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Mental Health, Social Inclusion and the Workplace


Stigma and discrimination are the greatest barriers to social inclusion, quality of life and recovery for people with mental ill-health. Our research shows more ... – PowerPoint PPT presentation

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Title: Mental Health, Social Inclusion and the Workplace

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Mental Health, Social Inclusion and the
Workplace Dr Jeanne Moore Policy Analyst,
NESC NDA Seminar 13th May 2011
  • If you broke your leg youd be fairly confident
    that your company would stick by you and youd
    still have your job to walk into when youd be
    better again. If youre off with depression,
    because theres that whole is he mental? thing
    about it, is he a liability? that you would
    fear what your company will do when you get
  • Employee, Dublin.

Key Points of Presentation
  • The NESF Project on Mental Health and Social
  • 3. Why Mental Health is Everyones Business
  • 4. The Role of the Workplace
  • Millward Brown IMS Research
  • 5. Towards an Integrated Approach
  • Main Recommendations

  • National Economic and Social Forum (2007) Mental
    Health and Social Inclusion Report
  • NESF Project Project Team
  • Chaired by Professor Cecily Kelleher, UCD.
  • Representatives from four strands of social
    partners and included clinicians and service
  • Aim of Project
  • To increase the social inclusion of people with
    mental ill-health as well as identify broader
    strategies and actions for the promotion of
    mental well-being across Irish society.

Key Perspectives of NESF Report
Mental Health and Social Exclusion
  • Mental health is used here to refer to a state
    of well-being in which the individual realises
    his or her abilities, can cope with the normal
    stresses of life, can work productively and
    fruitfully and is able to make a contribution to
    his or her community (World Health Organisation,
  • Those who are socially excluded have an increased
    incidence of mental ill-health and vice versa so
    that it can develop into a cycle of exclusion
    (Social Exclusion Unit, 2004).

Mental Health is Everybodys Business (WHO,
  • The societal costs of poor mental health are
    enormous reduced economic performance, human and
    social capital and increased health and social
    welfare costs (WHO, 2006).
  • Not just about specialist services The vast
    majority of mental health care in Ireland happens
    in primary care- 85 of GPs referred fewer than
    5 of their patients to mental health
  • Not just important for health policy
    International good practice guidance makes clear
    that mental health should be an interdepartmental
    concern (Amnesty International, 2010).


Widening the Focus on Mental Health
  • The WHO European Ministerial Conference on Mental
    Health (2005) concluded that mental health is
    central to the human, social and economic capital
    of nations and should therefore be considered an
    integral and essential part of other public
    policy areas such as human rights, social care,
    education and employment.
  • E.g. Finnish Health in All Policies includes
    housing, transport, education etc.
  • 2005- EC Green paper Improving the Mental Health
    of the Population- EU strategy on mental health.
    2008-European Pact for Mental Health and
  • 2011- No Health without Mental Health (2011) A
    Cross Government Mental Health Outcomes Strategy

Irish Policy Context
  • We have the vision. The blueprint for mental
    health policy development in Ireland is A Vision
    for Change (Department of Health and Children,
    2006). Provides policy framework for an
    integrated approach.
  • The Independent Monitoring Group (IMG) is
    monitoring progress. Implementation has been slow
    to date without a comprehensive implementation
    plan (2009). Mental Health Commission (2009) From
    Vision to Action Analysis of the Implementation
    of A Vision for Change and (2007) The Quality
    Framework for Mental Health Services in Ireland
    Amnesty International (2010) The Missing Link
    Co-ordinated Government Action on Mental Health.
  • A welcome development has been the establishment
    of the Office for Disability and Mental Health
    which is driving implementation of this policy
    the Mental Health Commission.
  • Wider context National Disability Strategy
    National Action Strategy on Suicide Prevention
  • Commitment in new (2010) Programme for Government
    for cross-departmental group.

Improving Mental Health Co-ordinated Action
Across Levels
Improving Mental Health
Why Work is Key
  • Maintaining work can be critical for those
    experiencing mental ill-health (Fine-Davis et al,
    2005). The risks of social exclusion greatly
    increase with loss of employment. Most people
    with severe and enduring mental ill-health are
    not in employment.
  • Work is a gateway to civil and economic life of a
    community (Pavis et al, 2002). Many paths to
    recovery work is a continuum from meaningful
    unpaid activity to paid employment.
  • Retaining employment makes sense for everyone if
    supports are there.
  • At the time of the project, little was know about
    attitudes in the workplace towards mental health

Mental Health and the Workplace
  • Millward Brown IMS Research
  • Lack of workplace policies only 20 of
    employers had written policies in place but most
    wanted more information and guidance.
  • Mostly supportive of employees with mental
    ill-health but still some negative attitudes -54
    agreed with the statement that they would be
    taking a significant risk when hiring someone
    with mental ill-health.
  • Disclosure- There is a fear of disclosing a
    mental health issue to employers and colleagues-
    58 of employees would tell their employer and
    43 would tell their colleagues.
  • 16 of employees experienced mental ill-health in
    last 2 years.

Workplace Research Conclusions
  • The stigma of mental health is in the workplace.
    Negative attitudes persist.
  • Employers and employees need information,
    guidance and guidelines as to what to do if they
    face a mental health problem.
  • At a policy level, the workplaces role to
    support and foster positive mental health has not
    received sufficient attention.

Work, Training and Meaningful Occupation
  • A range of schemes, programmes, rehabilitative
    training and workshops and supported employment
  • Shift towards placement in jobs rather than
    prevocational training increases peoples chance
    of genuine social inclusion.
  • Early intervention is key.
  • A virtual ramp for returning to employment
    (Hooper, 1996).
  • Aim is facilitate the delivery of a seamless
    service through formal coordination structures
    (Vision for Change, 2006).

Six Pillars of Recommendations
The Workplace and Employment
  • A Health and Well-Being Framework Strategy for
    the workplace including
  • Guidelines and information on good employment
  • A code of practice for employers and employees on
    their statutory obligations and duties.
  • An integrated strategic plan for the delivery of
    training, work and employment services.
  • Integrated vocational support within mental
    health services a part of a Supported Employment

Final Conclusions
  • Actions in mental health have to be considered
    across the breadth of all social, economic and
    health policy in Ireland. Constrained resources
    can be a driver for collaboration and
    stream-lining approaches.
  • Responses have to be both at a strategic level,
    for everyone, and targeted at vulnerable groups
    and individuals.
  • Policy implementation is complex and messy-
    requires organisational and cultural change as
    well as clear delivery plans, accountability,
    targets and a focus on outcomes. Lessons from
    NESF work on implementation of Child Literacy and
    Social Inclusion and Home Care Packages.
  • Current work at NESC- Quality and Standards in
    Human Services

Contact Details
  • For further information please contact
  • Dr Jeanne Moore
  • The National Economic and Social Council
  • Direct Line 01 814 6366
  • Email
  • All references in this presentation are available
    in the Mental Health and Social Inclusion Report
    and this report alongside the Mental Health in
    the Workplace Report are still available to
    download from NESF website or hard
    copies are available from the NESC.
  • .
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