Mental health problemo kosti societo billions da funto. That’s Esperanto for ‘mental health problems costs society billions of pounds.’ Too often, experts don’t translate their jargon into the language of their audience; this is true of mental health and employment as it is of many areas.
NPC has tried to translate the jargon into a simple guide for funders, launched yesterday: Job well done: Employment and mental health problems. To mark the launch, NPC and the Centre for Mental Health hosted a debate amongst experts about what works in mental health and employment. Our biggest challenge now is communicating the messages from this discussion to those who can do something about the problem: philanthropists, employers and government. We need to translate our expert jargon into their language.
The experts broadly agreed that two main things need to happen if more people with mental health problems are to gain and retain employment, which I’m going to talk about below. Under each, there’s a role for philanthropists, employers and commissioners:
1. We need more effective employment support for people with mental health problems. As of 2008, only half of those suffering mental health problems were receiving employment support from government, and only a fraction of these are likely to receive the most effective support: Individual Placement and Support (IPS). IPS is designed to help people with severe and enduring mental health problems back to work. It joins up employment advice and treatment, and places people directly into jobs they want. So far it has only been adopted in about 1 in 6 mental health trusts in England. IPS is the most proven approach, but is not the only one. Charities deliver a range of employment support, many with promising results (including Mental Health Matters‘ ‘Back in Touch‘ service and Hillside Clubhouse‘s transitional employment scheme). However, these need more robust evaluations to prove they help people back to work.
Philanthropists could… spread IPS by directly funding charity employment advisors to deliver IPS within NHS mental health teams; fund the Centre for Mental Health to train government employment advisors to deliver IPS; fund and evaluate promising but less proven approaches like those provided by Mental Health Matters and Hillside Clubhouse.
Commissioners could… use central government funding to fund employment advisors to deliver IPS.
2. We need to make more workplaces mental health friendly. Not enough employers realise mental health problems are affecting their staff. In fact, the problem affects millions and costs employers £20bn every year. Many also don’t know there are solutions provided by charities like Stand to Reason, Mind and the Centre for Mental Health. Their services to employers can prevent mental health problems arising, and support people with mental health problems to manage their condition and stay in work. Employers need to be convinced that improving mental health in the workplace will benefit the bottom line. We need to show them the huge costs and likely savings: as much as £2.50 for every £1 spent (see Job well done for these calculations). But there is another business argument: caring employers, who take care of employees’ mental health, are most likely to thrive (see Who Cares Wins).
Philanthropists could… scale up services for employers that improve the mental health of their staff run by charities like Stand to Reason, Mind and the Centre for Mental Health. ’Strategic’ core funding could help them grow and reach more employers. Funding for impact evaluations would show whether these schemes create savings for employers, helping build the business case for investment.
Employers could… invest more in making their workplaces mental health friendly, using services provided by Stand to Reason, Mind and the Centre for Mental Health.
So there is a huge amount that philanthropists, employers and commissioners could do in this area. But why would they? What do they get out of it? I think there’s a pretty strong case for action:
Philanthropists can transform the lives of people with mental health problems and generate a huge return for society. They can expect a positive social return of at least £1.50 in social value for every £1 invested. This is real money in the pockets of individuals, employers and government.
Employers can expect to improve their bottom line and sustainability. They could save £2.50 in reduced leave and increased productivity for every £1 invested (see Job well done). Being a caring employer can help build a sustainable business.
Government can make big savings. By providing effective employment support, commissioners should increase the number of people with mental health problems who are working, so increasing tax take. It should also reduce people’s reliance on health services, because appropriate work can improve mental health.
NPC and the Centre for Mental Health are keen to follow-up on this roundtable. We want to reach beyond the experts to philanthropists, employers and commissioners. We’ll make sure we speak to them in plain English, not Esperanto…
At vaious times over the last 25 years I have worked in six different kinds of mental health employment service, all of which had the same aim of being instrumental in helping clients to find permanent paid work. I now believe that a great deal of money and time has been poorly invested in trying to prepare people for work, or provide them with sheltered alternatives because we now know that Individual Placement and Support is by far the most effective, in terms of the numbers and percentages of people which it succeeds in helping, and the speed at which this is achieved.
Being in employment should be an equal right for everyone. Legislation and recommendations to employers have gone some way to making this a reality, but it is still a fact that people with mental health conditions experience more difficulties in finding a job than anyone else, and as the prevalence of mential ill health is one in six people of working age, this is a significant loss of national potential.
Interestingly people with mental health problems report that they find employment to be the best treatment for their mental health condition, and IPS is the best method of achieving that result. Any investor who wants to see the measurable effects of their financial participation in improving lives should give IPS a close look.
We know work is generally good for people’s mental health and it’s essential that anyone with a mental health problem who is currently out of work gets the very best support to find and maintain a job – the evidence is now pretty clear what are the best ways of doing this. But of course it can be the workplace that is the cause of people’s problems in the first place, so it’s just as important that all employers create mentally healthy workplaces. In the Mental Health Foundation’s experience of advising people on how to create a mentally health workplace, it’s not that they don’t know what one looks like, it’s just that they don’t always put the time and effort into actually achieving it. New evidence of the economic benefits to business of keeping people well at work, mentally and physically, should help change attitudes. We also need to remember that it’s not just about overcoming possible stigma and discrimination from employers and work colleagues. Some people will stigmatise themselves, believing that because they have been diagnosed with a mental disorder, they are not capable of paid employment. We need to make sure that proven psychological therapies are widely available to help people to feel empowered about their own lives.
But it’s not justwe musn’t forget that it’s not just about offering people support to get a job. Some people