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Start a free trialThere's a poster in your office kitchen. It's been there for three years. It has a phone number on it and some reassuring words about confidential support being available 24/7.
Here's what nobody will tell you: not a single person in your company has called that number. If they have, it probably didn’t help.
If you're a founder or leader at a small business, you probably know this already. You bought the Employee Assistance Programme with good intentions. It felt like the responsible thing to do. The salesperson said it covered everything from stress to legal advice for £1 per person per month. You signed a three-year contract. Job done.
Except it isn't done, is it? You’re missing the “A” in EAP.
I have a friend who works in occupational health. She's been in the industry for 30 years, and when I asked her about EAPs, she got a bit defensive.
"You have to understand the context," she said. "In the 1970s and 80s, workplace mental health support didn't exist. We were dealing with serious substance abuse issues. EAPs were genuinely revolutionary. For the first time, employers were saying: “we'll help you with personal problems because we recognise they affect your work."
She's right. Traditional EAPs emerged with good intentions. The model made sense for the era: provide a confidential phone line, offer short-term counselling, refer people to specialists. For manufacturing plants with thousands of workers, this was transformative.
But then something shifted. As EAPs became standard workplace benefits, the market changed. To stay competitive, providers bundled in additional services: legal advice, financial guidance, childcare support. They dropped their prices to £1 per employee per month and locked companies into multi-year contracts.
"The problem," she admitted, "is that when you're charging £1 per person per month, you can't actually afford for people to use the service much. The economics only work at utilisation rates below 3%. And because most big companies just want the box ticked, nobody really minds."
A designer I know, let's call him James, works at a 12-person startup. Last year he had a proper breakdown. Panic attacks, couldn't sleep. He tried to use his company's EAP.
"I called the number on my lunch break, sitting in my car because I didn't want anyone to hear. Got transferred three times. They asked me to rate my crisis level from one to ten.
Could I call back tomorrow between 9 and 5? The thing is, in a company our size, everyone notices when you're struggling. I needed help fast, not in three weeks after multiple phone assessments."
James eventually found help…through his GP.
This is where traditional EAPs hit a wall with small and high-growth businesses. In a 5,000-person company, a 3% utilisation rate means 150 people got help. Most employees are not critical to day-to-day operations. The business keeps going.
In a 12-person startup? A 3% utilisation rate means nobody gets help. When your lead developer can't focus, when your head of sales is having panic attacks, there's no corporate buffer. The business feels it directly.
I spoke to another founder recently. Fifty-person scale-up, growing fast. She'd bought an EAP two years ago and finally checked the utilisation stats.
"Zero," she said. "Not a single person had used it. And I knew at least four people were struggling. Two had told me directly. One had quit partly because of burnout. But when people actually needed help, the service was useless to them."
This is the fundamental mismatch. Traditional EAPs were designed for large organisations and crisis intervention. They optimise for coverage: many services, few users.
Small and high-growth businesses need something different:
Six months after his breakdown, James's company switched to a different provider. Not an EAP in the traditional sense, but a modern mental health platform.
"It's completely different," he told me. "I booked an appointment through an app at 11pm on a Sunday. Had a video call with a therapist two days later. The therapist specialised in work-related anxiety. We've had five sessions now, same person every time. I'm actually performing better at work. I'm clearer, more focused, less reactive. What's more, our little company has now got a dedicated company counsellor through a fractional model, but technology ensures we still have near-instant access."
This is the crucial bit that traditional EAPs miss: in small and high-growth businesses, mental health support isn't just an ethical obligation, it's a business necessity. When you support your people effectively, they propel the business forward.
Modern mental health support for small businesses needs to be genuinely accessible (digital-first booking, rapid access within days), high quality by default (experienced therapists who specialise in work stress, not generalists), designed for prevention (helping people build resilience before problems escalate), and integrated with business reality (recognising that supporting individual wellbeing directly impacts business performance).
Traditional EAPs aren't bad. They were an innovation that helped millions of people. They still work in certain contexts: large corporations, public sector organisations.
But they were built for a different world. For anonymity, not visibility. For crisis management, not prevention. For low utilisation rates, not high engagement.
If you're running a small or high-growth business, you can't afford that model. You need every person performing at their best. You need support that recognises this simple truth: when your people thrive, your business thrives.
When evaluating mental health support, ask yourself:
Your employees deserve mental health support that actually works. And your business deserves a team that's supported well enough to do their best work. In small and high-growth companies, those two things aren't separate. They're the same thing. The poster in the kitchen is not.
Ready to explore a modern approach to employee mental health? Discover how Spill can support your team through CharlieHR's Marketplace.
This article was authored by Harry Dryden, VP Operations, Spill.
