'Employment is Nature's physician, and is essential to
human happiness'
Galen of Pergamon,
Greek physician, surgeon and philosopher, 172 AD
As the quote from Galen, the Greek physician
shows, it has long been recognised that work, be it paid or unpaid,
plays a central role in the health and well-being of most
people. We know that work gives us material rewards, but it
also gives people a sense of identity and connection with others in
our society; it gives us a sense of personal achievement; it is a
means of structuring and occupying our time and helps us to develop
mental and physical skills. Work also provides us with the
financial and material resources necessary for our daily
lives.
Of course work sometimes has negative
connotations. Some workplaces are associated with stress
where choice in activity is limited and the work culture is one of
bullying and harassment, particularly for people with a mental
health condition. Despite this, research studies have found
that unemployed people do not exploit the extra time on their hands
to follow leisure and social pursuits. Instead unemployment
is associated with increased apathy, a shrinking social circle and
decreased motivation. The consensus is that being out of work
causes ill-health and that poor health tends to deteriorate when a
person is not working. This sets up a vicious circle which
reduces the chances of a person returning to work.
Work and employment are important
for health and well-being
We know that many people with a mental health
condition do not participate in key activities of society, they are
socially excluded, and that being in work can reduce the likelihood
of this. The right work, with the right support from
employers, colleagues, carers and health and care professionals can
actually aid recovery for people with mental health problems.
No one is intrinsically unemployable, studies show that,
given the right conditions and support, the vast majority of people
who are out of work and use mental health services want to return
to or to start work. However, people with mental health
problems do face significant challenges when trying to access
employment. Some of these challenges are shared with other
people such as the need to adjust the physical environment, or to
mitigate language difficulties or the need for extra support or
training. However, often these obstacles are less tangible
owing to some differences between mental health problems and other
impairments:
* They are not immediately
obvious and can develop at any time in a person’s life
* They attract fear and
prejudice e.g. myths of incompetence or dangerousness
* They typically fluctuate
and it can be difficult to predict when these fluctuations will
occur
* They affect a person’s
ability to negotiate the social, rather than the physical world of
work.
Importantly, the right employment actively can
improve mental health and protect against relapse
Remember also that many people who are working
also experience mental health problems and may have periods of
ill-health whilst at work thus contributing to presenteeism and
absenteeism.
The comprehensive systematic review of the
research evidence carried out by Waddell and Burton, 2006,
concluded that in general:
* Work is beneficial to health
and well-being
* Lack of work is detrimental to
health and well-being leading to higher consultation rates with GPs
than in the general population, increased prevalence of depression
and anxiety and higher suicide rates.
* For people without
work, re-employment leads to improvement in health and well-being,
whereas continued unemployment leads to deterioration
* For people who are
sick or disabled, placement in work improves health and
psychosocial status
* The health status of
people of all ages who move off welfare benefits improves
* These benefits apply
equally to people who have mental health problems including those
with severe mental health problems.
There is no evidence that work is
harmful to the mental health of people with severe mental
illness.
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Work and employment
are important for health and well-being