Kevin Jarman, the Joint Unit for Work and Health’s Lead on the Employment Advisors in IAPT (Improving Access to Psychological Therapies) programme, spoke at our staff conference about the project’s progress so far...

MHM has been delivering IAPT (Improving Access to Psychological therapies) services around the country since the NHS piloted IAPT in 2008. Since 1993 we've also led the way in providing specialist employment support for people struggling with their mental health. In 2017, we began taking part in pilots of the Employment Advisors in IAPT programme, combining these two areas of our expertise. These pilots aim to improve the employment support provided in IAPT services. Kevin Jarman, the Joint Unit for Work and Health’s lead on the Employment Advisors in IAPT programme, spoke at our staff conference about the project’s progress so far.

There is a massive employment gap for people who experience mental ill-health. Only 32% of people with mental illness are in work, compared with 48% of people with physical disabilities. (For comparison, 80% of people who do not have physical or mental health conditions are in work.)

Many people with mental illnesses want to work, and feel better when they do, but find it difficult to find or stay in work.

Several mental health charities, including us, point out that many people with mental illnesses want to work, and feel better when they do, but find it difficult to find or stay in work. The Stephenson/Farmer report published in October 2017 backed this up. Work is very often good for our health. People who are in a job they enjoy often recover much better from mental ill-health than those who are out of work.

In 2016 the independent Mental Health Taskforce to the NHS in England recommended increasing peoples' access to qualified employment advisers within IAPT services. The 2017 ‘Improving Lives’ paper set out the Government’s vision for the future of health and disability at work. It pledged to work with employers to improve the working environment for disabled people, making sure everyone’s job supports their health and wellbeing. The paper focused on the need for early action to help people who are struggling to stay in work, as well as better employment support to help people feel ready to find work. The EAs in IAPT project also plays a key part of this vision.

IAPT services had always offered employment support, but before 2017 this was very under-resourced. In 2015, for every 54 IAPT therapists there was only one Employment Advisor! Using pilot funding, IAPT services are aiming for one Employment Advisor to every 8 therapists. People accessing treatment from IAPT will receive better employment support, and the positive impact of this support will last longer. This new 1 to 8 ratio of EAs to therapists is currently being piloted in several IAPT services across the country. MHM is taking part of this pilot in Coventry and Warwickshire, Hertfordshire, Oxfordshire, Warrington and Worcestershire. We hope that these pilots will standardise and improve the quality of employment support provided in IAPT services. If successful, the programme will be rolled out across the nation.

MHM is taking part of this pilot in Coventry and Warwickshire, Hertfordshire, Oxfordshire, Warrington and Worcestershire.

So how do people get support from an Employment Advisor in these pilot services? When someone is assessed for treatment in an IAPT service they should be offered employment support. Throughout their treatment they will also be reminded of this offer of extra support. Employment support can start at a different time to when someone starts IAPT treatment, and can continue after they have been discharged from the IAPT service.

Employment Advisers support people to remain in work, get back to their job or find work. They work together with therapists to support clients to improve their mental health and reach their goals. The client leads the whole process, based on their personal aspirations. We document all that work on an action plan to help the IAPT staff and the client to their measure progress. Data is also collected to measure whether the improved availability of employment support correlates with the service helping more people to recover.

So far, the pilot project is going well. By February 2018 there were 337 Employment Advisors in IAPT services, well over double the amount that were working in 2015. They are already supporting thousands of people. During January-March 2019, over 4,000 people started employment support, and we expect that figure to rise.

As these are pilots, there have of course been some challenges and lessons learned. It is vital that the teams collect accurate data to make sure we can prove the success of the project. There are also some more complex areas where the role of the EA needs to be given more thought. For example, what do we offer those clients who are in particularly difficult situations (involved in sickness absence, disciplinary and grievances processes, etc.)? Then there is the importance of securing funding to ensure that the pilot sites can keep the Employment Advisors they have recruited, and receive more funding to expand the project to all IAPT services.

During January-March 2019, over 4,000 people started employment support.

Kevin feels that the future looks positive for this programme. Services taking part in the initial pilots have reported that people who need and receive specialist employment support experience much better mental health outcomes than those who only receive IAPT treatment. There are also many reports of Employment Advisers making a positive impact on clinicians' ability to deliver great support. This is because therapists are able to concentrate on the provision of psychological treatment, whilst EAs are able to address work-related issues, working together to support the client’s needs.

Find out more about the Employment Advisor services MHM are providing in IAPT