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.
People with mental illness face severe barriers to employment,
- 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
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
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
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
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
- Gender reassignment
- Marriage and civil partnership
- Pregnancy and maternity
- Religion or belief
- 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.