Employment, policy and social inclusion

The experience of unemployment has attracted considerable research throughout the past century, much of it documenting the negative impact and its role in excluding people from mainstream society. Recent evidence has noted the beneficial effects of work and its role in recovery after illness and injury (Waddell & Burton, 2006: see tinyurl.com/4asugd). But does it follow that being in work equates to social inclusion and not being in work leads to social exclusion?

On the surface this is a plausible hypothesis. But social exclusion and poverty can afflict people who are in work too, particularly where work is poorly paid with long hours, is hazardous, of low skill and repetitive (Atkinson & Hills, 1998). There is good work and toxic work, which makes people unwell; although in general being in work is good for physical and mental health, we need to attend to the quality of work as well as helping individuals to find work. When discussing the links between employment and social inclusion or exclusion (e.g. Barnes, 2005; Gingrich, 2008), policy should respond to individual and social needs. Given the time people spend in work, it is important that it is a positive experience.

As a result, efforts are increasingly focused on helping employers to create healthy workplaces so that workers can remain in work for as long as possible and enjoy the benefits of good health and work while in employment. There have been attempts to understand what good work entails and the action management can take (e.g. the Health and Safety Executive's Management Standards: see tinyurl.com/hsemanstan) to create workplaces that support individual well-being.

Psychologists are also aware that individuals will interact differently with a job and the workplace (Bywater & Martin, 2006) and this will have consequences for the individual's well-being and for the organisation. Similarly, the experience of being in work is not only beneficial for individuals but also has broader benefits for families and communities (Waddell & Burton, 2006). Having a parent in work improves the life chances of children. Work influences the prosperity of communities and enables greater social cohesion. It also reduces the risk of antisocial behaviour and offending. So what is the government doing, and how can psychologists become more involved?

Supporting people excluded from employment opportunities

The government has set ambitious targets to eradicate child poverty by 2020. Progress will depend on helping the rising number of lone parents into quality work. Good-quality work that develops employability, incorporates flexibility and accommodates family life can in turn aid social inclusion. The government's New Deal for lone parents has made progress. There are now over one million working lone parents, and income support claimants have fallen by over 300,000 in the last decade.

Social inclusion involves people's well-being at work, safeguarding health and safety, defending interests, championing rights and enabling people to remain in work. There are 2.6 million people claiming incapacity benefit: claims are reducing but some people will have drifted out of employment unnecessarily. Estimated annual costs to the UK economy of working age ill-health are £100bn, and over 170 million working days are lost to sickness absence. Musculo-skeletal disorders affect more than one million people and cost £7.4bn a year, accounting for up to a third of all GP consultations and 9.5 million lost working days. Lower work productivity due to common mental health problems could cost in excess of £15bn a year. This requires a radical reappraisal of employment and healthcare support.

The report Working for a Healthier Tomorrow by Dame Carol Black, the National Director for Health and Work, reviewed the need for change in how working people are supported following illness or disability (Black, 2008). An important step in the review was the ground-breaking consensus statement signed by more than 30 health professional bodies, including the British Psychological Society, British Medical Association and Royal College of General Practitioners, pledging to help people enter, stay in or return to work, where appropriate, because it is often in the patients' best interests. Timely early interventions could reduce the number of working days lost through ill health. The government response (in England) to the Black report was published in November 2008 (tinyurl.com/blackresp) and sets out a challenging forward agenda to improve the health, work and well-being of individuals. It is anticipated that both the Welsh Assembly Government and Scottish Government will make a response in due course.

Work practices are ever changing, and the economy is increasingly skills- and knowledge-based – this will be a challenge for those who have lower basic skills or no vocational qualifications. How do we ensure that those who find obtaining employment more difficult than most are given the opportunity to work? The joint skills strategy by the Department for Innovation Universities and Skills (DIUS) and the Department for Work and Pensions (DWP) will provide support to individuals who need help with basic and work-related skills. The DWP is working to implement the measures set out in Opportunity, Employment and Progression: Making Skills Work (tinyurl.com/p4ujh4). This will ensure that more people can acquire the training to unlock their talent, progress into work and develop while there.

Over the past decade the government's welfare reform programme has aimed to tackle the high rates of economic inactivity among working-age people. The recent Green Paper No One Written Off (http://bit.ly/6P55Is) is a significant step to enable those who can work to move into sustainable employment. The DWP leads on two important public service agreements which are at the heart of promoting social inclusion. They aim to maximise employment opportunities, tackle poverty and promote later-life independence and well-being. Every day the DWP contributes positively to the lives of millions of people, by helping 6000 people find work, conducting over 45,000 adviser interviews and providing child support to over 30,000 children. By enabling children's parents to move into work, children are lifted out of poverty and this raises the aspirations of the next generation. It is a purposeful investment that creates stability and financial security for individuals and families now and in later years.

How can psychologists become more involved?

So what of the future and how can psychologists become more involved? DWP Psychologists contribute in a number of important ways – through organisational interventions, providing input to strategic policy-making and through direct services to job seekers. All this is effort is geared towards one important aim – to enable individuals to believe that they can obtain work, perform well, and move to a better job not only helps individuals make successful life transitions but is central to personal and community well-being. Organisational psychologists in DWP help with organisational design, employee engagement, recruitment and selection, culture change, talent management and organisational development initiatives. This helps the organisation to be fit for purpose. Working corporately, organisational psychologists help Jobcentre Plus and the Pensions Service to deliver better services to customers by having the right staff, skills and processes in place.

