Hold the applause, please.

Those who follow my articles and contributions on LinkedIn would no doubt be aware of my irritability and intolerance in the face of fanciful claims. Anyone who monitors their news feed, particularly in the financial services sector, would be confronted by numerous reports on mental health, lunches, ribbon-wearing and gratitude trees. While much of this activity is well-intentioned, are intentions enough with a problem that is often quoted as having a 9-figure economic impact?

This week, Anna Patty reported the findings from an iCare Foundation report that was based on commissioned work from Urbis. The released report won an award from an organisation sponsored by Urbis. The report that was released was a summary of Urbis' findings. It stated that it was a combination of the work of Urbis and iCare, although there was no clear demarcation about the contributions. The headline finding was that a dollar spent would return $65 for those investing. Such fantastic figures are nothing short of Nobel-Prize winning outcomes, were they true. Which rational employer would look past such interventions with such powerful economic impacts? So its certainly worth examining the evidence closely.

The original article by Anna Patty has since been amended as the iCare Foundation has refused to release the actual Urbis report citing issues of commercial confidentiality preventing them from doing so. This was an interesting explanation, given the recipients of employer-premiums were several organisations, some based in the not-for-profit sector.

The iCare Foundation was set up with good intentions, it states that it wants to improve the lives of those injured by injury prevention, improved well-being and better injury management. These are all noble ideals. The execution, however, falls well short of the ideals. The devil is always in the details. Take, for example, the study from UNSW that is the basis of the incredible $65 return. To be clear, I have considerable respect from the researchers, such as Sam Harvey and Nick Glozier. They have fine minds and have shown tremendous leadership in their areas of interest. They have created (or supported, it is not clear), some excellent interventions based on theory. Their app, that I downloaded is well-designed, embraces cognitive-therapy and mindfulness constructs and is full of useful advice. There is no doubt that its efficacy was worth testing, particularly given the size of the problems. From a philosophical perspective though, I don't like it at all. I recall when I separated from my wife and experienced tremendous suffering being away from my children. I went to seek help from one of my colleagues, a distinguished professor. What I needed at that time were empathy and support. What I was offered, was an app. Policy-makers love apps, they are not resource-intensive, don't take sick-leave or create HR issues. But they short-change those that need real help.

To be fair, the UNSW researchers were not just using apps, they had at least 3 different kinds of interventions that received positive feedback from participants. While feedback is important, the metrics that we should be caring about most, include illness duration and severity. In one paper that was published in 2017 by my colleagues, in the prestigious medical journal Lancet, they reported that their approach yielded a 0.28% decrease in work-related sick leave in the group that participated in the training. The standard error, a metric to determine the accuracy of that measurement was 0.23. This means that the true impact may have even been much lower. For argument's sake, let's accept that 0.28% figure. On that basis, the authors concluded that the return on investment was around 10+ pounds per pound invested. So small percentages may make big impacts.

The jaw-dropping moment in this research was when the researchers reported that non-work-related sick leave in the same group went up by 0.48%. This means that in the treated group, there was overall an increase in sick leave by 0.2%. So, in reading the arguments put forward by the researchers for the iCare Foundation that there was a return of around $150 mil overall, in part based on their earlier research, one should approach these findings with considerable sobriety. There are further studies from this group that are yet to be published that are central to the $65 claim, but based on what they have already published, one would be entitled to some scepticism. It would certainly be worth holding off any awards, especially those that are sponsored by the group that was commissioned to do the evaluation. The optics of this are terrible.

Without close scrutiny, that is impossible from a summary, such findings are likely to drive investments from both the public and private sector into a direction that is far from proven. Disappointingly the iCare Foundation has failed us all by being seduced by its own evangelism.