Employment support and barriers to work - supporting people with mental health problems into good jobs

Much of the Westminster chat last week centred on whether a briefing apparently aimed at shoring up the Prime Minister’s position had backfired. As it so happened, I was also speaking to MPs last Wednesday about efforts that are having the opposite effect to those intended: employment support for disabled people.

The fact that the Work and Pensions Committee, where I was giving evidence, has held inquiries on this topic before hints at the ongoing failure to properly support disabled people – including those of us with mental health problems – into work. But the clearest indicator of the need for change is in the employment statistics. Only half (49%) of disabled people for whom a mental health problem is their main health condition are in work, compared to 82% of non-disabled people. 

Moving into a job won’t be the right answer for everyone experiencing mental ill-health. For those of us in that group, it’s essential that support from the benefits system and sick pay provides a decent standard of living, rather than trapping people in the ‘too ill to work, too broke not to’ cycle. But as members of our Research Community – a group of 5,000 people with personal experience of mental health problems – have made clear, many people with mental health problems would like to work. They’re equally clear on what’s going wrong with the current employment support offer.  

Three big issues repeatedly crop up. The first is a lack of knowledge among advisers about how mental health problems affect us practically. Common symptoms of many conditions can impact our memory, concentration, planning and communication skills. Trying to support someone when you don’t understand what they’re experiencing is setting everyone up to fail.

A second issue is the push to get people into any job, without factoring in whether it will meet the person’s needs. This stems in part from the knowledge gap but, as the discussion at the Committee touched on, a government-wide emphasis on finding savings from the benefits bill is also likely to be a driver.

The third is the threat of sanctions. If you’ve been out of work for a while or had a bad experience with a previous employer related to your mental health, building up the confidence to take on a new position can be tricky. But doing that while the threat of a financial hit is hanging over you can worsen your mental health, ultimately leaving people further from the labour market and in need of additional support from the NHS.

What needs to change? A first point to acknowledge is that better support alone won’t help to close the employment gap. A recurring phrase at the evidence session was of an “ecosystem”, with employers and the health system other important parts of the mix. The recently-published Mayfield Review has some sensible ideas on how to deliver that wider shift. Beyond that, the government has already taken some helpful steps, such as giving people who are out of work the ‘right to try’ a new job with the safety net of being able to return to the same level of benefit.

But much more needs to be done. The government has committed £1 billion in additional spending on employment support. To deliver value for that money, it should take heed of what the evidence says actually succeeds. Schemes like Individual Placement and Support (IPS) and Employment Advisers in Talking Therapies are voluntary to take part in and they join up employment and health expertise and have produced impressive results. Ongoing relationships are crucial too; IPS for example offers continues to liaise with both the person and their employer after the initial match is made. 

Expanding targeted programmes like those will be vital but upskilling Work Coaches and the ‘mainstream’ service is also badly needed. With four in ten people who are out of work having a common mental health problem, every customer-facing DWP staff in Job Centres should complete high-quality training on how these conditions affect our day-to-day lives and back that up with a dedicated mental health expert in every JobCentre.

Reforming Access to Work is another must. It’s a programme with huge potential, and when it does what it’s meant to – helping people to pay for tools and assistance to enable them to get into work – it can be transformative. But the wait times to get a grant are far too long, the system is hard to navigate and, as elsewhere, our Research Community members have found staff to be lacking that practical knowledge about mental health. A speedier, simpler and better-informed Access to Work would be a real asset in closing the disability employment gap.

Whatever happens next with all the briefings and intrigue, any occupant of Number 10 should be seeking to help more disabled people find jobs that suit their needs. These steps would help to do that.