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Work & Employment
Evidence & Policy
See evidence & policy for other inclusive practices and domains
Published in the October 2006 edition of US publication Psychiatric Services, this study determined whether the clubhouse model of community support and psychiatric rehabilitation can produce competitive employment outcomes that are comparable or superior to those of the Program of Assertive Community Treatment (PACT) model.
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Establishing a Framework for Analysis
An Interim Report
Kent County Council has published an interim report from an independent study of the cost:benefit effectiveness of its supported employment service. Whilst there are some caveats on some of the data used, early indications point to average annual savings of £1290 to the council and over £3500 to the taxpayer for every person in work. The study considered changes to welfare benefit entitlements, the cost of services received and tax and national insurance payments before and after employment.
The study suggests opportunities for achieving greater savings by:
• obtaining more full time jobs for those not in receipt of day services and/or are unknown to social services;
• developing a greater focus on those who are dependant on local day services prior to obtaining a job;
• increasing the resources allocated to support people with mental health problems.
The study, undertaken by Dr Mark Kilsby and Dr Steve Beyer, has a further two phases that will refine the data used and it is hoped that this may allow a ‘cost per hour’ per person comparison to be made. It would also allow a more accurate calculation of the likely savings that would accrue due to reduced service usage, and determine more fully the cost implications of ‘crossover’, whereby some employees continue to use local services while in supported employment.
Many local authorities are reviewing their provision of supported employment services as potential savings need to be found. It is hoped that this study will flag up the potential savings to be made by redirecting day service resources towards the provision of supported employment services.
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Report of Initial Consultation
Skills for Health is the Sector Skills Council (SSC) for the UK health sector.
Skills for Health (SfH) has been working closely with a number of third sector employers to identify the workforce needs of the sector. This research was commissioned as part of a developing approach to explore the feasibility of introducing a skills passport and its value as a means of supporting and facilitating workforce development.
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This is a Sainsbury Centre evaluation report on the process of involving people who use services in the re-commissioning of their day and vocational services.
This report provides insight into what worked during re-commissioning day and vocational services. Full of quotes from the people involved, it should help anyone wishing to embark on the re-commissioning of day and vocational services in their own area.
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The Work Capability Assessment (WCA) was introduced in October 2008 to assess entitlement to Employment and Support Allowance (ESA). Section 10 of the Welfare Reform Act 2007 commits the Secretary of State to lay an independent report before Parliament each year for the first five years of operation.
Improving the Work Capability Assessment (WCA) will be an ongoing process to ensure that the system works as well as possible for people going through it.
Professor Harrington was reappointed to lead the second independent review in 2011. His second review sets out a series of recommendations to the Government based on the evidence he collected as part of the review and which build on complement the recommendations from his first review. The main recommendations focus on:
- Introducing checks on benefit decisions to ensure fairness and consistency.
- Working with disability groups to help develop guidance for Atos healthcare professionals and Decision Makers.
- Improved support and communications for people who move onto Jobseeker’s Allowance to make sure they get the help they need.
- Regularly publishing data on performance and quality to improve the transparency of the face-to face assessment.
This document outlines the Government's next steps on welfare reform. It sets out how they will help the long-term workless back into work and support disabled people and those with health conditions who are at risk of long-term unemployment and worklessness to make sure no one gets left behind in the recovery.
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NDTi Insights
This publication summarises the learning from work undertaken by NDTi around supporting people with learning disabilities and people with mental health problems into paid work. Conclusions include that there is:
- An overall weakness in the planning and commissioning processes
- Limited understanding amongst many commissioners of the evidence base around what works
- Inadequate actions to expand the market for employment supports
- A failure to link employment supports to the growth of individual budgets.
The economic and financial case for supported employment
The NHS can make better use of millions of pounds by commissioning the best form of employment support for people with severe or enduring mental health problems, according to a report published by Sainsbury Centre for Mental Health.
Commissioning what works: the economic and financial case for supported employment shows that Individual Placement and Support (IPS), which helps people into paid competitive work, is effective, is good value for money and is affordable to the NHS.
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What we now know about successful interventions.
A progress review from the Sainsbury Centre for Mental Health.
