Publisher Health

A new study finds that policies to reduce carbon dioxide (CO2) emissions from motor vehicles combined with investments in electric vehicles and public transportation would reduce air pollution and bring large benefits to children’s health. They would also save money.
The findings by researchers at Columbia University Mailman School of Public Health with collaborators at the University of California, Los Angeles, the University of North Carolina at Chapel Hill, and the Boston University School of Public Health appear in the journal Environmental Research Letters.
The researchers modeled the benefits of implementing multiple scenarios of the proposed climate policy framework known as the Transportation and Climate Initiative (TCI) in 12 Northeast and Mid-Atlantic states and the District of Columbia. Under the most stringent cap on CO2 emissions and the investment scenario that devoted the most resources to mass transportation, they estimated a total of over 58,000 avoided cases of infant mortality, preterm birth, low birth weight, autism spectrum disorder, new cases of asthma, worsened asthma symptoms, and other respiratory illnesses. The related economic savings were $82 million annually. Assessment of the distribution of avoided cases of worsened asthma symptoms indicated that children in all racial and ethnic groups benefited, with somewhat greater health benefits in non-white populations.
Under TCI, fuel suppliers would be required to purchase carbon emissions allowances, the proceeds of which would go towards clean transportation programs. While this program was not implemented, it serves as a useful model for other climate mitigation policies. Specifically, researchers modeled changes in ambient fine particulate matter (PM2.5) and nitrogen dioxide between 2022 and 2032 associated with on-road transportation sector emissions under nine hypothetical CO2 emissions cap and investment scenarios proposed under TCI. They estimated potential health co-benefits for adverse birth, pediatric respiratory, and neurodevelopmental outcomes using BenMAPR, a health impact assessment platform that builds from the EPA’s Environmental Benefits Mapping and Analysis Program.
“Health benefits assessments often overlook children’s health outcomes. Yet we know that early exposure to air pollutants has multiple detrimental effects on children’s health and well-being; and these are preventable,” says co-author Frederica Perera, PhD, DrPH, professor of environmental health sciences and director of translational research at the Columbia Center for Children’s Environmental Health at Columbia Mailman.
Researchers also note the importance of strategic decarbonization efforts as the climate crisis escalates. “Ambitious carbon caps and policies that focus on vulnerable groups, including children, can both improve health outcomes and help mitigate the impacts of climate change,” says first author Alique G. Berberian, MPH ’19, PhD student and graduate student researcher at the University of California, Los Angeles,
The researchers also note the importance of including health and environmental justice in climate policies. “Climate policies can have major effects not just on climate, but also on health and environmental justice. Our research shows the importance of including these other benefits of policies when evaluating climate policies,” said senior author Jonathan Buonocore, ScD, assistant professor of Environmental Health at Boston University School of Public Health.
Additional study authors include Kaitlyn E. Coomes at Columbia Mailman School of Public Health, Saravanan Arunachalam and Calvin Arter at the University of North Carolina at Chapel Hill; and Jonathan I. Levy, and Laura Buckley at the Boston University School of Public Health.
The study was supported by the John Merck Fund, the John and Wendy Neu Foundation, the New York Community Trust, the Barr Foundation, and the Energy Foundation.

