Dr Bill Gunnyeon

Chief Medical Adviser

Department for Work and Pensions

3 March 2011

MENTAL HEALTH, EMPLOYMENT AND DISADVANTAGE Making A Difference

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

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

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

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

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

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

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

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