We live in uncertain times and this impacts mental well-being to a greater or lesser extent. The access to, and promotion of mental well-being is being supported through various platforms, including the Singapore Government. However, challenges exist in overcoming the stigma and barriers to mental well-being programs. A platform that may help break down such barriers is workplace counselling. This is easy access to people not only for on-job performance but mental health that they may be silently dealing with.
Introduction
A recent in-depth study conducted by the Institute of Mental Health (IMH) cited 13% of the surveyed population reported experiencing symptoms of depression or anxiety in the period from May 2020 to June 2021 (Goh, 2021). Living with uncertainty is hard, when as human beings our brains perceive ambiguity as a threat, it diminishes our ability to focus on anything (Carter, 2020). We all experience uncertainty differently, for some, it is uncomfortable, whereas for others it may be unbearable.
Mental health as a result of work pressure and stress are causes of physical illness such as heart disease, hypertension, headaches and psychological challenges like anger, depression, anxiety, negative attitudes, low self-esteem and burnout (Geldard & Geldard, 2010). As it stands an article in the Straits Times (2019) cites that Singapore spends about US$2.3 billion (S$3.1 billion), or 18 per cent, of its total healthcare expenditure on stress-related illnesses annually (Goh, 2019). The benefits as cited in a 2012 study that looked at over 28,000 clients who participated in counselling at their workplace showed that 70% experienced improvement, far outweigh the costs let alone the personal well-being of staff (Hughes, 2015).
Workplace Counselling a Meta-Perspective
Currently, workplace counselling is typically used mostly in the context of performance management, and at best wellness/wellbeing programs exist. According to Liederman (2019), 9 out of 10 organizations globally offer at least one kind of wellness to employees, and she begs the question if employers have employees’ best interest at heart, or are focused on competitive advantage, protecting their reputations or even their bottom line (Liederman, 2019).
According to Briner (1997) counselling intervention goal is to assist individuals experiencing problems and high levels of distress, either at work/work to home or home to work. Workplace counselling is a way of supporting, relating and responding to employees to help them for self-awareness, and self-acceptance and realise their potential for growth. According to McLeod (2001) workplace counselling helps to reduce symptoms of anxiety and depression, improves mental health, lowers levels of sickness and increases job satisfaction and commitment (McLeod, 2001).
For all good intentions the groundwork has been laid by the Singapore Government; as in the Tripartite advisory (2020), which is to “Provide access to counselling services such as through Employee Assistance Programmes (EAPs). These services allow employees to speak to a professional on their work and non-work related challenges.”
Even then, according to a news article “12 companies recognised for ‘exemplary efforts to promote mental health at work” (Yeoh, 2021), with the exception of the Civil Defence Force, all were multi-national companies, which begs the question of local companies’ involvement.
Is this cultural or organizational stigma, as in fear of a stymied career progression or a combination of factors? According to Hanisch et al (2016), the stigma of mental illness may be a contributing factor to the underutilization of healthcare in the workplace, with employees responding reactively when their symptoms severely interfere with their work as opposed to seeking help early (Hanisch et al, 2016).
Or perhaps the concerns may lie in Lane’s (1990) view that counselling is “seen as a method which picks up people who are problems rather than as a framework of psychology which can enhance potential and ensure performance” (Lane, 1990).
It may be that employees’ capacity to cope is driven by a collectivist culture; like in Singapore, where team support may account for resilience in coping with adversity, or disruptive events through perseverance and adaptive processes (Carmeli et al, 2013; McEwen & Boyd, 2018).
Or it may be that in a high-power-distance culture; that exists in most East Asian countries, due to a strong impact of Confucianism, deference is given to leaders and they contribute to the development of the team (Edmondson et al, 2001).
Options for Workplace Counselling
Given that employees typically spend much of their day at work, they may require workplace counselling to deal with the problems they face there (Newstrom & Dewis, 1997), and that may extend to personal problems and family. Workplace counselling can be either an internal service; where counsellors are in-house and part of the company, or an external service, wherein it is outsourced to an external service provider.
A significant role of HR is to support and facilitate employee job satisfaction and enhance their performance in the organization (Summerfield & Van Oudtshoorn, 1995). As such there may be a case; that makes it more credible, for HR to integrate counselling skills into their existing roles to offer an internal service. The added value is that there is continuity in therapeutic working alliances with employees in the organization (Caroll & Walton, 1999).
Leveraging on this, with the right training and supervision, co-workers, supervisors and managers could conduct counselling; within the scope and context, of stress-related challenges (Cole, 2003). These efforts provide a positive relationship between the employee and the organization, as shown in studies that have reported work improvements in supervisor-rated work performance (Guppy & Marsden, 1997).
Some of the benefits of an internal service provider is the ownership of the program, knowledge of the organization and its culture, assessments that can be made in the context of the organization, onsite problem assessment capability, and may be better integrated with other HR programs (Sharar et al, 2013). The downside, is the concern of confidentiality, the cost of such a program; especially for smaller organizations, practitioners may be more subjective in assessments, and too closely identified to departments, eg. HR, groups or individuals (Sharar et al, 2013).
The case for an external service provider, there may be better accountability, lower legal liability and easier implementation requiring less internal resources; which would be mainly for coordination. Organizations and employees may have a better perception of confidentiality. However the drawback is perceived as a lack of integration with the workplace and knowledge of the organization and its culture (Sharar et al, 2013).
Another consideration is a hybrid model that shares elements of both models where there may be EAP staff “onsite” (in the organization or multiple locations), and may also have “offsite” EAP staff in many locations. Despite the merits of these models, there is little evidence to suggest one with better outcomes (Sharar et al, 2013).
Benefits of Workplace Counselling
The British Association for Counselling and Psychotherapy, in a comprehensive review claims that after counselling, work-related symptoms return to normal in more than half of all clients, and sickness absence is reduced by over 25%; that workplace counselling is an effective treatment for anxiety, depression and substance misuse as well as “stress”. It is claimed that such results can be produced by as little as three sessions of any style of counselling as they all turn out to be effective” (Henderson et al, 2003).
EAP and Well-being programs are part of employee engagement, and in Pricewaterhousecoopers (2010) global study, engaged employees put in 57% more effort in their work and were 87% less likely to resign compared to disengaged employees (Kay & Tumwet, 2015). According to Seligman (2002), engagement is a key element needed to achieve more lasting happiness (Seligman, 2002).
Conclusion
The current state of mental wellness; further exacerbated by Covid and other global uncertainties, makes for a strong case to introduce workplace counselling in organizations. The APAC, Benefits Strategy Study (2017) found that 62% of organizations in Singapore had plans; at the time of the article, to implement such programs in the future.
This needs to be fast-tracked. Nonetheless, it is important that such programs are holistic and blend with the organizational culture, where staff can capitalise on counselling services in a psychologically safe environment.
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