Mental Health and Employment

This article is part of theGIST Science for Society 2014 Article Competition. The top three articles will present their work at the conference. Vote for your favourite article here. Voting closes on Friday 31st October 2014.

Unemployment is often stressful and has impacts both on the individual and their families, as well as the wider society. The government has introduced various schemes to help people find jobs, such as the Work Programme. However, not everyone can find a job as easily as others with one frequent obstacle being mental health issues. People with mental health disorders are four to five times more likely to be permanently unable to find employment [1] and tend to have a lower household income. However, mental health issues are rather common – you will probably know someone who currently has or had a mental illness at some point in their lives, or you may even have one yourself. The Office for National Statistics estimates that 1 in 6 of the working age population in Great Britain will experience mental health issues at any one time. A further sixth experience symptoms which do not meet the diagnostic criteria, but nevertheless are severe enough to impact day to day functioning, such as sleep problems and fatigue. So even if you are in employment, mental health can have an impact on your day to day productivity. This is not just an issue for the employees, but the society as a whole. Since mental health issues in the work force are so widespread, it is important to address them and develop appropriate policies to help those afflicted.

The government is intending to do more to tackle mental illness. For example, Nick Clegg recently proposed to cut waiting times for people with mental health issues and to tackle the taboos associated with this class of illnesses, but, at the moment, is enough being done to help get people with mental health difficulties into employment? It seems that we still have a long way to go. According to Paul Farmer, Chief Executive of the charity Mind, the WorkProgramme is failing to adequately help people with mental health disorders find work. He says that “at present there is too little specialist support; too much focus on mandating people to undertake activities rather than addressing the real barriers …”.

Politicians can come up with new schemes and set targets all they like, but we cannot address the issues hindering employment, unless we understand the specific barriers faced by people with mental health issues, and research effective ways of tackling them. That is why evidence-based policy is crucial to solving the issues at hand.

Various barriers to employment have already been identified. There are of course some obstacles faced directly as a result of the person’s particular condition. For example, someone with social anxiety would find it hard to work in an environment that requires a lot of interaction with other people. However, many people are potentially able to work in a variety of jobs. An estimated 30-50% of people with schizophrenia are able to work; however, only around 10-20% actually do so [2].

Another major barrier is stigma. Although a number of health conditions can lead to stigma, mental health disorders, such as depression, are in fact in second place after HIV, in rankings of stigma [3]. Many people feel that the stigma of mental illness is more disabling than the disorder itself. Other people’s beliefs about mental health are likely to cause anxiety and low self-esteem for people with mental illness, which would make them less likely to seek out employment in the first place. For those that do apply for jobs, employers’ misconceptions can be the reason they are not hired. Some employers may incorrectly believe that someone with a mental health disorder will be worse at their job. Figures show that half of employers would not wish to hire someone with a mental health condition [4], although only 15% of those that chose to do so regretted the decision. Thus perception and reality are actually misaligned.

It is understandable that businesses want to employ the best and most effective people for the job. And although direct discrimination is against the law, in practice certain groups of people can find themselves excluded on the basis of prejudice and misconception. However, we must remember that a diverse group of people constitute our society. Perhaps what we need is a different mindset, and focus on what people can do, instead of what they cannot do. We should find the jobs to match the people, rather than trying tomould the person to fit a particular job. Different personality types are better suited to different jobs, so it makes sense. Every person can be a valuable member of the workforce, so it is important to provide better support for people with mental health issues that are trying to find employment, as increasing time away from the workplace could worsen their condition, leading to a downwards spiral.

However, even once we understand the barriers to employment, we must still research the best ways to tackle them. Fortunately, this is already underway. For example, research carried out at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London [5], has shown that personal contact with people that have mental health problems is the most effective way to reduce discrimination and prejudice, and that social marketing campaigns can make a real difference. One research project also showed that educating pupils about mental health as part of the regular curriculum made a positive difference to their attitudes. This is exactly the kind of evidence that can, and should, guide policy. There are so many misconceptions around mental health that we cannot rely on “common sense strategies” alone.

Article by Yulia Revina

[1] Meltzer H, Singleton N, Lee A, Bebbington P, Brugha T, Jenkins R. The social and economic circumstances of adults with mental disorders. London: The Stationery Office. 2002.

[2] Marwaha S, Johnson S. Schizophrenia and employment. Social Psychiatry and Psychiatric Epidemiology 2004; 39(5): 337-349.

[3] Roeloffs C, Sherbourne C, Unützer J, Fink A, Tang L, Wells, KB. Stigma and depression among primary care patients. General Hospital Psychiatry 2003; 25(5): 311–315.

[4] Manning C, White P. Attitudes of employers to the mentally ill. Psychiatric Bulletin 1995; 19: 541-543.

[5] Discrimination and stigma. Retrieved fromhttp://www.mentalhealthcare.org.uk/discrimination_and_stigma (accessed 23 October 2014).