Mental Health and Employment

1. Mental Health and Employment Mark Logan. Regional Manager – RehabCare

2. Outline and themes • The value of work – research review, • Current issues – the case for change, • Exploding the myths – where you stand affects your point of view, • The consumer experience, • Stigma • The way forward.

3. What Work Means • ‘Work is at the very core of contemporary life for most people, providing financial security, personal identity, and an opportunity to make a meaningful contribution to community life.’ (NAMI / WHO Mental Health and Work 2000) • Work is a fundamental counterpoint to play. • Approximately 70% of relationships are formed in work.

4. Unemployment and Mental Health Problems. • People with mental health issues live in poverty, • Diagnosis adversely affects job prospects, • Research (UK and Ireland 1993) suggested that 61% -73% were unemployed but wanted to work, • Recent Galway based study found 75% unemployed, consistent with the National Economic and Social Forum (2007) study finding 80% of people with serious mental health problems were unemployed. (L. McGuire 2008) • Mental illness is linked to the economic environment, • People who are working more likely to stay out of hospital, and for longer periods,

5. Value of work – contd. • Strong research evidence points to the harmful effects of unemployment, and increasing depression and anxiety, • Self esteem and confidence is lowered, concentration is affected, and the risk of suicide is greatly increased, • Research evidence that supported work reduces dependence on mental health services, • Repper and Perkins (2003) cited research that with the right supports 60% of people with more serious problems could find and retain employment (Bond et al 1997, 2001 and Crowther et al 2001) • ASK - attributes, attitudes, and abilities, - skills, - knowledge. (EVE Ltd Employment Services)

6. Current Issues – money and mental illness • The share of total public health spending on mental health fell from 14% in 1984 to 7.76% in 2007, (Mental Health Commission, 2008) • On-going over emphasis on institutional as opposed to community care, • Mental Health Commission Report last week emphasised the cost of mental illness in Ireland - €3 billion in 2006, • Direct and Indirect costs of Schizophrenia found to be €420m (@10,000 people in Ireland ) • Both figures likely to be underestimated (Dr. Caragh Behan - Irish Journal of Psychological Medicine 2008)

7. Exploding the Myths. • Only 20% of people who experience severe mental illness fail to recover, • For most people problems are temporary although difficulties can last for some time, • People with mental health problems are not any more, or less, dangerous than anyone else, • They are not more / less unpredictable than anyone else, • Have to lie for fear of being judged, • Recovery from the consequences of experiencing mental illness can be harder than recovery from the illness itself.

8. The Consumer Experience • People feel guilty about their circumstances, • Mental illness has a negative impact on self esteem, confidence, and purpose, • An isolating experience compounded by poor communication, • Stigma cited as being a major issue for people who experience mental health problems,

9. STIGMA !!!! • Stigma is the application of pejorative labelling and stereotyping, contributing to separation, status loss, and discrimination, • ‘Brand, stain, blemish, defect, or scar – a mark of shame and discredit.’ • ‘The Economics of Mental Health Care in Ireland’ authors Eamon O’Shea and Brendan Kennelly (NUIG) suggest that stigma may prevent citizens and politicians from investing in mental health services and their development. • 1984 – 14%, 2007 – 7.76% • Suicide accounts for twice the number of deaths than road traffic accidents yet the National Office for Suicide Prevention has a sixth of the budget of the Road Safety Authority.

10. Stigma contd. • The World Health Organisation cites stigma as one of the greatest challenges facing people who have experienced serious mental health problems, • The U.S.A.’s National Institute for Mental Health found that people would rather tell employers they had committed a petty crime and served time in prison than admit to time spent in a psychiatric hospital, • We fear, mistrust, isolate, ignore, and attack people with serious mental health problems, • Stigma is a major contributor to suicide, drug and alcohol misuse, homelessness, and imprisonment.

11. Where Do We Go From Here? • Where you stand affects your point of view, • Are you job ready? • Do you have the requisite skills, self awareness, and commitment / passion to engage the business community about employment and mental health? • Who are the experts? • Is there scope for a symbiotic relationship? • Who else needs to be involved? • How do you get them involved?

12. Next Steps and Actions • Engage a trainer in mental health awareness training – equivalent to disability awareness training, • Honestly appraise your own and your teams views and feelings about mental illness, • Who in your team is best placed to engage and ‘sell’ the idea to employers, • Has this person been trained in presenting to business people e.g. using PowerPoint and other tools? • Can you involve and include people with experience of mental illness in your engagement strategies?

13. Actions contd. • Form strategic alliances and partnerships with the mental health sector both statutory and voluntary, • Offer to facilitate training, information sharing, and self help support for businesses and their employees, • Include and involve service users and review impact of your overall strategy, • Seek the input of ‘friendly’ employers to improve on your strategy, • Always be positive and concentrate on what people can do.