30 July 2009 – Publication of DWP research report 593: People with mental health conditions and Pathways to Work

This new report published today by the Department for Work and Pensions presents the findings from qualitative research exploring how Jobcentre Plus Pathways to Work may better meet the needs of the heterogeneous mental health client group. The study was conducted by the Policy Studies Institute and involved qualitative interviews with 44 incapacity benefit claimants with mental health conditions and 28 key professionals working with this client group in three Jobcentre Plus led Pathways districts.

This report emphasises the varied character and experiences of this client group, with some key findings as follows:

Clients’ feelings about work reflected their concerns about their health conditions, their levels of confidence about functioning in the workplace, anxiety about the stigma attached to mental health and fear of disclosure to prospective employers.

Those clients in employment reported positive experiences of disclosing their conditions, securing reasonable adjustments, and of the benefits of work to their wellbeing. However, there were exceptions and crucially, some clients reported targeting employers with a good track record on this issue.

Client experiences of Pathways

• These were greatly informed by experiences of the first Work Focused Interview (WFI). This induced feelings of anxiety and vulnerability in some clients, but most felt reassured by their adviser after attending this first interview.
• Many clients were satisfied with the support they received from Pathways
• Some felt that the opportunity to participate had come at the wrong time for them because their mental health condition or other difficult life circumstances may have prevented them from engaging sufficiently or thinking about work at that stage.
• People who felt ready for work reported that Pathways offered a balance of soft skills and work focused activity.

Client relationships with Incapacity Benefit Personal Advisers (IBPAs) were crucial to their Pathways experience, with positive advisory relationships facilitated by:

• Co-ownership of the back to work process – client directed pace and focus with adviser support;
• Good adviser communication skills – attentive, non-judgemental and personally tailored support;
• Understanding the health condition – clients recognised that advisers are not medical experts, but stated that empathy and knowledge were key.

Working with people with mental health conditions – Some IBPAs were concerned about their capacity to support this client group within their working context. There was a perception that the performance target culture could distort their capacity to provide a tailored, individualised service which respected the varied length of time needed by clients to progress towards employment.

This report highlights several facilitators of positive client journeys towards employment:

• The timing of intervention – the study suggests that voluntary customers had more positive experiences and in these cases, that later intervention led to more successful employment outcomes.
• Individually tailored, long-term support and case management are important, because many people with mental health conditions take longer to return to employment. The report also identifies the need for better coordination of services and collaboration between IBPAs and community based mental health services.
• Support outside of Pathways, such as counselling and talking therapies, group interaction and the presence of support workers.
• Informal social networks of friends and family to contribute to health improvements, practical and emotional support.
• GPs embracing the ethos of Pathways.

Notes to Editors

1. The DWP research report: People with mental health conditions and Pathways to Work is published today on DWP website.
2. Pathways to Work provides extra help for people on incapacity benefits and Employment and Support Allowance to find work. As part of the programme, a variety of work and health related services, known collectively as the Choices package is available. This research reports on the experiences of customers in Jobcentre Plus led Pathways districts.
3. The report authors are Maria Hudson, Kathryn Ray, Sandra Vegeris and Sheere Brooks from the Policy Studies Institute.
4. The report is based on in-depth qualitative interviews with 44 Pathways customers with mental health conditions (mandatory and voluntary) and 28 professionals working with this client group in three Jobcentre Plus districts (IBPAs, Disability Employment Advisers, work psychologists and Condition Management Programme staff).

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