HOPE PROMOTION Mental Health and Employment BASE Conference Manchester Simon Francis June 2009

Context Economic downturn rising personal debt Rising Unemployment, who gets jobs Fewer jobs Impact of targets – Broad range of priorities Numbers of people with common MH conditions increasing, SMI stable.

Overarching Government Drivers Recession Demographic time bomb. Pensions. Pledge to abolish child poverty in Britain in a generation. Citizenship Rights and responsibilities, work for those who can support for those who can’t Devolution?

Overarching Government Drivers (2) Tackling social exclusion, work is the best way out of poverty. Regeneration and active communities Creating the conditions for business success and economic growth. Health Work and wellbeing, Workplace MH. Tackling unemployment and worklessness

The issue  Stigma and discrimination. Over 2/3 of people put off applying for jobs due to unfair treatment.  Less than 40% of employers would recruit from the MH group. SEU report  Low aspiration  3X More likely to be in debt  Procurement and Targets,  Low employment rates  70% of people find their job fairly or very stressful BACP/ Future foundation Base 2004.

But Poor Mental Health is not Unusual and people recover 1 in 4 people have a MH problem at some time in their lives 1 in 6 people experience mental distress at any point in time. Strong association between poverty, poor MH and unemployment. Intergenerational effects Most people recover from mental illness Work provides hope and optimism for the future and hope is integral to recovery.

Health Therapeutic value of work, people in work experience better health than those out of work, But sometimes work is part of the problem Being unemployed carries the same health risks as smoking 200 cigarettes a day, with unemployment itself is a cause of poor MH Suicide biggest killer among young men with Strong association with unemployment.

The Cost  Britains biggest social problem  Poor mental health costs each household £2K p.a  Cost for Yorkshire and the Humber £6.5bn Francis and Lindsay 2008  Annual cost to employers is around £600 per employee. CIPD and CBI.  Presenteeism likely to cost around 1.5 times more than absenteeism. Sainsbury Centre 2007  Significant, impact on individuals their families and communities.

Government Response Policies Life Chances of Disabled People Reaching Out National: Action Plan to Tackle Social Exclusion 2006 Working for a Healthy Tomorrow 2008 Public Service Agreement Target PSA 16, Work Recovery and Inclusion. Delivery Strategy IDEAs National Strategy for Mental Health and Employment Perkins Review New Horizons Work Recovery and Inclusion

There are opportunities This is the right thing to do. Positive messages around mental health (Time to Change/Shift) Raft of Government policies, high on Government social policy agenda. PSA targets Funding, DH investment in the regions, through Government Office and SHA. IAPT Future Jobs Fund, critical

Continued Existing delivery partnerships, RETs Public Sector to Lead by Example, Job opportunities Strong Evidence base on what works IPS Existing delivery partnerships Range of existing best practice

Perkins review Commissioned by DWP SoS Recommendations for Pre Budget Report, cost neutral Strong fit with Work Recovery and Inclusion especially adults with SMI Looking at cost benefit analysis for intervention

Perkins Review Scope How people with common mental health needs should be supported, to ensure the speediest and most effective work-focussed support; How to get additional employment and health support to enable those with more complex needs – SMI – to realise their aspiration to work, including through self employment. How wider access can be provided to progressive, individually tailored employment support How innovative models (including an IPS model) could be used alongside and/or in strengthening DWP existing suite of employment programmes and employment support services across government; How the right balance of support can be achieved, using existing resources in the most effective way.

Perkins Possible Options for Progress Personal Budgets to be used for employment support, especially in work Possible short term work trials Refocusing health services toward evidence based interventions IPS Welfare benefit system as enabler Closer working between health and employment

Work Recovery and Inclusion Offers a vision for Employment of people with severe mental illness Sets out principles for services and delivery Sets out policy options Builds on and adds value to current work, including Perkins review Sets out a coherent delivery model, national local and regional delivery Makes the business case for intervention

Work Recovery and Inclusion Shift the culture and aspiration of services toward the case for the recovery and therapeutic value of work. For both System and Individuals Restate the importance of effective co- ordination of health and employment services Commit services to act as an enabler to work Explores the perceived and real barriers to work surrounding the welfare benefit system, offer solutions

Work Recovery and Inclusion Employment is considered within context of wider determinants of social inclusion, such as housing, learning and skills. Service user consultation is at the heart of policy development locally, regionally and nationally. Ensure change is driven by the best use of evidence and data and continuing to build the evidence base. Ensure that infrastructure is focused on delivery and a broad range of providers (the third sector). NHS and Public sector lead by Example

Themes: Links with young people agenda, intergenerational effects Positive about mental health. Build capacity in individuals and organisations, Trust development Ensure that Learning and Skills agenda is an integral part of our efforts. How best to enable people to stay in FE and HE. Get people into work, manage the transition Engage and support employers and employees Promote good and mentally healthy work

Final Career Limiting Thoughts What Do people Need? A. Home and a Job same as you and me, and to be treated with dignity and respect Do resources follow need? Is there a broad range of provision available in each locality? Do people know about it? What more is needed? Whose responsibility?