Researchers investigating how exactly the brain processes the incoming stream of information from the heart and lungs, discovered that specific neurons in the thalamus are actively involved in processing cardiac and respiratory signals.
The human brain constantly receives information from the body, specifically from internal organs such as the heart and lungs. This information seldom reaches consciousness but is crucial for maintaining a healthy body and for influencing performance in the brain, including perception, emotion, and cognition. Now, researchers are investigating how exactly the brain processes the incoming stream of information from the heart and lungs, leading to a broader understanding of brain-body integration and the resulting health or disease.
Publishing their work in the Proceedings of the National Academy of Sciences (PNAS), co-senior authors Vibhor Krishna, MD, associate professor of neurosurgery at the UNC School of Medicine; Ali Rezai, MD, director of the Rockefeller Neuroscience Institute and associate dean of neuroscience at the West Virginia School of Medicine; and Olaf Blanke, MD, PhD, director of the laboratory of cognitive neuroscience at the Swiss Federal Institute of Technology, discovered that specific neurons in the thalamus are actively involved in processing cardiac and respiratory signals.
“Each heartbeat and every breath create a rich, incoming stream of sensory information for the human brain,” said Krishna. “However, a deeper understanding of how the brain integrates this information has remained elusive. We have been interested in discovering how the human brain achieves the integration of cardio-respiratory information and whether its breakdown is linked to any disorders of the brain, heart, or lungs observed in the clinic.”
Over the years, clinical and research teams collaborated to painstakingly study this integration using an established technique of microelectrode recording during deep brain stimulation surgery. Using a new approach to study single neurons in three different thalamic regions, the researchers were able to observe a direct functional involvement of thalamic and subthalamic neurons in processing cardio-respiratory signals. This information can help to better characterize how subcortical regions of the brain process signals through a functional pathway from internal organs.
To complete this work, the research team took advantage of microelectrode recordings during deep brain stimulation for patients undergoing treatment for neurological conditions. The researchers then used these recordings to investigate the activity of single neurons related to cardiac and respiratory functions in three subcortical regions: ventral intermedius nucleus and ventral caudalis nucleus of the thalamus, and the subthalamic nucleus.
They found that about 70% of the recorded neurons were modulated by either the heartbeat, the cardiac inter-beat interval, or the respiration.

These cardiac and respiratory response patterns varied largely across neurons both in terms of timing and their kind of modulation, the authors wrote. A substantial proportion of these visceral neurons — about 30% — were responsive to more than one of the tested signals, underlining specialization and integration of cardiac and respiratory signals in subthalamic nucleus and thalamic neurons.
“We think our work will be significant for several medical specializations, including cardiology, pulmonology, neurology, psychiatry, and psychological research,” Krishna said.
Rezai added, “Better understanding of the human brain is the next frontier. And interdisciplinary collaborations between functional neurosurgeons and neuroscientists will enable us to gain an unprecedented window into the inner functioning of the human brain.”
Applauding this research as a significant step forward, Nelson Oyesiku, MD, PhD, chair of the UNC Department of Neurosurgery, said, “We understand that the brain maintains homeostasis throughout the body through direct neurological and endocrine regulation. This research reveals that the incoming information from the heart and lungs is processed in the thalamic and subthalamic brain regions, besides other regions, enabling our brain to effectively assume its role in regulating bodily functions.”

Approximately 11% of 12th-grade students across the United States reported past-year use of delta-8- tetrahydrocannabinol (delta-8-THC, or delta-8 for short), according to an analysis of data from the 2023 Monitoring the Future survey, which is funded by the National Institutes of Health. Delta-8 is a psychoactive substance that is typically derived from hemp, a variety of the Cannabis sativa plant. Delta-8 has intoxicating effects similar to delta-9-THC (delta-9), the primary THC component responsible for the “high” people may experience from using cannabis.
The researchers measured delta-8 use for the first time in 2023 to investigate the drug’s popularity among teens as more hemp-derived THC products enter the market and become more accessible. Studies show an association between cannabis use and negative health impacts for teens, underlining the importance of monitoring use of delta-8 and other cannabis products among younger people.
Among those who reported delta-8 use, close to 91% also reported marijuana use, contributing to the approximately 30% of 12th graders overall who reported past-year marijuana use. The survey also showed delta-8 use was more common in the South and Midwest regions and in states without cannabis legalization or delta-8 regulations. In contrast, levels of marijuana use did not differ by state-level cannabis policies. The findings were published as a brief report in JAMA. The Monitoring the Future survey is conducted by researchers at the University of Michigan, Ann Arbor, and funded by the National Institute on Drug Abuse (NIDA), part of NIH.
“11% is a lot of people — that’s at least one or two students in every average-sized high school class who may be using delta-8. We don’t know enough about these drugs, but we see that they are already extremely accessible to teens,” said Nora Volkow, M.D., NIDA director. “Cannabis use in general has been associated with negative impacts on the adolescent brain, so we must pay attention to the kinds of cannabis products teens are using, educate young people about potential risks, and ensure that treatment for cannabis use disorder and adequate mental health care is provided to those who need it.”
Delta-8 is one of over 100 cannabinoids in the Cannabis sativa plant. There is no federal minimum age requirement to purchase delta-8 products, which may be sold online or in gas stations and convenience stores. In 2022, the U.S. Food and Drug Administration issued a consumer update warning of the serious health risks associated with use of delta-8 THC, including reports of adverse events involving use of delta-8 products and risks of exposure to toxic byproducts.
Numerous studies have found that adolescent cannabis use is associated with adverse effects on learning, memory, and attention; changes in brain development; and the development of cannabis use disorder and other psychiatric disorders, such as depression, psychosis and suicidality. There are no existing medications to treat cannabis use disorder, and current treatments are primarily through psychosocial interventions, such as cognitive behavioral therapy. More research is needed to understand how delta-8, specifically, impacts these and other health outcomes.
This analysis of Monitoring the Future survey results also found that approximately 14% of 12th graders in the South and 15% in the Midwest reported delta-8 use, compared to 10% in the Northeast and 5% in the West. Around 14% of those in states without cannabis legalization reported delta-8 use, compared to 8% in states with legalization. In states without existing delta-8 regulations, 14% reported use compared to 6% in states with delta-8 legislation.

