Employee mental health services have become a billion dollar industry. New hires, after finding the restrooms and enrolling in 401(k) plans, are presented with a plethora of digital wellness solutions, mindfulness seminars, massage classes, resilience workshops, coaching sessions and sleep apps.
These programs are a point of pride for forward-thinking HR departments, proof that employers care about their employees. But a British researcher who analyzed survey responses from 46,336 workers at companies that offered such programs found that people who participated in them were no better off than colleagues who did not.
The studypublished this month in the Industrial Relations Journal, looked at the results of 90 different interventions and found one notable exception: Employees who were given the opportunity to do charity or volunteer work seemed to improve their well-being.
Across the large study population, none of the other offerings—apps, coaching, relaxation classes, time management or financial health classes—had any positive effect. Trainings on resilience and stress management appeared to have a negative effect.
“It’s a pretty controversial finding that these very popular programs weren’t effective,” said William J. Fleming, the study’s author and a fellow at the University of Oxford’s Wellness Research Center.
The analysis of Dr. Fleming suggests that employers concerned about employee mental health would be better off focusing on “basic organizational practices,” such as scheduling, pay, and performance reviews.
“If employees really want access to mindfulness apps and sleep programs and wellness apps, there’s nothing wrong with that,” he said. “But if you’re serious about driving employee wellbeing, then it has to be about work practices.”
The study of Dr. Fleming is based on responses to Britain’s Healthiest Workplace survey in 2017 and 2018 from employees in 233 organisations, with slightly over-represented financial and insurance workers, younger workers and women.
The data captured workers at a single time point, rather than tracking them before and after treatment. Using thousands of matched pairs from the same workplace, he compared measures of well-being from employees who participated in wellness programs with those of their co-workers who did not.
It’s possible there was selection bias, as workers who enroll in, say, a resilience training program may have lower well-being to begin with, Dr. Fleming said. To address this, he analyzed the responses of workers with high pre-existing levels of job stress separately, comparing those who participated and those who did not. But even in this group, the survey responses showed that the programs had no clear benefit.
The findings call into question practices that have become commonplace in all areas of work. But researchers said it was no surprise.
“Employers want to be seen as 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.
Workplace mental health interventions can send the message that “if you’re doing these programs and you’re still feeling stressed, it must be you,” Mr. LaMontagne said. “People who don’t have a critical point of view may internalize this failure: ‘So I’m really lost.’
The corporate wellness services industry has grown in recent years, with thousands of sellers compete for billions of dollars in revenue. Companies invest in the interventions in hopes of saving money overall by improving employee health and productivity.
Some research supports this expectation. A 2022 study tracking 1,132 workers in the United States who used Spring Health, a platform that connects workers with mental health services such as therapy and medication management, found that 69.3 percent of participants experienced an improvement in their depression. Participants also missed fewer days of work and reported higher productivity.
Adam Checkrud, co-founder of Spring Health and an assistant professor of psychiatry at Yale, said Dr. Fleming’s study looked at interventions that were “not particularly reliable” and measured well-being many months later. A blanket rejection of workplace interventions, he said, risks “throwing the baby out with the bathwater.”
“There is recent and extremely reliable data that things like mental health programs improve all of these metrics that he mentions,” Dr. Checkrud said. “This is the baby you shouldn’t throw out.”
There is also strong evidence that practices such as mindfulness can have a positive effect. Controlled studies have consistently demonstrated this lower stress and reduced anxiety and depression afterward awareness training.
The innocent 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. “Light touch” interventions, such as apps, he added, are generally less effective than individual or group training sessions.
The study of Dr. Fleming, he said, “misses most of these details, condenses intervention types into broad labels, yes/no participation, and dismisses intervention participants’ reports that they felt they benefited from the programs they did.”
A key omission, he added, is longitudinal data showing whether participants experience improvement over time. The result is a “top-down view” of participants’ well-being that “overrides changes that may occur at the individual level,” he said.
Dr Fleming said he was aware of the body of research supporting the treatments’ effectiveness, but that he had “never been so convinced by the very positive findings”, as the data comes from controlled trials in which the treatment works very well, which can not occur in employer-provided programs.
Dr David Crepaz-Keay, head of research and applied learning at the Mental Health Foundation UK, who has advised the World Health Organization and Public Health England on mental health initiatives, described the data and analysis of Dr. stronger” than “most of the research that has built a consensus that employee assistance works.”