Sean DugganEmployers and the health system need to do more to help get people with mental health issues back into work, a new report has claimed.

Mental health issues cost the UK about £70 billion every year, or roughly 4.5% of GDP, in lost productivity at work, benefit payments and health care expenditure. But early action by employers and the health system is the best way to prevent poor mental health leading to benefit dependency, both when people are still at work and early on during the sick-leave period, the report by economic and social policy group the Organisation for Economic Co-operation and Development (OECD) argues.

The OECD’s report, Mental Health and Work: The United Kingdom, said that around one million claimants on employment and support allowance (ESA), and as many on Jobseeker’s Allowance (JSA) and other working-age benefits, have a mental disorder such as anxiety and depression that is hurting their prospects of finding work.

Up to 370,000 Britons move onto disability benefit every year – 1% of the working-age population – the highest rate in the developed world and twice the OECD average. The leading cause for such benefit claims is mental illness, which accounts for about 40% of all new claims.

The OECD report adds that while recent welfare reforms designed to tackle high disability benefit caseloads “go in the right direction”, further improvements are needed to ensure that reforms bring people into work. 

Likewise, the report adds, if welfare cuts are to be made, they need to be matched by increased efforts to address the barriers to finding and remaining in work.

But the OECD criticises the government’s Work Programme, saying it is “struggling” to place ESA and JSA claimants with mental health problems into work, noting that their unemployment rate is more than double the overall rate.

Likewise, the risk of people with mental ill health falling into poverty is almost double the overall average.

Health and employment interventions

The OECD added that the majority of benefit claimants with mental ill health need a combination of health and employment interventions to improve their chances of finding a suitable job. While it noted that access to common mental health treatments has increased in recent years, it also highlighted how waiting lists are still too long in some part of the country. 

It added that positive changes are also taking place to inform GPs about common mental disorders and return-to-work issues, but more systematic action in dealing with workplace matters is needed through a revised training curriculum.

The OECD recommends that UK authorities:

• Ensure that the new Health and Work Service, to start in 2014, is implemented quickly and universally, with a strong focus on mental health and those still in work and with much stronger involvement of employers

• Increase the attention to mental health and its impact on employability and work capacity in all parts of the welfare system

• Increase resources and refine financial incentives for employment service providers to ensure better employment outcomes for customers with mental health problems

• Build on recently improved integration of health and employment services to ensure that integrated health and employment interventions for those with mental health issues are widely available

• Further expand access to psychological therapies for those with a common mental disorder.

Fair chance

The report demonstrates that the government, NHS and employment services have a lot more to do if they are to offer people with mental health problems a fairer chance in the labour market, the Centre for Mental Health’s chief executive, Sean Duggan (pictured), said.

“This report is a timely reminder of the need for improved support for people with mental health problems to get and keep work,” he said. “Too many people lose their jobs when they have a mental health problem for lack of the right support. And too few people with mental health problems are offered effective support to get work despite clear evidence of what would give them the best possible chance of success.

“Offering people with mental health problems effective support to get and keep work is excellent value for money. We know that Individual Placement and Support (IPS) for people with a severe mental illness reaps big economic benefits. We now need to find out if the same results can be achieved by adapting IPS to people with depression and anxiety, who are too often given scant health and employment support at a high cost to them and to the economy.

“The Government recognised the importance of supporting more people with depression and anxiety to get work in its recent Mental Health Action Plan. Piloting the use of IPS for people who are receiving psychological therapy is a promising way to improve the support they are offered.

“We hope that today’s report will encourage the Government, the NHS and Work Programme providers to take a broader, more concerted and evidence-based approach to supporting the employment aspirations of people with a range of mental health problems.”

Paul Farmer, chief executive of Mind, also welcomed the report and agreed that more specialist support is needed. “This will help tackle the barriers to entering and retaining work faced by people with mental health problems. The report also identifies the need for better integration between employers, the health service and the benefits system, as well as initiatives like Improving Access to Psychological Therapies (IAPT). Too many people currently fall through the gaps because these services are not joined up.

“Early intervention is key to supporting good mental health, and the new Health and Work service is an opportunity to help individuals get the right support at the right time. For the service to be effective, however, we need to see case managers with expertise in mental health who are able to recognise the impact a complex, fluctuating condition can have on somebody’s ability to work. 

“The report appears to support the reforms to the welfare system, including compulsory reassessment of those claiming out-of-work and sickness benefits. However, we know that sanctions do not help people back into work, in fact they often make it harder for people to engage and result in individuals being pushed even further from the workplace.”