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Well Issue 3: Autumn/Winter 2003/04

this working life
Addressing Mental Health and Working Life in Scotland

For many of us work forms a central part of our lives. It contributes to our mental health and well-being, helps define us, binds us to others, gives us a sense of purpose and builds confidence and self-esteem.

But for many people with mental health problems the benefits of work are denied to them. For a wide range of reasons - social inclusion, improving the nation's health and supporting the development of a flourishing economy - it is now time to address this issue with a coordinated programme of policy and practice development.

For the last four years, Sheila Durie, employment programme manager for the Scottish Development Centre for Mental Health (SDC), has been consulting with a wide range of groups to draw together knowledge and experience from mental health service users, the practitioners who have been trying to help them reach their employment goals and the policy makers who could be better supporting these initiatives.

Funded by the Scottish Executive Mental Health Division, the result is a mental health and employment policy for Scotland, a document which, for the first time, addresses the need for major improvements in job retention, employability and supportive attitudes towards mental health service users in the workplace, and sets out a range of practical recommendations.

"Issues of unemployment amongst people with mental health problems have not been properly addressed in the past, and insufficient resources dedicated to supporting individuals who want to work," says Sheila. "There is now, however, a recognition of the scale of economic inactivity amongst this group, where many thousands of Scots are denied the opportunity to work. The costs of this are huge - recent estimates in England suggest that the economic and social cost of mental illness is in the region of 77 billion.

"21% of all people claiming Incapacity Benefit are doing so as a result of mental health problems, yet only a tiny fraction of this enormous bill is spent on preventing job loss through mental ill health or in supporting people to gain employment.

"But it's important to bear in mind that research shows that 90% of mental health service users do want to work. That doesn't necessarily mean that they want to be employed full-time
in the open labour market, but overwhelmingly they want meaningful, work-related activity which can aid recovery and be a stepping stone to employment if they choose."

Sheila argues that there are a whole range of barriers to be addressed, most importantly stigma and fear on the part of employers who believe that an employee with mental health problems will prove unreliable and difficult to manage.

However, an increase in skills shortages and the potential for mental health service users to make good employees mean that this group can no longer be ignored in the longer term. "Our economy is losing out by not supporting people with mental health problems - they have talents, skills and abilities that we cannot afford to ignore."

This is a period of transition, says Sheila, where a changing emphasis in the workplace is required, where problems and attitudes that have previously been hidden and stigmatising should be addressed openly.

"Most employers don't realise that they are likely to have a quarter of their work force experiencing mental health problems in any one year. But they are largely unaware because individuals don't tell them they are experiencing difficulties for fear of dismissal. "Unfortunately, their fears are usually well-founded, as 34% of users report being dismissed or forced to resign from their jobs as a result of their mental health status."

The focus now is on educating employers to understand that unless people with mental health problems are supported in their jobs, a large proportion will become ill and drop out. Employers then have to recruit staff to replace them. Not only is this costly, but they will have difficulty in recruiting because of the increasing skills shortage. So ultimately it is in employers' best interests to be more supportive of improved mental health practices in their workplace.

Sheila concludes: "There's a very strong business case here that we have to get across to employers, but it needs a range of approaches. We need to look at improving support for employers and employees around mental health issues by raising awareness and providing staff training, especially for new managers. We also need to develop new job retention services for both employers and employees, to stop people losing their job, or dropping out of the employment market. More effort and resources are required to help unemployed people regain their confidence and skills, and provide opportunities for supported employment and we need programmes to support young people, and others who may never have worked before.

"Most importantly, however, we need a change in attitudes. This is a complex message but the sheer number of individuals who could benefit make it a very valid one."

For a copy of the mental health and employment policy for Scotland contact:

Scottish Development Centre for Mental Health
Tel: 0131 555 5959
Email:sdc@sdcmh.org.uk
www.sdcmh.org.uk

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