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Work and the mental health crisis in Britain
- Authors:
- WALKER Carl, FINCHAM Ben
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2011
- Pagination:
- 196p.
- Place of publication:
- Chichester
There is longstanding interest in the relationship between mental health and work. This book suggests that the impact of neoliberal social and economic activity in the UK over recent years has meant the return of potentially debilitating forms of subjugation and exploitation. More people now struggle for fewer jobs of increasing intensity, reduced legal protection and lower real wages. The book, based on recent data gathered from employees and managers, challenges the cultural maxim that work benefits people with mental health difficulties, and illustrates how particular cultures and perceptions can contribute to a crisis of mental well–being at work. It fills a need for an up–to–date, detailed work that explores the ways that mental health and work experiences are constructed, negotiated, constrained and at times, marginalised. It is designed for academics and professionals who work in the mental health sphere, but also accessible to interested lay readers
Work therapy: welfare reform and mental health in California
- Author:
- CHANDLER Daniel
- Journal article citation:
- Social Service Review, 85(1), March 2011, pp.109-133.
- Publisher:
- University of Chicago Press
California has set aside Temporary Assistance for Needy Families (TANF) funds for counties to use in identifying and treating welfare participants experiencing mental health problems that impede employment. Los Angeles County spends $23 million annually on mental health services for welfare participants. This study examined mental health treatment in Los Angeles County as a means for improving the employment outcomes of TANF participants with psychiatric disabilities. The participants were a sample of 433 TANF participants whose mental health services ended between March 2004 and February 2005. Detailed reports from Department of Mental Health (DMH) staff on clients’ status and treatment were analysed. The staff reported that 70% of the sample members had positive change in their mental health status. However, only 17% of the clients completed the treatment successfully, and only 26% reported employment at discharge or in the 6 months after discharge. Analyses suggested that predictors of completing services successfully differ from predictors of employment. Further, successful completion of treatment did not predict employment. Some of these results are disappointing. County staff are restructuring these mental health services in order to improve these outcomes.
The clinical and occupational effectiveness of condition management for Incapacity Benefit recipients
- Authors:
- KELLET Stephen, et al
- Journal article citation:
- British Journal of Clinical Psychology, 50(2), June 2011, pp.164-177.
- Publisher:
- Wiley
Condition Management Programmes (CMP) were established with the goal of helping Incapacity Benefit recipients manage their health conditions more effectively and thus return to work. The aim of this study was to evaluate the effectiveness of CMP by examining the clinical and employment outcomes from 2,064 participants with a variety of physical and mental health conditions. In a prospective cohort design, measures of employment status and psychological well-being were taken at 3 time points; prior to CMP, immediately following CMP, and 3-months after completing CMP. The participants voluntarily attended a 7 session cognitive-behaviourally informed psychoeducational group intervention. The psychological measures used were the Clinical Outcomes in Routine Evaluation-Outcome Measure, Work and Social Adjustment Scale, Self-Efficacy Scale, and the Intrinsic Motivation Scale. The findings showed that following CMP, 50% of participants experienced a reliable improvement in psychological well-being and 26% had either taken some steps towards work or returned to work at follow-up. Participants with a mental health condition were more likely to experience a reliable improvement in psychological well-being compared to those with physical health conditions. The results suggest that participation in CMP may be helpful in facilitating more effective self-management of the health conditions contributing to unemployment.
Desirable outcomes of of WORKSTEP: user and provider views
- Authors:
- MEAH Angela, THORNTON Patricia
- Publisher:
- Great Britain. Department for Work and Pensions
- Publication year:
- 2005
- Pagination:
- 110p.
- Place of publication:
- London
In this report disabled people said it was important to set themselves goals and experience achieving them. Achieving things through their jobs, they said, encouraged them to set goals outside work, like learning to travel independently or to drive. Going to work gave disabled people the chance to meet new people and make friends. This was especially important to people with learning disabilities who complained of feeling bored when ‘stuck at home’. The routine of work was important to people with mental health conditions. They said it offered a distraction from their condition and gave them a sense of an ‘ordinary life’. Disabled people said that having a job was a sign of ‘wellness’ and getting on with life.
Working all together
- Authors:
- THOMAS Tina, SECKER Jenny, GROVE Bob
- Journal article citation:
- Mental Health Today, June 2004, pp.30-33.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Job retention schemes have an essential role in a recovery orientated mental health service. This article looks at a job retention team (JRT) based in Avon and Wiltshire Mental Health Partnership Trust (AWMHTP). The JRT operates on a case management model, and offers a free service to people in employment currently experiencing mental health problems and at a risk of loosing their jobs as a result. The ultimate aim of the pilot is to develop a model for job retention services across the UK. Summarises findings from a qualitative evaluation of the project's first year of operation, from June 2002 to May 2003. Semi-structured interviews were conducted with 13 of the 29 clients with whom the JRT had worked over the 12 months, 5 of their employers, 6 of their GPs and 2 case managers.
A capitated model for a cross-section of severely mentally ill clients: employment outcomes
- Authors:
- CHANDLER Daniel, et al
- Journal article citation:
- Community Mental Health Journal, 33(6), December 1997, pp.501-516.
