Mental health: Sick forced out of UK workforce

Mentally unwell people being forced out of workforce: Six in 10 people who are economically inactive because of long-term illness are living with a mental health problem, researchers found.

The revelation suggests that a rise in mental health problems across the country is a key contributor to the shrinking UK’s labour market, where 2.5 million people are inactive because of their health – the highest level since records began.

Solving the UK’s mental health problems may be the answer to improving the nation’s economy as the research also shows the UK’s labour market recovery from Covid-19 is slower than among its peers – with the UK the only G7 nation where employment rates have not recovered to pre-pandemic levels.

While issues such as anxiety and depression are affecting people of all ages, young adults out the labour market due to sickness (20-29 years old) are 50 per cent more likely to report a mental health problem than older working-age adults (60-65).

The ONS has recently found that the recent rise in economic inactivity due to sickness has been driven by younger adults: inactivity of this kind has risen by 42 per cent among 25–34-year olds, versus 16 per cent among 50–64-year olds.

With more than a million people already waiting to access mental health support – and the cost of living crisis likely to worsen mental health this winter – it is likely that the number of people unable to work due to health problems will increase in the coming months.

Other health conditions implicated in the record number of people out of work due to sickness include:

• Autism spectrum disorder: Reported by nearly one in three 18-29 year olds who were out the labour market due to their health (31 per cent)
• Disabilities/problems relating to legs or feet: This was the most prevalent diagnosis among 60 – 65 year olds who were economically inactive due to their health (53 per cent)
• Multiple conditions: Three in four people economically inactive due to their health had 2 or more conditions – while half had three or more and a full quarter were trying to cope with six or more health conditions

The landmark report by IPPR also shows that the UK has scope to significantly improve population health, including among working-age people. On an international scale, the UK places 6th in the G7 for preventable deaths and disability among people aged 15 – 69.

The report’s analysis of preventable deaths shows that if the UK did as well on prevention as the best performing G7 nation (Japan) it could prevent around 25,000 deaths a year among this age group alone – a feat that would have huge human and economic value. It would also save people from entirely avoidable pain and disability.

As well as on prevention, the report finds significant scope to do better on both NHS waiting lists and adult social care provision. In 2020/1, over 200,000 requests for adult social care by people of working age in England led to no further action – a 25 per cent rise on 2016-7 levels. And NHS England data shows over 400,000 waiting at least a year for care, compared to just a few hundred through 2013/14.

The IPPR commission on health and prosperity – chaired by Lord Ara Darzi and Dame Sally Davies, and with commissioners including Mayor Andy Burnham and Sir Oliver Letwin – will publish a full set of policy recommendations in the final report due in 2023. However, this report begins to set out a framework, including three key principles:

• Prevention shift – Preventing illness is both effective and cost-efficient. Many of the conditions impacting the labour market, such as cardiovascular diseases, can be prevented.
• Treatment shift – Faster access to the NHS, earlier diagnosis and innovative treatments will create a healthier and more productive population.
• Social shift – Some people will inevitably have to live with health conditions, however by having better social care services, stronger routes to work and more inclusive workplaces, barriers can be removed.

The report also highlights the importance of public services working together – to help meet complex needs, such as the interaction between physical illness, poverty and mental health problems.

Professor Dame Sally Davies, commission co-chair, former Chief Medical Officer for England and Master of Trinity College Cambridge said:

“Covid-19 showed how vulnerable our society, our economy and our day-to-day lives are to illness. It is time for policy makers and politicians to wake-up to the pivotal role of good health in good lives and a strong, fair economy.

“This report’s findings are clear: a fairer country is a healthier country, and a healthier country is a more prosperous one. Over the next year, our Commission on Health and Prosperity will design a bold new plan for a fairer, happier, and healthier country.”

Professor Lord Ara Darzi, commission co-chair, former health minister and Paul Hamlyn Chair of Surgery at Imperial College London said:

“Too often, politicians have seen health as a cost to be contained, rather than an opportunity to be unleashed.

“This report shows that we need three, urgent shifts. First, towards prevention – so less people experience avoidable mortality and morbidity. Second, towards more modern healthcare – to help diagnose conditions earlier and treat them more effectively.

“Third, we need to ensure that living with a health condition doesn’t limit people’s economic opportunities. That means creating an inclusive job market and significantly improving adult social care provision.

Chris Thomas, head of the commission on health and prosperity at IPPR, said:

“It is no surprise to see population mental health in crisis. Access to services steadily worsened during austerity. And a combination of Covid-19 and the cost-of-living crisis are taking a huge toll. We face nothing short of a mental health recession.

“Until recently, nobody was talking about health as having a role in the labour market. This report now shows that mental health, as well as physical health and multiple conditions, are driving the UK’s poor economic outcomes.

“This trend isn’t going anywhere. As the population ages, and public services deal with cuts, health looks set to deteriorate. Without a bold new strategy for health and prosperity, we face a generation that is far poorer and sicker than those that came before it.”