Mental health in the uk

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  • 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