Government paper focuses on mental health improvements

For occupational health practitioners, anything that helps to raise the profile of mental ill health within the workplace or highlight the need to improve provision or reduce stigma is going to be a good thing.

Yet, from the OH perspective, the Government’s latest strategy document No health without mental health, published in February, does appear to have missed a trick, as Sally Wilson, research fellow at the Institute for Employment Studies makes clear.

“It is quite telling and I think, to an extent, a shame that occupational health is barely mentioned at all; there is really just a passing mention. Yet occupational health and employers clearly do have a major role in supporting the mental health of the working population,” she points out.

Getting the message across

“Occupational health practitioners are on the ground and very much seeing the impact of mental ill health on absence, attendance, illness and productivity,” adds Wilson.

In fact, the only specific mention of occupational health within the strategy is in the context of the Government restating its commitment to expanding the Improving Access to Psychological Therapies (IAPT) programme, which involves Jobcentre Plus, employers and occupational health providers.

Overall, the strategy outlines six key objectives for improving the mental health and wellbeing of the population (see box). Specifically, in terms of employment, it argues that “high-quality employment support” needs to be based upon highlighting the importance of:

  • confidence in returning to and retaining work;
  • better recognition that an individual can perform the job and that their condition is manageable within the workplace;
  • better interaction between appropriate work and wellbeing; and
  • employers ma­king “appropriate” recruitment decisions and managing workplace health.

The document also makes it clear that a key part of its strategy will be the Fit for Work service pilots plus, potentially, the fit note. It also reiterates that the Government is examining the possibility of “incentives” within the sickness absence system.

Nevertheless, the fact that the Government is prioritising mental health and wellbeing in an economic climate where it could be just as easily swept under the carpet is positive, say mental health bodies.

What is more, when you place the document in the context of the public health White Paper Healthy lives, healthy people, published in December 2010, it is possible to see this as part of a wider vision that could in time transform how the public, health providers and employers view public health and wellbeing.

At one level, simply making the point that mental health needs to be something “in the mix” and that needs cross-departmental cooperation is a significant step forward, concedes Simon Lawton-Smith, head of policy at the Mental Health Foundation.

Cost analysis

The focus on using mental health services to help improve support into paid work and the commitment to extend the availability of psychological therapies to more people are also welcome, argues Centre for Mental Health joint chief executive Professor Bob Grove.

“Failing to provide proven therapies in time not only damages health but can also cost people their livelihoods and cost the NHS more because of more expensive treatments,” says Grove.

Yet there remains a lack of clarity as to whether or not there is going to be any new money for some of the things that have been mentioned, such as the proposed expansion of the IAPT programme, suggests Wilson.

“There is very little sense of how this fits within the context of the cuts that are currently going on within the health service and elsewhere,” she points out.

Gathering interest

It may also be that a document such as this will be read by, and mostly appeal to, the converted – in other words those employers that have already recognised the value of this sort of intervention.

The wider challenge – and the key longer-term test of success – will be whether or not, or how, the Government reaches out to employers and managers who remain either unconvinced or just uninterested in adding this issue to their in-tray at a difficult time.

As Wilson argues: “In some respects, I do not know if something like this will change any minds. Even if you have a positive message it may not be enough by itself to change minds.

“But the more employers can be encouraged to be flexible, supportive and inclusive, and to help people generally, the better.”

Key objectives

The “No health without mental health” strategy sets out six objectives for improving the mental health and wellbeing of the nation:

  • To ensure more people will have good mental health through better wellbeing, including through “working well”.
  • To ensure better recovery rates, including giving people the skills they need for living and working and better chances of employment.
  • To ensure more people with mental health problems have good physical health.
  • To ensure more people have a positive experience of care and support.
  • To ensure fewer people with mental health problems suffer avoidable harm.
  • To ensure fewer people with mental health problems experience stigma and discrimination.

In terms of practical measures, the Government has said that it will set up a new mental health strategy ministerial advisory group to work alongside the NHS Commissioning Board and the new Public Health England service. It has also asked Liz Sayce, chief executive of disability charity RADAR, to conduct an independent review of specialist disability employment programmes, to report by this summer.

The advisory group, it says, could advise on improving indicators for tracking progress against the mental health objectives as well as act as a hub for “sustained partnership working”.

XpertHR provides advice on managing staff with mental ill health in the workplace.

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