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Dr Bill Gunnyeon
Chief Medical Adviser
Department for Work and Pensions
3 March 2011
MENTAL HEALTH, EMPLOYMENT AND DISADVANTAGE Making A Difference
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Department for Work and Pensions2
These three are inextricably linked
– Mental health problems – currently make employment less likely, and contribute to other disadvantages• Employment rates very low for people who have mental health conditions• People with depression have significantly worse survival rate from cancer and
heart disease.
– Unemployment – bad for health and causes wider disadvantage• Unemployment can increase the risk of developing mental health problems• Parental unemployment is associated with a 2/3 fold increased risk of emotional
or conduct disorder in childhood.
– Disadvantage – increases risk of mental health problems• Men living in poorest households are three times more likely to have a common
mental health condition.• Children from poorest 20% of households have threefold increased risk of mental
health problems.
Mental health, employment and disadvantage
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Department for Work and Pensions3
The employment penalty for mental health
0
10
20
30
40
50
60
70
80
90
100
Em
plo
ym
en
t R
ate
s (
%)
Generalpopulation
People withany disability
People withany mentalillness (mid-point)
Peoplereceivingsecondarymental healthservices
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Department for Work and Pensions4
These three are inextricably linked
– Mental health problems – currently make employment less likely, and contribute to other disadvantages• Employment rates very low for people who have mental health conditions• People with depression have significantly worse survival rate from cancer and
heart disease.
– Unemployment – bad for health and causes wider disadvantage• Unemployment can increase the risk of developing mental health problems• Parental unemployment is associated with a 2/3 fold increased risk of emotional
or conduct disorder in childhood.
– Disadvantage – increases risk of mental health problems• Men living in poorest households are three times more likely to have a common
mental health condition.• Children from poorest 20% of households have threefold increased risk of mental
health problems.
Mental health, employment and disadvantage
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Department for Work and Pensions5
Scale of the problem
• Problem: Employment rates for people who have mental health conditions are too low.
• Societal cost– Benefits
• c.£8bn a year paid to people out of work with diagnosed mental health condition
– Lost productivity and wasted potential• c.£25bn in ‘lost productivity’
– Costs of wider ‘disadvantage’ exacerbated by reduced opportunity for employment
• Personal cost– Financial– Health
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Department for Work and Pensions6
Addressing the problem
Needs an integrated approach, built on key principles:
• Encouraging positive mental health
• Tackling stigma
• Identifying mental health problems early (childhood)
• Ensuring speedy access to appropriate support
• Building strong links between healthcare and employment support to improve work outcomes
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Department for Work and Pensions7
So what is being done?
Welfare Reform • Universal credits• WCA developmentEmployment Support• Work Programme and Work Choice• Access to Work also being reformed • Sayce ReviewThe Role Of Health Services• IAPT – severe conditions and employment support• Health outcomes frameworks (NHS, Social Care and Public Health)Support for employers • Adviceline• Fit For Work Service• Fit Note
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Department for Work and Pensions8
The role of Public Health
• Public Health:
“the science and art of promoting and protecting health and well-being, preventing ill health and prolonging life through the organised efforts of society” (Faculty of Public Health)
• Improving employment rates for people promotes health and wellbeing, and needs the organised efforts of society
• Recognised as such in No Health Without Mental Health (the Mental Health Strategy)
• Healthy Lives, Healthy People (the Public Health White Paper) also recognises this– Tackles health (including mental health) over the life course– Seeks to address health inequalities– Employment rates of people with mental illness are included in the
Outcomes Framework currently out for consultation
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Department for Work and Pensions9
Future challenges
• Persuading GP commissioners
• The role of MH in new Public Health system
• Work Programme and A2W / Work Choice
• Stigma
• Economic climate