MENTAL HEALTH
“Work is too often seen as something people should be protected from, and people with mental health problems are too often held back by low expectations and negative assumptions.”
There is compelling evidence to show a positive link between employment and mental health.5
People enjoy better mental
health when they are in work and worse mental health when they are out of work. The longer they are workless, the more damaging the consequences for their men- tal health. For people with mental health problems, a return to work improves men- tal health by as much as the loss of employ- ment worsens it. Getting someone a job can be a more effective health intervention than any medication or therapy.
Some aspects of the work environment can of course pose a risk to mental health and well-being, for example, excessive hours, work overload or lack of control, but the overall balance of evidence is not in doubt: work is good for mental health. The benefits of employment greatly outweigh the risks, which are very small compared with the harmful effects of long-term worklessness.
This has major implications both for em- ployers and for the NHS in all parts of the UK. First, it calls for a fundamental change in attitudes in health services towards paid work. Work is too often seen as something people should be protected from, and peo- ple with mental health problems are too often held back by low expectations and negative assumptions. We need to see what
people can do, not what they can’t, and re- gard good work as a health-promoting in- tervention. This is particularly important for GPs to understand and hopefully the advent of the Fit Note will encourage a dif- ferent approach.
Secondly, it reinforces the need for employ- ers to identify employees who are in difficul- ties at an early stage and to try to avoid hav- ing them signed off with depression without taking steps to help them remain in or to get back to work. Ignoring the problem while people are still at work can lead to much longer periods of sickness absence and long- term sickness absence too often leads to un- employment. Encouraging people to seek treatment and making adjustments as part of a well-managed return to work, if people need to take time off sick, can actually speed up recovery for many people.
Thirdly, it shows how important it is for specialist mental health services to offer good quality support for people to get and keep paid work. The Individual Placement and Support approach is now proven to be much more effective than any other form of employment support6
yet is still not univer-
sally offered by the NHS to those who could benefit from it.
And finally, it emphasises the need for the Prof Bob Grove FOR MORE INFORMATION
Visit
www.centreformentalhealth.org.uk or
www.samh.org.uk
national health executive May/Jun 11 | 53
NHS to support the mental health of its own workforce of some 1.3 million people.
Managing mental health at work should be a priority for any NHS organisation, ensur- ing for example that all line managers and supervisors are able to respond well to col- leagues when they become unwell and di- rect them to specialist support when they need it.
Colman, I, Ploubidis, G, Wadsworth, M, Jones, P and Croudace, T (2007) A longitudinal typology of symptoms of depression and anxiety over the life course. Biological Psychiatry, 62, 1265-1271.
1
Green, H, McGinnity, A, Meltzer, H, Ford, T and Goodman, R (2005) Mental Health of Children and Young People in Great Britain, 2004. Crown Copyright. Basingstoke, Hampshire: Palgrave Macmillan.
2
Collishaw, S, Maughan, B, Goodman, R and Pickles, A (2004) Time trends in adolescent mental health. Journal of Child Psychology and Psychiatry, 45 (8), 1350-1362.
3 4
Centre for Mental Health (2009a) The Chance of a Lifetime. London: Centre for Mental Health
5 Waddell, G and Burton,
K (2006) Is Work Good for Your Health and Wellbeing? London: Stationery Office.
Centre for Mental Health (2009b) Commissioning What Works.
6 London: Centre for Mental Health
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