UK government has much to say on mental health and employment

December 7 2009 saw the publication of the Perkins Review, and two other government reports on mental health and employment.

Unemployment amongst those with experience of mental health problems is shockingly high. Lack of support, stigma and low expectations are amongst the reasons [1] why around only 21% of people with a mental health condition are currently employed, compared to 47% of those who identify as having a disability, and 74% of the working age population [2].

The Perkins Review (full title: 'Realising ambitions: better employment support for people with a mental health condition' (pdf 1MB), is an independent review looking at how people who are currently out of work, and who have a ‘mild to moderate’ or ‘severe’ mental health condition,  can be supported into employment. The review was led by Dr Rachel Perkins of South West London and St George’s Mental Health Trust, and commissioned by the Department for Work and Pensions (DWP).

'Work Recovery and Inclusion' (pdf 1.4MB), lays out the government’s commitments to help people in contact with secondary mental health services access work, and forms part of the UK government’s response to the Perkins Review. Commitments relating to the DWP have application UK-wide, while those relating to health and social services are applicable in England only.

The Perkins Review makes 51 recommendations. Many relate to improvements to existing structures without the need for additional investment, but a strong case is also made for providing additional investment to roll out an Individual Placement and Support (IPS) model.

IPS focuses on getting people into a job as quickly as possible, and then providing support for as long as it’s needed. Evidence cited in Perkins (p 60) has shown that with this approach, 61% of people with a ‘serious mental health’ condition can access employment through an open competitive process, compared to only 23% through the traditional approach, where people are trained first, and then placed. The government acknowledges that the case is persuasive, but has not committed to implementing IPS. It has, however, agreed to make changes to the Access to Work programme so that it better meets the needs of those with a mental health condition.

Dr Perkins’ recommendations for developing a more personalised service using existing resources include the promotion of peer support, provision of better training for existing staff, and more effective communication between the DWP and health and social services.

One exciting suggestion for promoting the use of peer support is to encourage people who have returned to work after experiencing problems to apply for employment posts at Jobcentre Plus. The government has agreed to look into this.

Improvements to monitoring systems are also recommended. The government sees improved monitoring as a long term challenge, but has agreed to look into the practicalities of making changes.

Also published on December 7:

• a DWP news release announcing the launch of a new network of Jobcentre Plus mental health coordinators; and the extension of Access to Work.
• ‘Working our way to better mental health: a framework for action‘ (pdf 1.6MB) - the UK government’s first cross cutting strategy looking at mental health and employment across the whole population.
• the Department of Health’s ‘New Horizons: A shared vision for mental health’ (pdf 1.3MB), which lays out the goverment’s approach to mental health improvement in England.
  

[1] Realising ambitions: better employment support for people with a mental health condition (2009) – ‘The Perkins Review’.
[2] Office for national Statistics (2009) Labour Force Survey, Q1, as cited in The Perkins Review.

Related links

DWP policy page on Perkins
News release on Work, Recovery and Inclusion
Government pages on Working our way to better Mental Health
New Horizons webpage

Updated 10th June 2010