People with mental health problems often get chewed up and spat out of work. The NHS can lead the way in breaking a vicious circle that has a high price for both employee and employer, says Steve Shrubb

Work is one of the key building blocks to our modern life. Obviously there is the remuneration aspect and all that entails but there is also the fact that work allows us opportunities for socialisation and helps structure our lives.

There is strong evidence to show that work is beneficial to mental health. In 2005 the NHS Confederation gathered some statistics on mental illness and employment that still make for sobering reading.

Here are just two: more people with mental health problems claim incapacity benefit than the total number of people on jobseeker's allowance, and once someone has been on incapacity benefit for two years they are more likely to die or retire than they are to ever work again.

It is clear to me that as service providers we need to support those suffering from anxiety and depression as early as possible. This is so that, if things get worse, sufferers do not end up in a downward spiral where they have to leave their jobs and may well end up requiring much more complex - not to mention costly - services down the line.

Pilot schemes in Doncaster and Tower Hamlets to improve access to talking therapies are a step in the right direction. Talking therapies are useful in many ways. They allow service users to manage their anxiety or depression - including some of the more unpleasant features of their condition such as panic attacks - and they provide structured advice on how to cope with their problem in everyday life. Often this will focus on life at work.

Not only this, but there is clearly demand for such therapies. Over 1,000 people used the new services in Doncaster in just the first three months of the pilot opening. These and similar schemes are so popular precisely because they allow people to take control of their mental health issues so they can maintain their jobs and quality of life.

Moral case

Unsurprisingly, it is hard to put a price on what mental illness costs the UK economy. The CBI has estimated that output lost from time off due to depression, anxiety and stress is around£4bn a year. However, the argument should not, and I would argue cannot, be based on money saved for the taxpayer. One in four people in the UK will develop a mental illness within their lifetime and by an overwhelming proportion this will take the form of anxiety, depression or similar.

There is a clear moral case to make sure that we do what we can to stop these people - many of whom will be our family and loved ones - getting into the state where they may enter a period of unemployment that will not only be almost impossible to get out of after a time but will also worsen their condition.

As one of the largest employers in the world, the NHS has a vital role to play here and the opportunity to help drive through this kind of approach is one of the reasons why I was especially keen to lead the NHS Confederation's Mental Health Network when it was set up in May. I am pleased to see that, in conjunction with World Mental Health Day on 10 October, this week sees the release of NHS Employers' Healthy Workplaces Handbook, with its new chapter on mental health and employment.

It contains a wide range of useful information for human resource departments about mental illness. Most heartening though, the book is very clear that NHS organisations should set an example in communities of employing people with mental health problems.

Some trusts already do great work in helping service users in employment. Furthermore, their work does not just concentrate on talking therapies that are aimed at nipping problems before they get more serious. All service users are involved. South West London and St George's Mental Health trust and the excellent work of their director of quality assurance Rachel Perkins is perhaps the best known.

Job placements

There are many others. South east London's Oxleas foundation trust has a membership organisation run by service users called Horizon House. The scheme is backed up by positive results from similar projects in the US. Its specific aim is to get people into employment, not simply with the trust itself but with any local employer. Six-month paid job placements are set up and the centre offers career support and advice for service users to focus on what they want to do and what training they might need.

Service users can also help trusts improve the care on offer. Norfolk and Waveney Mental Health Partnership trust employs service users as liaison officers between patients, family and clinical staff.

As a result, clinical staff have much better lines of communication with service users and their families. In a similar way, South London and the Maudsley foundation trust and mental health charity Mind do some truly inspiring work running an employment information and advice service, led by a service user called Shaun Williams.

One of the most interesting things to come out of it is how service users who are in work are seen as positive role models among their peers, which in turn further encourages them as they seek work.

All of these organisations give life to what my colleagues at NHS Employers are trying to do and they should be warmly congratulated. There is, however, an overall context to all this good work that is equally important. Anyone with a mental health problem continues to face massive problems with stigma and discrimination. You are far more likely to be fired from a job if you have a mental illness - and that is assuming you can actually find a job, as you are also less likely to be hired. Attitudes in the public at large remain unhelpful.

Perhaps more worrying is a recent survey on the website, which found that 64 per cent of GPs are unaware of the beneficial effects of work.

Negative perceptions

Coupled with this is a diet of media coverage of mental illness that continues to focus on the terrible occasions when people who are seriously mentally ill commit acts of violence against others.

We must continue to try to get to the bottom of such horrible events. What we must also do is combat the negative perceptions that such stories inevitably generate about mental health service users.

Recently the government announced an anti-stigma mental health campaign called Moving People, to be run by Sue Baker who led a similar successful campaign in New Zealand. I am very hopeful that the campaign will also be successful here and am keen to work with charities such as Mind and Rethink, which are leading the programme to, where necessary, draw some of this work into the NHS itself.

As leaders in the provision of mental healthcare we cannot see challenging stigma as something that would be nice to do once we have worked our way through all the other things that occupy our time such as implementing the new Mental Health Act, dealing with payment by results and contract negotiations.

I passionately believe that it is an essential part of what we offer service users and ultimately gives greater meaning to all our work. Government and mental health service users can have few better places to start than in developing effective ways of helping people into work.

For more on the Healthy Workplaces Handbook, click here

To read Aidan Warner's response to this article, click here