Beyond the wellbeing app: is targeted treatment the next big shift in workplace health?

For years, workplace wellbeing has largely been built around access. Give employees an app. Provide a webinar. Offer some educational content. Add a meditation programme, fitness platform or wearable and give people the tools to manage their own health. 

A shift may be, however, starting to take place. As employers look more closely at workforce health, absence, productivity and human sustainability, the question is moving from what wellbeing benefits do we offer? to something more fundamental: does the support actually address the problem an employee has?

Sleep could be one of the clearest examples of what comes next. Employees have arguably never had more information about how to sleep well. Sleep trackers measure duration and quality. Apps provide meditation and relaxation. Podcasts discuss circadian rhythms, while countless articles tell people when to stop drinking caffeine, put down their phones and make their bedrooms darker. Yet poor sleep remains a significant workforce health issue.

CIPD research cited by sleep specialist Kathryn Pinkham, founder of The Insomnia Clinic, found 43 per cent of employees had experienced sleep problems during the previous year.

Pinkham believes the problem is not necessarily a lack of information. “We have never had more information about how to sleep,” she says. “There are sleep apps, wearable technology, podcasts, meditation programmes and countless articles telling us what we should and shouldn’t be doing before bed.”

The challenge, she argues, is distinguishing between helping somebody understand sleep and treating somebody who has developed a persistent sleep problem. That distinction could prove important well beyond sleep.

Much of the first generation of workplace wellbeing has concentrated on awareness, education and access to tools. The emerging opportunity is to create more sophisticated pathways that identify different levels of need and connect employees with an appropriate intervention.

In other words, workplace wellbeing could be moving from providing everybody with broadly the same resources towards providing the right support at the right point. For sleep, that means recognising the limitations of sleep hygiene. Education about caffeine, alcohol, routines and bedroom environments can also be useful, particularly for somebody experiencing occasional poor sleep.

But Pinkham says an employee who has struggled with sleep for months or years is unlikely to have an information gap.

“They probably already know every piece of conventional sleep hygiene advice and they may have bought blackout blinds, changed their mattress, downloaded an app, bought magnesium and tried meditation, but they still lie awake for hours,” she says.

Persistent insomnia can instead become maintained by the way people respond to not sleeping. Stress, anxiety, illness, menopause or a difficult life event might trigger the initial problem. As poor sleep continues, an individual can start worrying about sleep itself, going to bed earlier, spending longer in bed, watching the clock and becoming increasingly anxious about how they will function the following day.

The effects on employees might be present without appearing prominently in absence statistics. Data from one of The Insomnia Clinic’s workplace sleep pilots found 27 per cent of employees were sleeping fewer than five hours a night. Among employees experiencing poor sleep, 75 per cent said it had made them feel they should take a sick day, but they went to work anyway. That presents a human sustainability issue as much as a traditional wellbeing one.

An employee may technically be at work but doing so while exhausted, struggling to concentrate or finding everyday demands harder to manage. Poor sleep can therefore become part of the wider conversation around presenteeism, sustainable performance and an individual’s capacity to remain healthy and productive at work.

And this is where a more clinically informed approach to workplace wellbeing becomes interesting. Cognitive behavioural therapy for insomnia (CBT-I) is an evidence-based treatment for chronic insomnia. Rather than simply providing more information about sleep, it addresses the thoughts, behaviours and patterns that can perpetuate the condition.

Pinkham believes employers should distinguish much more clearly between education and treatment. “The point is not that apps, webinars or general wellbeing tools have no value,” she explains. “They can raise awareness, provide useful education and help people recognise when something is wrong, but education and treatment are not the same thing.”

Technology still has an important role. But that role may also need to evolve. Wearables and sleep trackers have helped make sleep visible. For some employees, the data can be useful. But knowing somebody has a problem is different from solving it.

“Tracking poor sleep is not a treatment for poor sleep,” says Pinkham. “For someone who is already preoccupied with how much sleep they are getting, more data and another low sleep score may not be the answer.”

This points towards a potentially important next generation of workplace health provision: technology as the front door, rather than the destination.

Digital tools could help employees understand their health, recognise potential problems and access support. But behind that front door there needs to be a pathway capable of guiding people towards evidence-based interventions when self-guided information is no longer enough.

It is a model already familiar in other areas of healthcare, but one that could become increasingly important within workplace wellbeing. Rather than buying a single sleep solution, for example, an employer could create a tiered pathway.

Education, webinars and Q&A sessions could provide population-level awareness. Structured digital programmes could support employees with more persistent problems. Specialist one-to-one treatment could then be available for those with more complex needs.

The potential innovation is not necessarily another piece of technology. It is better orchestration of the support employers already buy. That matters as workplace wellbeing moves into the wider human sustainability agenda.

If organisations want to understand whether workforces can remain healthy, capable and productive over the long term, simply measuring how many benefits are available tells them relatively little.

The more useful questions are likely to become: what health problems exist within the workforce? How early can they be identified? What level of intervention does an employee need? Is there a clear pathway to it? And does the intervention produce a measurable improvement?

Sleep provides a useful test case because the difference between awareness and treatment is relatively easy to see. The Insomnia Clinic says 96 per cent of participants across its programmes have found them helpful, while 47 per cent no longer met clinical criteria for insomnia. It also reports that 64 per cent experienced improved mood and 67 per cent of those using sleep medication reduced or stopped it.

The figures are provider-reported outcomes rather than evidence that every workplace sleep intervention will achieve the same results. But they illustrate the type of outcome measurement that could become increasingly important as employers scrutinise wellbeing investment.

The question becomes less about whether employees opened an app or attended a webinar and more about whether their health changed. That could also influence how HR and benefits teams procure workplace wellbeing.

Instead of asking providers predominantly about content libraries, engagement rates and utilisation, employers may increasingly want to understand the evidence behind an intervention, the population it is designed for, where it sits within a wider care pathway and what outcomes can realistically be measured.

For Pinkham, employers can start with a straightforward question: what currently happens when an employee says they cannot sleep?

“Do employees have access only to general sleep information?”, she asks. “Do they know what to do if poor sleep becomes persistent? Is there a clear route from education to evidence-based treatment? And, before investing in more support, do you actually know how sleep is affecting your workforce?”

Those questions could equally be asked across workplace health. The next big development in wellbeing may therefore not be another app, wearable or employee benefit. It may be the move from a collection of wellbeing products towards connected, evidence-based health pathways – using technology and education for the people they can help, while recognising when an employee needs something more.

As Pinkham puts it: “Good workplace wellbeing is not about offering the greatest number of benefits or adding another generic solution that ticks a box. It is about understanding the problems employees are experiencing and making sure the support available is capable of addressing them.” This is also where the connection with human sustainability becomes much clearer.