Mental Health: Access to Work Support Service

Baroness Bottomley of Nettlestone Excerpts

Monday 18th June 2012 Lords Chamber

[Baroness Bottomley of Nettlestone]

My Lords, I congratulate the noble Baroness on securing time to raise such an extraordinarily important and practical topic. During almost 30 years in this and another place, I have never ceased to take up opportunities to identify the critical importance of mental health. How excellent it is that so many in this House take this topic seriously.

In their strategy document entitled No Health without Mental Health, the Government made a strong statement on the importance of mainstreaming mental health. We all know the traditional stigma whereby if you had schizophrenia you would say that you had depression and that if you had depression you would say that you had flu, but you would do anything to avoid declaring openly that you were suffering from any form of mental health difficulty. How warmly I congratulate those many Members of Parliament who, in a recent debate in another place on the Mental Health (Discrimination) Bill, were able to discuss the mental health problems that they had faced. Such a debate would have been quite inconceivable when I first became a Member of Parliament. I congratulate them, as I do the many celebrities who use their celebrity status to talk about their own mental health problems, because the first challenge is to get people to talk about this issue which will face perhaps one in four people in their lifetime.

That brings me to the topic of today. I have a very high regard for our Minister. The merits or otherwise of bringing people out of the real world—I am not sure whether banking is the real world—into government are often discussed. What I have noticed about the Minister for Welfare Reform is that he has a forensic, tenacious approach to topics and brings his form of thinking not only to analysing the problem but to finding practical solutions. Ever since his independent report of 2007, Reducing Dependency, Increasing Opportunity, on the welfare-to-work system, he has seized the issues where a practical step can be made. People facing mental health problems lack confidence, lose their skills and feel isolated and stigmatised. Only today, in a reception given in another place for the campaign to fight hate crime, Mencap spoke of people with learning disabilities who are ridiculed, humiliated and made ever more isolated.

I have campaigned over many years on issues such as discrimination against women in the workplace, racism—we still do not have enough of our top managers from ethnic-minority backgrounds—and disabilities of all sorts. In some of the early meetings that I had with many people with mental health problems, I tried to suggest that one of the dilemmas for mental health is that employers do not understand it, particularly when there is a condition that may fluctuate. If you have a broken leg, a cancer or many other conditions, the employee’s behaviour can be predicted and the employer knows how to respond. The dilemma for mental health so often is that, with the best will in the world, the employer simply does not know how they should respond—“Is this going to get better? Is it going to get worse? Should I be sympathetic? Should I be more bracing and challenging? Should I be encouraging? Should I be empathetic?”. What is this all about for somebody who, because of the nature of society, does not understand how to assist for the best?

Here is a practical scheme. I join the noble Baroness in saying how delighted I am that Remploy is responsible for it, because it, of all organisations, has an excellent track record. Again I say that I so admire the way in which the Government set up an initiative and outsource it to an appropriate provider who can take forward practical schemes.

It is quite amusing, when we look at the figures produced so far for the number of people helped by the Access to Work scheme, to note that 580 people had mental health conditions, but that some 4,500 had difficulties in hearing or seeing and that 3,000 people had back or neck problems. The noble Baroness is of course absolutely right that we should do all that we can to ensure that as many people as possible understand this excellent scheme.

How much I commend the other organisations which are beginning to take a part. The noble Baroness mentioned the Chartered Institute of Personnel and Development, but the CBI—another great leader in the employment field—in its Healthy Returns? Absence and Workplace Health Survey 2011, stated:

“Mental health conditions emerge as the single most widespread cause of long-term absence amongst both manual and non-manual workers. When respondents were asked for the five main causes of long-term absence in their organisations … non-work related stress, anxiety or depression emerged as the most widespread health problem”.

Interestingly, that was the case among very many more of the non-manual employees than the manual employees.

There is no excuse for us now not to give priority to this issue. The biggest single reason for claims for incapacity benefit, now employment and support allowance, is mental and behavioural disorders. There are nearly 1 million recipients in that category, accounting for some 40% of total incapacity benefits.

Like the noble Baroness, I hope that more can be done to promote the scheme, particularly among small employers. It is easy for large businesses with global brands, stakeholder relationships and great concern for corporate social responsibility to set up excellent initiatives, but smaller employers often simply do not have the resource and the ability to deliver in practice.

I look forward to hearing the comments of the noble Baroness, Lady Meacher, on her husband’s excellent report for the mental health policy group at the LSE’s Centre for Economic Performance.