HOPE PROMOTION Mental Health and Employment BASE Conference Manchester

Simon Francis

June 2009

Rehabilitation

Lifelong learning

and training

Research and EvaluationResearch and EvaluationResearch and Evaluation

Key TasksJob RetentionSickness ManagementOccupational HealthIn work SupportSustainable employmentEmployer InvolvementCultural change at work

Reduce Stigma

Key Tasks

Pathways to WorkJob brokingBenefit managementJSAWork IncentivesTransitional helpEmployer engagement

Key TasksOutreach and marketingAddress barriers to work UpskillingWider agenda e.g. neighbourhood renewalBuild capacityCondition Management

AimTo promote sustainable employment by encourage progressionTo aid profitabilityTo stop the drift to benefits

AimGet people workTo manage the benefit gatewayEncourage employers to recruit people

AimTo engage the long term unemployed in the LMPromote motivation and cultural change

In WorkClose to WorkLong term Sick

Health

Disadvantaged areas

Context

• Economic downturn rising personal debt

• Rising Unemployment, who gets jobs

• Fewer jobs

• Impact of targets – Broad range of priorities

• Numbers of people with common MH conditions increasing, SMI stable.

Overarching Government Drivers

• Recession• Demographic time bomb. Pensions.• Pledge to abolish child poverty in Britain

in a generation.• Citizenship Rights and responsibilities,

work for those who can support for those who can’t

• Devolution?

Overarching Government Drivers (2)

• Tackling social exclusion, work is the best way out of poverty.

• Regeneration and active communities• Creating the conditions for business success

and economic growth. • Health Work and wellbeing, Workplace MH.• Tackling unemployment and worklessness

The issue Stigma and discrimination. Over 2/3 of people put off applying for jobs due to unfair treatment.

Less than 40% of employers would recruit from the MH group. SEU report 2004.

Low aspiration

3X More likely to be in debt

Procurement and Targets,

Low employment rates

70% of people find their job fairly or very stressful BACP/ Future foundation Base 2004.

But Poor Mental Health is not Unusual and people recover

• 1 in 4 people have a MH problem at some time in their lives

• 1 in 6 people experience mental distress at any point in time.

• Strong association between poverty, poor MH and unemployment. Intergenerational effects

• Most people recover from mental illness • Work provides hope and optimism for the

future and hope is integral to recovery.

Health• Therapeutic value of work, people in work

experience better health than those out of work, But sometimes work is part of the problem

• Being unemployed carries the same health risks as smoking 200 cigarettes a day, with

unemployment itself is a cause of poor MH • Suicide biggest killer among young men with• Strong association with unemployment.

The Cost Britains biggest social problem

Poor mental health costs each household £2K p.a

Cost for Yorkshire and the Humber £6.5bn Francis and Lindsay 2008

Annual cost to employers is around £600 per employee. CIPD and CBI.

Presenteeism likely to cost around 1.5 times more than absenteeism. Sainsbury Centre 2007

Significant, impact on individuals their families and communities.

Government Response Policies • Life Chances of Disabled People• Reaching Out National: Action Plan to Tackle Social

Exclusion 2006• Working for a Healthy Tomorrow 2008 • Public Service Agreement Target PSA 16, Work

Recovery and Inclusion. Delivery Strategy• IDEAs• National Strategy for Mental Health and Employment• Perkins Review• New Horizons• Work Recovery and Inclusion

There are opportunities

• This is the right thing to do. Positive messages around mental health (Time to Change/Shift)

• Raft of Government policies, high on Government social policy agenda. PSA targets

• Funding, DH investment in the regions, through Government Office and SHA. IAPT

• Future Jobs Fund, critical

Continued• Existing delivery partnerships, RETs

• Public Sector to Lead by Example, Job opportunities

• Strong Evidence base on what works IPS

• Existing delivery partnerships

• Range of existing best practice

                            

Perkins review

• Commissioned by DWP SoS

• Recommendations for Pre Budget Report, cost neutral

• Strong fit with Work Recovery and Inclusion especially adults with SMI

• Looking at cost benefit analysis for intervention

Perkins Review Scope• How people with common mental health needs

should be supported, to ensure the speediest and most effective work-focussed support;

• How to get additional employment and health support to enable those with more complex needs – SMI – to realise their aspiration to work, including through self employment. How wider access can be provided to progressive, individually tailored employment support

• How innovative models (including an IPS model) could be used alongside and/or in strengthening DWP existing suite of employment programmes and employment support services across government;

• How the right balance of support can be achieved, using existing resources in the most effective way.

Perkins Possible Options for Progress

• Personal Budgets to be used for employment support, especially in work

• Possible short term work trials • Refocusing health services toward

evidence based interventions IPS• Welfare benefit system as enabler• Closer working between health and

employment

Work Recovery and Inclusion • Offers a vision for Employment of people with

severe mental illness • Sets out principles for services and delivery• Sets out policy options• Builds on and adds value to current work,

including Perkins review• Sets out a coherent delivery model, national

local and regional delivery • Makes the business case for intervention

Work Recovery and Inclusion• Shift the culture and aspiration of services

toward the case for the recovery and therapeutic value of work. For both System and Individuals

• Restate the importance of effective co-ordination of health and employment services

• Commit services to act as an enabler to work• Explores the perceived and real barriers to

work surrounding the welfare benefit system, offer solutions

Work Recovery and Inclusion• Employment is considered within context of wider

determinants of social inclusion, such as housing, learning and skills.

• Service user consultation is at the heart of policy development locally, regionally and nationally.

• Ensure change is driven by the best use of evidence and data and continuing to build the evidence base.

• Ensure that infrastructure is focused on delivery and a broad range of providers (the third sector).

• NHS and Public sector lead by Example

Themes:• Links with young people agenda, intergenerational

effects• Positive about mental health.• Build capacity in individuals and organisations, Trust

development • Ensure that Learning and Skills agenda is an integral

part of our efforts. How best to enable people to stay in FE and HE.

• Get people into work, manage the transition• Engage and support employers and employees• Promote good and mentally healthy work

Final Career Limiting Thoughts • What Do people Need? • A. Home and a Job same as you and me, and

to be treated with dignity and respect• Do resources follow need?• Is there a broad range of provision available

in each locality? Do people know about it? • What more is needed?• Whose responsibility?