Centre for Mental Health

Family doctors need to do more to keep people with depression in jobs

20 September 2007

Family doctors should do more to help people with depression to keep their job and avoid keeping them off sick for too long, says a paper published today by the Sainsbury Centre for Mental Health.

Work and Wellbeing argues that the road to long-term unemployment for people with depression begins in the GP surgery with the writing of a sick note. While this may be the right thing at the time, if the person is not properly supported to get back to work as early as possible, they can find themselves excluded from their workplace and forgotten by their colleagues. Before long, they are unemployed and living on benefits.

Work and Wellbeing calls for GPs to be encouraged through their contract to provide work-focused help for people signed off sick with depression. This would include the timely provision of proven psychological therapies such as CBT (cognitive behavioural therapy) and referral to employment advisors where necessary.

It argues that practices should be able to make local agreements with other services to support patients back to work. This would involve local authorities and voluntary organisations to have a say in the commissioning process at practice level.

Dr Bob Grove, Sainsbury Centre director of employment, said: "Unemployment is worse for your health than either smoking or obesity. People with mental health problems can face a lifetime of exclusion if they are not helped to get back to work when they become ill. GPs have a pivotal role in helping people to get their lives back rather than leaving them facing years of poverty, isolation and ill health."

Dr Alan Cohen, Sainsbury Centre primary care adviser and a practising GP, said: "Issuing a sick note is as serious a task as making a prescription. Like a prescription, it can help some people over a tough time but it can also have potentially devastating side-effects. GPs need to bear these in mind when they issue a sick note. They need to keep in touch with patients on sick notes and to support them in their journey back to work.

"The Government has begun to address this issue, by educating GPs about the health risks of unemployment and the steps they can take to help. We welcome that progress and hope our proposals will be taken up to sustain it."

Earlier this month, the Department for Work and Pensions published a leaflet for GPs following a survey showing that 64% of GPs are unaware of the health benefits of work. Read our response to their announcement.