Review of HA 2023 Service Trends

Overview of the Counselling Helpline

Amidst the evolving landscape of mental health and wellbeing, Health Assured’s 24-hour, immediate support helpline demonstrated remarkable adaptability and innovation in 2023. For counselling, ‘anxiety’ continues to be the leading theme of counselling calls to the immediate support helpline, followed closely by ‘low mood’. This trend is consistent with previous years. However, ‘depression’ as a main reported reason for a person accessing counselling support has fallen to fifth place with callers requesting support with their ‘Partner’ difficulties the third most reported reason for accessing support. While anxiety and low mood remain prevalent concerns, there is a noticeable increase in calls related to issues such as relationships and bereavement. This diversity highlights the complexity of individuals’ experiences and underscores the need for comprehensive support services, such as an EAP/SAP service, to be in place to support a wide range of individuals without them having to wait for GP referrals or the NHS Talking Therapies for anxiety and depression programme (formerly known as Improving Access to Psychological Therapies, IAPT) assessments.

Calls made to Health Assured in 2023 displayed a variety of trends, mirroring the varied range of mental health difficulties individuals are experiencing, which has also contributed to a 10% increase in risk and safeguarding calls to the helpline than the previous year.  While the 24-hour helpline experienced a 10% reduction in incoming calls, the service experienced a rise in the number of wellbeing referrals received (20.2%), compared to those received in 2022. This increase in referrals is consistent with the rise in mental health referrals received by the NHS, which has seen a 5% increase in the past year but a 22% increase since the beginning of the COVID-19 pandemic. It is important to highlight that many people will be seeking support via a wellbeing referral through their employee assistance programme at Health Assured after already attempting to access support through the NHS and finding themselves on a long waiting list or with limited support options, depending on what is available in their area. Therefore, wellbeing referrals are increasing, for they ensure that the referring manager, for example, has sufficiently supported their colleague and is able to ensure the appropriate counselling support is offered.


Overview of structured counselling and specialist psychological services

55,214 cases were matched for structured counselling sessions in 2023: a 6.6% increase from the previous year and saw an increase in face-to-face sessions of  21.5%. 93.1% of these cases were matched with an appropriate counselling professional in 24-hours or less. An increase of 47.9% was observed for individuals accessing digital CBT through the SilverCloud programme. While the top five categories for accessing counselling support were Anxiety, Low mood, Partner, Bereavement and Depression, other categories saw a significant increase in their utilisation. Managing life changes, Menopause, Midlife and Redundancy categories saw the largest increase, with Managing Life Changes recorded as a 6000% increase, Menopause a 98% increase, Midlife 298% and Redundancy an 86% increase from the previous year. These large increases can be attributed to more specific categories being added and utilised in the system creating accurate recording upon client contact as well as more understanding and conversations around life changes in middle age. The menopause, including its physical, mental and emotional effects, is more widely acknowledged and supported. Health Assured offers resources to aid and educate to employees and clients/service users through this important life stage.

As a direct result of the COVID-19 pandemic, since 2020 those accessing counselling support through Health Assured’s services reduced in their requests for in-person appointments. This trend has been consistent, even after face-to-face counselling sessions were reintroduced. However, with the pandemic receding, there has been a noticeable uptick in face-to-face counselling sessions, although this figure is below 20% of all counselling matches. While the helpline statistics demonstrate that there was a reduction in the percentage of individuals choosing to access counselling support via video counselling platforms, it is likely that this is because of the increase in face-to-face sessions and digital (CBT) support as people return to in person counselling sessions or opt for the appropriate digital support to fit in with their lifestyle and availability. To ensure that Health Assured is resourced to facilitate in-person session as these referrals increase, further affiliate counsellors have been recruited onto the network, with 2023 seeing an increase of 7.4%. The year closed with a total of 1,939 active affiliate counsellors on the Health Assured network available to support clients with an increase of 36.6% more counsellors offering in-person counselling sessions than in 2022. As recruitment for the affiliate network is ongoing, this number is constantly increasing to ensure full coverage of the service for the UK and Ireland for the full range of counselling and specialist psychological support, including in-person, online and telephone sessions.

As well as the helpline and structured counselling support offerings, the specialist psychological service experienced an increase in CBT (34.2%) and EMDR (20.1%) referrals and completed double the number of psychological assessments than were completed in 2022. The rise in specialist support and psychological services can be attributed to the growing demand for more tailored mental health assistance, directly influenced by the current socioeconomic climate in the UK, considering the current cost of living crisis, increased mental health awareness, cuts to mental health services and the impact of stressors originating from societal and economic global events. However, for the first year since 2020, the counselling service recorded significantly fewer calls in the ‘Pandemic’ category, indicating that emotional support as a result of the impact of Covid-19 is lessening, while calls for support with general mental health, relationship difficulties and redundancy stressors has increased in the past few years.

References for NHS stats: &

Overview of the Legal helpline

The legal team has increased its Legal and Financial Wellbeing Advisors by 31% as well as a 58% increase in Information Consultants in 2023 to best support callers on the helpline requiring support in a timely and appropriate manner. The top five reasons for legal calls are consistent with the previous year: Employment, Divorce and Separation, Civil, Housing and Childcare. The number of calls for each recorded category has remained fairly consistent with a notable increase in calls to support with Data Protection (86% increase) and Personal Insolvency (111% increase). During times of economic uncertainty, such as a pandemic, political changes (Brexit) and financial concerns as a result of furlough schemes, and increased cost of living and interest rates, there has been an increase in calls related to employment, housing/tenancy and childcare. The helpline works in a way in which those calling for support with the above are screened by the advisor and counselling support is available should they feel that it would be helpful.

Health Assured recognises that there is often an overlap between clients seeking support from both the counselling and legal departments when reaching out to the helpline. This crossover demonstrates the interconnectedness of legal issues with wellbeing. The legal team are uniquely equipped to provide practical advice from a legal perspective and the service user can be referred through to speak with a member of the counselling team for emotional support, if they wish. This approach acknowledges that an individual’s circumstances when managing legal issues and disputes has the potential to increase stress and have a negative effect on their wellbeing and resilience. Therefore, the legal and counselling departments work collaboratively to empower their clients to navigate any challenges that they encounter in life with confidence.  

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