MENTAL HEALTH AND WORK: UNITED KINGDOM

OECD Conclusions and Recommendations

Shruti SINGHDirectorate for Employment, Labour and Social AffairsOECD

www.oecd.org/els/disability >UK

Dissemination Seminar, The Work Foundation, London, 10 Feb 2014

Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

KEY FACTS: MENTAL ILL-HEALTH IN THE UK

Mental ill-health costs the UK economy 70 billion ₤every year

- loss in employment & productivity: 53%- health care costs: 47%

People with mental illness fare badly in the labour market

- large employment gap - high unemployment rates

Poverty risks are almost double the overall risk and the highest in a comparison of ten countries OECD countries.

Key factor for labour market exclusion - 40% of disability caseload has mental ill-health

Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

New disability claims are among the highest in OECDNew claims per 1 000 of the working-age population (inflow rates), latest year available

0

2

4

6

8

10

12

OECD

ACTING EARLY: WHEN PEOPLE STILL HAVE A JOB The challenge: lack of early intervention

ACTING EARLY: WHEN PEOPLE STILL HAVE A JOB Possible ways forward

Policy recommendations Rigorous implementation of the new Health & Work service:

- Ensure good access for SMEs- Sufficiently resourced with qualified staff- Linkages with health sector e.g. with IAPT

Strengthen employer incentives: obligations and sanctions for non-compliance; co-financing of the Health & Work service

Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

Performance problems at work for those with a common mental disorderPercentage of workers not absent in the past four weeks but who accomplished less than they would like as a result of

either an emotional or a physical health problem

ACTING EARLY: WHEN PEOPLE STILL HAVE A JOB The challenge: Helping those struggling at work

0

10

20

30

40

50

60

70

80

90

100

Severe Moderate No mentaldisorder

Severe Moderate No mentaldisorder

United Kingdom Europe 21

2010 Average 2010

ACTING EARLY: WHEN PEOPLE STILL HAVE A JOB Possible ways forward

Policy recommendations

Make Access to Work scheme widely available Make better use of management tools and guidelines. Extend HWS to those struggling at work

Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

Panel A. Outflow from ESA as a % of total ESA caseload, 2012

Panel B. Employment outcomes: ESA claimants with mental health problems

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

Total Mental Musculoskeletal Circulatory

WRAG Support Group

2 680

101 420

Got a job Did not get a job

BETTER AND TAILORED EMPLOYMENT SUPPORTS The challenge: Poor return to work outcomes

Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

Mental ill-health is very widespread among all benefit recipients Percentage of those with a mental disorder, 2007

0

10

20

30

40

50

60

Incapacity benefit /Severe

disablementallowance

Statutory sick pay Jobseekersallowance

Income support /One parent benefit

Housing benefit Disability livingallowance

Recipients Total population

%

BETTER AND TAILORED EMPLOYMENT SUPPORTS The challenge: Reaching other claimants with mental-ill

health

BETTER AND TAILORED EMPLOYMENT SUPPORTPossible ways forward

Policy recommendations Strengthen early intervention in welfare system

- Make use of validated instruments e.g. at registration with JCP or during work-focused interviews with ESA clients.

- Consider re-introducing multidisciplinary assessment tool

Getting incentives right - Strengthen financial incentive for Work Programme providers

- Raise work-search requirements for ESA WRAG combined with treatment, rehabilitation and ongoing support

BETTER AND TAILORED EMPLOYMENT SUPPORT Possible ways forward

Providing integrated mental health and employment services

- Automatic enrollment of claimants with mild and moderate mental health disorders in IAPT.

- Begin pilots using evidence-based models such as Individual Placement Support for claimants with common mental

disorders

Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

Most mild to moderate mental disorders remain untreatedShare of people who sought treatment for their mental illness in the past twelve months, by type of treatment

THE ROLE OF THE HEALTH SYSTEMThe challenge: Enhancing employment focus

0 10 20 30 40 50

2005

2010

2005

2010

Uni

ted

Kin

gd

om

Eu

rop

e

Specialist treatment Non-specialist treatment

MENTAL HEALTH RISKS IN THE WORKPLACE Possible ways forward

Access to psychological therapy

- Further reduce waiting times

Empowering GPs

- Improve mental health and work-related knowledge of GPs through extension of GP curriculum

Building and sustaining employment capacity

- Improve integration of employment in IAPT (IPS based)

- Rigorous evaluation of integrated services

- Sustain and expand funding

CONCLUSIONS

• Mental ill-health creates considerable labour market disadvantage and very high costs for the economy

• The UK system is in a good position in principle to tackle mental health issues forcefully

• A number of steps can be taken to improve outcomes

– … related to ongoing welfare and labour market reforms that need to deliver

– … related to the integration of health and employment services

– ….turning good policies into action in a joined-up way

Thank you for your attention!

For more information and OECD publications on the topic:

www.oecd.org/els/disability

Including free access to the Executive Summary and all tables and charts of “Mental Health and Work: United

Kingdom”