Pushing mentally ill people from their hospital beds and into offices will only make things worse

Liz Kendall, the work and pension secretary, suggested earlier this month sending work coaches to mental health hospitals to encourage patients to return to work. This policy is riddled with bias and ultimately reinforces the stereotype that mental illness is something that you can simply shake off. The implication is that if you appear physically ‘fine’, you are able to work.

The rationale for this proposed policy is that 21.5% of 16-60 year-olds are currently “economically inactive”, and the disability benefits bills are rising. The government – or perhaps the country – cannot afford this, so the aim is to incentivise those on disability benefits, including those suffering from mental health conditions to re-enter the workforce.

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There is so much wrong with this idea that it’s hard to know where to begin, but we should start by exploring how physical and mental health are regarded in such different and damaging ways.

There are approximately 42 million people in the UK aged 16-60. 21.5% of this figure amounts to  around 9 million that are economically inactive. According to the King’s Fund, there are around 17,000 mental health beds, which account for just 0.1% of this economically inactive population. While not every mental health bed will be taken by someone in this age range, for argument’s sake, let’s assume they are.

These 17,000 mental health beds are occupied by the very sickest patients who are not capable of working right now. We wouldn’t send work coaches onto hospital wards filled with patients recovering from heart attacks, strokes, cancer or surgery, and the mere thought of this would be preposterous. So why is it acceptable to target our most vulnerable mental health patients? This policy is actively targeting those least likely to be able to return to work any time soon, which is frankly abhorrent.

When we focus on the small portion of people who can even access a mental health bed, this is a problem in itself, given the magnitude of the mental health epidemic in the UK. The fact that the government is planning to target this pool of people is incredibly niche – this is such a tiny proportion of the group that is economically inactive – that the impact will be incredibly small.

So, what should the government be doing instead?

For starters, we need to be far more ambitious. Mental health in the UK is deteriorating. Depression is expected to become the leading cause of disease burden by the end of the decade, affecting almost half a billion people. People are getting worse, not better, because they are stuck on waiting lists, waiting for treatment that might not come quickly enough. We need to fund treatments that work but have waiting lists; for example, we need to adequately fund Improving Access to Psychological Therapies (IAPT services) so that patients can get the help they need at the right time, which will make them more likely to recover and need less time off work.

We need to target a much broader demographic of people struggling with mental health, those who are recovering or have recovered and, therefore, much more likely to return to work sooner. We need to help these people re-enter the workforce – people who are actively willing and would benefit from the support. Additionally, we need to focus on those with more straightforward issues who can engage with work coaching and are more likely to succeed.

Ultimately, we must recognise the severity of mental health issues and understand that there is a scale, with some individuals suffering more severely than others. Mental health isn’t about having one too many duvet days, nor is it about laziness; it can be a debilitating illness that impacts individuals in many ways – including their physical capabilities. Mental health needs attention from the government – it needs funding, and people need more support to manage mental health in the UK. However, pushing patients from their hospital beds into offices will only worsen the situation.

Dr Claire Ashley is a GP and a workplace mental health expert at Headspace.

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