Is mental health one of the greatest challenges to UK productivity?
Authors: Karen Steadman
10 September 2014
A new report yesterday morning (9 September) called for action on one of the greatest challenges to productivity in the UK. Costing the UK economy 4.5% of GDP annually, addressing, preventing and managing mental ill health is not just a challenge for the health system, it is a challenge across government, it is a challenge for business, and it is a challenge for us all….
The Annual Report of the Chief Medical Officer, Professor Dame Sally Davies, released yesterday makes the case once again for increasing and improving investment in mental health services. Representing almost a quarter of the burden of disease in the UK, there is continuing concern about the balance in funding for mental health care against physical health care. Evidence shows current mental health treatment does not meet people’s needs. Though the introduction of free psychological therapy through the NHS (the IAPT program) has been a huge boost, concerns about long waiting lists in many areas remain (10% waiting over a year). Psychological therapy improves not only health, but also employment outcomes - with many service users moving off sick pay benefit’s into employment. The quality of the service is also an issue, with evidence indicating that having a fuller range of therapies on offer significantly improves employment outcomes.
It is the relationship between mental health and employment that I wish to focus on here. As the report shows, mental illness is estimated to cost the economy between £70-100 billion each year. These costs are realised through the four out of ten new benefit claims attributed to mental illness (according to the OECD), through the estimated 70 million days annually of sickness absence, and through the lost productivity of presenteeism, (coming to work while ill) the costs of which are thought to eclipse those of sickness absence.
Figures like this would not be out of place at the front of a BIS or even a Treasury report. Especially when you consider yesterday's G20’s commitment to boost GDP by 2% by 2018, against the 4.5% GDP estimated cost of mental health every year. The productivity implications outlined in this report will hopefully be a wake up call to these departments, particularly in these cost-cutting times. The All Parliamentary Group on Wellbeing Economics just this morning called for improving people’s wellbeing as a primary objective of all policy. The impact on health and wellbeing should be a primary consideration in every policy.
I also hope it provides the impetus to drive more cross-department working in the health and work area, as led by the, particularly in the context of the Health, Work and Wellbeing initiative (which includes DWP, DH, BIS and others). The joint working between DH and DWP on the four pilots based on the recommendations of the RAND psychological wellbeing and work report is a great example of this progression.
The integration of IAPT with other services, not just physical health services (as discussed in the CMO’s report) but also with employment support services needs full commitment. This is the basis for one of the aforementioned psychological wellbeing and work pilots. IAPT is being integrated with a supported employment intervention and offered to those with common mental health conditions to see how effective it might be in increasing employment more widely. Given the dramatic failing of the Work Programme in supporting those with health conditions back to work, this could be a hugely beneficial intervention and one that will highlight the close relationship between mental health support and employment outcomes.
Of course, the responsibility for all this should not fall solely on government – as discussed in the report employers in particular have a considerable role to play. The implementation of health and wellbeing interventions may be part of this (e.g. provision of access to counselling), but as our research has shown us, good people management, and particularly perceptions of employer supportiveness about health conditions can be just as important.
For government and for departments, the message here is simple – poor treatment for mental health conditions has considerable implications for productivity in this country. It is not just an issue for the health service or within the rigid (and often stigmatised) confines of welfare discourse. It is time for this to be all our agendas.
Find out more about our forthcoming event on workforce health and wellbeing policy here
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