“Delta-8 products are out there where teens can easily find and buy them, and there needs to be continued surveillance of its use, as well as public health efforts to help youth and parents stay informed and safe,” said Alyssa Harlow, Ph.D., MPH, clinical assistant professor of population and public health sciences at the University of Southern California (USC), a member of the USC Institute for Addiction Science and lead author of the study.
“The national trends documented by the Monitoring the Future survey provide critical information for research and policy to keep pace with new developments in the market for cannabis products, which has seen considerable change in recent years,” said Richard A. Miech, Ph.D., team lead of the Monitoring the Future study at the University of Michigan and co-author of the study.
Because the survey is taken in school settings, students who were absent, not enrolled, or with less engagement in school — a known risk factor for drug use — may have been less likely to participate in the survey, the investigators note. This exclusion may have potentially led to an underestimation of adolescent use of delta-8. Future work will need to assess delta-8 use in younger teens; include a larger survey sample across a wider range of states; and examine the use of other hemp-derived products, including delta-9 and delta-10.Top of Form
The Monitoring the Future survey is given annually to students in classrooms in eighth, 10th, and 12th grades who self-report their substance use behaviors over various time periods, such as past 30 days, past 12 months, and lifetime. In 2023, the survey included questions on delta-8 for the first time, and they were administered to a randomly selected one-third of 12th grade students, resulting in 2,186 12th graders in 27 states. Given the prevalence of use found in the 2023 survey, questions on delta-8 have been added to future surveys for all age groups.