In 2005 the British Occupational Health Research Foundation (BOHRF) published a systematic evidence review of published evidence for effective interventions that help people with these conditions to remain in or return to work. They have now surveyed various research literature to update the 2005 systematic review and have examined a broad range of evidence, published in the last five years, about the management of common mental health problems in the working age population.
This paper presents the outcome of that review and discusses some of the key points of evidence that support developments to improve the management of common mental health problems among working age people.
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In December 2009, four highly significant policy papers and two Government initiatives were all launched on the same day. In these documents, the Government, through its Health, Work and Wellbeing initiative, has set out its vision and declared that it will be made reality only through the partnerships and effort of the many stakeholders in the field - they are looking for ideas for practical action, and partners with whom to make it happen.
This briefing is a introductory guide to the reports, how they relate to each other and the key messages for mental health and employment. It then asks what happens next.
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Vocational rehabilitation is a term used by many people to describe an approach whereby those who have a health condition, injury or disability are helped to access, maintain or return to employment.
The Department for Work and Pensions (DWP) is looking to produce a Framework for Vocational Rehabilitation that will:
- Demonstrate the Government's commitment to provide leadership on vocational rehabilitation;
- Be the first step towards a better understanding, and improving practice, of vocational rehabilitation;
- Provide longer-term help to establish a new approach to rehabilitation in the UK.
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Vocational services for people with severe mental health problems
This guidance enables commissioners of mental health services to commission vocational services for people with severe mental health conditions. A key to this guidance is not only to help people to gain employment but, importantly, to retain employment.
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A new approach to increase the number of people entering and staying in work has been announced in DWP's Commissioning Strategy.
Private and voluntary sector organisations will now be paid to help support customers who have been long-term unemployed into sustainable jobs.
The strategy describes how DWP will sign larger, longer-term contracts with providers, enabling a more responsive service to customers and raising the quality of provision. These top-tier providers will manage a chain of suppliers down to local level, to help the most disadvantaged customers into work and achieve the outcome that is best for them.
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This paper summarises findings of a review of research evidence and expert opinion about occupational interventions for people with mental health problems (Schneider, Heyman and Turton, 2002).
The research was commissioned by the Department of Health's Policy Research Programme.
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For Specialist Incapacity Benefit Personal Advisor (SIBPA) service in North East London for customers with mental health problems
This project sought to evaluate the impact of additional mental health training to Specialist Incapacity Benefit Personal Advisors working for Jobcentre Plus. The methodology proposed to collect data including qualitative, quantitative and behavioural measures (including interviews, focus groups, statistical data and questionnaires) from customers and service delivery stakeholders.
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From the National Mental Health Development Unit, a short document outlining key facts and figures on Mental Health and Employment.
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Issues, activities and support for people with mental health needs.
The aim of this paper is to identify and explore the most effective way of delivering work-related support for people who may be trying to manage a mental health condition whilst seeking employment, or trying to maintain an existing job.
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"In this paper there are some ideas for making work support services better. We have listened to many people, including disabled people.
We want to make the system easier to use and make sure that it meets the needs of disabled people and their employers. We want to make it easier for Jobcentre Plus
workers to meet people's needs."
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Since May 2010, the Government has set out an ambitious programme of employment support to ensure that people disadvantaged in the labour market will get the help they need to find and keep jobs.
In December 2010, the Secretary of State asked Liz Sayce, the Chief Executive of RADAR, the UK’s largest disability campaigning organisation, to conduct an independent review of the Government’s specialist disability employment programmes. A key aim of the review was to examine how more disabled people could be supported into work within the available funding. The findings of that review were published on 9 June 2011 in "Getting in, staying in and getting on."
On 11 July 2011, the Government published its response to Liz Sayce’s independent review of specialist disability employment programmes "Getting in, staying in, getting on" and a consultation on the recommendations.
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Doing what works
Sainsbury Centre for Mental Health: Briefing 37
There is strong evidence that Individual Placement and Support (IPS) is the most effective method of helping people with severe mental health problems to achieve sustainable competitive employment.