- Publisher:
- Springer
Describes the employment outcomes in the USA of a three year controlled study of two Integrated Service Agencies (ISAs) for a cross-section of severely mentally ill clients. At each site significantly more ISA members than comparison clients obtained some paid employment. At the urban site the difference was dramatic: 73 against 15 per cent worked during the study period, and 29 per cent of the ISA clients worked competitively. The significant but still limited ISA results argue for increased employment opportunities for all seriously mentally ill clients.
Children placed in out-of-home care as midlife adults: are they still disadvantaged or have they caught up with their peers?
- Authors:
- BRANNSTROM Lars, et al
- Journal article citation:
- Child Maltreatment, 22(3), 2017, pp.205-214.
- Publisher:
- Sage
International research has consistently reported that children placed in out-of-home care (OHC) have poor outcomes in young adulthood. Yet, little is known about their outcomes in midlife. Using prospective data from a cohort of more than 14,000 Swedes born in 1953, of which nearly 9% have been placed in OHC, this study examines whether there is developmental continuity or discontinuity of disadvantage reaching into middle age in OHC children, compared to same-aged peers. Outcome profiles, here conceptualized as combinations of adverse outcomes related to education, economic hardship, unemployment, and mental health problems, were assessed in 1992–2008 (ages 39–55). Results indicate that having had experience of OHC was associated with 2-fold elevated odds of ending up in the most disadvantaged outcome profile, controlling for observed confounding factors. These findings suggest that experience of OHC is a strong marker for disadvantaged outcomes also in midlife. (Publisher abstract)
Enhancing the career planning self-determination of young adults with mental health challenges
- Authors:
- SOWERS Jo-Ann, SWANK Paul
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 16(2), 2017, pp.161-179.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population. (Publisher abstract)
A randomised controlled trial of time-limited individual placement and support: IPS-LITE trial
- Authors:
- BURNS Tom, et al
- Journal article citation:
- British Journal of Psychiatry, 207(4), 2015, pp.351-356.
- Publisher:
- Cambridge University Press
Background: Individual placement and support (IPS) has been repeatedly demonstrated to be the most effective form of mental health vocational rehabilitation. Its no-discharge policy plus fixed caseloads, however, makes it expensive to provide. Aims: To test whether introducing a time limit for IPS would significantly alter its clinical effectiveness and consequently its potential cost-effectiveness. Method: Referrals to an IPS service were randomly allocated to either standard IPS or to time-limited IPS (IPS-LITE). IPS-LITE participants were referred back to their mental health teams if still unemployed at 9 months or after 4 months employment support. The primary outcome at 18 months was working for 1 day. Secondary outcomes comprised other vocational measures plus clinical and social functioning. The differential rates of discharge were used to calculate a notional increased capacity and to model potential rates and costs of employment. Results: A total of 123 patients were randomised and data were collected on 120 patients at 18 months. The two groups (IPS-LITE = 62 and IPS = 61) were well matched at baseline. Rates of employment were equal at 18 months (IPS-LITE = 24 (41%) and IPS = 27 (46%)) at which time 57 (97%) had been discharged from the IPS-LITE service and 16 (28%) from IPS. Only 11 patients (4 IPS-LITE and 7 IPS) obtained their first employment after 9 months. There were no significant differences in any other outcomes. IPS-LITE discharges generated a potential capacity increase of 46.5% compared to 12.7% in IPS which would translate into 35.8 returns to work in IPS-LITE compared to 30.6 in IPS over an 18-month period if the rates remained constant. Conclusions: IPS-LITE is equally effective to IPS and only minimal extra employment is gained by persisting beyond 9 months. If released capacity is utilised with similar outcomes, IPS-LITE results in an increase by 17% in numbers gaining employment within 18 months compared to IPS and will increase with prolonged follow-up. IPS-LITE may be more cost-effective and should be actively considered as an alternative within public services. (Publisher abstract)
Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial
- Authors:
- HENDERSON Claire, et al
- Journal article citation:
- British Journal of Psychiatry, 203(5), 2013, pp.350-357.
- Publisher:
- Cambridge University Press
Many mental health service users delay or avoid disclosing their condition to employers because of experience, or anticipation, of discrimination. This study investigates whether a decision aid can help to support decision-making about disclosure to an employer, aims to determine whether a large-scale trial is feasible; and to optimise the designs of a larger trial and of the decision aid. An exploratory randomised controlled trial (RCT) was conducted in London, with participants randomly assigned to use of a decision aid plus usual care or usual care alone. Follow-up was at 3 months. Primary outcomes were: (a) stage of decision-making; (b) decisional conflict; and (c) employment-related outcomes. Eighty participants were recruited and interventions were completed for 36 out of 40 in the intervention group; in total 71 participants were followed up. Intention-to-treat analysis showed that reduction in decisional conflict was significantly greater in the intervention group than among controls. More of the intervention group than controls were in full-time employment at follow-up. The observed reduction in decisional conflict regarding disclosure has a number of potential benefits which next need to be tested in a definitive trial. (Edited publisher abstract)