Obesity, which could reach 50% of the population in certain developed countries by 2030, is a major public health concern. It not only affects the health of those who suffer from it, but could also have serious consequences for their offspring. Scientists at the University of Geneva (UNIGE) and the Geneva University Hospitals (HUG) have studied the impact of maternal obesity on the risk of developing liver disease and liver cancer. Using an animal model, the team discovered that this risk was indeed much higher in the offspring of mothers suffering from obesity. One of the main causes was the transmission of a disturbed intestinal microbiota from the mother, resulting in a chronic liver disease whose effects became apparent in adulthood. These results, which have yet to be confirmed in humans, are a warning signal and a call for action to limit the deleterious effect of obesity on children. This research is published in the journal JHEP Reports.
The scientific community suspects that maternal obesity disrupts the metabolic balance of the unborn child, and even increases the risk of childhood cancer and colorectal cancer. But to what extent? ”We wanted to understand whether the children of mothers suffering from obesity were at greater risk of developing liver diseases, and by what biological mechanisms,” explains Christian Toso, full professor at the UNIGE Faculty of Medicine and director of the Division of digestive surgery at the HUG, who led this research. ”Indeed, while the risk of liver cancer due to a hepatic virus is decreasing, obesity-related liver diseases are constantly on the rise.”
The scientists studied two groups of female mice: the first fed with a diet rich in fat and sugar — similar to junk food — which rapidly became obese. The second — the control group — was fed normally. All their offspring were fed with a normal diet and were not overweight. The only difference was therefore the maternal obesity of the first group. ”At 20 weeks, which corresponds to adulthood in humans, we could not detect any notable differences,” explains Beat Moeckli, junior staff surgeon and researcher in professor Toso’s team, the first author of this work. ”However, at 40 weeks, a senior age in mice, the liver health of the first group began to deteriorate. All the parameters of liver disease — fat deposits, fibrosis, and inflammation — were significantly higher in the offspring of mothers suffering from obesity. And these are the main risk factors for liver cancer in humans”.
From disease to cancer: the role of microbiota
To confirm whether these mice had a higher risk of developing liver cancer, the team injected two groups of these mice with an oncogenic product just after weaning. And indeed, the offspring of obese mothers had an 80% risk of developing cancer, compared with 20% for the control group. ”The mother’s obesity thus has an impact long after the birth of its offspring, which seem to inherit a dysfunctional microbiota despite their own living conditions,” analyses Beat Moeckli. ”Obesity alters the composition and diversity of the mother’s microbiota, which is passed on to the next generation and persists throughout life”.
However, by placing mice from both groups in the same cage, the scientists observed a normalisation of the microbiota. As mice are coprophagous (they eat their faeces), they quickly share the same microbiotic strains. Bacterial diversity then increased, favouring the good bacteria. As a result, the healthy microbiota naturally regains the upper hand, and the marker of liver disease dramatically decreased. ”We see a clear effect of the microbiota on the risk of developing liver cancer, indicating its central role in transmitting the risk of disease from mother to child.”
The junk food diet encourages the proliferation of bad bacteria and reduces bacterial diversity. This altered microbiota, transmitted at birth, then leads to greater inflammation in the liver and, over time, generates fibrosis and steatosis (an excessive presence of fat), which in turn increase the risk of developing liver cancer. Normalising the microbiota also normalises the risk of cancer.
And in humans?
These data come from a study on an animal model, in a highly controlled environment. To be applied in a clinical context, they need to be confirmed in humans under real-life conditions. The first stage will consist of an epidemiological study based on large bodies of data obtained from following mothers and their children over several decades. ”However, we already know that it is possible to modify the microbiota, for instance by using probiotics. ”Having highlighted the importance of the microbiome represents a first step towards new therapies,” the scientists conclude.

Published4 minutes agoShareclose panelShare pageCopy linkAbout sharingBy Sophie HutchinsonBBC NewsA mental health trust linked to thousands of unexpected patient deaths repeatedly failed to act on coroners’ safety warnings, campaigners say.BBC News has been given exclusive access to new evidence from coroners’ reports gathered by a campaign group.It wants a criminal investigation into why so many patients died at Norfolk and Suffolk NHS Foundation Trust – and has sent police the evidence.The trust said it was “working really hard” to learn from past deaths.Bereaved families told the health minister the trust should be shut down.Campaigners, including patients and bereaved families, claim it is failing to make vital safety improvements despite promising to do so. Last summer, a report found more than 8,000 mental-health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022. This is defined as the death of a patient who has not been identified as critically ill or whose death is not expected by the clinical team.The new evidence, based on 38 coroners’ prevention of future death (PFD) reports since 2013, suggests there were repeated warnings more patients could die unless safety issues were addressed, including:dangerously poor record-keeping and communicationfamily concerns being ignored unsafe levels of staffing at the trustAnd campaigners say the trust’s failure to improve safety has led to more deaths.’Real change’They met Minister for Mental Health Maria Caulfield and MPs, at Westminster, on Tuesday, and demanded an independent public inquiry over “the ongoing deaths crisis” at the trust.Natalie McLellan, whose daughter Rebecca died in November, says the 24-year-old was abandoned by her mental health team after being diagnosed with bipolar disorder. She wants “real change”.”You can’t keep ignoring mental health in this country – there is a death crisis and these beautiful young people, and old, are losing their lives because of inadequacies,” Natalie said. “We need to address it now.”Seven years ago, following the death of Henry Curtis-Williams, 21, a coroner warned about poor record-keeping.Image source, Curtis familyHenry was sectioned and taken to hospital in 2016, after being found by police on a bridge, but was discharged the next day by a junior member of staff and a few days later killed himself.In the PFD report about Henry’s death, assistant coroner Dr Séan Cummings said there was a “culture of not recording contemporaneous notes” and communication between staff was “very informal” with “no record kept of important messages relayed”.Henry’s mother, Pippa, says her only child’s death has had a catastrophic impact on her and she remains devastated by his treatment.”I replay it in my mind often,” she said. “It really was a catalogue of one failure after another, particularly in the clinical note keeping and the premature discharge. “I feel on a daily basis nothing other than anger and bitter resentment towards the trust.”If you don’t keep accurate clinical notes in chronological order, then how can a new nurse that comes on shift have any idea what’s happened previously to the patient?”Since Henry’s death, the evidence from campaigners suggests nine other other mental health patients have died with some of the same safety issues raised in the PFD reports. Five of those deaths were linked to unsafe record-keeping, campaigners say.One of the reports also refers to the falsifying of records.The trust said its quality of care rating had, earlier this year, been upgraded from “inadequate” to “requires improvement”.And over the past six months, it had improved its collection, processing and use of mortality data.’Recovery-support programme’An official said: “We offer our sincere condolences to all families and carers of people who have lost loved ones. “We can assure all families and carers that we are working really hard to learn from these incidents and do our very best to ensure they are minimised in future. “A review of prevention of future deaths is already under way to ensure improvements in practice have been made and learning is embedded across our clinical services.” NHS England said it would ensure the improvements needed to deliver safe and high quality care to patients were achieved and targets in the wider improvement plan reached.”We are working with Norfolk and Suffolk Foundation Trust and have already helped them to achieve an improved CQC [Care Quality Commission] rating,” an official said.”The trust will remain in NHS England’s national recovery support programme to receive the highest level of scrutiny and support.”More on this story’Spin doctors’ paid £800k by struggling NHS trustPublished7 November 2023Bereaved mum wants unsafe mental health care endedPublished12 December 2023Public inquiry call over mental health death dataPublished10 July 2023NHS trust lost track of patient deaths, review findsPublished28 June 2023

