Centre for Mental Health

Fitness for work: the Government response to ‘Health at work – an independent review of sickness absence’ is the Government's response to the independent review of the sickness absence system by Dame Carol Black.

The report highlights the support that healthcare professionals and GPs in particular, require in helping individuals back to work and supports the recommendations of the review that fit note guidance is in need of revision and GP knowledge and awareness of the benefit system requires improvement. Download the report here.

Further qualitative research examining programme delivery will be conducted with participants, Jobcentre Plus and providers, which will enable further testing of the findings noted here. Survey work will also be conducted with participants and providers, which will allow an examination of the scale and intensity of findings.

This research is the first national study dedicated to examining the psychological health and wellbeing of Jobseeker’s Allowance (JSA) claimants.

People who started a JSA claim in the first quarter of 2011 had worse mental health than people of working age in the population as a whole. After standardising the JSA claimant cohort to the age and sex profile of the general population, 14.7 per cent were found to have a level of symptoms almost certain to warrant treatment. This is nearly twice the rate for the general population (8.5 per cent).More than a fifth (22.6 per cent) of the cohort had a CMD like anxiety or depression. In the months after a claim commenced the average mental health of men in this cohort remained poor, while that of women improved. Read more on the DWP website here.

British Occupational Health Research Foundation has published the final report of its study to investigate a cognitive behaviour therapy (CBT) intervention that could be administered in the workplace. This study found that users of MoodGYM took less time off work during the study period, leading to lower costs for employers.

Read Computerised CBT for common mental health disorders: RCT of a workplace intervention on the BOHRF website.

Participants in the latest survey of community mental health services said they are treated with dignity and respect by the health or social care worker they had seen most recently. However, some would have liked more support in getting help with aspects of day-to-day living.

The vast majority of participants said that they:

• were treated with respect and dignity, were listened to carefully and had trust and confidence in the health or social care worker they had seen most recently.
• could ‘always’ contact their care co-ordinator/lead professional if they had a problem and that their care co-ordinator/lead professional organised their care and services ‘very well’.

However, over a third of participants who had physical health needs said that they would have liked more support from a member of staff at their mental health service but didn’t get it.

The survey results also suggest that a considerable proportion of respondents who needed help would have liked more support in some aspects of day-to-day living such as:

• caring responsibilities.
• finding or keeping work.
• finding or keeping their accommodation.
• financial advice or benefits.

Depression, anxiety and related problems are very common indeed - in the UK about one in six workers have levels of distress that doctors would diagnose as illness. This article, published in the New Zealand Mental Health Foundation's newsletter, sets out the ways in which employers can create healthy productive workforces and manage the mental distress. Read the article online here.

The leading exectives of eight of the UK’s most prominent companies have urged UK business to offer more jobs to former prisoners and those still in jail. In a recent letter to the Financial Times, the company chiefs call for fellow bosses to take advantage of the skills many ex-offenders can offer; “It makes sense for UK companies to recruit these individuals and to make use of their skills and enthusiasm”. The letter was published on the day that Justice Secretary Ken Clarke announced plans for every prison in England and Wales to start up a profit-making company staffed by inmates.

Acknowledging evidence that re-offending figures are significantly reduced among prison leavers who go into a full-time job upon their release, the business leaders back the government’s efforts to “introduce real work into prison”, so that offenders can learn new skills while behind bars.

The NHS Confederation's Mental Health Network has produced this briefing, which summarises the strategy’s six objectives and describes how progress will be measured. It also outlines further work to support implementation, which will be taken forward over the next year and beyond.

The Government today published a Mental Health Strategy, No Health Without Mental Health, setting out its six key objectives to improve mental health in England and the lives of people with mental health problems.

It also published a Call to Action in support of the strategy. Centre for Mental Health is among the signatories to the Call to Action and supports the six objectives in the strategy.

Read our response and the Future Vision Coalition's response.

The DWP has published a list of preferred private and voluntary sector providers of the new Work Programme, which will replace a range of existing employment programmes.

We have produced a briefing about providing employment services to people with mental health problems.

