Working for Wellness; Improving Access to
Psychological Therapies (IAPT) Employment
Support Services
“The total loss of output due to depression and chronic
anxiety is some £12 billion a year – 1% of our total
national income. Of this the cost to the taxpayer
is some £7 billion – including incapacity benefits and
lost tax receipts”.
Lord Layard (2006)
Employment business case
"The positive link between employment and mental health is
proven“*
Unemployment has been identified as one of the ten most important
contributors to the total burden of disease in the 1990s. **
Those in employment are more likely to recover from mental illness
than those who are long-term sick or disabled (80% and 22%
respectively over 18month follow-up). ***
The proportion of unemployed persons in need of psychological
treatment is more than double the proportion of considerably
distressed employed persons (34% & 16% respectively).****
The risk for mental health problems continues to rise throughout the
first nine months of unemployment *
Each year, over 200,000 people with a mental health condition move
onto incapacity benefits.**
The relative risk of unemployed people developing symptoms of
depression and anxiety is over double those who are not.***
Anxiety and depression are 2-3 times more likely in unemployed
people & 4-10 times more likely if unemployed for over 12 weeks****
Each week one million people report sick, of which 3,000 remain off
work six months later, and 80% of these will still be off work five
years later.*****
Unemployed people attend GP more than employed people*
Only 8% of people using secondary MH services are in
employment**
46% of those claiming Incapacity Benefit in London do so for a
mental illness - largely anxiety disorders and depression - 122,000
people***
Of those in manual work, stress (43%) and mental illness (17%) are
reported as major causes of sickness absence, in non-manual work
it is even higher (52% % 25% respectively).****
Gaining or retaining employment leads to a more rapid and
sustainable recovery
Response
IAPT has invested £49 million in London from 2008 – 2011. The regional
targets for 2008-11 are to enable 4000 people to retain and/or return to
employment.
In London Working for Wellness has managed an additional resource
allocation of £4.5million in Employment Support Services across 27 PCTs to
help reach these targets.
London Model: resource allocation to 15 Wave One and Two PCTs
Specification:
National £
£50K
IAPT ESC
Contribution
Regional £
Dept of Health
CSL
£50K
Contribution
Local £
£100K+
PCT Match
Funding
and/ or
demonstrate
sufficient
local
“match
resource”
Local
NB: IAPT Board decided that each “full” Wave 1 and Wave 2
Service should aim to invest £200K in order to employ a team
of at least 3 employment support workers
a£200K
aComms model
aLSP monies
aService design
aRetention/ Back to
Work components
aMarketing function
aJSEPA
aEmp Leads
Network
aROI (Emp Dataset)
A pathway through a Wave 1&2 IAPT service in
London
Psychological Therapy (PT)
Recovery
Clinician
Health Needs
Integrated PT & ES
interventions
Referral
Assessment
Employment Needs
Employment worker
Employment Support (ES)
Return to work/
retain job
Additional products and services
Realising the Benefits... Commissioners and Implementation
Guidance (inc IAPT Employment Dataset)
London IAPT Employment Leads Network
IAPT Employment Training Curriculum
MITIE Real Apprentice Scheme
Royal Mail Linked Employer Scheme
Working for Wellness – The Five Step Model Employer
Engagement
www.workingforwellness.org.uk
Achievements and Future Plans
Pioneering employment as a health intervention
Integrated clinical and employment service
Over 2000 people moved off sick pay and benefits into
paid employment to date (as of March 2011)
Designed Employment Dataset that has been taken on
by national team
Building first evidence base for primary care mental
health employment services