Report 48: Mental health, employment and the social care workforce
The importance of mental health in employment
Employment rates vary greatly according to the type of impairment a person has; only 20 per cent of people with mental health problems are in employment (2)
This section sets out the main reasons why mental health is an important issue in social care employment (as well as in employment generally).
It shows the findings from research which looks at social justice and rights, economic costs and benefits, the value of work to people with mental issues, and what they can offer to employers and organisations.
Social justice and rightsOpen
Socio-economically deprived employees are at heightened risk of mental health problems associated with lower occupational or educational standing, poorer quality of work and less secure employment (10).
People with mental health problems who find work are more likely to be underemployed, employed in low status or low-paid jobs or employed in roles which do not reflect their skills or level of education (12)
This group are over-represented in the secondary labour market that consists almost entirely of part-time temporary jobs, which although they might offer flexibility, are often unstable, poorly remunerated, open to exploitation and offer limited opportunities for training and career development (7).
Economic and social costs of mental health and workOpen
Mental health problems at work are known to have economic and social consequences, though these can be hard to separate from each other in research terms. The Centre for Mental Health figures for the total cost of mental ill health in England in 2009-10 are £105.2 billion, which is a substantial increase since the 2002/2003 figures of £77.4 billion (13).
However, of 2009-10 total, only 30 per cent - £30.3 billion - was attributed to lost economic output, while £21.3 was spent on health and social care. The largest amount, £53.6 billion, is an estimated figure representing the negative impact on life quality for those personally affected by mental health problems. This figure is based on QALYs (quality-adjusted life years) (14). The human costs fall on those who suffer from mental health problems, together with their families.
Sickness absence is easy to measure but ‘presenteeism’ (reduced productivity while at work) is not, and for this reason is often ignored. For example reduced productivity can be a feature of a phased or managed work recovery plan. Researchers suggest there should be performance measures able to pick up significant change in individual performance, with occasional use of specific measures such as the WHO Health and Work Performance Questionnaire. (15) (8).
Other researchers suggest that although psychological distress does lead to increased absenteeism, in contemporary workplaces, staff often work evenings and weekends to make up time, and if these additional hours are calculated, psychological distress has lower impact on productivity (9).
Two way benefits of retaining and regaining people with mental health problems Open
Work not only has a positive influence on health and wellbeing, but also is associated with less chance of a mental health issue recurring. According to evidence, the majority of people with mental health problems say that they want to work (17) and have a lot to contribute, despite ongoing problems, and sometimes because of the life experience gained in overcoming mental distress:
‘whilst working in a busy store and having so many customers to serve I wasn’t reflecting on my thoughts and becoming paranoid about my problems’ (18).
Besides an income, positive outcomes include reduction in anxiety and depression and improvement in health and psychosocial status (7)
Although stressful work situations have been reported to cause mental health problems, including for those working in social care (19), suitable work in a safe and healthy workplace is generally good for people (20) In an attitude survey on health, work and wellbeing, more than eight in ten employees agreed that:
‘...taking everything into account, paid work is very good or good for mental health’(22).
Qualitative research with people with mental health problems in Scotland endorses this premise:
‘I feel as if, very slowly and very surely, there’s a confidence coming back, especially when I got accepted into the organisation, it’s boosted my confidence immensely’ (22).
Qualitative research with people with mental health problems makes plain that they have something positive to contribute to the workforce, not least because they are keen to be back at work and to prove themselves as employees:
‘I would like to inform them [employers] that they are missing out on a great opportunity. There are a large group of people who are willing and able’ (22).Some people felt that their experiences were valued by their workplace, and a number of respondents worked in the mental health field where personal experience of the issues was seen as a definite plus (19).