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Mental Health

Background

Individuals with mental health problems often find it difficult to obtain and sustain paid employment. A 2005 study suggested that 79% of people with serious, long-term mental health problems in Scotland were not in employment. Individuals with mental illness now form the largest proportion of people claiming incapacity benefits and over a third of incapacity benefit claimants cite mental ill health as their primary reason for claim. Around 90,000 people in Scotland wish to work, but are economically inactive due to mental health problems.

Barriers Faced

People with mental illness face severe barriers to employment, notably:

  • Stigma and discrimination, including employer stigma and discrimination and self-stigma and anticipated discrimination.
  • Perception that work will lead to worsened mental health (although there is evidence to suggest that unemployment is more likely to be detrimental to mental health)
  • Poor work record due to fluctuating levels of impairment.
  • Low expectations of health care professions who assume that some individuals will never be able to work.
  • Lack of access to support services.
  • Lack of partnership working between agencies and services.
  • Fear of losing benefits or of being financially worse off in work.

Policies and Interventions

Policy widely recognises that being in appropriate employment is good for a person's health and wellbeing and improves their quality of life and that with the right support and opportunities many people with mental ill health can work effectively, improving their chances of increased confidence, income, empowerment and quality of life.

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 and it is estimated that mental ill-health accounts for between £30 and £40 billion of this. The UK and the Scottish Government made commitments to establish a national framework for action on employment and mental health in their response to Dame Carol Black's Review.

In December, 2009 the UK Government launched 'Working our Way to Better Mental Health: a Framework for Action', the first ever mental health and employment strategy for Britain. The strategy is designed to:

  • Improve well-being at work for everyone.
  • 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.

A current priority for the Scottish Government is to tackle and address health and income inequalities and to ensure that the mental health and wellbeing of Scotland's people flourishes. The Mental Health Strategy for Scotland: 2012-2015 identifies linkages between mental health and employability and highlights the importance of improving and increasing access to employment for those with mental illness. Within the strategy the Scottish Government makes a commitment to promote the evidence base around what works in employability for those with mental illness.

Like all people with disabilities, people with mental health problems can contact a disability employment adviser (DEA) at their local Jobcentre Plus for information and advice on the specialist services available through the DWP, such as Work Choice, residential vocational training, and support in employment through Access to Work. A DEA can also refer a client to a specialist work psychologist who will undertake an 'employment assessment' and recommend therapy or therapeutic activities.

In supporting people with severe mental health problems into work, evidence suggests that the most effective intervention is the provision of personally tailored and intensive support to accessing competitive paid employment, followed by in-work support for both the employer and employee for as long as it is needed. This 'work first' approach is often termed as Individual Placement and Support (IPS) and has been shown to work better than approaches that try to upgrade an individual's skills before placing them in employment. The latter can result in people losing confidence and motivation when the preparation/training period becomes prolonged.

The Equality Act

The Equality Act (2010) is the main piece of legislation that addresses discrimination and inequality in the UK. It brought together nine separate pieces of legislation into one. The majority of the provisions came into force on 1 October 2010. The following are the characteristics which are protected under the Equality Act (2010):

  • Age
  • Disability
  • Gender reassignment
  • Marriage and civil partnership
  • Pregnancy and maternity
  • Race
  • Religion or belief
  • Sex
  • Sexual orientation

The law prohibits both direct and indirect discrimination relating to any of these characteristics and individuals who feel they have been discriminated against on any of the above grounds can bring an action in court against the perpetrator. The law also prohibits victimisation of persons who have brought action against a perpetrator or given evidence in connection with proceedings under the Act. 

The Act prohibits discrimination across a broad range of areas including employment, the provision of goods and services to the public and the exercise of public functions. In addition a Public Sector Equality Duty came into force in April 2011. It assigned public bodies (and others discharging public functions, such as third sector organisations) the following duties:

  • Eliminating unlawful discrimination.
  • Advancing equality of opportunity. 
  • Fostering good relations.

Specific duties within the Act require fit-for-purpose equality monitoring to be undertaken, at both national and local levels. As a result, a number of listed public authorities in Scotland are now required to publish a set of equality outcomes and to report on progress every two years. The specific duties also require the listed public authorities to undertake Equality Impact Assessment of new or revised policies and practices and to consider relevant evidence when making their assessments. 

 

Research

 

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