Work, Unemployment and Mental Health

Abstract

There is an association between unemployment, poor mental health and suicidal behaviour. There is a modulating effect of the strength of national social security programmes: countries with the weakest welfare states showed a greater impact of unemployment on rates of suicide.While employment may be beneficial to health, exposure to a range of psychosocial hazards can also put workers at risk of poor mental health. People with mental health conditions now represent the largest group receiving out-of-work sickness benefits. In the UK, rates of employment of people with schizophrenia may have fallen. Supported employment is significantly more effective than pre‐vocational training. The initial business case for IAPT (Independent Access to Psychological Treatment) assumed that the receipt of cognitive behavioural therapy (CBT) would result in people returning to work, but few did. More recently, we have seen a shift from ‘work’ as therapy to ‘work’ as a human right. Annual surveys conducted in England between 2004 and 2008 repeatedly showed that, of those who use mental health services and were unemployed, more than half would have liked help in gaining employment but mental health services had not offered such help.