Image source, PA MediaPA MediaWest MidlandsOprah FlashBBC News West MidlandsPublished1 hour agoYoung people across the UK are being urged to have their measles, mumps and rubella (MMR) vaccine following a rise in measles cases.At the start of the year, the West Midlands saw the highest number of people with measles since the 1990s, health officials said.There have been 733 cases of measles in England since October last year, two months ago this figure was 133.The NHS is now urging more than 900,000 adults aged 19-25 who have not yet had the jab to take part in a catch-up campaign.These youngsters would have been eligible for a jab when the vaccination rates began to fall in the late 1990s and early 2000s.Take up of the MMR jab started to drop following a 1998 report by Andrew Wakefield which falsely linked the jab with autism, according to a UK Health Security Agency (UKHSA) 2023 measles briefing document.Now vaccine coverage is the lowest it has been for more than a decade, with just 85% of youngsters having both doses of the jab before they start school aged five.The West Midlands initially reported the largest measles outbreak outside of London, however cases have now been identified in the North West, London, East Midlands and Yorkshire and the Humber.Appointment invitation letters are being sent to those living in the West Midlands, London and Greater Manchester.’One of the most infectious diseases’A number of pop up vaccination clinics have been launched and the jab is also available at GP surgeries.”Measles is one of the most infectious diseases in the world and can cause serious harm to adults and children of all ages,” said Steve Russell, NHS England’s director of vaccinations and screening.Dr Gayatri Amirthalingam, consultant medical epidemiologist for immunisation at UKHSA, added: “Being unvaccinated also means you risk spreading the disease to others, including those at greatest risk of becoming seriously ill – like infants, who aren’t able to receive their MMR vaccine until their first birthday, pregnant women and those with a weakened immune system.”The MMR jab also protects against complications from mumps in young adults. I strongly urge anyone who’s not vaccinated to protect both themselves and those more vulnerable around them.”Follow BBC West Midlands on Facebook,

