Individual Placement and Support (IPS) for people on ESA with a mental health condition Nicola Oliver Centre for Mental Health Nic Taylor-Barbieri South Essex Partnership University NHS Foundation Trust

Number of people on ESA with mental health needs In February 2013 there were 1,591,040 ESA claimants 46% of these were claiming on the basis of mental or behavioural disorders. (Department for Work and Pensions (2013) Statistics)

ESA breakdown Support group and WRAG group Proportions of people at each stage of ESA are broadly similar across the impairment groups. (Department for Work and Pensions (2013) Statistics)

Unemployment and mental health are linked Unemployment can cause poor mental health; people who have been unemployed for six months or more are likely to develop depression. And poor mental health is often at least a part of the reason for unemployment. (Diette et al Causality in the relationship between mental health and unemployment, 2012) (Rinaldi, et al Increasing the employment rate for people with longer-term mental health problems, 2011)

Unemployed people with a mental health condition need help Of the 700,000 people on ESA with a mental health condition, there are probably today 300,000 needing appropriate help to get back to work.

Work Choice outcomes for people with mental health problems From June 2012 – June 2013 Work Choice the DWP scheme for people with disabilities and health conditions has supported 10,170 people into work. 15% of these job outcomes were for people with mild to moderate mental health conditions just 1% (100 jobs) were for those with more severe mental health problems. (DWP, Work Choice: Official statistics Aug 2013)

Mental health stigma and discrimination in the workplace The stigma attached to mental health is still a problem. Time to Change, the anti- stigma campaign is seeing a very slow improvement in knowledge and behaviour among the general public towards people with mental health needs. (Smith, Anti-stigma campaigns: time to change, 2013.) © SANE - Mental health charity - Meeting the challenge of mental illness Because of the stigma associated with the Black Dog of depression, I tried to keep him hidden at work

Overcoming barriers to employment caused by mental health problems People need: Not to be written off as unemployable A personalised approach (small caseloads) Someone to convince employers A bridge-builder between support with health and employment needs Access to advice on benefits Time-unlimited support

Could Individual Placement and Support be a more effective method?

Individual Placement and Support (IPS) 8 evidence-based principles : 1. Eligibility is based on individual choice; 2. Supported employment is integrated with treatment; 3. Competitive employment is the goal; 4. Rapid job search (within 4 weeks); 5. Job finding, and all assistance, is individualised; 6. Employers are approached with the needs of individuals in mind 7. Follow-along supports are continuous; 8. Financial planning is provided.

Individual Placement and Support (IPS) evidenced effectiveness IPS has an established evidence-base of more than 20 clinical trials A six-centre European trial (EQOLISE) found: o IPS participants were twice as likely to gain employment (55% v. 28%) compared with traditional vocational rehabilitation alternatives; o IPS participants sustained jobs longer and earned more than those who were supported by the best local vocational rehabilitation alternatives; o Better results were obtained by implementing all IPS principles in full;

Recommendations for working with people claiming ESA Train the employment workers in NHS Mental Health Trusts to use IPS Promote IPS practice to all DWP funded employment workers who support people with mental health problems Place IPS workers with primary care psychological therapy services (IAPT) Enable Job Centre workers (DEAs, ESA advisers) to refer customers to IAPT services Attach IPS workers to GP practices Replace general Work Choice schemes for people with mental health needs with specifically ‘IPS method’ services

Thank you For more information contact Centre for Mental Health: