SoFarr Study An investigation of the usefulness of Social Firms in promoting vocational recovery for people with mental health problems SoFarr Study An.

SoFarr Study SoFarr Study An investigation of the usefulness of Social Firms in An investigation of the usefulness of Social Firms in

promoting vocational recovery for people with promoting vocational recovery for people with mental health problemsmental health problems

Eleanor Gilbert & Alyssa Milton

Coventry and WarwickshireCoventry and Warwickshire Partnership TrustPartnership Trust

OverviewOverview

Background – Mental Health and EmploymentBackground – Mental Health and Employment

Phase 1 of Research: Results from a National SurveyPhase 1 of Research: Results from a National Survey

Phase 2 of Research: Current interviews with employeesPhase 2 of Research: Current interviews with employees

Phase 3 of Research: In-depth peer interviews with employees Phase 3 of Research: In-depth peer interviews with employees and focus groups with Social Firm managers & Health and focus groups with Social Firm managers & Health

ProfessionalsProfessionals


Work and Mental Health – Work and Mental Health – the benefitsthe benefits

In the UK most people with severe mental illness (SMI) State that they wish to work (Secker et al 2001).

Employment is associated with: Better QoL and well being (Marwaha et al 2008). Improved mental health (Social Exclusion Unit 2004). Social identity and status Social contacts and support A means of structuring and occupying time Activity and involvement A sense of personal achievement (Shepherd 1989).


Unemployment and Mental Unemployment and Mental Health – the costsHealth – the costs

In the UK there are high rates of unemployment (80-90%) for people with SMI (Marwaha & Johnson 2004).

Lack of work is a core part of the social exclusion people with mental illness (Social Exclusion Unit 2004).

Unemployment is associated with earlier death and greater levels of psychological illness (Moser et al 1987, McKee-Ryan e al 2005).

The financial costs of SMI are approximately £3.4 billion (2005) for those with schizophrenia (Managalore & Knapp 2006).


Work & Mental Health on Work & Mental Health on the agendathe agenda

Policy reports have highlighted that health services need to focus on maintaining and promoting economic activity in those with SMI (Black 2008) No one model of service is right for everyone, and each approach may help different people at different times in their recovery (Boardman 2003). Vocational schemes targeting mental health have had limited evaluation in the UK (Boardman 2003).


Part 1: National surveyPart 1: National survey

Aim: to understand How many Social Firms employ people with a history of

mental ill health Distribution of these firms What types of employment Social Firms offer this group How employment of people with MH problems affects

business

Part 2: Interviews with Part 2: Interviews with employeesemployees

Cross sectional design used to survey 120 participants.Cross sectional design used to survey 120 participants. Aim is to compare the data gathered from workers in Aim is to compare the data gathered from workers in

Social Firms to secondary mental health service users.Social Firms to secondary mental health service users. Additionally, gain an understanding of:Additionally, gain an understanding of:

Types of work social firms offer.Types of work social firms offer. The range of age, gender and ethnicity of Social Firms workers.The range of age, gender and ethnicity of Social Firms workers.

Current levels of symptoms and contact with mental health services.Current levels of symptoms and contact with mental health services. Levels of income received through work and the impact on their Levels of income received through work and the impact on their

finances.finances. Levels of satisfaction with life in general and in particular with their Levels of satisfaction with life in general and in particular with their

working lives.working lives.


Part 3a: Peer interviews Part 3a: Peer interviews with Social Firm employeeswith Social Firm employees

In depth qualitative semi-structured interviews In depth qualitative semi-structured interviews completed by Peer Interviewers with approximately 30 completed by Peer Interviewers with approximately 30 employees.employees.

Sampling considerations (e.g. age, position, MH, job Sampling considerations (e.g. age, position, MH, job tenure).tenure).

Questions will probe areas such as:Questions will probe areas such as: Pathways into and through Social Firms.Pathways into and through Social Firms. The benefits and challenges of working in Social Firms.The benefits and challenges of working in Social Firms. The perceived impact of working in Social Firms on areas of life The perceived impact of working in Social Firms on areas of life

such as symptoms, social networks, self concept and QoL.such as symptoms, social networks, self concept and QoL. Stigma experiences.Stigma experiences. Support mechanisms in Social Firms.Support mechanisms in Social Firms.


Part 3b: Focus groups – Part 3b: Focus groups – Social Firm ManagersSocial Firm Managers

Explore Social Firm managers' views of the Explore Social Firm managers' views of the employment of people with MH in their organisations. employment of people with MH in their organisations. Such asSuch as:: The benefits and problems for people with MH working in Social The benefits and problems for people with MH working in Social

Firms.Firms. Challenges experienced in managing staff and support Challenges experienced in managing staff and support

processesprocesses Social Firms suitability for people with range of MH problemsSocial Firms suitability for people with range of MH problems Typical accommodations made in the workplaceTypical accommodations made in the workplace Exploring the balance between supporting workers and running Exploring the balance between supporting workers and running

a business a business The types of business experience of successful Social Firms and The types of business experience of successful Social Firms and

markers of success. markers of success. Coventry and WarwickshireCoventry and Warwickshire

Partnership TrustPartnership Trust

Part 3c: Focus groups – Part 3c: Focus groups – Health ProfessionalsHealth Professionals

Explore Explore the views of mental health professionals on the views of mental health professionals on the benefits and difficulties of Social Firms for the benefits and difficulties of Social Firms for people with mental health problems.people with mental health problems. Levels of awareness and experience of Social FirmsLevels of awareness and experience of Social Firms The perceived benefits and problems of this type of work The perceived benefits and problems of this type of work

for people with MHfor people with MH How the Social Firms model compares to IPSHow the Social Firms model compares to IPS Their views on types of people suitable for Social FirmsTheir views on types of people suitable for Social Firms Whether developing links with Social Firms would be seen Whether developing links with Social Firms would be seen

as beneficial including the methods in which this would as beneficial including the methods in which this would occur.occur.


