Synopsis
Just one in four people suffering from a long-term mental illness are in work. Mental health problems at work cost our economy £34.9bn with a cost to business of £26bn each year. The service offers support to people with complex mental health to achieve their employment goals with hope, optimism and confidence. The Vocational Rehabilitation Service is occupational therapy-led and forms part of core community services. The multidisciplinary service includes a 12 week job taster programme.
Ambition
Despite legislation and changing attitudes there is still often a stigma to mental health among employers. A reported 71% of people would worry about telling their employer if they had a mental health condition. Employment is not just about earning a wage; but also self-esteem, social interactions and having a meaningful role in the community.
There is increasing pressure on secondary care services which has increased demand affecting resourcing and challenges educating professionals to provide appropriate referrals. The current changes to universal credit also present additional challenges.
The service aims to:
- Facilitate a speedy return to work following discharge
- Reduce demand on community mental health teams
- Reduce the likelihood of re-entry into secondary mental health services
- Reinforce the value of work in sustaining recovery
- Offer rapid and early intervention support for clients sick from work or struggling in work
with this group seen In 24 hours or less following referral
- Reduce hospital admissions
- Educate and support all sizes of employers
- Offer a 12 week job taster programme
- Support clients transitioning to university
- Build confidence and teach new skills techniques e.g. interviews.
- Provide vocational and employment advice and support for individuals who use secondary
mental health community services
Outcome
Our target is to support 120 back to work in this financial year. From April 2018 to March 2019, 193 people retained their job or secured paid/self-employment as a direct result. Therefore we expect to significantly exceed our target based on strong current performance. These outcomes helped people to achieve greater financial independence, increase self-esteem, reduce hospital admissions and improve their mental health. People who have been supported report that:
- They feel a positive link between employment and self-worth
- There is a reduction in mental health symptoms, including anxiety while reintegrating back
into the workplace
- They feel confident that they can manage their mental health in the work environment with
support from the service.
Employers also report an increase in confidence in managing their employees’ mental health needs in the workplace and value the input from the service. The efficiency of the service has also helped to reduce pressure on other areas of the trust such as community mental health teams.
Difficulties faced included resourcing demand with six clinicians, commissioning challenges and often complex cases. Educating trust wide staff helped to upskill professionals and generate a better understanding of the service which has improved the referral process.
Spread
The service was one of four UK services featured in a 2018 Royal College of Occupational Therapists (RCOT) report: ’Getting My Life Back: Occupational therapy promoting mental health and wellbeing’.
KMPT was highlighted as an example of excellent, innovative practice which should be replicated across the country. We worked with RCOT and submitted impact data including case studies. At the report launch we also spoke to MPs including former Health Minister Norman Lamb to help spread information.
We disseminated information and successes internally via a range of communication channels including our staff phone app; intranet; social media platform; website, weekly bulletin and quarterly Connected magazine with a feature in the summer edition; ‘From hospital to parliament’.
We have worked with professionals including the AHP lead to help shape the trust’s first AHP strategy, ‘Rebuilding Lives ’Enable Transform Influence’2018 -2021’.
Our work has helped to inspire other trusts and professionals both inside and outside KMPT to engage with and maximise the therapeutic benefits of vocational rehab. A KMPT Consultant Psychiatrist reported that: “input to clients is always positive and the team members highly appreciate your help and support offered to clients, which make a difference to their quality of life.”
Value
From April 2018 to March 2019, 292 people completed their treatment programme with over 193 retaining or gaining new employment.
Employers including BT Security praised the service: ’Thank you for the invaluable support. Without your service resolution of our employee’s situation would be much more prolonged.”
South London and Maudsley NHS Foundation Trust (Adele Gardner, Head Career Coach)
’The Job Taster Programme is fantastic. Thank you for giving me the opportunity to meet you again and your staff. It was a very interesting afternoon.”
Service user: “It is thanks to the service that I found my spark again.’
Former service user Helen was helped by the service. Her vocational specialist helped work with her employer to ease her back into work, establish a ‘buddy” system while at work and also provide ongoing support to her and her employer. Helen commented: “the support from the vocational specialist gave me confidence to ask for adjustments. Working with the employer and my family was invaluable. I would highly recommend the service to anyone.’
Without your help I honestly believe I would not be here today. I am so grateful that you came into my life. Thank you again forgiving me my life back.
Involvement
Key stakeholders include staff e.g. occupational therapists, nurses and psychologists with whom regular face to face contact is key.
We proactively engage with the third sector including charities such as Porchlight and the Shaw Trust as well as organisations such as Royal College of Occupational Therapists and the Royal British Legion.
A new, innovative stakeholder is Kent and Medway Recovery College which opened in September and is being piloted in Thanet. The service is delivering a portfolio of training to over 300 registered students and building strong partnerships with facilitators.
The service works with employers of all sizes across the public, not for profit and private sectors and delivers free mental health at work sessions to companies such as Saga. These sessions have crucially raised awareness and understanding of mental health.
The most important group of stakeholders are service users and we work really hard to personalise their support. One person said:
“I did not think I would ever work again. The support I have had is amazing. I am now back at work and loving it. I have my life back again!”
Engaging with this group and getting their trust is key to achieving the best possible outcomes.
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