.3 percent of participants showed a improvement in his depression. Participants also missed fewer days of work and reported greater productivity.
Adam Chekroud, co-founder of Spring Health and assistant professor of psychiatry at Yale, said Dr. Fleming's study looked at interventions that “weren't very credible” and measured well-being many months later. A complete rejection of workplace interventions, he asserted, risks “throwing the baby out with the bathwater.”
“There is recent, very credible data that things like mental health programs improve all of the metrics that he mentions,” Dr. Chekroud said. “That's the baby you shouldn't throw away.”
There is also strong evidence that practices such as mindfulness can have a positive effect. Controlled studies have consistently shown reduced stress and anxiety and depression after mindfulness training.
The lackluster benefits Dr. Fleming found may reflect variations in offerings, said Larissa Bartlett, a researcher at the University of Tasmania who has designed and taught mindfulness programs. “Lightweight” interventions, such as apps, she added, are generally less effective than individual or group trainings.
Dr. Fleming's study, she said, “omits most of these details, condenses intervention types into broad labels, yes/no participation, and dismisses reports of intervention participants who felt they benefited from the programs they carried out”.
A key omission, he added, is longitudinal data that shows whether participants experience improvements over time. The result is a “big picture view” of participants' well-being that “overlooks changes that may occur at the individual level,” she said.
Dr. Fleming said he was aware of the body of research supporting the treatments' effectiveness, but he had “never been so convinced of the very positive findings,” since the data comes from controlled trials in which the treatment is implemented very good. , something that may not be the case in employer-provided programs.
Dr. David Crepaz-Keay, head of research and applied learning at the UK Mental Health Foundation, which has advised the World Health Organization and Public Health England on mental health initiatives, described Dr. Fleming as “certainly stronger” than “most of the research that has created the consensus that employee assistance works.”
