Most organisations now have something in place. An EAP, mental health first aiders, some training for managers, a wellbeing page on the intranet. Far more than twenty years ago.
And most of it goes unused.
Around four fifths of UK employers provide an EAP. Depending on whose figures you take, somewhere between 3% and 10% of eligible employees use it in a year. The PAM Group’s 2025 report found that 57% of UK workers wanted workplace counselling and 22% were getting it.
That last pair of numbers is the interesting one, because it rules out the easy explanation. It isn’t that people don’t want support. Well over half say they do. The support is there, it’s paid for, and most of the people who want it are not using it.
So the question worth asking isn’t how to promote it better. It’s what these options ask of a person before they give anything back.
What An EAP Is Good At
An EAP can be a decent thing to have. It costs the employee nothing, there’s no waiting list of the sort the NHS has, and someone in a bad week can get to a person quickly. For the people who use them, they can help.
The limits are known and mostly practical. The number of sessions is capped. A large share of calls are signposted to self-help material or elsewhere rather than resulting in counselling. The sessions run to a schedule, so it suits someone whose difficulty is stable enough to fit an appointment three weeks out. And depending on the provider, there’s no guarantee of getting the same person twice, so you may be starting again with somebody new each time.
Then there’s the part that isn’t practical at all. It arrived through your employer. The provider is independent, the confidentiality is real, and the employee still has to decide whether they believe that, about a service their employer chose, pays for and receives reports about. Most people are told the reports are anonymised. Not everyone finds that reassuring, particularly in a small team where the anonymity is thin.
Why Manager Training Doesn’t Travel
The quality of mental health training for managers varies enormously. Some of it is very good. Some of it is an hour of slides delivered to a room that would rather be elsewhere.
Which is the other part. Managers usually attend because they’ve been told to, not because the subject interests them, and plenty of them have no interest in it whatsoever.
It also tends to be one off, and generic by necessity, since it has to work for a room of managers from different departments with different teams. Nothing in it changes the workload, the targets or the culture they go back to.
So whether any of it survives contact with Monday depends entirely on the individual manager. Some care about this and were doing it already. Some tick it off and carry on exactly as before. An employee has no way of knowing which one they’ve got until they try.
Who Gets Picked As A Mental Health First Aider
Mental health first aid is well intentioned and the training is real.
The question nobody asks out loud is who ends up doing it.
First aiders are usually volunteers, or people a manager thought would be good at it. Neither of those is the same as being someone colleagues would confide in. Being willing to help is not the same skill as being able to hear something difficult without it changing how you behave afterwards.
And everybody in an office already knows who talks. People form a view about who is discreet within weeks of starting a job, and that view rarely matches the list on the poster by the lift. An employee weighing up whether to speak to a first aider isn’t assessing the training. They’re assessing that specific colleague, who they will see at their desk tomorrow, and next year, and who may one day be on an interview panel.
Not Everyone Trusts Their Manager
Most of these routes assume a reasonable relationship with a line manager. Notice something, have a conversation, signpost to support.
That assumption doesn’t hold for a lot of people. Some don’t trust their manager. Some don’t like them. Some have watched what happened to a colleague who disclosed something. And in a fair number of cases, the manager is a significant part of why the person is struggling in the first place, which makes them the last person anyone would tell.
None of that shows up in an engagement survey, because nobody puts it there.
What All Of This Has In Common
Look at the four together and the same requirement runs through every one.
To get support, you have to disclose something personal to a person connected to your employer. A counsellor the employer engaged. A manager. A colleague trained by the organisation. A first aider whose name is on a list at work.
For plenty of people that’s fine, and they use these services, and the services do what they’re meant to.
For everyone else it’s the whole obstacle, and no amount of awareness campaigning touches it. You can put posters up, run a wellbeing week and mention the EAP in every all-staff email, and organisations that do this consistently see usage move up somewhat. But it plateaus a long way below the number of people who said they wanted support, because the barrier was never that they hadn’t heard of it.
They heard. They decided.
The People Who Never Come Forward
I spent 26 years in this field before building anything, and the group I kept thinking about was never the people in the room.
It was the ones who don’t want to be vulnerable in front of another person. The ones who won’t have anything personal written down and held on a file. The ones who’ve learned not to trust easily, usually for reasons that made sense at the time. The ones who don’t want a fixed appointment every week. The ones dealing with something at home they aren’t ready to say out loud to anybody, let alone somebody at work.
Those people are in every organisation. They don’t appear in EAP usage figures, they don’t tell their manager, and they don’t approach the first aider. From the outside they look fine, and eventually they look like absence, or turnover, or a resignation that surprised everybody.
That’s the group we built for.
What We Offer Organisations
Otto is a Digital Partner. He can be provided to a team or a whole organisation, and he’s designed for exactly the person the existing routes don’t reach.
There’s no appointment and no waiting. He’s there at eleven at night and at three in the morning, which is when a lot of this gets difficult. There’s no colleague involved, nobody at work who now knows, and no name on a list. Conversations can be deleted whenever the person wants them gone.
He isn’t a lesser version of the other options. For a lot of people he’s the only one that was ever going to work, because the rest were never going to reach them. You can’t replace something that was never available to somebody in the first place.
He’s for those people.
We also build Digital Partners for specific purposes, so an organisation with a particular need can have one designed around it rather than taking something generic.
The Question For Anyone Buying This
If most of your workforce says it wants support and a fifth of them are getting it, the shortfall isn’t going to be fixed by promoting the same options harder.
It’s worth asking what your current provision requires from someone before it helps them, and how many of your people were never going to meet that requirement.
That’s not an argument against what you already have. It’s a question about who it was ever going to reach.
If you’d like to talk about Otto for your organisation, get in touch.
About the Author
Karen Ferguson is the founder of MindMotive AI, where she develops Digital Partners designed for specific purposes. Otto, built to help people make sense of situations, relationships and decisions at the point they need to, is one of them.
She has worked as a therapist for 26 years, as a hypnotherapist since 2000 and later as a counsellor, and for nearly 20 of those years as a trainer and supervisor. She has trained more than 1,000 therapists.
MindMotive AI was created in response to a simple question: what happens to the people who never access traditional forms of support? Karen’s work combines decades of professional experience with the deliberate development of Digital Partners designed to give people another way of accessing support when and how they choose.
Karen is a Fellow of the ACCPH (Accredited Counsellors, Coaches, Psychotherapists and Hypnotherapists).