The UK Government elected earlier this year has recently published two major papers setting out its approaches to improving living standards and achieving its stated ‘missions’. The Get Britain Working white paper and Plan for Change together paint a picture of the Government’s priorities at this time.
The former describes its purpose as being “to enable everyone to have the opportunity of secure, rewarding and fulfilling work” and it details the Government’s plans across a range of areas including education and training, employment support, health care, and the role of employers. Its stated aim is to reduce the number of people who are out of work, noting that 2.8 million people are currently ‘economically inactive’ for health reasons, and recognising the toxic effects of rising levels of poverty among both adults and children in the UK.
The white paper signals some changes in emphasis from the previous Government’s approach to health and employment. It recognises that systemic change is needed, both to provide better health and employment support and to create healthier workplaces. It looks beyond individual factors to the wider influences on people’s chances in the labour market, noting (some of) the harms of the conditionality regime facing jobseekers today.
Yet it misses some very obvious opportunities to act decisively to shift the dial. It notes that mental health problems are the most common cause of long-term sickness among younger adults, yet its emphasis on reducing NHS waiting times focuses solely on (physical) elective care, ignoring the one-million-plus people waiting for mental health care. It also misses the connection between mental and physical health conditions – for many people who are unable to work, it’s a combination of both that makes it so difficult to enter or re-enter the labour market.
More positively, it signals continued expansion of evidence-based Individual Placement and Support (IPS) employment services for people with a mental illness, as well as ensuring that employment advisers are connected to NHS Talking Therapies services. These are very welcome moves, continuing the growth of the last five years in IPS: and for as long as it remains faithful to the model, it will give more people a better chance in life.
The white paper also introduces Connect to Work, a programme drawing heavily on IPS principles for a wider range of disabled people; it signals changes to JobCentres, to be more focused on work and careers and less on gatekeeping benefits; and it talks about the importance of employers creating better working conditions for disabled people.
Finally, the white paper signals the Government’s intention to introduce reforms to disability benefits, including to the Work Capability Assessment, but without as yet saying what these reforms will look like. Change is urgently needed to a system that leaves too many people without the financial help they need, and feeling like second class citizens. A truly modernised social security system that provided a decent safety net and treated people with compassion and understanding would be a major step forward to a mentally healthier future. But social security system reforms have often brought with them even greater hardship and punitive approaches, and many people with a mental illness will be worried about what’s coming down the tracks in that regard.
The more recent Plan for Change highlights a wider range of government actions to enable it to deliver on its ‘missions’. All will affect the nation’s mental health, and several of them will only be achieved if attention is paid to our mental health. Despite this, mental health is barely even alluded to in the document. As a result, the Government risks missing an opportunity to make good on its promises by leaving out a crucial ingredient from its plans.
But this need not be a dead end. Taking a cross-government approach to mental health would allow ministers to apply evidence-based approaches to achieving its missions. It’s welcome that the Government is committed to extending the network of Family Hubs as part of the ‘opportunity mission’, for example, and within those it could ensure families get access to effective parenting programmes. Similarly, the ‘health mission’ can only fulfil its promises, including reducing suicide deaths, by acting both to prevent mental ill health and improve mental health care.
A cross-government approach to mental health, backed up with a plan, a policy test, and a Commissioner to coordinate action between departments, would help to create a healthier society with better living standards for all. It’s not too late for ministers to take the opportunity to build a mentally healthier nation, and start early enough in this Parliament to make a sustained and lasting difference.
