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TX: 07.12.09 - Mental Health Strategy Response

PRESENTER: JULIAN WORRICKER

THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE Βι¶ΉΤΌΕΔ CANNOT VOUCH FOR ITS COMPLETE ACCURACY.

WORRICKER
So back to our main story. The government are announcing an overhaul in the way people with mental health disorders will be helped to find and keep work. One of the recommendations was to set up more individual placement support centres. Catherine Carr visited the Central and North West London NHS Foundation Trust, which has recently become an IPS. They routinely offer employment support to people with mental health issues, alongside healthcare support, as Lynn Miller - the vocational services manager - explained.

MILLER
This involves actually basing an employment specialist within one of our community mental health teams and the idea is to help that team become much more focused on supporting service users to get back to work or education because traditionally employment services have worked quite separate to mental health services and it's much more powerful if the two work together in an integrated way.

CARR
Lynn says this lack of joined up thinking has, in the past, led to mental health professionals believing that employment of their clients was impossible.

MILLER
Traditionally clinical staff might have sort of said oh well don't think about working now or might not have had a lot of knowledge about how to support someone to get back to work or what agencies are around locally that could support people. But that all changes when you have an employment specialist in a team. And then once the team can actually see it happening, that's what makes a real difference.

CARR
As an employer of over 3,000 staff themselves the trust decided to lead by example. So they now offer support to clients using their mental health services to find work at the trust, should they want to. To date they've found jobs for 63 people within the organisation, placed a further 26 on educational courses and offered work experience roles to another nine. Claire is one of the 63 now working at the trust. She's a recovering alcoholic and didn't want her full name used.

CLAIRE
I'd been on benefits for eight years. I had two detoxes after going through a difficult marriage and divorce. I know I was basically trying to make a recovery by getting back to work, there was a huge gap in my life which had been left by the fact that I was no longer drinking and I really needed something to fill it. And I eventually got a letter from the Job Centre Plus offering me help to get back to work which I responded to straightaway.

MILLER
Getting the job is just the first step. The next step is actually keeping the job and that's a big part of the individual placement support model - actually providing people with in-work support.

CLAIRE
I had the support of Raj Patel from the User Employment Programme. She helped me with my CV, she gave me pep talks, she helped me build my confidence, she came with me to my interview and when I was there and up and running she constantly kept in touch with me to make sure that everything was fine, that I was okay.

CARR
So how important is having a job to somebody with the sort of mental difficulties that we're talking about.

MILLER
Well work is central to most people's lives, it's how most people define themselves. And I think people with mental health problems or people recovering from addictions are particularly sort of sensitive to impact of being unemployed and excluded from the normal day to day things that we take for granted.

CLAIRE
I desperately wanted to be amongst those people wearing the black trousers and the black jackets getting on the train in the morning, seeing them going towards the station at sort of eight o'clock on their way to work. I was sitting there doing nothing, I have so much to offer, I had a brain in my head that was slowly coming back to life after all the traumas that I've been through and I just wanted to be part of it.

CARR
Today's announcement recognises that it can sometimes be better to find work for people with mental health problems early. The disability minister Jonathan Shaw described getting a job as part of the prescription. It certainly helped this man, who completed a six month work experience placement with support from the trust. He didn't want his name or his voice used on radio, an actor's being used to speak his words.

ACTOR
I still try and avoid going in to general public or you know if there's a gathering - a social event - I try and stay away because if I do talk about my mental illness they would think that something is wrong with me. They still - I mean they do ask me - why are you not working - I just say I'm not feeling well, don't give a reason behind it. Yes there is a stigma behind it.

CARR
So compare the man talking to me now to the man in the middle of that two year period.

ACTOR
A great difference. Before I wasn't able to talk to anyone, including family or anyone outside, I was totally cocooned into my own world and it's totally the opposite now - I'm not 100% there but gradually building up my confidence.

CARR
The whole aim of the individual placement support centres is to build up client's confidence in those everyday aspects of life to make passage to work possible. As Lynn Miller said that is a long term project requiring hard work on behalf of the team. But the pay off, says Claire, is immense.

CLAIRE
It's like a rebirth - I'm actually - the feeling of being able to stand on my own two feet, I am actually myself again whereas before I felt like a national insurance number. I'm now an up and functioning, self supporting woman in her own right and yes I'm completely reborn.

WORRICKER
Catherine Carr reporting. Well listening to that is the shadow disability minister Mark Harper, good afternoon.

HARPER
Good afternoon.

WORRICKER
Do you support what the government has outlined today?

HARPER
Yeah I've looked at the report by Rachel Perkins, it's a very valuable report and it reminds us that people with mental health conditions remain excluded in a lot of cases and over a million of them are on benefit and indeed that problem's got worse over the last 10 years or so - the number on benefit with a mental health problem has almost doubled. And so there's a real task to do that your report highlighted, clearly some successful strategies for dealing with it.

WORRICKER
The government sees this as a 10 year plan - if you win the next election will you stick to it?

HARPER
Yeah a lot of the things in the report are - in the Perkins' report - are very welcome. Our policy proposals on welfare reform will already deliver on some of the key recommendations about providing more specialist support for people with a mental health condition and also, just as importantly, helping people manage those mental health conditions whilst they're actually in work. And I think the most - one of the most important things about the report is it makes clear that we can move a lot of the way towards implementing these proposals without necessarily requiring extra resources but by actually looking at how we spend existing resources better, which I think is very important given the very tough public finance situation we find ourselves in.

WORRICKER
Indeed but there may well come a time when it does require extra resources, if that time arrives will you provide them?

HARPER
Well one of the ways we can provide those resources within our welfare reform proposals is that the shadow chancellor has agree that the savings - some of the savings we make from getting people back into work and thereby saving on benefits, those savings can be used to help fund some further help and support to get people into work. So I'm confident that as we succeed with our welfare reform proposals about getting people, including those with mental health problems, into work there will be the resources to keep that process going to try and tackle those more than one million people who are currently out of work who'd benefit both from the financial perspective and for their mental health by getting back into the workplace.

WORRICKER
We've had some correspondence to the programme since we began by discussing this very issue from some who say they were bullied at work as a result of their mental health condition, why on earth would they want to go back. The fear in some people's minds is that they're going to be pushed to going back to work when they have a mental health condition and actually they don't want for very good reason.

HARPER
Sure, well I mean clearly you've got to get people back into appropriate employment and clearly in those situations if someone's going to be going back into work and they're going to be bullied that's not going to be good for them. I think one of the other proposals in the Perkins' report is looking at the other side of that, which is the government working with mental health charities to deal with the important issue that came up in your package about the stigma that's associated with mental health, which isn't associated with a lot of physical health conditions. Those two things have to go in parallel to make sure that there will be employers that are willing to hire people with mental health problems and that their colleagues are prepared to treat them appropriately so that work actually helps their mental health condition, rather than make it worse. The evidence says that most people who have a mental health condition, when they get back into work, their condition gets better not worse and that's obviously very important for us to make sure we can manage to deliver that.

WORRICKER
And what can politicians do about that stigma?

HARPER
Well I think part of it is to talk about it and raise it. I mean I, in my own case for example, raised this issue with the Prime Minister at Prime Minister's Questions about a piece of discriminative legislation that involves members of parliament but I think one of the things we can do is exactly what we're doing in this discussion now is talk about it, have people see that mental health is not a - is a fairly common occurrence - one in four people are going to have some kind of mental health problem in their life and will likely know somebody with a mental health problem. We have to make dealing with it as matter of fact as dealing with a physical health problem.

WORRICKER
But do you back it up with legislation?

HARPER
Well we already have legislation like the Disability Discrimination Act, which makes it - which puts some rules about how you deal with discrimination and make sure employers have to make reasonable adjustments for example. One of the complexities - and it's touched on in the Perkins' report - is that there's a lack of understanding about what that means for someone with a mental health problem. I think people are fairly clear that - what a physical adjustment might be - to have access for somebody with a wheelchair - but it's sometimes it's the changes in routine and enabling someone to fit into a workplace with a mental health problem, a lot of employers simply don't understand that and that's one of the things we need to work on and tackle.

WORRICKER
Mark Harper many thanks for that.

HARPER
Thank you.

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