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Local Practice
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Local Study Cover Report Introduction Most social policy is developed using statistical data. This is especially true in employment and health policy. We therefore see, for example, that welfare to work policies target efforts towards incapacity benefit, arguably because of the sheer weight of numbers, and of course for reasons of social justice. This also happens with special strategies, and so we see action teams for jobs working in the most statistically disadvantaged areas and, of course, the Northern Way is symptomatic of this. This study has a particular focus on mental health; most statistics will show that people with mental health needs are among the most disadvantaged groups when we look at employment and life chances, both in terms of numbers and percentages. This type of information is useful, however statistics are of relatively little use in reality without a clear understanding of how statistics translate into individual experience. We therefore suggest the importance of this research is to get behind statistical descriptions to discover the meaning and experiences behind the numbers. During autumn 2006 a multi-disciplinary team set out to explore the dynamics of economic activity among people with mental health needs in the North East. The study comprised of several strands and took place in three locations. Namely, Newcastle (West End), Durham City and Sedgefield Borough. The aims of the research were to: Explore the differences in perceptions/attitudes and understanding of employment opportunities between potentially different areas within a region and between different actors. To identify the barriers to work from a range of perspectives. To understand further the implications of cultural factors that impact on employment To test the response to mental health needs among key stakeholders To gain a picture of the relationship between key stakeholders. To explain why some areas have vastly different employment outcomes from other areas. The outcomes of this research will hopefully help inform a range of key stakeholders at the regional level, nationally for health work and well being interventions and locally for better targeted intervention and partnership working. Method Three areas were chosen in which to carry out the study which included Sedgefield ( a semi-rural area with significantly poorer health than comparative boroughs), Durham City( an area of perceived affluence) and the neighbour of Sedgefield and Newcastle (West)( an inner city area with high levels of unemployment and health deprivation). Consultation took place with three key groups of stakeholders which included Service users, Employers and the Voluntary and Statutory Sector. Members of the North East Mental Health and Employability steering group were assisted by colleagues in carrying out the voluntary and statutory sector interviews and report. Ian Mcdonald of Infinite Resource (A private consultant and local businessman) was commissioned to carry out the employer interviews and report and the Arise Project (a service user led research and development project based in Middlesbrough) were commissioned to carry out the service user interviews and report. His report contains additional data from Stockton. Few differences between study sites on the basis of geography and local infrastructure were found. There were however strong themes coming though from each of the three stakeholder groups. In light of this reports have been compiled on the basis of the stakeholder group rather that geographical study site. Minor area based differences are highlighted in the thematic reports where relevant. A set of guide questions was used for each of the stakeholder groups, a full list of which is provided within the thematic reports. Area Profiles Sedgefield Borough Sedgefield has a population of 87,800 of whom 53,500 are of working age. The borough is semi rural and is made up of a number of small towns and villages largely separated by farmland. The borough is serviced by three acute hospital trusts in neighbouring Authorities and at the time of investigation was served by one single primary care trust. The borough has a history of mining; many of the villages were entirely dependent on the mines up until their closure. Of the 15,100 economically inactive individuals within the borough only 3,100 are seeking employment, 8% of the population are in receipt of a sickness related benefit (severe disablement allowance or incapacity benefit) 33% of whom have declared a mental health problem as the initial/main reason for being unable to work. The borough also houses one of Europe’s largest industrial estates. Standards of housing and rates of crime are better than the England average, and access to key services is good for a rural area; however, rates of health are significantly poorer than other areas of the country with similar infrastructures. Life expectancies at birth for males and females in Sedgefield are significantly lower than the England average whilst death rates from smoking, heart disease, stroke and cancer within the borough are significantly higher than the England average. Alcohol consumption and binge drinking are also significantly higher than the national average in this borough which has recently been ranked one of the most obese areas in the country. Additionally, academic achievement amongst young people is poor with significantly fewer 15 year olds than the England average achieving at least five good GCSE passes in 2005. Nine of the nineteen wards within Sedgefield fall within the most deprived 25% of wards within the country based on indices of multiple deprivation 2005. Durham City Durham City has a population of 92,200 of which 62,500 are of working age with only Employee Jobs 44,144 available within the City. The City is small with a significant student population which are resident for only 6-8 months of the year. The City boasts a prestigious historic City Centre and house prices are significantly higher in this area than the North East average. However, outside of the City Centre lie a number of small communities which in some areas suffer from severe levels of deprivation. Of the 12,400 economically inactive individuals in the city only 3,300 want a job. Slightly higher than Sedgefield Borough, 36% of Durham’s incapacity benefit claimants state a mental health problem as the main reason they are unable to work. Local Authority housing in some areas of the city is significantly poorer than England average but rates of violent crime remain relatively low. Durham houses only 2 wards in most deprived 25% in England 6 in the least deprived 25%. However, the suicide rate is significantly higher than Sedgefield at 12.1 per 100,000. Newcastle The city of Newcastle upon Tyne has a population of 276,400 of which 81,400 are of working age benefiting from 167,735 employee jobs. This City has a well developed centre, recently came close to being named a European city of culture and has benefited from regeneration programmes in recent years. Of the 45,300 economically inactive individuals in the city 14,100 want a job. The area has the highest incidence of mental health related benefit claims in the study at 45% and a significantly higher suicide rate at 18 per 100,000 Local Authority housing is significantly poorer than the England average with 18 wards in most deprived 25% in England and only 1 ward on the least deprived 25% Key Findings in Brief and Implications for Priorities Thematic Report: Service Users Almost all service participants had aspirations to engage in some kind of employment Of those who had received two or more forms of support all were in employment (paid or unpaid) No one gave their mental health as a reason for not wanting to gain employment Current services were often not meeting patient need – this implies that progress could be made through more responsive, efficient use of current resources Sporadic funding is affecting the continuity of services Service users had received misinformation regarding benefits, thus putting unnecessary barriers in the way of employment aspirations Employers were seen as a major barrier to engaging in employment Interpersonal relationships were of the utmost importance in care, home and work settings In work support required services to work flexibly Thematic Report Voluntary and Statutory Sector Lack of understanding of and effective working with the necessary range of partners Services not being exploited to realise the full contribution they can make to the employability agenda Lack of central funding. Requirements of external funders stifled innovation and ability to effectively respond to local need Thematic Report: Employers Very poor awareness of mental health in general and within their own workforce Broad negative assumptions about the behaviours and performance of employees with mental health problems Little-no awareness of help and support available from the voluntary and statutory sector. Implementing Policy A significant number of the issues outlined in the study have to some extent been addressed by policy and national guidance, however this policy and guidance is not being comprehensively implemented. Two issues are of relevance here. The first is the extent to which professionals engaged have the skills set to effectively implement policy and guidance within their locality/organisation and the second is the authority with which national guidance on this subject is published. A fuller exploration of these issues can be found in Policy and Guidance Overview and Report
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