There is strong evidence that being in work improves people's quality of life and wellbeing. Despite this, there are significant barriers to employment for people with a mental illness, learning disability or long-term condition. With effective support, they can access the benefits of long-term work. But this requires co-operation between employment services, social workers, health professionals and others.
Meaningful work is important in helping people recover from a mental illness. But there are many barriers to employment of people with mental health problems, including stigma and prejudice.
The rate of employment amongst adults of working age (16-64) with a mental illness markedly increased from 26.6% in Q4 2006/07 to 45.6% in Q1 2018/19. This may partly reflect a true improvement in employment rate, but it could also be due to destigmatisation of mental illness in recent years. People are more likely to self-report that they have a mental health disorder in the Labour Force Survey, which could disproportionally affect those who are employed. In fact, the number of people reporting that they have a mental illness in the Labour Force Survey increased from 1.5 million in Q4 2006/07 to 3.4 million in Q1 2018/19.
The employment rate in the general population has been increasing gradually since 2012, at a much slower rate than for people with a mental illness. In Q1 2018/19, 75.7% of working-age people in the general population were employed. The employment gap between people in the general population and people with a mental illness decreased from 44.8% in Q4 2006/07 to 30.1% in Q1 2018/19. This is a significant improvement, however further progress is needed to reduce the employment gap.
People with severe or complex mental health needs tend to have their care coordinated under the Care Programme Approach (CPA). The term 'CPA' describes a framework introduced in 1991 to support and coordinate effective mental health care for people in contact with secondary mental health services. As part of the CPA, people should have regular care review meetings. Here we look at the proportion of adults (aged 18-69) in these meetings who are recorded as being employed.
Annual data shows that the proportion of adults receiving secondary mental health services on the CPA who are employed decreased from 9.5% in 2010-11 to 6.7% in 2015-16. This measure was not published in 2016-17 due to the completeness and quality of the data. By 2017-18, the employment rate had improved slightly to 7%.
Enabling people with learning disabilities to find employment when they want can enhance their quality of life, enable them to maintain a family and social life and contribute to community life, and can help to prevent loneliness or isolation. Here we look at the proportion of adults with a learning disability who are known to the council as being in paid employment or self-employed.
The proportion of adults with a learning disability in paid employment has fluctuated over time, from a high of 7.1% in 2011-12 to a low of 5.7% in 2016-17. A higher proportion of men with a learning disability are employed than women, although the size of the gap has decreased slightly over time. In 2017-18, 5.2% of women with a learning disability were in paid employment compared to 6.6% of men.
Around one quarter of adults in England are living with two or more long-term conditions. The employment rate of people with a long-term condition was 63.9% in Q1 2018/19, which is 11.8% lower than that of the general population.
Between 2007 and 2011, the employment rate of the general population fell from 72.8% to 70.6%, while the employment rate of people with long-term conditions increased slightly from 57.9% to 59%. This resulted in a narrowing of the employment gap from 14.9% in 2007 to 11.6% in 2011. Since then, the employment rate has increased for both groups, resulting in the highest rate of employment for people with long-term conditions in 2017 of 75.5%. The employment gap between the two groups, however, has not decreased and remained at 11.8% in Q1 2018/19.
There is considerable variation in the employment rate of people with long-term conditions across regions of England. The trend follows a similar pattern to that of the general population. The employment rate of people with long-term conditions is highest in the South West (69.4%) where the employment gap is relatively low (10%). In the North East, only 56.3% of people with a long-term condition are employed, and the employment gap is the highest (14.4%).
About this data
Employment of people with a mental illness is indicator 2.5.i and employment of people with long-term conditions is indicator 2.2 in the NHS Outcomes Framework. The proportion of adults in contact with secondary mental health services in paid employment is measure 1F and the proportion of adults with a learning disability in paid employment is measure 1E in the ASCOF.
The data for the two NHS Outcomes Framework indicators are sourced from the Labour Force Survey (LFS) and all values are calculated by the Office for National Statistics (ONS). ASCOF indicator 1E sources its data from SALT, and indicator 1F sources its data from the Mental Health Services Data Set (MHSDS).
For more information, please see the NHS Outcomes Framework indicator specifications and The Adult Social Care Outcomes Framework 2018/19 Handbook of Definitions.