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A systematic rapid evidence assessment: The effectiveness of interventions for people with common mental health problems on employment outcomes

Who wants to know and what do they want to know?

The 2006 Budget announced a review of the policies needed to improve mental health and employment outcomes. Too many people of working age are excluded from work when, with proper help and support, it should be possible for them to find or remain in work, benefiting their own health and welfare, as well as the wider economy.  The Rapid Evidence Assessment reported here contributed part of the evidence base for the Policy Review Team by systematically assessing research on ‘what works’ in terms of interventions that address employment outcomes for people with mental health problems.

What did we find?

Studies focusing on common mental health problems aimed either to improve the treatment of people’s mental health problems, and thereby their employment prospects (‘mental health’ interventions) or to assist people with mental health problems to gain or retain employment (‘employment’ interventions).

While the studies were variable in terms of their quality and ability to answer the review question, there is evidence to suggest that ‘mental health’ interventions can improve employment status, especially for those already employed. There is some evidence that ‘employment’ interventions can be implemented and are popular and acceptable among clients and practitioners. However, these evaluations tended to be less robust than those evaluating ‘mental health’ interventions and they could not provide evidence that ‘employment’ interventions are effective in helping people obtain or stay in work.

What are the implications?

On the basis of existing evidence, for those currently employed (but not necessarily for those currently unemployed), the following conclusions were reached:

  • Improvements in mental health are associated with better employment outcomes
  • Receiving recommended primary care improves employment outcomes.
  • Interventions to improve guideline implementation and adherence can improve employment outcomes.

Implementation and process data from the studies on ‘employment’ interventions provide some support for these interventions and could make a useful basis for the development and evaluation of future programmes.

More research needs to be undertaken on what works to help people with common mental health problems find work, if they are unemployed, or stay in work if they are employed.  More research on how to help those currently unemployed is particularly important, given the paucity of evidence addressing this issue.

How did we get these results?

First, they looked at the question: What research measures the impact of interventions to increase employment among people with mental health problems?. In agreement with other research, our initial evidence map revealed a relatively limited number of studies about mental health that measured employment outcomes (155 studies).  It also showed there is much more research activity (135 studies) on interventions for people with severe mental health problems (such as psychosis and schizophrenia), than for those with common mental health problems (such as depression and anxiety), despite the greater prevalence of the latter.  An in-depth review was undertaken on the eight interventions we found which targeted those with common mental health problems.

The EPPI-Centre’s reference numbers for these reports of this review are 1509R (Report) and 1509T (Technical Report). The full citation is:

Underwood L, Thomas J, Williams T, Thieba A (2007) The effectiveness of interventions for people with common mental health problems on employment outcomes: a systematic rapid evidence assessment. In: Research Evidence in Education Library. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.

  
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