The document summarizes key facts about mental health and work in the United Kingdom. It notes that mental illness costs the UK economy £70 billion annually, with over half due to lost employment and productivity. People with mental illness fare poorly in the labor market with high unemployment. It recommends early intervention for those with mental illness who still have jobs, improving employment supports for those on welfare benefits, and enhancing the employment focus of the health system to better integrate mental health and employment services.

1. MENTAL HEALTH AND WORK: UNITED KINGDOM
OECD Conclusions and Recommendations
Shruti SINGH
Directorate for Employment, Labour and Social Affairs
OECD
www.oecd.org/els/disability >UK
Dissemination Seminar, The Work Foundation, London, 10 Feb 2014

2. 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.

3. ACTING EARLY: WHEN PEOPLE STILL HAVE A JOB
The challenge: lack of early intervention
New disability claims are among the highest in OECD
New claims per 1 000 of the working-age population (inflow rates), latest year available
12
10
8
6
4
2
0
Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.
OECD

4. 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 noncompliance; co-financing of the Health & Work service

5. ACTING EARLY: WHEN PEOPLE STILL HAVE A JOB
The challenge: Helping those struggling at work
Performance problems at work for those with a common mental disorder
Percentage 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
2010
Average 2010
100
90
80
70
60
50
40
30
20
10
0
Severe
Moderate
No mental
disorder
Severe
United Kingdom
Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.
Moderate
Europe 21
No mental
disorder

6. 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

7. BETTER AND TAILORED EMPLOYMENT SUPPORTS
The challenge: Poor return to work outcomes
Panel A. Outflow from ESA as a % of total ESA
caseload, 2012
WRAG
Panel B. Employment outcomes: ESA
claimants with mental health problems
Got a job
Support Group
Did not get a job
4.5
4.0
2 680
3.5
3.0
2.5
2.0
1.5
1.0
101 420
0.5
0.0
Total
Mental
Musculoskeletal
Circulatory
Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.

8. BETTER AND TAILORED EMPLOYMENT SUPPORTS
The challenge: Reaching other claimants with mental-ill
health
Mental ill-health is very widespread among all benefit recipients
Percentage of those with a mental disorder, 2007
Recipients
Total population
%
60
50
40
30
20
10
0
Incapacity benefit / Statutory sick pay
Severe
disablement
allowance
Jobseekers
allowance
Income support /
One parent benefit
Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.
Housing benefit
Disability living
allowance

9. BETTER AND TAILORED EMPLOYMENT SUPPORT
Possible 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

10. 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

11. THE ROLE OF THE HEALTH SYSTEM
The challenge: Enhancing employment focus
Most mild to moderate mental disorders remain untreated
Share of people who sought treatment for their mental illness in the past twelve months, by type of treatment
Specialist treatment
United Kingdom
0
10
Non-specialist treatment
20
30
2005
2010
Europe
2005
2010
Source: OECD (2014), Mental Health and Work: United Kingdom, Paris: OECD Publishing.
40
50

12. 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

13. 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

14. 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”