The Department of Health has published an Atlas of variations in the NHS. It shows variations in the NHS across England and contains three mental health-related maps (from p34 in the PDF) on suicide rates, expenditure and rates of Incapacity Benefit claimants with mental health needs (p38 in the PDF).

The first review of the Work Capability Assessment (WCA) has been carried out by Professor Malcolm Harrington. The review and the Government’s response to it are available here.

Professor Harrington reviewed the fairness and effectiveness of the WCA. He set out a substantial series of recommendations to the Government based on the evidence he collected as part of the review. The main recommendations focus on:

• empowering and investing in Jobcentre Plus Decision Makers
• Jobcentre Plus taking control of the process and supporting individuals through it
• Atos employing “champions” at each Medical Examination Centre
• establishing a programme of work for the second review.

This briefing from NHS Employers helps senior managers in the NHS make staff health and well-being part of their organisation’s culture and embed it into their policies.

It also examines the business case for improving staff health and well-being and sets out what trusts need to do to help meet the challenge of achieving £555 million in savings on sickness absence.

The WHO has published a report on mental health and well-being in the workplace. It suggests ways to respond to the challenges that modern working life presents to mental health and well-being and to overcome barriers to employment for people with mental health problems.

It also discusses opportunities for integration and empowerment given the global economic downturn from the viewpoint of service-user and family-caregiver associations, enterprises, trade unions, politicians and researchers. It is essential reading for employers and policy-makers.

A new report from CIPD shows that public-sector absence rates remain 'persistently higher' than in other sectors, with stress increasingly blamed.

But organisations are taking a more proactive approach to managing absence and that investing in well-being is paying off.

(See our workplace training programme: onsite training from 1 to 4 hours, delivering good mental health at work.)

The Equality Act 2010 has now become law. The Equality and Human Rights Commission has produced guidance for employers, workers, service providers and service users on what the new parts of the Act will mean for them.

There are nine protected characteristics for employees:

• Disability
• Gender reassignment
• Marriage or civil partnership
• Pregnancy and maternity
• Race
• Religion or belief
• Sexual orientation
• Sex (gender)
• Age

Further useful information is available on the Mind website.

A new report by the Work Foundation confirms that 'sickness presence' is something employers should take seriously, with a small survey showing that over a 4-week period 45% of employees self-reported one or more days of sickness presence, compared with 18% reporting one or more days of sickness absence. (See also their blog post on the subject.)

Citing the Sainsbury Centre's Mental Health at Work, the report notes the high estimated costs of ill health at work, and supplies important UK data that employers can use to begin get to grips with ‘sickness presence’ in their own businesses.

Sainsbury Centre would welcome further research into this important issue, to help employers create workplaces that both benefit employees for whom work is an important part of recovery from mental illness and can respond appropriately to employees experiencing mental distress at work.

The NHS Confederation has produced a guide to mental health and employment. This Briefing outlines the key themes from recently launched government policies in this field and sets out actions for the NHS, as both an employer and service provider.

On the 6 April 2010 the sick note will change and become the fit note.

Evidence shows that work is generally good for your health and that often going back to work can actually aid a person’s recovery. The new fit note can help. Doctors will be able to advise people who are on sick leave for over 7 days on whether, with extra support from their employer, they could return to work earlier.

For more information, visit the DWP website.

This document forms part of the Government’s response to the Perkins Review (Realising Ambitions). Focused specifically on people in touch with secondary mental health services, this document applies only to England and is the product of the Socially Excluded Adults Public Service Agreement (PSA16).

Work, Recovery and Inclusion endorses the recommendations of the Perkins review for a more 'joined-up' approach to service delivery across DWP and health and social care services. It commits the Government to improving the employment chances of people in touch with secondary services, with the long-term vision being to see a large increase in the number of people in employment by 2025.

The plan covers supporting people to build skills to compete for jobs, enabling people to get jobs, and supporting employers and employees to keep people in work. The plan will be delivered on a local scale by a 'broad spectrum of providers' and the new Mental Health Coordinators in Jobcentre Plus form part of the Government's commitment to strengthening partnerships at a local level.

This is an independent review of services, led by Rachel Perkins of South West London and St. George’s Mental Health Trust and supported by Paul Farmer of Mind, and Paul Litchfield at BT.

