Becca Stacey, Senior Research Officer, Money and Mental Health Policy Institute
Joining the dots between mental health and employment support
17 April 2023
In 2022, one in four (26%) people who were out of work due to long-term sickness said a mental health problem was their main health condition. Support aimed at helping people with such conditions who want to enter and stay in work is therefore vital. The increasing number of employment advisers in Improving Access to Psychological Therapies (IAPT) services – which provide talking therapies – is welcome. So is the commitment in last month’s Budget to widen access to the Individual Placement Support (IPS) service, which provides employment support for people with more severe conditions accessing community mental health teams.
But a recent survey we ran with members of our Research Community – a network of nearly 5,000 people with lived experience of mental health problems – demonstrates the extent to which people are unable to access these services, and so cannot benefit from their respective employment offers. And those who are falling between the cracks of mental health services are receiving limited or no mental health support, let alone help with getting back to work.
The barriers people face to accessing mental health services
When people are struggling with their mental health, access to good quality and timely support can be the difference between being able to stay in or make a swift return to work, or drifting further from the labour market. As outlined above, it can also enable access to tailored employment support.
But a concerning proportion of the respondents to our survey are unable to access mental health support. 42% had been unable to access talking therapies, and 35% said they’d been denied mental health support from their GP. This is especially worrying given that GPs are often a gateway to other services.
The main reason members of our Research Community gave for not being able to access services was long wait times. This deterred some from registering for support in the first place. For others it meant they were advised to find private services instead, which many are unable to afford.
“[My GP] told me to get in touch with our local talking therapies service. I’ve been there 6 times already and I know the waiting time is 2 years, which is absolutely pointless registering for.” Expert by experience
People also frequently spoke about not being eligible for a service. Many have been told that their mental health condition was either not severe enough or too severe to access a service. Others were told they weren’t eligible because they were already receiving support from another service, despite the fact that this was often helping with a different aspect of their mental health.
“Told I was not ill enough for one [service] but too ill for another.” Expert by experience
“Unable to be seen by neuro psychiatry while having a course of CBT through general Psychiatry and vice versa.” Expert by experience
The impact of not being able to access mental health services
Not being able to access the right support can take a huge toll on people’s mental health, with members of our Research Community frequently speaking about how this led to a deterioration of their condition. People also spoke about how it led to a reduced ability to work, with many having to reduce their hours or stop work altogether.
“Felt very frustrated as I desperately needed to talk with someone who could help. Work gradually got on top of me and I felt unable to cope so I was off sick for sometime.” Expert by experience
If and when people are finally able to access help, many have been out of work for so long that a return to the labour market becomes significantly harder or, in some instances, impossible.
Joining the dots
The majority of those we surveyed who are unable to access mental health services are currently receiving no formal support. A key part of reducing economic inactivity is removing the extensive barriers to mental health services.
Among those who are still accessing some form of help with their mental health, this was most commonly from their GP – where unlike in certain IAPT and community mental health services, there isn’t usually access to employment support. As we outlined in our recent paper on mental health and inactivity, greater connection is needed between employment support and mental healthcare for people who are not eligible for or unable to access IAPT or secondary mental health services.
Health Justice Partnerships provide an exemplary model of a more joined up offer of support. They deliver legal advice or support for social welfare issues – like benefits, housing and debt advice – often in healthcare settings like GP practices. A similar offer aimed at supporting people who are falling between the cracks of mental health services to find and retain work is also needed, if we’re to address the high rates of economic inactivity.