UK Covid-19 InquiryCopyright: UK Covid-19 InquiryThe inquiry is shown notes from Morgan, in which she writes “is Matt Hancock hopeless?”. Another entry reads: “Prime Minister – Chaos”.She is then asked whether the remarks jotted down were linked to text messages published in June 2021 by former Downing Street adviser Dominic Cummings, in which then-Prime Minister Boris Johnson criticised the approach from those in Cabinet during the pandemic.”I’m guessing it must have been and it would have made sense in terms of the timing,” Morgan replies.She adds that those notes would be “more political in nature”, something she would show to her political group – and the notes aided her in remembering what was happening at the time.Another
entry relates a meeting, when Morgan was not invited and learnt of
“English moves” via the media, in what she describes as a “wholly unsatisfactory situation.”She
tells the inquiry Welsh ministers were being invited to meetings very late and being given information
“sometimes minutes before.” Morgan adds she was concerned in one meeting
that she was a
“lone voice” and the majority would come out against the public health
position when it came to tourism.

Published6 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, PA MediaPeople with signs of winter vomiting virus have been urged to stay away from hospitals and other health facilities.The NHS said “very contagious” norovirus was “doing the rounds” in Cornwall and it wanted to prevent it spreading.”If you have symptoms please stay at home,” said Dr Chris Reid, chief medical officer at NHS Cornwall and Isles of Scilly.Anyone with symptoms due to have a GP appointment should call the surgery.Some hospital wards have also been affected, so it may not be possible to visit patients, NHS Cornwall said.People who want to visit should phone the ward before setting out to check the current arrangements.NHS Cornwall added the best way to prevent spread is to wash your hands regularly with soap and warm water, and said alcohol hand gels do not kill norovirus.Although norovirus is unpleasant, for most people it usually passes in a couple of days, the NHS said.Follow BBC Cornwall on X (formerly Twitter), Facebook and Instagram. Send your story ideas to spotlight@bbc.co.uk.More on this storyNorovirus: Winter vomiting virus cases risingPublished30 November 2023Norovirus: ‘Ferrari’ of virusesPublished24 December 2012Related Internet LinksNorovirus (vomiting bug) – NHSThe BBC is not responsible for the content of external sites.

Published16 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Josh ParryLGBT & Identity ProducerA shortlist of artists competing to create London’s first permanent Aids memorial has been announced.The monument will be situated near the former site of Middlesex Hospital, the UK’s first dedicated Aids ward famously opened by Princess Diana in 1987.Campaigners hope it will pay tribute to those lost to Aids-related illnesses and help educate about the disease.The charity behind the project, Aids Memory UK (AMUK), officially began campaigning for a memorial in 2016.A panel of judges including AMUK trustees, art historians, and doctors specialising in Aids and HIV, as well as a board of people who represent communities affected by the Aids crisis, will select a winner from five shortlisted artists.The five, who live or work in London, are former Turner Prize nominee Anya Gallaccio, Ryan Gander, Harold Offeh, Shahpour Pouyan and Diana Puntar. The winning artist will be announced in June 2024 with the final memorial set to be unveiled in 2026.It will be situated in central London, close to the hospital where the UK’s first dedicated Aids ward was opened by Princess Diana.Her visit to Middlesex Hospital was credited with helping to challenge the belief that HIV or Aids could be transmitted by touch, after she famously shook hands with a man suffering from Aids.Image source, Emile HolbaA statement released by AMUK says the memorial aims to raise awareness of the “continuing impact of HIV and Aids”, as well as celebrate those living with HIV, and those who campaigned for better care for people living with the condition.Ash Kotak, founder and artistic director of AMUK, said the shortlist announcement was “incredibly exciting.”He added: “It has been a long journey to get to this point of delivering the first permanent Aids Memorial in London.”This group of acclaimed and very inspiring artists, with their diverse practices, each bring a different perspective to the memorial.”Mayor of London Sadiq Khan has committed £130,000 from the city’s Commission for Diversity in the Public Realm to help fund the memorial.He said: “I’m proud that London is leading the way in tackling HIV globally, and we are doing all we can to address the stigma related to the virus. “This permanent memorial will ensure we remember those affected and honour the ongoing fight against HIV and Aids, and tackle the discrimination around it.” More on this storyMayor commits £130,000 for first-ever Aids memorialPublished1 December 2023London’s first Aids memorial planned by campaignersPublished7 April 2021

Published24 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Alys Harte & Ella RuleBBC File on 4Claims 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.Image source, Getty Images”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 ProgrammesAlys 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