Critical Mental Health Forum
17 June 2002
Employment- Too much, not enough or the wrong sort?
Mark Bertram & Peter Linnett
- Good work is good for people (Health and psychosocial gains, less likely to be admitted to hospital).
- No work is bad for people (no money, no dignity, no choices, more likely to be admitted to hospital, commit suicide, be depressed and anxious)
- Figures cited 66% to nearly 100% service users unemployed, worse for ethnic groups/ people with an offending history (O`Flynn, 2001).
- Health Care response termed `Vocational rehabilitation` originally from USA. VOCO = calling? What does that mean nowadays? No agreement on the terms or concepts, who should be providing it, how and what works best for who? Conflicts between rehab and market orientations. Scarce research in U.K.
- Range of models, sheltered workshops, mobile work crews, social enterprises, social firms, Clubhouses, supported employment. Most are benefits+ schemes. Mainly 4F`s… Food, flowers, folding and filth. Many projects risk dependency and exploitation, currently paying £4.00 or less for a full days work. The train and place or place and train `theoretical` argument unresolved in UK. Also danger of single model fallacy.
- Government initiatives partial and inadequate. NSF "where local circumstances allow". Welfare/civil rights reforms, DDA act, Permitted work rules. Minimum wage legislation , are people diagnosed exempt from this rule?
Obstacles
- Employer discrimination and stigma (people with a diagnosis face the most difficulty of all groups in getting a job) + `Task Performance` knows no ambivalence or forgiveness, capitalist productivity (McDonaldisation of society) means economic imperatives…having rather than being mode of life
- Benefit trap+ increase the £20.00 earning limit/means tested benefits means penny for penny reductions in housing/council tax/income support. £ 66.00 claimed by dept of work and pensions an illusion.
- Insufficient investment in employment initiatives/patchy varied provision
- We don’t really know what constitutes `adequate/appropriate support and encouragement`, probably individualised. Insufficient appreciation of what it means/takes for a person to commit themselves to a role. It is never easy its always scary.
- General lack of user involvement in employment provision
- Not having houses in order re: employing users in NHS (pathfinder, the exception)+ professions profoundly ambivalent about recruiting people with a diagnosis.
Possible ways Forward
- Increasing involvement of users in all areas of provision+ shifting power and resources. Gaining insight/learning from personal experiences of distress
- Highlighting the dismal unemployment rates as a civil rights/disability discrimination issue
- Lobbying for flexible benefit reforms that act as an incentive
- Addressing employers concerns and motivations/ training/ creating a meaningful evidence base/training base for employment provision
- Shifting resource from containment services to employment/community provision
- Clearer policies with legal rights to decent employment opportunities