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 for people with mental health problems, including stigma and prejudice.
The rate of employment among adults of working age (16-64) with a mental illness increased markedly from 27% in Q1 2007/08 to 49% in Q1 2019/20. This may partly reflect a true improvement in employment rate, but it could also be due to de-stigmatisation of mental illness in recent years. People are now more likely to self-report that they have a mental health disorder in the Labour Force Survey, which could disproportionally affect the employment rate. In fact, the number of people reporting that they have a mental illness in the Labour Force Survey increased from 1.6 million in Q1 2007/08 to 3.6 million in Q1 2019/20.
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 2019/20, 76% 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 46 percentage points in Q1 2007/08 to 27 percentage points in Q1 2019/20. 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 who are 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.
Between 2010-11 and 2015-16, annual data shows that the proportion of adults receiving secondary mental health services who are recorded as being employed decreased from 9.5% to 6.7%. Due to a change to the methodology, data pre- and post- 2013-14 are not directly comparable, but the proportion decreased in both time periods. The measure was not published in 2016-17 due to the quality and completeness of the data. There was a further change to the data set in 2017-18, and since then the proportion has increased from 7% to 8% in 2018-19.
Enabling people with a learning disability to find employment when they want it can enhance their quality of life, enable them to maintain a family and social life and contribute to their community, and help them avoid 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.
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.
In 2014-15 there was a change to the definition of the eligible population so results prior to this are not comparable. For further details, please see ‘About this data’ below.
Around one quarter of adults in England are living with two or more long-term conditions. The rate of employment among adults of working age (16-64) with a long-term condition increased from 57.5% in Q1 2007/08 to 64.8% in Q3 2018/19. The employment gap between people in the general population and people with a long-term condition decreased slightly over the same time period, from 15 percentage points to 11.4 percentage points.
About this data
In the NHS Outcomes Framework, employment of people with a mental illness is indicator 2.5.i and employment of people with long-term conditions is indicator 2.2. 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 the Short and Long Term Services (SALT) collection, and indicator 1F sources its data from the Mental Health Services Data Set (MHSDS).
For indicator 1E, prior to 2014-15, all adults with learning disabilities who were known to the council were included. In 2014-15, the eligible population was changed to include only those client who have received a long-term support service in the previous year with a primary support reason of learning disability support.
For indicator 1F, prior to 2013-14 the measure was calculated annually from the Mental Health Minimum Data Set. From 2013-14 it was calculated each month from a snapshot and the ASCOF measure derived as an average of these monthly scores. Additionally, in January 2016, the mental health data set changed from the Mental Health and Learning Disabilities Dataset (MHLDDS) to the MHSDS. As a result of this change, the ASCOF measures for 2015-16 are calculated using the average of eight monthly scores from April to November from the MHLDDS and data for 2016-17 was not published due to the quality and completeness of the data.
For more information, please see the NHS Outcomes Framework indicator specifications and the Adult Social Care Outcomes Framework 2018/19 Handbook of Definitions.