It consists of intensive, individual support, rapid job search followed by placement in paid employment, and time-unlimited in-work support for both the employee and the employer.
This briefing paper describes the key principles of IPS, presents an overview of the research evidence and provides information on further reading.
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Mind and CIPD urge employers to get staff talking about mental health issues in 2012 as economic woes conspire to create the perfect ingredients for a surge in mental ill health.
The issue of mental ill health is still being swept under the carpet in most workplaces, with just four in ten employees saying they would feel confident to disclose a mental health problem to their employer.
That’s according to the latest research by the Chartered Institute of Personnel and Development (CIPD), published today to coincide with the launch of a new guide to help more employers to manage and support mental health at work, which has been developed by CIPD and leading mental health charity Mind.
The survey of 2,000 people in employment in the UK1 reveals that despite more than a quarter (26%) of employees having experienced a mental health problem while in employment, too few employers are taking positive steps to manage this increasingly business critical issue.
Just 25% of respondents say their organisation encourages staff to talk openly about mental health problems and only 37% say their employer supports employees with mental health problems well.
The guide, Managing and supporting mental health at work – disclosure tools for managers (PDF), will help employers ensure that how they manage people supports their mental wellbeing and resilience, and also encourage more employees to talk about any mental health issues they may be facing at an early stage.
Key indicators for the development of evidence-based employment services
In today's world that which is not measured is not done. If people with mental health problems are to get the high quality services they need to enable them to meet their employment aspirations, it is vital that commissioners and service providers routinely collect and publish information about progress against key indicators of success - that they measure what matters.
This paper puts forward a set of key performance indicators (KPIs) to assist local mental health and employment services to monitor employment outcomes and target development priorities for people in contact with specialist mental health services.
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Briefing 33 from The Sainsbury Centre for Mental Health
This briefing paper looks at the barriers to employment for people with common and severe mental health problems and at the positive initiatives that are being undertaken by the public, voluntary and commercial sectors to help them find and sustain work. It highlights the importance of employment as part of the recovery
from and prevention of mental health problems.
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Key opportunities to put policy into practice
This paper from the Sainsbury Centre for Mental Health aims to make sense of what the new policy set out in New Horizons, Working our way to better mental health, Realising ambitions and Work, Recovery & Inclusion means in practice and pick out the key commitments and opportunities as we see them.
It follows on from their summary of the policies and looks at how employment and other services can put these opportunities into practice.
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Is there a role for big employers?
From the November 2010 issue of the British Journal of Wellbeing, Shaun Crowe, Louise Kendall and Brendan McLoughlin ask what implications the ‘big society’ might have for employment, and review the impact of an award-winning employment project.
This guidance, Mental Health and Employment in the NHS, updates and revises the Department of Health guidance produced in 2002. It encourages NHS employers to tackle discrimination and stigma, promote equality in their staff and provide the opportunities that people with mental health problems are now entitled to expect.
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The WHO Regional Office for Europe, the German Alliance for Mental Health, the German Federal Ministry of Health and the Directorate-General for Health and Consumers of the European Commission held the Conference on Mental Health and Well-being at the Workplace – Protection and Inclusion in Challenging Times in Berlin, Germany, on 17 and 18 March 2009.
About 130 representatives of user and family caregiver associations, enterprises,
trade unions, politicians and researchers from 20 countries in the WHO European Region discussed ways to respond to how modern working life challenges mental health and wellbeing, how to overcome barriers to employment for people with mental health problems and opportunities for integration and empowerment given the global economic downturn.
This publication is based on the presentations given at the Conference.
Developing the Business Case
Every organisation in Britain is affected by mental distress and ill health in the workforce. At any one time one worker in six will be experiencing depression, anxiety or problems relating to stress.
The total cost to employers is estimated at nearly £26 billion each year. That is equivalent to £1,035 for every employee in the UK workforce.
Simple steps to improve the management of mental health in the workplace should enable employers to save 30 per cent or more of these costs - at least £8 billion a year.
This policy paper looks at how mental ill health in the workforce affects employers and details the costs of ignoring mental distress at work.
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Measuring what counts
This paper is based on a seminar organised jointly by Sainsbury Centre and the Department of Health in 2009.
