January 20, 2014
New report advises the Department for Work and Pensions and the Department of Health on better ways to help people with common mental health problems, such as anxiety and depression, to find and stay in work
The benefits system and employment services in England are under pressure from an increasing number of clients with common mental health and behavioural disorders such as anxiety and depression. This new research by RAND Europe suggests that the government should pilot four interventions that address mental health and employment outcomes together, to provide much-needed evidence on what works best.
At any one time, 18 percent of the working-age population in England (some 6 million individuals) has a mental health problem, and over 40 percent of sickness claims record a mental or behavioural disorder as a primary condition. The government is seeking new approaches to improve employment outcomes for affected individuals, reduce substantial costs to the treasury of providing services, and contribute to improving the general health and well-being of the population.
The RAND Europe team and their partners reviewed the evidence for effectiveness of current interventions and consulted with a wide range of subject experts in mental health and employment. They then compiled a list of evidence-based and innovative policy options most likely to improve employment outcomes for people with the sort of mental health problems that most commonly occur in welfare benefit claimants — principally anxiety and depression.
The team identified several challenges in current service provision. “We found that services are often not joined up, because they tackle either the mental health problem or the employment need as a discrete issue. Our consultations also revealed that service provision is often delayed and protracted, which can lead to the individual's problems getting worse,” said report co-author Joanna Hofman, a senior analyst at RAND Europe.
The four interventions recommended for piloting were chosen on the basis of being acceptable to stakeholders, feasible, effective and also testable — so that they can help to build a much-needed evidence base in this area. They are:
- Embed vocational support into primary care settings
- Enhance support to those out of work, to build resilience against setbacks faced when job-seeking
- Provide access to online mental health and work assessments and support — for example building on computerised cognitive behavioural therapy interventions
- Offer telephone assessments and support to people with common mental health problems who are out of work.
“Improving the employment outcomes of those with common mental health problems is a complex issue and there is no ‘one size fits all’ solution,” said project leader and report co-author Christian van Stolk, director of employment, education, social policy and population at RAND Europe. “To address the issue we are likely to need a variety of interventions and so the policy options we propose are complementary. Where we have the data, the benefits to the government are estimated to exceed the costs.”
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RAND Europe is an independent not-for-profit research institute whose mission is to help improve policy and decisionmaking through research and analysis.
Project background: This study was commissioned through the Contestable Policy Fund, and used targeted literature reviews, key informant interviews and stakeholder consultations.
Further information: including project information and link to a blog post by the research leaders can be found at http://www.rand.org/randeurope/research/projects/psychological-wellbeing-work.html.