Mental Health and Work

ISSN :
2225-7985 (en ligne)
ISSN :
2225-7977 (imprimé)
DOI :
10.1787/22257985
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The costs of mental ill-health for individuals, employers and society at large are enormous. Mental illness is responsible for a very significant loss of potential labour supply, high rates of unemployment, and a high incidence of sickness absence and reduced productivity at work. In particular, mental illness causes too many young people to leave the labour market, or never really enter it, through early moves onto disability benefit. Despite these very high costs to the individuals and the economy, there is only little awareness about the connection between mental health and work, and the drivers behind the labour market outcomes and the level of inactivity of people with mental ill-health. This series contributes to filling that knowledge gap. It offers both a general overview of the main challenges and barriers to better integrating people with mental illness in the world of work, as well as a close look at the situation in specific OECD countries.
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Mental Health and Work: United Kingdom

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Auteur(s):
OCDE
Date de publication :
10 fév 2014
Pages :
144
ISBN :
9789264204997 (PDF) ; 9789264204980 (imprimé)
DOI :
10.1787/9789264204997-en

Cacher / Voir l'abstract

Tackling mental ill-health of the working-age population is becoming a key issue for labour market and social policies in OECD countries. OECD governments increasingly recognise that policy has a major role to play in keeping people with mental ill-health in employment or bringing those outside of the labour market back to it, and in preventing mental illness. This report on the United Kingdom is the sixth in a series of reports looking at how the broader education, health, social and labour market policy challenges identified in Sick on the Job? Myths and Realities about Mental Health and Work (OECD, 2012) are being tackled in a number of OECD countries.

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    Foreword

    Tackling mental ill-health of the working-age population has become a key issue for labour market and social policies in many OECD countries. It is an issue that has been neglected for too long despite creating very high and increasing costs to people and society at large. OECD governments increasingly recognise that policy has a major role to play in improving the employment opportunities for people with mental ill-health, including very young people; helping those employed but struggling in their jobs; and avoiding long-term sickness and disability caused by a mental disorder.

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    Acronyms and abbreviations
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    Executive summary

    Throughout the OECD, mental ill-health is increasingly recognised as a major problem for social and labour market policy; a problem creating significant costs for people, employers and the economy at large by lowering employment and generating substantial productivity losses. In an international comparison, the United Kingdom is among the most advanced countries in terms of awareness about the costs of mental illness for society as a whole, as well as the benefits employment brings for a person’s mental health. Integration of employment and health services is also being developed gradually – the most controversial policy challenge in this field facing OECD countries. Recent reforms of the disability benefit system including tighter benefit eligibility and large-scale reassessments are moves in the right direction but more can be done; i) in terms of earlier identification of work barriers and early intervention; ii) in meeting the needs of claimants moving from disability to unemployment benefits as a result of the reassessment process; and iii) in the attempts to raise the takeup of employment supports to increase participation of disability claimants in the labour market. Addressing these challenges will be difficult given the tight fiscal constraints facing the United Kingdom, but poorly designed spending cuts can worsen the medium and long-term fiscal and social costs. Further improvements are needed to ensure that on-going reforms live up to their promise. Currently, incentives for improving outcomes are still weak for several important players, including employers, employment service providers and the health sector.

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    Assessment and recommendations

    Mental ill-health has become a major driver for labour market exclusion in the United Kingdom. Each year, mental ill-health costs the economy an estimated GBP 70 billion, equivalent to 4.5% of GDP, through lost productivity, social benefits and health care. Mental disorders have become the most common reason for a disability benefit claim, accounting for almost 38% of all new claims. But mental illness is also widespread among workers and the unemployed and those receiving other social benefits, in particular income support and housing benefit. At the same time, people with a mental illness face a considerable social disadvantage, reflected in a large employment gap and an unemployment rate which is double the overall rate for those with a moderate mental disorder and four times the overall rate for those with a severe mental disorder. Taken together these labour market disadvantages culminate in very high income poverty risks for people suffering from mental ill-health, higher than in other OECD countries.

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    Mental health and work challenges in the United Kingdom

    This chapter discusses the current labour market performance of people with a mental disorder in the United Kingdom in terms of their employment, unemployment and income situation. Building on the findings in the OECD report Sick on the Job?, it highlights the key challenges ahead, such as the high share of people on different social benefits who suffer from a mental health condition. The chapter also provides a short description and assessment of the two main systems catering for people with mental illness: social security and health care.

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    Achieving higher labour market participation in the United Kingdom

    This chapter takes stock of the recent major reforms to the UK disability benefit scheme (now known as the Employment and Support Allowance) and addresses the challenges that remain including i) paying more attention to mental ill-health, ii) providing support that addresses both employment and health-related barriers; and iii) balancing rights and responsibilities. It also examines the employment support provisions delivered to disability and unemployment beneficiaries via the new contracted Work Programme; the incentives of providers to prioritise claimants with health problems; and more generally the ability of the system to deal with mental health issues in view of the high prevalence of mental illness among benefit recipients, including recipients of Jobseeker’s Allowance.

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    Sick on the job

    Employers are ideally placed to help people in the workforce to deal with mental health problems and retain their jobs. This chapter first describes the link between mental ill-health and working conditions, reduced productivity and sick leave. It then discusses prevention strategies to address psychosocial risks at work as well as strategies of UK employers to deal with mental health problems at work and their role towards managing sickness absence. The chapter ends with a focus on new reforms in the United Kingdom to address sickness absence and improve early intervention in the sickness period and related implementation challenges.

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    The new role of the health sector in the United Kingdom

    This chapter looks at the role of the (mental) health system which has a growing responsibility in supporting return to work of those who are out of work due to mental ill-health. It first assesses the effectiveness of the mental health care system in providing adequate treatment to persons with mental disorders. Particular attention is given to new initiatives put in place to increase psychological therapies to individuals’ with mild and moderate disorders. It then reviews the role and challenges of GPs in providing treatment and managing sickness absence and work-related matters. Finally, it looks at various innovative and promising new policies integrating employment with health outcomes.

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