In its launch publication, Towards Happier, Healthier Lives, Thrive LDN made three key recommendations in relation to employment and mental health in the capital:
- Making employment a health outcome for people affected by both common and more serious mental health within NHS, Social Care and Public Health agencies plans and shining a light on the data that is collected routinely in London for employment outcome.
- Improving workplace wellbeing for all, reducing workplace stress and developing plans to ensure mentally healthy workplaces.
- Increasing the provision of evidence based support, specifically Individual Placement and Support (IPS) to both individuals and their managers to ensure that those with mental health challenges can gain and prosper in employment.
The case for closing the employment gap in mental health is widely recognised. Only 5.7% of Londoners using secondary mental health services in London were in employment and 55% would have liked help to find or keep work but did not get it.
The benefits of IPS as an evidenced-based and cost-effective intervention are well known. National policy and the evidence in relation to the employment gap provide a clear case for action.
Find out more by watching the following video from NHS England:
Sustaining existing structures
In May 2017, the London Mental Health Employment Partnership recommended that the Cavendish Square Group establish a London implementation infrastructure to promote the development of IPS services across the capital.
Dr Rachel Perkins brought together IPS services across London to explore the possibilities, benefits and support needs of such an infrastructure, recognising the uniqueness of London as a city and as a system.
IPS London continues to act as a learning and development network for the people leading IPS services across London and in so doing fulfils a number of key functions:
- Workforce development
- Performing reviews
- Standardising outcome data
- Sharing research and best practice across London and contributing to the research base
- Sharing information about employment opportunities across London
- Co-ordination and liaison with other employment support programmes
Developing IPS within London STPs
A second strand of work was undertaken through Thrive LDN to establish Sustainability and Transformation Partnerships’ (STP) state of readiness, current state of play and future plans, to ensure a connected approach. The themes identified were:
- IPS is something that STPs are committed to and wish to develop.
- There is a clear desire to ensure that employment opportunities can be more easily and successfully accessed by those with mental health challenges.
- There is limited consistency in plans for development and operational delivery.
- Co-ordination beyond the work of London IPS group has been limited and there remains a risk that the lack of broader oversight could result in variable results across the capital.
Perhaps, most importantly, an opportunity has arisen for Thrive LDN to provide a ‘home’ for IPS expansion, to support its development, through jointly working with NHS England and STPs to ensure buy in to this model, London wide provision and to jointly capture and use data on outcomes.
Workplace mental health
Thrive LDN has recently begun a piece of work in partnership with South West London and St George’s Mental Health NHS Trust looking at the way in which NHS organisations respond to incidences of poor mental health within their workforce.
It is critical to ensure the appropriate support and response to individuals in enabling them to recover and maintain their employment. There is a reported tendency for NHS organisations to focus on only the individual with the presenting issue through a predominantly clinical lens. However, such a singular focus does not address the wider issue of how organisations function more broadly in way that promotes good mental health or the ways in which the expectations placed on staff can, at times, contribute to poor mental health.
The incidence of depression and anxiety amongst NHS staff are particularly high, but there appears to be little in the way of process for addressing this. This seems especially pertinent at a time of increasing workload demand, significant financial pressures and system change. We aim to address this by:
- seeking to establish, if possible, the cost of depression and anxiety to an NHS Trust.
- considering what, if any, return on investment case could be developed to enable the establishment of any programme of work to address anxiety and depression in NHS Trusts.
- describing, in outline form, what service of model of intervention and support could be developed and trialled.
The work is being undertaken using a mixture of desk based review and consultative interviews. This involves the review of data relating the absence in an NHS Trust and applying an analysis of those costs, including working days lost. It also involves the consideration of current projects in London that are focused on similar issues – notably Guys and St Thomas’ programme on returning to work after pregnancy to identify lesson learnt and to establish what, from such programmes could be drawn upon.
A roundtable will be held in partnership with NHS Improvement and the International Initiative on Mental Health Leadership on international approaches to workplace mental health and wellbeing in December 2018. This will be in response to the Mayor’s Health Inequalities Strategy and the desire to build healthy minds and healthy places.
If you are interested in finding out more about the roundtable, watch this space or email Alex Belsey at firstname.lastname@example.org.