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TX: 07.12.09 - Mental Health Strategy

PRESENTER: JULIAN WORRICKER

THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 大象传媒 CANNOT VOUCH FOR ITS COMPLETE ACCURACY.

WORRICKER
So the government has announced an overhaul in the way people with mental health disorders will be helped to find and keep work. Mental health coordinators based in job centres and advice lines for small businesses are among the initiatives announced. Currently only one fifth of people with serious mental health disorders work. The recommendations follow a review by Rachel Perkins - an expert in mental health issues - and we'll be speaking to her in a moment. Reporter Carolyn Atkinson has been to hear the government announcement this morning.

ATKINSON
Well I'm here at Westminster where the health minister - Phil Hope - has just launched this new horizons report. It replaces the National Service Framework for Mental Health, which ran out in September and this is what the government is calling their long term vision for the next decade or so. The aim is not only to provide mental health services in terms of the medical side of things but for the first time to include and make other areas a key part and employment is the biggest area that they're looking at as the DWP minister, Jonathan Shaw, just said work is part of the prescription. So they're linking up with the MOD as well for ex-service personnel and veterans, so they can be helped better. The Department of Children, Schools and Families are involved, the Treasury's involved and even DEFRA, who are looking at the environment has on mental health.

Work though is the biggest big new idea here. One million people on benefits at the moment have mental health problems and the government aims to reduce that by what they call a change of culture amongst GPs, amongst employers and amongst us, the public, given that one in six people have a mental health problem at any one time. They've also made three new announcements today: the creation of a mental health coordinator post in 49 Job Centre Plus district offices across England, Scotland and Wales; they've announced an occupational health phone advice line for small business employers and they've also announced a big boost to the Access to Work scheme, which helps disabled people back to work - only 1% of those people on the scheme have mental health problems.

So they're saying the stakes are very high, they're saying this is all about a social and not just a clinical approach to mental health. Paul Farmer, chief executive of MIND is with me. Paul, you have been involved in advising the government on this and all the work that's gone towards it but do you think they've actually cracked it, is this going to work?

FARMER
Well I think this is a very significant moment for mental health policy because it's taking mental health out of being a subset of the NHS into being part of a whole government approach. So I think there's some very positive signs that recognises that people's lives, the lives of people who experience mental health problems, don't simply sit in the Department of Health. I think the real challenge is going to be getting this implemented and making it work on the ground. We're not very far away from a General Election, I think this is now setting down a new blueprint for the way that we ought to be thinking about mental health, that some of this does require significant cultural change and that's going to be a real challenge in the coming months.

WORRICKER
Well that was Paul Farmer, chief executive of the mental health charity MIND and we'll be hearing from the shadow disability minister Mark Harper later in the programme as well.

Joining me now though is Rachel Perkins who carried out the independent review into mental health services for the government. Good afternoon to you.

PERKINS
Good afternoon.

WORRICKER
How important is it for government to make this clear connection between work and mental health?

PERKINS
I think that we've got to recognise that appropriate work is good for your mental health and being unemployed can actually cause mental health problems. And when we think about people with mental health problems treatment is part of the answer but I guess what we're really trying to do is help people to rebuild their lives and that, for many people, involves work.

WORRICKER
Can I read you this e-mail because it came in from somebody listening to the programme in anticipation of this very conversation? Stephen Noke writes: "I have wide experience of employment issues due to mental health problems. I was retired early from a major bank in the year 2000 for reasons of stress and/or depression. I've had problems since in acquiring any sort of meaningful employment, even though I've since obtained a first class degree. I have wide experience of interviews (and rejections) - he adds in brackets - I'm currently working as a self-employed driver as this is all I could get." How typical is he do you think?

PERKINS
Sadly I think he reflects the experience of an awful lot of people. And I think that's what my review was designed to try and stop. We need to think about how we can support both individuals to get back to work but also employers. I think what we really must remember when we think about employment is that we're talking about a relationship and we do with both health and employment services need to be supporting both sides of that relationship, so we can actually use the talents of gentlemen like that - it's a waste.

WORRICKER
Are there other people that you've come across - particular stories that you can think of - which resonate with the one I've just read?

PERKINS
Oh absolutely. I've certainly met a number of people - social workers, teachers, nurses - in almost all walks of life I listen to people who've lost jobs. But equally I also meet a lot of people who with support have managed to maintain their jobs and indeed get their jobs back. One young woman I worked with had been told she would never work again and she now has a doctorate and is working for the NHS very successfully but she'd been told she would never be able to do that. We need to make that a more common story.

WORRICKER
You speak with great passion about this because you know personally what this is all about don't you.

PERKINS
Absolutely yes, for almost - 20 years ago I developed mental health problems that caused me to be off work for some time and at that point I believed my life was over, I believed no one would ever want to know me again, that I'd lose my job - everything that I hold dear. I was one of the very fortunate ones, I had an employer, at the time, who valued me, who believed I could do the job and who really did encourage me to go back to work. Sadly, I'm in a minority in that respect.

WORRICKER
There will be employers listening to this conversation who might have all manner of good intentions in this area but they will also have to look at the practicalities, they may be running a small business, they may employ - for sake of argument - five people, what would you say to that employer who might say I'm potentially taking a risk here, why should I take that risk when I could employ somebody else who doesn't offer that level of risk?

PERKINS
Well I think one of the main thrusts of our recommendations in the review is actually reducing that risk. First of all making sure that there's someone there if you're not quite sure what to do. Secondly, making sure that that small employer can have the resources - that they can be helped to bring in temporary cover, should the person be off sick. But I think we've got to be right - not everyone with mental health problems goes off sick all the time, in fact sickness rates are no higher than the rest of the population. But I think what we're talking to that employer is you are missing out on a huge range of skills and commitment, why wouldn't you want to employ me - 30 years of experience of working, 24 years of full time education - it is a waste not to use those skills. But we do need to make sure that employers have the support they need to make a reality of that employment.

WORRICKER
And if they have that support is that cultural change, that we just heard referred to by Paul Farmer, is that going to happen in the next 10 years?

PERKINS
I really hope so but the cultural change also needs to happen within health and social services. Too often there's a culture of low expectations. I am shocked and horrified when I still hear people say - oh no my doctor told I'd never be able to work again. One young woman I spoke to recently had just got a degree from Oxford University and her doctor had told her that she would not be able to work. I think we've got to raise expectations all round - within health, within social services, within employment services and in society more generally.

WORRICKER
Rachel Perkins, thank you very much. Later on in the programme we'll be talking to some people with mental health problems who used an individual placement support centre to get back to work and as I say we'll talk as well to the shadow disability minister.

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