Impact of supported employment on service costs and income of people with mental health needs

Abstract

Background: A 12-month study of UK supported employment providers found that 77 (54.6%) of the participants in the study remained unemployed, 32 (22.7%) got jobs and 32 (22.7%) retained the jobs they held at the outset.

Aims: To explore the impact of moving into employment on service use, earnings, benefits and tax allowances claimed.

Methods: Service use and frequency were measured at baseline and 12 months. Comparisons paid particular attention to the differences between people entering work and those who remained unemployed. Costs were analysed from a government perspective (excluding earnings) and a societal perspective (excluding welfare benefits and taxes).

Results: People who entered work reduced their consumption of mental health services (p < 0.001). However, use of supported employment increased (p = 0.04), in contrast to falling use by people who remained unemployed (p < 0.001) and those who had been working for more than one year (p = 0.002). The increase in earnings for those entering work (p = 0.02) was not offset by a similar reduction in benefits.

Conclusion: This indicates that mental health services may make savings as a result of their clients engaging in paid work. It raises questions about the optimal nature and organization of employment support for this service user group.

Keywords:

• Employment
• costs
• benefits

Acknowledgements and note on contributors

Nicola Gardner, University of Durham, calculated the unit costs for the supported employment inputs. The study would not have been possible but for the funding of the European Social Fund Higher Education initiative, and the co-operation of the provider agencies and service users. Professor Eric Latimer made helpful suggestions about an earlier version of this paper. Professor Jenny Secker, Anglia Ruskin University and South Essex Trust, Bob Grove, The Sainsbury Centre for Mental Health and Professor Mike Floyd, City University, co-directed the study with the author. Jan Slade, Melanie Boyce and Robyn Johnson collected and costed the service use data analysed here.

Declaration of interest: This paper is one output of a study funded by the European Social Fund, with contributions in kind from the following agencies providing supported employment: Department of Work and Pensions, Mental Health Matters, Remploy, Richmond Fellowship Training and Employment, Shaw Trust and South West London & St George's Mental Health NHS Trust. All errors and omissions are the lead author's.