Employment and Mental Health

Established: April 2005

Convenors (Chair): Professor Tom Craig, Health Service Research Department, Institute of Psychiatry, King's College, London & Dr. Bob Grove, Sainsbury Centre for Mental Health

Members:
Professor Tom Burns (University of Oxford); Dr. Bob Grove* (Sainsbury Centre for Mental Health [SCMH]); Dr. Paul McCrone (Institute of Psychiatry, KCL); Mr. Miles Rinaldi (South West London and St George’s Mental Health Trust and the Department of Health / Social Exclusion Unit); Professor Jenny Secker (Anglia Polytechnic University & South Essex Partnership Trust); Professor Justine Schneider (University of Nottingham / Nottinghamshire Healthcare Trust); Professor Geoff Shepherd (Cambridgeshire & Peterborough, Mental Health Partnership NHS Trust); Professor Graham Thornicroft* (Institute of Psychiatry, KCL) (* Joint Convenors of the Research Group).

Remit and Aims:
Work represents an important goal for many people with mental illnesses. One strand of the work of this Clinical Research Group aims to generate research proposals to answer important remaining questions about: the adaptability of Individual Placement and Support models to a UK context, alternative models of delivering supported employment (e.g. Workstep, Clubhouses), the influences on decisions to go to work, whether different intervention models, such as social firms, work better for some service users, and the impact on employment outcomes of work-related skills training. The other strand aims to improve the evidence base on ways of preventing and managing common mental in the workplace, reducing sickness absence and job loss and developing mentally healthy workplaces – especially in the NHS.

Current Status & Future Plans:
There have been four meetings since receiving notice of the award. At the second of these meetings - a specially arranged "scoping day" attended by 20 members of the network - the broad topic areas that the group wants to cover in its proposals were discussed and decided. Task groups have been formed to draft outline research ideas.

Research ideas to date include:
(i) multi-site RCT of Individual Placement and Support with both careful assessment of process variables and attention to candidate active ingredients in this complex intervention;

(ii) national survey of employer’s policies, attitudes and practices with in depth follow up to identify factors associated with willingness to employ and retain in work people with mental health problems;

(iii) longitudinal study of a sample of service users to look at their pathways through employment, the barriers and incentives;

(iv) study of the outcomes of job applications for posts where the written applications are identical except for the disclosure of a history of mental illness;

(v) methodological developments including cost-effectiveness using a decision tree model where the cost-effectiveness of a number of schemes can be compared using data from RCTs, observational and routine sources;

(vi) Multi -site evaluation of effectiveness of having employment advisers in GP Practices;

(vii) “Self-help for common mental health problems- development and evaluation of a web-based tool to reduce job loss and absence from work” Proposal developed and submitted to BUPA International Competition and also to MHRN for approval. Lead applicant Dr Bob Grove SCMH (part of IOP at King’s College London);

(viii) Evaluation of the effect of improved access to psychological therapies on work as well as health outcomes.

Key areas to follow up are the research agenda proposed in the recent evidence review by the British Occupational Health Foundation "Workplace Interventions for People with Common Mental Health Problems" and to continue to work on the evidence base for employing people with severe and enduring mental health problems.