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The Royal College of Psychiatrists Improving the lives of people with mental illness
Work and mental health

Work and employment are important for health and well-being

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.

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. 

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.

Links to resources:

No health without mental health: a cross-Government mental health outcomes strategy for people of all ages 

No health without mental health: a cross-Government mental health outcomes strategy was published in early 2011.  It sets out six shared objectives to improve the mental health and well-being of the nation.  It stresses the interconnections between mental health, housing, employment and the criminal justice system.  


Realising ambitions: Better employment support for people with a mental health condition

Rachel Perkins, Paul Farmer and Paul Litchfield

Department for Work and Pensions, December 2009

This review (also known as the Perkins Review) was commissioned by the Secretary of State for Work and Pensions to look at mental health and employment and to identify how Government could help people with mental health conditions fulfil their employment ambitions.  It is predicated on the conclusion that appropriate work is good for you: it improves your mental health and protects against relapse. 


Social Inclusion and Mental Health

Jed Boardman, Alan Currie, Helen Killaspy, Gill Mezey

Royal College of Psychiatrists, June 2010
This book reviews the ways in which people with mental health problems are often excluded from participating in society.  It examines the steps that psychiatrists and mental health workers can take to facilitate the social inclusion of people with mental health problems.

Mental health and work
Royal College of Psychiatrists, Health, Work and Wellbeing, 2008
This review was commissioned by the cross government Health, Work and Wellbeing Programme.  It focuses on mental ill health because these have a greater impact on people’s ability to work than any other group of health problems.  It includes sections on the effect of work and worklessness on mental health. 

Centre for Mental Health
Employment and mental health
The Centre aims to find practical and effective ways of overcoming the barriers faced by people with mental health problems.  It carries out research, policy work and analysis to improve practice and influence policy in mental health.  The website includes a section on employment and mental health.

Working for a healthier tomorrow
Dame Carol Black's Review of the health of Britain's working age population, 2008
Chapter 3 looks at the role of the workplace in promoting and maintaining health and well-being.

Working our way to better mental health: a framework for action
Department for Work and Pensions, 2009
This cross government strategy is built on the conclusion that there is a positive link between employment and mental health.  It draws on the work of Dame Carol Black, National Director for Health and Work, as well as other academics and organisations.  Research shows that people generally enjoy better mental health when they are in work. In contrast, the longer individuals are absent from or out of work, the more likely they are to experience depression or anxiety. Work can therefore play a vital role in improving everyone’s well-being and mental health.

Is work good for your health and well-being?

Gordon Waddell  and Kim Burton, 2006

This review collates and evaluates the scientific evidence on the link between work and health.  The review focused on adults of working age and the common health problems that account for two-thirds of sickness absence and long-term incapacity (i.e. mild/moderate mental health, musculoskeletal and cardio-respiratory conditions).


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Work and mental health for clinicians

Work is a key clinical outcome

Working together to support people recovering from mental ill health at work

Developing and supporting a return to work plan