Everybodys Business Integrated mental health services for older adults A service development guide

1
Welcome
 
 
 
From Incapacity to Health Employment and Mental
Health
Booking Form 15th June 2006 930am 400pm
Quality Hotel, Loughborough  
What?
When?
Who?
Why?

• The Launch of the Regional Employment Network
• 15th June 2006
• At the Quality Hotel, Loughborough
• This is a joint initiative between Job Centre
  Plus and CSIP East Midlands. The Network aims to
  support partnerships bringing together PCTs
  public health leads, mental health trust
  managers, PCT commissioners, Local Authority
  elected members, welfare to work programmes, Job
  Centre plus, regional job brokers and the
  independent sector.
• 175,000 people on incapacity benefits in East
  Midlands. 60,000 people have mental health
  difficulties.
• 2004 Mental Health Social Inclusion Report
  highlighted issue of employment as being of high
  importance to people who use services.
• Mental Health Employment likely to be key issue
  in the next annual report by Regional Director of
  Public Health.
• Department of Health Department of Work
  Pensions issued guidance for commissioners on
  provision of Vocational support.

Enrolling!
 
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East MidlandsEmployment for people on health
benefits

• David Gardner
• Social Inclusion Lead
• With Grateful thanks to the data provided by Bob
  Kendal Job centre plus , Simon Francis (NSIP) DWP
  Miles Rinaldi (NSIP)and Vaughan Galt and Jennie
  Simms East Midlands public Health

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This presentation covers

• Mention of drivers
• The data for the east midlands for IB The
  answers to the questions
• A little bit about Mental Health and NHS Action.

4
Consultation FindingsTop 5 Issues

• Stigma Discrimination
• Better support to enable people to work
• Benefits
• Lack of social networks / social activities
• Lack of confidence
• Unwell some of the time, excluded all of the
  time

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Less than 40 of employers would recruit people
with mental health problems
Two thirds put off applying for jobs for fear of
unfair treatment

• but many ...
• highly skilled
• relevant experience
• able to work with minimal adjustment

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Health

• Therapeutic value of work, people in work
  experience better health than those out of work
• But sometimes work is part of the problem
• Unemployment is itself a cause of MH
• Suicide biggest killer among young men, strong
  association with unemployment.
• Work is the best route out of poverty

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Stress management Guidance
Management standards for work-related stress Why
should you read this? Work-related stress is a
major cause of occupational ill health. That
means sickness absence, high staff turnover and
poor performance in your organisation. HSEs
Management Standards will help you, your
employees and their representatives manage the
issue sensibly and minimise the impact of
work-related stress on your business. In fact, it
might help you improve organisational
performance.
QU 10
25 pop will suffer some form of mental health
problem WHO
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Stress

• . HSE guidelines on stress.- good to use them in
  local partnerships. How many employers using
  them??
• What is stress page 4 of your mini brain
  manual. An adverse reaction a person has to
  excessive pressures or other types of demands
  placed upon them
• Question 9 answer

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Government Drivers

• Life Chances of Disabled people
• SEU report on MH and exclusion
• Choosing health
• National Service Framework for MH
• Framework for VR
• Work health and well-being 2005
• Welfare Reform Green paper 2006

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Case for Change

• Now the largest economically inactive group in
  Britain with 2.7 million working age people
  receiving IB
• A million people claiming IB say they would like
  to work
• In the east midlands 64,868(may 64,564)
• JOB SEEKERS 2.5 working age Population But
  175,000 0r 6.5 working age pop on IB.
• ANSWER TO QUESTION 12

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Question 3
Proportion of Males and Females on IB and SDA in
East Midlands County and Unitary Local
Authorities May 2005
Source Nomis
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QU4
Source Nomis
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Percentage of Working age Population Claiming IB
and SDA by GB Region 1997 to 2005
Incapacity Benefit and Severe Disability
Allowance in the East Midlands   Vaughan Galt and
Jennie Simms
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Figure 2 Percentage of Working age Population
Claiming IB and SDA by East Midlands County and
Unitary Authorities 1997 to 2005
Incapacity Benefit and Severe Disability
Allowance in the East Midlands   Vaughan Galt and
Jennie Simms
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IB Customer Percentages By Ward
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Pathways to Work Derbyshire

• Key facts in Derbyshire
• Around 1000 new claims per month to incapacity
  benefits
• 46,325 claiming an incapacity benefit
• 7.5 of working age population
• Average length of claim is 8 years once claiming
  over 1 year
• Once claiming for 12 months only 20 return to
  work within 5 years
•  