It argues that public services do not routinely collect data on mental health inequalities and that the information they do collect is not used to its full potential.
It calls for better information to be collected and used to measure inequalities in mental health and the life chances of people with mental health problems.
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The National Social Inclusion Programme (NSIP) has now transformed the SEU's 27-point action plan into a programme requiring delivery which is organised into 8 themes.
To visit their workstream on employment and mental health please follow the link below:
Findings from the final cohort in a qualitative longitudinal panel of incapacity benefits recipients
The aim of the overall evaluation is to establish whether, and by how much, the package of measures in Pathways to Work helps people claiming incapacity benefits move towards work and into paid jobs.
As part of this aim, the evaluation includes description and exploration of processes and factors that influence people's experiences of the Pilots and different outcomes achieved.
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The impact of benefit receipt to the under 25s
This report describes the impact of Pathways to Work (Pathways) on those aged between 18 and 24 at the start of their claim for Incapacity Benefit (IB) within the original seven pilot areas and the first two groups of expansion areas (those areas where Pathways was introduced in October 2005 and April 2006).
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The influence of outcome-based contracting on Provider-led Pathways to Work
This research explores the influence of outcome-based contracting upon the management and delivery of Provider-led Pathways to Work (PL Pathways). PL Pathways was introduced across 31 districts in two phases (December 2007 and April 2008), with which the national coverage of the programme was complete.
This report presents findings from qualitative research with a range of key stakeholders from the Department for Work and Pensions, Jobcentre Plus, provider and subcontractor organisations from four PL Pathways districts. The study was conducted by the Policy Studies Institute.
The study focused on the contracting and delivery arrangements within each district, performance management of both providers and subcontractors and key relationships in the PL Pathways supply chain, as well as the influence of outcome-based contracting on the service delivery from the perspective of both management and front-line staff.
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The experiences of new and repeat customers in Jobcentre Plus expansion areas
The Pathways to Work pilots were introduced for new and repeat incapacity benefit (IB) claimants from October 2003. Following its introduction in pilot areas, the programme was rolled out to Jobcentre Plus 'expansion' areas in three phases from October 2005. This report presents findings from a survey of new and repeat IB customers who were included in the first two phases of the expansion of Pathways to Work.
This study was conducted by the National Centre for Social Research, and provides a description of the customer profile, their experiences of involvement with Pathways to Work, their work and other outcomes. The report also presents specific analysis on the role of partners, the experiences different age groups and those customers with mental health conditions, and draws comparisons with customers in the pilot areas throughout.
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The following useful report was posted by Sainsbury Centre for Mental Health.
Main extract below and links follow:
Pathways to Work and customers with mental health conditions
Evidence on the effectiveness of Pathways for those customers who have a mental health condition is mainly positive. 4 out of the 5 the impact measures estimated to date (covered by three reports) for this group are positive.
Independent researchers found a significant off-flow impact for this sub-group in Pilot areas (new claimants) - similar to that of customers without mental health conditions. But, the study did not find a statistically significant impact on employment rates for this sub-group in Pilot areas.
However, significant off-flow and employment impacts were found for existing claimants. And the employment impact for customers with mental health conditions was higher than those without. In Expansion areas the off- flow impacts were also significant for this sub-group and substantially better than those without mhc. Measures of employment impacts in Expansion areas are due Jan 09.
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Mental Health, Learning & Skills and Housing
The very latest policy on mental health and housing is encapsulated in a Public Service Agreement (PSA). The papers attached here are a commentary on PSA 16.
The Home and Neighbourhood Network of Develop will be discussing PSA 16, developing a local understanding and lobbying for mental health as a local priority during 2008.
Resources and links:
On 7 December 2009 Rachel Perkins, Paul Farmer and Paul Litchfield delivered their independent report on mental health and employment “Realising ambitions: Better employment support for people with a mental health condition” to the Department for Work and Pensions.
This report sets out the reviewers’ vision for change to ensure the Government can better help more people with mental health conditions who are workless into sustained employment.