National Survey - methodNational Survey - method A UK national survey was completed of Social Firms A UK national survey was completed of Social Firms

and other types of social enterprise or supported and other types of social enterprise or supported businessbusiness

Only included those providing paid employment for Only included those providing paid employment for people with history of mental ill health. people with history of mental ill health.

Membership lists:Membership lists: Social Firms UK, Social Firms UK, Enterprise UK, Enterprise UK, Social Social Traders, Social Social Traders, British Association for Supported Employment British Association for Supported Employment The International Centre for Clubhouse DevelopmentThe International Centre for Clubhouse Development


MethodMethod

Snowballing technique Snowballing technique Local authoritiesLocal authorities Job Centre Plus officesJob Centre Plus offices Lead Occupational Therapists in Mental Health Lead Occupational Therapists in Mental Health

TrustsTrusts Mental health charities and academics asked to Mental health charities and academics asked to

provide details of any relevant businesses they provide details of any relevant businesses they were aware of were aware of

An internet searchAn internet search


QuestionnaireQuestionnaire

Questionnaire was developed and piloted with Questionnaire was developed and piloted with Social Firm managers. Social Firm managers.

Employers asked about:Employers asked about: goods or services suppliedgoods or services supplied finances finances sickness managementsickness management recruitment of workers with mental illnessrecruitment of workers with mental illness liaison with mental health services. liaison with mental health services. information about employees with a history of mental information about employees with a history of mental

illnessillness


ResultsResults

67 Social Firms and 82 social enterprises or 67 Social Firms and 82 social enterprises or supported businesses (149 total) identified as supported businesses (149 total) identified as potentially employing people with a history of MH potentially employing people with a history of MH problems. problems.

Responses from 145 employers -Responses from 145 employers -8383 confirmed they confirmed they currently employed at least one person with mental currently employed at least one person with mental illness.illness.

Questionnaire were completed by 74 of the eligible Questionnaire were completed by 74 of the eligible businesses businesses

Represented 550 employees with history of mental Represented 550 employees with history of mental ill health ill health


MappingMapping The organisations surveyed were located The organisations surveyed were located

throughout the UK. throughout the UK. 40% south of England, 40% south of England, 27% north and the midlands, 27% north and the midlands, 22% Scotland22% Scotland 11% Wales. 11% Wales. Mainly manufacturing and services/catering. Mainly manufacturing and services/catering. Average number of years of operation was 6.8 for Average number of years of operation was 6.8 for

Social Firms and 24 for social enterprises Social Firms and 24 for social enterprises /supported businesses /supported businesses


Social Firms N=32

Social Enterprise/ Supported Business

N=42 Median number of employees with MH problems (range) 3 (1-70) 5.5 (1-110)

Trade Manufacturing Service/catering Recycling Packing/gardening

8

14 8 1

23 9 5 7

Employee in post > 2 years (%)

50%

89%

Business has MH employees in management

34% 28%

MH sickness impacts on day to day running of business (yes)

34% 48%

MH sickness impacts on long term viability of business (yes)

13% 28%

Proportion of businesses employing people with: Schizophrenia Bipolar Disorder Anxiety / Depression

34% 19% 47%

32% 37% 52%


Conclusions from National Conclusions from National SurveySurvey

Employment of people with a history of mental ill Employment of people with a history of mental ill health in Social Firms and social enterprises is health in Social Firms and social enterprises is currently on a very small scale.currently on a very small scale.

People with wide ranging mental ill health are People with wide ranging mental ill health are employedemployed

Social Firms tend to have been developed in the Social Firms tend to have been developed in the last decadelast decade

Increasing awareness may lead to expansion of Increasing awareness may lead to expansion of employment for this group of people in Social Firmsemployment for this group of people in Social Firms

May provide a viable alternative to individual May provide a viable alternative to individual placement and support (IPS).placement and support (IPS).


What next?What next?

Currently carrying out interviews with employees – Currently carrying out interviews with employees – data gatheringdata gathering

In-depth peer interviews with employees in the autumnIn-depth peer interviews with employees in the autumn

Focus groups with Social Firm managersFocus groups with Social Firm managers

Focus groups with cliniciansFocus groups with clinicians

Results next yearResults next year


Thank you Thank you

Contact details:Contact details:

Eleanor Gilbert (Warwick University)Eleanor Gilbert (Warwick University)

[email protected]@covwarkpt.nhs.uk

Alyssa Milton (UCL)Alyssa Milton (UCL)

[email protected]@ucl.ac.uk

Dr Steven Marwaha (Chief Investigator: Warwick Dr Steven Marwaha (Chief Investigator: Warwick University)University)

[email protected]@warwick.ac.uk

Professor Sonia Johnson (UCL)Professor Sonia Johnson (UCL)

[email protected]@ucl.ac.uk


SoFarr Study An investigation of the usefulness of Social Firms in promoting vocational recovery for people with mental health problems SoFarr Study An.

Documents

work mental health

usefulness of social

social exclusion people

types of work social

social identity

health services

employment of people

status social contacts