Question 5
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MENTAL HEALTH BRITAINS BIGGEST SOCIAL PROBLEM?
Richard Layard
QUESTION6
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Incapacity Benefit and Severe Disability
Allowance in the East Midlands   Vaughan Galt and
Jennie Simms
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Over 900,000 adults with mental health problems
claim Incapacity Benefits in England(60,000 in
Our region)

• IB claimants with mental health problems have
  almost doubled from 475,000 in 1995 to 848,000 in
  2002, with a further 58,200 claiming SDA
• doesnt include mental health problems as
  secondary condition
• Prevalence of mental health problems as measured
  by ONS has not changed over last decade
• Greater proportions still on IB after 1 and 3
  years cf. other IB claimants

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Incapacity Benefit and Severe Disability
Allowance in the East Midlands   Vaughan Galt and
Jennie Simms
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Case for Change

• Duration on IB increasing now averages 8-9
  years compared to 3 years in 1985
• Once people have been on IB for 1 year, their
  chances of returning to work diminish
  significantly
• Statistically if customers are on IB for 2 years
  or more, they are more likely to retire or die
  than go back to work

Question7
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Case for Change

• Two thirds of IB claims due mainly to 3 moderate
  conditions
• 35 mental health (stress, depression, anxiety),
  
• 22 muscular-skeletal (back/neck pain) and
• 11 cardio-vascular (angina, blood pressure)
• Mh Issues present in aprox ¾ ie including as
  secondary problem to primary diagnosis
• Medical research indicates work aids
  recovery/prevents further deterioration in many
  cases

Question8
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Less than a quarter of adults with mental health
problems are in work

• Main barriers
• fear of losing benefits
• employers attitudes
• fluctuating nature of condition
• low expectations of health professionals

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Health system can make it worse?
The stigma of mental health problems has
certainly reduced the number of positive
responses to my job applications and some
diagnoses have more stigma than others. Another
hindrance I have experienced is the attitude of
some mental health professionals to discourage me
from applying for paid work, and their insistence
that claiming Income Support is a must. Also, it
seems to me that there is no recognition that
someone may be fit to work part-time but not full
time, in other words an all or nothing approach
to medical certification.
 
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Source Derbyshire Social Inclusion
Group-D.Gardner.
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People can become Very Isolated
Services
Employment
?
?
?
Sport exercise
?
?
Education
?
?
Family neighbourhood
Volunteering
Faith communities
Arts and Culture
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Vocational Guidance

• 1.      The Mental Health Social Exclusion
  report identifies through imbedding vocational
  and social support in the CPA it will include
•  
• i.        Establish employment status on
  admission to hospital
• ii.    Support job retention
• iii.   Promote involvement of carers and
  families
• iv. Identify a lead contact on vocational and
  social issues in all secondary care teams
• v.  Strengthen links to key local partners, in
  particular Jobcentre Plus and education
  providers
• vi.   Promote access to advice and support on
  benefits issues.
• vii.  Monitoring vocational outcomes for people
  on CPA, and
• viii.Monitor the employment rates of people with
  mental health problems within their own
  organisation.

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I have worked since the age of 16 in a variety
of manual jobs, such as a Warehouse operative and
a Sheet metal worker. I also spent 3 months in
the Army before leaving, as it was not what I
expected.   I had been unemployed for 2 years
when I became ill. I was referred to the
Community Mental Health Team and I then started
to work with the Employment Specialist. My
biggest concern around working again was the
stigma surrounding mental illness. I did not
want to disclose my illness to work colleagues
and would only explain my schizophrenia on a
medical form.   The help I got from the Community
Mental Health Team was excellent. The Consultant
Psychiatrist changed my medication from
injections to oral tablets, which stopped the
side effects I had been having and the Employment
Specialist gave me focus to look for work. They
found the vacancy on the internet for me and
helped me through the application and interview
process.   Today I am in a job that I enjoy, take
my medication regularly and I am very grateful
for the help I received.
 
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March 2006 Budget statement

• 4.19 To inform the 2007 Comprehensive Spending
  Review the government will review policies needed
  to improve Mental Health Outcomes and Employment

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Contact Details
David Gardner Tel [phone], Mobile
07785387703 Email david.gardner_at_eastmidlands.csi
p.nhs.uk