It sets out a number of recommendations for Government. These fall in to three broad groups:
- increasing capacity and dispelling myths within existing structures so they are better able to meet the needs of people with a mental health condition
- “model of more support”: implementing Individual Placement and Support (IPS) in a Great Britain context
- establishing effective systems for monitoring outcomes and driving change.
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The recovery approach in community-based vocational and training adult mental health day services
This systematic map focuses on the particular area of vocation, meaningful occupation and training in the reshaping of mental health day services. The opportunity to have meaningful occupation (including paid and voluntary employment) and access to suitable training and support to achieve this is part of the mental health recovery model.
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Prisoners with mental health problems are not getting the support they need to gain employment when they are released, according to a policy paper published today by Sainsbury Centre for Mental Health.
Securing employment for offenders with mental health problems finds that many prison-based work preparation schemes exclude prisoners with mental health problems because they are not thought to be ready for work.
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Breaking the Barriers
Sickness and disability policies are rapidly moving to centre stage in the economic policy agenda of many OECD countries. Even before the onset of the recent recession too many people of working age who were able to work relied on sickness and disability benefits as their main source of income, and the employment rate of those reporting disabling conditions was low.
This report summarises the thematic review on Sickness, Disability and Work undertaken by the OECD over the past few years. It analyses key labour market outcomes of people with disability across the OECD and draws policy lessons from the thirteen reviewed countries (Australia, Canada, Denmark, Finland, Ireland, Luxembourg, the Netherlands, Norway, Poland, Spain, Sweden, Switzerland and the United Kingdom) in transforming their sickness and disability schemes to active
support systems that promote work.
Published in the October 2006 edition of US publication Psychiatric Services, this reports on how in a randomised controlled trial, a vocationally integrated programme of assertive community treatment (ACT) was compared with a certified clubhouse in the delivery of supported employment services.
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December 7th saw the launch of two extremely important papers for the mental health field: the National Mental Health and Employment Strategy, led by Dame Carol Black, and the Perkins Review.
This National Employment and Health and Innovations Network (NEHIN) meeting was larger than usual to hear from both Dame Carol and Rachel Perkins about these key documents and their future impact in this country. There was a series of workshops on the practical implications of both the Strategy and Perkins Review, as well as the PSA16 Delivery Plan, with people who already run innovative evidence-based services.
Visit website to view presentations and download relevant documents:
The Work Programme is the centrepiece of the Government’s plans to reform welfare-to-work provision in the UK, and ensure people have the right support as the economy moves out of recession and into recovery.
This prospectus has been produced as a working document to help interested parties understand the overall approach and current plans for the Work Programme following the results of the Spending Review.
Institute of Work, Health and Organisations.
This report considers the new work-related challenges to the health of working people in Europe that are associated with the changing landscape of work.
It describes what many agree are the appropriate concepts and framework, approachews and tools for dealing with those challenges through the extension of the generic risk management paradigm to focus on work-related psychological hazards and work-related stress.
Work, Recovery and Inclusion is a new government delivery strategy that sets out a series of actions that will help meet the aspirations of people in contact with secondary mental health services who want to work. It is deliberately challenging and aspirational and aims to bring about significant changes in outcomes.
The strategy looks to a future where people who are in contact with secondary mental health services are helped to get jobs, where they are equally valued for their contributions to the workplace, and where having a mental health condition is not seen as a barrier to work.
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Improving the health of the working age population is critically important for everyone, in order to secure both higher economic growth and increased social justice.
This Review has sought to establish the foundations for a broad consensus
around a new vision for health and work in Britain.
Also available for download is the presentation given to Oxleas by the author about the report.
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On 7 December, 2009 the Government launched Working our way to better mental health: a framework for action, the first ever national mental health and employment strategy.
The framework for action is designed to:
- Improve well-being at work for everyone, and
- Deliver significantly better employment results for people with mental health conditions, supporting them into work, helping them to stay in work and assisting them to return to work more quickly after sickness absences.
Dame Carol Black's review of the health of Britain's working age population estimated that the economy loses over £100 billion a year through ill-health and associated sickness absence and unemployment. Mental ill-health accounts for between £30 and £40 billion of this.
The strategy establishes a cross-government approach to tackling this cost and waste of talent.
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