Work, Welfare and Mental Health: Transitions Over Time

Research team

Dr Annie Irvine, University of York

Co-Investigators 

Prof Ben Geiger, ESRC Centre for Society and Mental Health, King’s College London

Background

Many people will experience mental health problems at some time in their life. It is important to understand how mental health affects people’s ability to work, and what helps to keep people connected with employment during times of poor mental health. Although lots of research has already been done on mental health and employment, more and more people are claiming out-of-work benefits because of mental health. Something is still not working. This research project used a biographical approach to see whether exploring the relationships between people’s work and mental health across the lifecourse could add important new insights.

Aims

Our aim was to understand in qualitative detail the complex and dynamic range of factors influencing transitions between work and welfare, for people with experience of mental health problems. By using a more unstructured biographical narrative interview method, we aimed to generate detailed and nuanced evidence on the real-world experiences of people navigating the world of work and welfare alongside mental health problems, shedding light on enablers and barriers from a more holistic perspective. The goal was to understand the role and impact of mental health within the wider context of people’s working lives.

Method

Twenty-three people took part in the study, all of whom had experience of mental health difficulties. Their ages ranged from mid-20s to late-50s. We invited people to tell the story of their whole working life, not just the times when they were unwell. Starting from their very first job, participants described every job they had had over the years, right up to the present time. We asked people how they had found each job, what it was like, why they left each job and what happed in any gaps between jobs. We also listened to details of other events that were taking place in people’s lives, alongside jobs and job changes. This ‘life story’ approach helped us to understand the links between mental health and work in the context of people’s wider life experiences. We included two waves of follow-up interviews, over approximately 18 months, to understand more about work, health and welfare transitions in the present time.

Key findings and policy implications

• By listening to the whole story of people’s working lives, it is clear that a wide range of life experiences affect people’s ability to find and stay in work. This includes difficult events during childhood, disruptions to education, family caring roles, relationship breakdowns, and experiences of violence and abuse.
• For many people, these life experiences are already putting up barriers to work, long before mental health problems become part of their story. These complex challenges then continue to affect people’s ability to work, in combination with their experiences of mental distress.
• Not everybody loses their job when their mental health hits a crisis point. Access to social and financial supports, and the quality and security of people’s employment, all shape the way people’s work is affected when mental health difficulties arise. This wider life context makes a significant difference to employment outcomes and transitions to benefits.
• Social policies need to focus on the root causes of both economic inactivity and mental health challenges; these root causes are often closely connected if not identical. Whilst a focus on mental health is vitally important, welfare and employment policies need to take a much wider view on the personal, socioeconomic and structural challenges people are facing.
• A holistic and lifecourse approach to understanding employment barriers, which includes but goes beyond mental health, is essential for government if it is to achieve its aim of helping more people to move off benefits and into sustainable work.