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
Stigma and discrimination, including employer stigma and
discrimination and self-stigma and anticipated
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
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
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 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
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
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
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
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):
Marriage and civil partnership
Pregnancy and maternity
Religion or belief
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.