By Amy Hardie
The ‘Improving Lives: Work, Health and Disability’ Green Paper was released in November 2016 recognising huge inequalities in employment between those who are disabled and non-disabled:
The UK employment rate is the highest since records began, but there are fewer than 5 in 10 disabled people in employment, compared with 8 in 10 non-disabled people, and this has been the case for several years
Department of Health, 2016
This includes those with long term physical and mental health problems. We responded in February using our research and experience in this area and this is our response. This consultation presents an opportunity to rethink the current system and develop a new approach which is safe, evidence-based and allows those with mental health problems employment support that works for them.
Achieving lasting change
For any offer of support to be effective it is vital that it is provided in a supportive, not coercive, way. There is no conclusive evidence that sanctions encourage people with mental health problems into work. There is however a lot of evidence that demonstrates how damaging it can be and the negative impact this can have on people’s wellbeing, mental health and self-worth. A very recent report from The House of Commons Public Accounts Committee urges The Department of Work and Pensions to review its use of sanctions, which it finds ‘have increased in severity in recent years and can have serious consequences’ (Benefit Sanctions Report, 2017).
We know from both research and experience that employment is an important determinant of mental health and that too many people with mental health problems have faced exclusion from the labour market. There is overwhelming evidence in the UK and internationally that IPS consistently outperforms every other form of employment support for people with mental health problems. It offers hope and opportunity to people who would otherwise have been given little of either in traditional vocational services.
IPS is based upon eight principles; employment services need to be closely aligned with these for them to be effective. The first two principles should be the foundation of employment support offered – it should be available to all people with mental health problems who want it.
Embedding good practices and supportive cultures
While accessing employment support may not be appropriate to all individuals in the Support Group, people who do want help with employment should have the choice. It is important however that this does not become stressful for the individual being offered help. And it should never include conditionality, sanctions or exclusions from benefits.
We have found that embedding employment specialists in mental health teams gradually changes the views and aspirations of their clinical colleagues. Many clinicians can feel pessimistic about people’s employment opportunities and abilities at first, but as they see examples of successful placements they can offer more hope to other people.
Changing the culture around work and health
The DWP’s current employment programmes are costly and mostly ineffective. IPS on the other hand is cheaper and has better results. No sanctions, no compulsions, no conditionality – just support into work when people wish to use it, drawing on a model that has been consistently found to show good results when implemented faithfully.
We believe that these five steps need to be taken to improve the experiences people with mental health problems have of employment support, and to allow them a fair chance into the employment market if this is what they want:
- Expanding the availability of IPS to all people using specialist mental health services who would like help with employment: building on the Mental Health Five Year Forward View pledge to double the number of people benefiting from IPS;
- Ensuring that people can self-refer to IAPT services to speed up access to help (combined with new waiting time standards for these services and the availability of employment specialists);
- Training and developing Jobcentre work coaches in supporting people with mental health conditions effectively;
- Expanding and raising awareness of Access to Work funding;
- Developing condition management programmes for people with mental health problems.
Read our full consultation response here
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