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By Alys Harte & Ella Rule
BBC File on 4
Claims about one of the UK's biggest providers of workplace mental health services are to be investigated by the British Association for Counselling and Psychotherapy (BACP), it has said.
BBC File on 4 has heard allegations that calls from vulnerable people to Health Assured were not always handled properly.
One caller claims he was advised "to go on a date" with his wife after he said he was having suicidal thoughts.
Health Assured refutes the allegations.
Employee Assistance Programmes - or EAPs - are intended to help employees deal with personal problems that might impact their wellbeing and performance at work.
Typically, they offer access to a helpline or short-term counselling services.
According to the UK Employee Assistance Programme Association, three quarters of the working population in the UK have access to one through their employer. The body describes EAPs as a "highly valuable resource to employees".
File on 4 has spoken to 15 current and former employees of Health Assured, an EAP that provides support to 13 million workers in the UK and Ireland.
Its clients include NHS trusts, universities, and police forces.
We spoke to counsellors and team managers who described low morale, high staff turnover, and a frequent struggle to keep up with demand.
Amy (not her real name), started working as a counsellor at Health Assured last year. She says people contacted the helpline for a wide range of issues, including trauma, bereavement, work-related stress, anxiety and depression, and very often, they thought they needed therapy.
However, she says she was limited in the number of people she could refer to structured counselling - usually about 20% of calls - because of company targets.
"Every time you put someone forward for therapy, you're stepping further and further away from your targets because the target is to put as few people through as possible," she says.
Health Assured has told the BBC that counsellors are not targeted on limiting how many people it refers on for further counselling - adding that it delivered more than 245,000 counselling sessions last year.
But BBC File on 4 has seen internal communications sent to counsellors which seem to show weekly targets being set. In one week, it appears they were asked to keep calls below 19 minutes and to refer just 18% of callers to therapy.
At one point, when the "average handling time" was deemed too long, a supervisor reminded the counsellors to keep the calls "solution focused" and said that calls were "not the right place" for clients to "outpour everything".
Investigating Employee Assistance Programmes
Alys Harte examines Employee Assistance Programmes - which almost 25 million workers in the UK have access to through their employer.
Listen on BBC Radio 4 at 20:00 GMT, Tuesday 12 March or on BBC Sounds
Health Assured says it uses a variety of methods to support callers and that the most appropriate route is decided by a detailed clinical assessment. It says it holds itself to the highest standard - both in the care it provides and the health and wellbeing of its employees.
Amy says her line manager was experienced and clinically trained, but adds that not all managers were. She says this meant some counsellors felt exposed or under-supported.
Nicola (not her real name) worked on the helpline as a support counsellor for over two years.
She says on one occasion, a "non-clinical" manager was not sure if they could call an ambulance for a caller she judged was at immediate risk of harm.
"I'm on the call," says Nicola. "If I say we need an ambulance, I'm clinically trained, that should be enough. It's risking lives."
In the event, the ambulance was called.
Health Assured says all managers from a non-clinical background have completed a comprehensive training programme on safeguarding and risk processes which are implemented across its services.
Mikey is an emergency nurse practitioner at an NHS hospital in Hampshire, who called Health Assured when he was experiencing suicidal thoughts.
He says one counsellor told him to "go on a date with his wife" and did not refer him on for structured counselling.
Mikey says it was not until his third call - six weeks after the first - that he was put in touch with a local therapist for face-to-face counselling.
File on 4 put these and other examples of safeguarding concerns raised with the BBC to the British Association for Counselling and Psychotherapy (BACP), the body that accredits Health Assured's counselling service.
It told the BBC it would investigate the allegations and take "appropriate action" if it found "unethical behaviour or poor practice".
It warned this could result in conditions on Health Assured's membership or even withdrawal of its membership.
Health Assured says its ultimate focus is on clinical excellence, and that its clinical processes and policies are audited annually as part of its BACP accreditation.
It says the pressures described by those we spoke to were a result of a widespread increase in the pressure on all mental health professionals during and after the pandemic.
Additional reporting by Vicky Carter