The Vocabulary Problem That Makes Good Mental Health Support Invisible
The Vocabulary Problem in Workplace Mental Health
Ask a counsellor and the employer paying the bill whether the counselling worked, and you can get two different answers about the same person.
It is rarely because their interests are opposed. A counsellor works for the person in front of them, and sometimes that means helping someone leave a role rather than stay in it. More often, though, both sides want much the same thing: someone who recovers and is able to keep working. The disagreement is seldom about the outcome. It is about how each side describes it.
Two vocabularies, one reality
Both sides are describing the very same events and giving them different names. What a clinician calls a client returning to baseline functioning, HR calls reduced absence. The drop in someone's exhaustion is, on the other side of the table, a drop in presenteeism. One reality, two vocabularies, and neither converts into the other on its own.
That conversion turns out to be rare in practice. Reviews of workplace mental health find the field leans heavily on individual clinical outcomes and lightly on organisational ones. Formal economic evaluation of these programmes remains scarce even where the case for them is strong. The value is often real. It is simply never said in the terms the budget is decided in.
The consequence
The consequence is quiet. The counsellor sees someone getting better. Finance sees a cost with no number next to it. Same work, two verdicts.
And the support that gets cut is seldom the support that failed. It is the support nobody translated.
This matters particularly in international companies, where the population most likely to need support, assignees navigating a new country, a new legal system, and a workplace culture that reads their signals differently, is also the population least likely to show up in utilisation data. They do not use the generic helpline. Their absence from the numbers looks like wellbeing. It is not.
What the translation requires
Bridging the two vocabularies is not straightforward. It requires someone who understands what recovery looks like psychologically, what it costs organisationally when it does not happen, and what the specific pressures are that shape whether a particular employee gets better or does not.
For international and Korean organisations in the Netherlands, that means understanding the Poortwachter framework well enough to know where psychological and legal timelines intersect, the cultural dynamics that determine whether an international assignee will seek help at all, and the organisational reality the employee is returning to after a period of difficulty.
None of that is visible in a generic EAP utilisation report. It sits in the space between the psychological relationship and the organisational one, and it is where the case for mental health support either gets made or gets quietly dropped from the next budget cycle.
Measuring it is possible
None of this means the value cannot be measured. It means the measurement has to be agreed before it is needed rather than reconstructed after. When both sides settle early on what progress looks like and how it will be recorded, the same recovery becomes visible to each of them: the clinician sees someone functioning again, and the organisation sees it in the terms its budget is decided in. Agreeing this at the start of a contract is far easier than assembling it at budget time, once the person has already improved and the record was never kept. To me, making sure that agreement exists is a large part of what a workplace mental health partner is for.
A note on sources
The observation about economic evaluation is not new. McDaid (2007) noted that the socio-economic costs of poor workplace mental health are substantial while formal economic evaluations of interventions remain few. More recent scoping reviews confirm the skew has not meaningfully shifted: interventions continue to lean toward individual-level outcomes, with the organisational and economic layer consistently underdeveloped. The gap is structural, not accidental, and closing it requires more than better data. It requires people on both sides of the conversation who can speak both languages.
Kelly Kim is an NIP-registered psychologist and workplace mental health specialist supporting international and Korean organisations in the Netherlands.About Kelly.
Sources:https://pubmed.ncbi.nlm.nih.gov/18333424/,https://pmc.ncbi.nlm.nih.gov/articles/PMC10713995/