Occupational psychologists engaged in policy work are at the forefront of an important government agenda contributing to the development and implementation of the DWP health, work and well-being strategy in partnership with the Department for Health and with a range of other important stakeholders. Working in a policy context in central government is somewhat unique for psychologists. Typically either the individual or the organisation is the unit of intervention, and rightly so, but to have a stake in policy making is a valuable opportunity to make a wider impact on the well-being of the working age population for generations to come. Through the design of better policies occupational psychologists are contributing to developing approaches to reducing the risk of employees spending long periods on sickness absence. One such approach which holds some promise is the training provided to line mangers to take a positive view of return to work from sickness absence. Policy work is a key area where psychologists should get more involved as they can really make a difference in policy-to-practice applications for the real world.

Occupational Psychologists employed as work psychologists located throughout the Jobcentre Plus network make a real difference to people's lives on a daily basis. Their focus is on enabling as many people to identify their talents and address challenges that may be hindering their progression into sustainable work. Jobcentre Plus job seeking customers value the range of psychological services they provide as do the jobcentre staff who look to them for advice, guidance and upskilling. The day in the life of Jobcentre Plus work psychologist is highly varied, with opportunities to help someone achieve their work goals, help an employer retain a valued member of staff or facilitate a case conference with Jobcentre employment advisers. Increasingly work psychologists are developing research programmes and playing a central role in shaping and enabling evidence-based work-related interventions for people with health conditions and disabilities to enter and sustain employment. This is an exciting growth area where psychologists can make a real impact in promoting social inclusion.

This work is complemented by the Improving Access to Psychological Therapies programme (see Clark & Turpin, 2008). The key to maximising the impact of all this work is for psychologists from different domains to work collaboratively to enable as many people to (re)enter and remain in work for as long as possible.

Making it happen

The recent study on the experiences and expectations of disabled people (www.officefordisability.gov.uk) highlighted the importance of choice and access to work opportunities to ensure economic well-being. Achieving this will mean building on programmes like Pathways to Work; early intervention following injury and illness and positive return to work management. Working with other government departments, healthcare professionals and community providers, the DWP is participating in taking forward the Health and Well-Being Strategy launched in 2005 (www.workingforhealth.gov.uk).

The government's vision is that by 2025, disabled people should have the opportunities and choice to improve their quality of life, and be respected and included as equal members of society. The DWP Commissioning Strategy underlines the government's commitment to ensure everyone who can work is offered the necessary support. Working through Jobcentre Plus and providers, the DWP aims to build a partnership network which gives employment-programme participants control over the service they receive, including choice of provider and how the support is tailored to meet their needs.

A supportive approach for individuals and employers will go some way to helping people view work as a real possibility, particularly those who experience mental health problems. Psychologists have a significant contribution to make here to help bridge the gap between inclusion and exclusion.

In conclusion, health and well-being are central to improving working life and reducing the risk of social exclusion through unemployment. Our nation's economic stability and global competitiveness depends on enabling people to work and developing their productivity. Our nation's equality and social cohesion requires that individuals and employers believe they can work, that good work is available to them, that people believe they are part of society and society believes they are contributing. This is an exciting time for policy with this emphasis on enabling as many people as possible to progress into and remain in work for as long as they would wish. Early intervention is increasingly accepted as the key. As with the old saying, prevention is better than cure – it is wisdom we cannot ignore.

Commentary

Kay Sheldon, Chair, DCP Service User and Carer Liaison Committee

The link between employment (particularly the lack of it) and social exclusion is clearly established. However, the relationship between the two concepts is complex and influenced by other factors. The article speaks encouragingly of ambitious aspirations, a raft of initiatives and an individual approach. However, I remain unconvinced that things are going to change much for those of us with mental health difficulties.

Flexible working, well-being initiatives and help for people to stay in or return to work as soon as possible make good economic sense. However, it is less likely that employers will want to 'risk' employing someone who has been unable to work through illness for some time and, I would hazard, particularly someone who has mental health problems. I have experienced numerous examples of discrimination within employment over the years. Last year I got turned down for a post that I was well qualified for. When I asked for a reason, the response was that I would require too much support. This was entirely based on assumptions and not fact.

Sometimes the people that are helping you are part of the problem: ignorance; low expectations; warnings that a job might be 'too stressful'; not understanding how someone might be affected by mental health problems and how this can be viewed in terms of 'reasonable adjustments'. No one has asked me what my needs are even when I have identified myself as 'disabled'. The reality is that I have had to fight and struggle disproportionately and in a different way to progress in the world of work. And I'm one of the lucky ones.

David Carew is with the Department for Work and Pensions
[email protected]

Richard Birkin is with the Department for Work and Pensions

David Booth is with the Department for Work and Pensions

References 

Atkinson, A.B. & Hills, J. (Eds.) (1998). Exclusion, employment and opportunity, CASE paper, Case/4. London: London School of Economics.
Barnes, M. (2005). Social exclusion in Great Britain. Aldershot: Ashgate.
Black, C. (2008). Working for a healthier tomorrow: Dame Carol Black's review of the health of Britain's working age population. London: The Stationery Office.
Bywater, J. & Martin, T. (2006). Reducing call centre staff turnover. Selection and Development Review, 22(1), 13-15.
Clark, D. & Turpin, G. (2008). Improving opportunities. The Psychologist, 21, 700–701.
Gingrich, L.G. (2008). Social exclusion and double jeopardy: The management of lone mothers in the market-state social field. Social Policy & Administration, 42, 379–395.
Waddell, G. & Burton. K. (2006). Is work good for your health and well-being? London: The Stationery Office. [Available from tinyurl.com/4asugd]