These key recommendations for action can be summarised under 3 main headings:

1. Make low-cost changes to existing services quickly through better joined-up working of frontline health and work staff and improving welfare-to-work services
2. Implement IPS in a UK context by embedding employment specialists in all mental health/social care teams, reforming Access to Work and making internships possible for people who have been long-term out of work and allowing a gradual build-up of hours
3. Monitor outcomes and drive change: agree definitions of employment and mental health and ensure routine monitoring of employment and mental health condition across the Department for Work and Pensions and health/social services. Performance indicators should require a year-on-year decrease in gap between the general employment rate and that of people with a mental health condition

This is the new cross-government national mental health and employment strategy. It addresses wellbeing at work for everyone and better employment outcomes for people with mental health conditions, both in and out of work.

This practical framework sets out a series of commitments from government and what it expects from health professionals, employers, organisations and individuals.

It identifies 6 key areas for action:

• Changing attitudes to mental health
• Improving health and wellbeing at work
• Early intervention
• Tailoring support (individualised) in and out of work
• Building resilience from early years
• Coordinating action across government

A companion guide to the strategy is available from SHIFT.

NICE has produced guidance for employers on promoting mental wellbeing through productive and healthy working conditions. The guidance aims to help reduce the estimated 13.7 million working days lost each year due to work-related mental health conditions.

Recommendations for employers include:

• Promote a culture of participation, equality and fairness.
• Create an awareness and understanding of mental wellbeing and reduce the potential for discrimination and stigma.
• Ensure systems are in place for assessing and monitoring the mental wellbeing of employees.
• If practical, provide employees with opportunities for flexible working according to their needs and aspirations in both their personal and working lives.
• Strengthen the role of line managers in promoting the mental wellbeing of employees through supportive leadership style and management practices.

Dr Steve Boorman's review of NHS Health and Well-being has published its interim report. The review sets out to investigate and improve the health of NHS staff, and their health and well-being provision at work.

The interim report calls for routine early intervention support for NHS staff experiencing mental distress and for all managers in the NHS to develop the skills to support staff health and wellbeing.

This study from the Mental Health Foundation examines the role of depression in returning to work after a period of sickness absence across four types of chronic illnesses: depression and anxiety, back pain, heart disease and cancer.

The report shows that almost half (45%) of those with a physical condition experienced mild to moderate depression, but were more worried about telling their employer about their mental health issues.

The outputs of the Foresight report have been published. The project was looking at the future challenges in mental health and wellbeing.

We contributed to the Scientific evidence on employment in SR-B9: Factors influencing recovery from serious mental illness and enhancing participation in family, social and working life.

These are the findings of a new pilot which placed employment advisers in GP surgeries. They acted as a link between patients and a range of services and support offered by Jobcentre Plus and other organisations.

The pilot has been largely successful with positive feedback from GPs, the advisers and the patients who consulted them in the surgery.

Dame Carol Black's review of the health of Britain's working age population Working for a healthier tomorrow recognises that for most people work is good both for their long-term health and for their family’s well-being. Its proposals focus on keeping people healthy at work, and also on helping them return to work if they get ill.

Key recommendations include:

• New Fit for Work service to be piloted for patients in early stages of sickness – if rolled out the aim would be to make work-related health support available to all
• If successful Fit for Work should be extended to those on incapacity and other out of work benefits. Government should also expand provision of Pathways to Work to cover all on incapacity benefit
• Outdated paper-based sick note should be replaced with an electronic ‘fit note’, stating what people can do, not what they can’t
• Occupational health should be brought into the mainstream of healthcare provision

CSIP has published a new guide to user involvement in CSIP. Valuing Involvement also provides information on working and benefits.

A new survey of 1500 GPs has found that two-thirds (64%) are unaware of the evidence that work is beneficial for physical and mental health. However, nearly 90% said that if they knew of this evidence it would affect the advice they give to their patients.

Evidence published last year conclusively found that being in work can help people with a health condition to get better; and returning to work from unemployment improves health. Work can be intrinsic to health and wellbeing, boosting self-esteem and quality of life.

Read our response to this initiative.