Job Retention and Mental Health in the Workplace Training Welcome!

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Job Retention and Mental Health in the
Workplace TrainingWelcome!
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Managing Health Social Risk in the Workplace

• Roger Butterworth
• Director of NHS Liason
• Work Life Partnerships Ltd.

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Why Job Retention?
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Why is prevention retention important? The
economic argument

• Mental health disorders account for 23 of those
  on incapacity benefit in England
• Mental health stress problems are now the
  leading cause of absence from work
• The annual cost of lost employment in England is
  19.4 billion
• Cost borne by employers in sick leave, lost
  production, recruitment retraining,
  compensation, litigation insurance, early
  retirement.

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Australian Study 1993for every dollar
spent on rehabilitation, 4 dollars saved
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Response from questionnaire relating to Job
Retention

• In our Trust 78 lost their jobs as a result of
  their mental health difficulties, and through
  lack of advocacy or effective case management
• Only 11 had found our Occupational Therapy
  service helpful
• Only 7 had found the Disability Employment
  Advisors helpful

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Dr Chris Manning PRIMHE/ Depression Alliance

• There is huge concern about this group in primary
  care
• GPs often do not have the time, knowledge or
  skill to deal effectively with work absence or
  sickness due to mental ill health

• Signing off is seen as protective, but is often
  at the expense of individuals longer term health
• These clients often pick up labels such as
  fat-filers, heart sinkers, psychosomatics

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GPs the facts

• It is estimated that around 40 of all GP
  consultations include a mental health problem
• Around 90 of mental healthcare is provided by
  Primary Care
• 30-50 of those with SEMI, who engage with
  statutory services, use only Primary Care Services

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The 3 tiers of prevention, retention and
rehabilitation

• Primary Prevention health promotion, reducing
  stress, prevention of illness and injury wherever
  possible
• Secondary Prevention Job Retention, early
  intervention, managing sickness absence
  policies
• Tertiary Prevention Vocational Rehabilitation

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As Vocational Rehabilitation Services
spread in Mental Health, there will be more need
for job retention to keep these individuals in
jobswhen they secure them
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The sick absence trajectory

• The chances of those individuals signed off sick
  returning to work after a period of 6 months is
  only 50
• After 1 year it is 25
• After 2 years it is practically nil 5

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Outcomes relating to Job Retention before the
pilot

• The successful creation of a job retention
  service, helping over 35 people to remain in
  their jobs, and 15 to find other career paths
• Development of key stages in job retention
  guidelines
• Training and education to OTs and other health
  professionals in Trust

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The Avon Job Retention PilotJune 2002-3

• Commissioned by NHS Executive
• Funded by DWP, DoH and AWMHPT
• Qualitative Evaluation by IAHSP, Kings College,
  London
• Our aim was to provide a one stop resource for
  employers case management for employees and all
  the interventions that are vital in creating
  healthy work environments

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Private Initiatives

• Occupational Health, managing absence
• Stress Policies Audits
• Workplace Counselling
• Employee Assistance Programmes
• Well- being Programmes
• Helplines
• Mediation Conflict Resolution

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Public Initiatives

• Health Promotion
• Job Retention
• Specialist Mental Health Services

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Key Points from the evaluation

• What a service user said
• I dont know what Id have done without their
  support. It meant so much to have someone on my
  side, who could understand what Id been through,
  and speak for me when I wasnt well enough to
  deal with anything. I think I have them to thank
  for still being in my job. Id have given up, Im
  sure of that.

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Key Points What an employer said

• We knew she was involved we knew she had a
  nurse, but they had never included us in things.
  It was so much easier when (the JRT) came on
  board. They made some useful suggestions on how
  to proceed, and the support they gave her and us
  made all the difference really.Wed have had to
  let her go, as things couldnt carry on as they
  were.

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Key points What GPs said

• It saves my time, and I know they will be able
  to help them, I know they will support my patient
  in sorting it out.
• They negotiate with work and stop the patient
  being frightened.They negotiate with the employer
  and know the patients rights. They also give
  them the confidence to go back. To have somebody
  they trust to do that, I just dont have the
  time.
• I honestly think its great. I really like
  having a service that recognises theres an issue
  I cant deal with as well as Id like to.

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Ongoing support at work

• Its just knowing that he is there. You know six
  months down the line, if I feel I cant keep it
  together, Ill ring him up.Its nice to have
  someone like that. Its the ongoing support in
  case any problems come up that I cant deal
  with.
• My case manager has been helpful in ironing out
  the problems Ive had since returning to work,
  and there are so many still going on. It takes a
  lot of the pressure off, and I dont feel so much
  on my own anymore.

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Saving the job, saving the marriage

• 69 of job retention cases are in permanent
  relationships
• 80 unemployed clients are single
• My husband thought I should let the situation
  go and not complain This caused problems between
  us. Financial stress! My case manager briefed him
  on my state of mind, this made a big difference.
  So then I had the support of my husband as well.

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Life after the pilot

• Rolling out a nationally co-ordinated Job
  Retention Service
• Giving an effective response to the SEU Report
• Answering the need for training with Diploma and
  Certificate in Case Management
• Developing Public/Private Partnership Initiatives
  with joint investment

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Key Elements

• Full range of professional services- qualified
  and accredited
• Standards across the professional boundaries, in
  addition to their own
• Training to manage cases proactively
• I could not have mustered all the services I
  needed thank-you.

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Summary

• The Strategy for Mental Health Work is clear
• Models tested in the UK are robust and confirmed
  by overseas experience
• Training Development is urgent we must have
  capacity it is ready to go
• Funding currently being reviewed
• We now need planes not pilots!!