1 May 2016

Summary

Quality employment can be hugely important for mental wellbeing and is central to many people’s sense of self-worth. It can also be a vital step on the way to recovery¹ from mental health problems. As a result, Mental Health Europe(MHE)² is pleased that the Council of the European Union adopted a recommendation in January on how to combat long-term unemployment.³ Long-term unemployment remains worryingly high despite the improved economic situation in the European Union and this is especially so for persons with disabilities and mental health problems.⁴ However, since this initiative was proposed by the Commission last year, we have been calling for greater recognition of the different barriers that different persons who experience long-term unemployment face including persons with psychosocial disabilities.⁵ MHE is concerned that these differences have not been addressed by the recommendation and therefore, it may have limited success. We would also like to remind the Council and Member States, that this recommendation should only be used to facilitate integration of persons with disabilities into the labour market who identify themselves as ready to work. This is why we will make the point that health services should play a key role in employment services for persons with psychosocial disabilities. We therefore call on the EU to take effective action and adopt a strategy for combating long-term unemployment of persons with disabilities in line with the recommendations received from the UN Committee on the Rights of Persons with Disabilities (the CRPD Committee) last year.

The Strengths

We have identified the following positive aspects of the recommendation:

• the integrated and individualised approach reflected in the recommendation is particularly welcome as MHE advocates for such employment services through our work on the very successful Individual Placement and Support method.⁶ This approach focuses on the individual who is looking for paid employment and prompting health and employment services to work together with potential employers to achieve a perfect job match.

• the practicality and the clarity in the procedure outlined in the recommendation.
• the clearly defined need to register long-term unemployed persons in order to ensure that they are getting access to the right services.

• We appreciate the emphasis placed on the need to develop closer links and partnerships between employers and other stakeholders including social partners, employment services and training providers. The principle aim of any strategy should be individualised support into paid jobs, if necessary by bypassing normal recruitment procedures by enlisting employers who are willing to give long-term unemployed persons with disabilities a job to show what they can do. We are also pleased to see mention of support and encouragement to businesses in the form of incentives including subsidies and reductions in contributions.
• the acknowledgement that the purpose should be to facilitate integration into sustainable and quality employment.

The weaknesses

We have highlighted the following weaknesses in the recommendation:

• The most important critique we have is that the 18-month cut-off point, by which a long-term unemployed person must be offered a job-integration agreement, seems arbitrary and indeed far too late, and may result in unintended consequences which further isolate people and keep themout of work. As noted in the OECD study Fit Mind, Fit Job⁷ even the most successful schemes which are intended to get people on long-term sick leave back to work are limited if offered too late. If a person is out of work off for 6 months with principle work limiting conditions, for example musculo-skeletal disorders (eg. lower back pain) and depression/anxiety, their chances of ever returning to work are at about 50%. As this period increases the likelihood of them working again reduces drastically. At 1 year it decreases to 25% and at 2 years it reduces to as low as 10%. Allowing employment services to wait for 18 months could simply create unnecessary dependence on disability allowances. Integrated support towards employment should begin at the earliest possible stage.
• If persons with disabilities are to return to the labour market then for many, including those with mental health problems, good healthcare is vital and must be integrated with social and employment support.

• Return to employment should be considered a positive healthcare as well as a social integration outcome.
• The emphasis on skills in the recommendation is positive for some but for individuals who are out of the labour market due to disability, the barriers they face are very different and the recommendation offers little in terms of addressing them. The primary barriers which persons with disabilities face include:

• 1. the reluctance of employers to even consider someone with long gaps in employment

• 1. psychological issues (ie loss of confidence and routine) which accumulate the longer a person is out of work and which can only be dealt with by actually getting back to work.

The way forward

We hope that some of these weaknesses, particularly the specified 18-month cut-off point, can be corrected by identifying and promoting good practices which can help to implement the recommendation such as the Individual Placement and Support referred to above. As the name suggests, this method gives priority to helping people to get a job as soon as possible and then supporting them to acquire the skills and confidence to build a career. Skills first or “train and place” methods simply postpones facing the psychological barrier which people fear most – having the confidence to hold down a paid job with all the relationship issues that being in a real workplace presents. MHE would be happy to provide information about the IPS method and the large amount of high quality research evidence which demonstrates its efficacy to the EU as well as Member States. Going forward MHE will be promoting this as a good practice which reflects the approach taken in the recommendation.

However, MHE believes that in order to truly battle long-term unemployment for persons with disabilities a separate strategy that actually reflects the barriers they face and promotes their human rights should be adopted. This would be in line with the recommendations received by the EU from the CRPD Committee which asked the EU to take effective measures to increase the employment rate among persons with disabilities in Europe.⁸ We therefore urge the EU to adopt a specialised strategy or recommendation which would address the employment needs of persons with disabilities.

1. Recovery is self-defined, but broadly means living a meaningful and satisfying life, with hope for the future. Recovery is not the eradication of the experiences or symptoms accompanying mental distress, as it would be used in the context of physical health. For more information on recovery, please see MHE’s video on recovery here.
2. ²MHE is a European non-governmental network organisation committed to the promotion of positive mental health, the prevention of mental distress, the improvement of care, advocacy for social inclusion and the protection of human rights for (ex)users of mental health services, their families and carers. MHE’s membership includes associations and individuals active in the field of mental health in Europe, including people with (a history of) mental health problems, as well as volunteers and professionals in a variety of related disciplines. MHE’s work is funded through financial support received from the European 
3. Union Programme for Rights, Equality and Citizenship. The views expressed herein should not be taken to reflect the official opinion of the European Commission. For more information, please see our website at: https://www.mhe-sme.org/.
4. Council Recommendation on the integration of the long-term unemployed into the labour market, January 2016, available at: http://data.consilium.europa.eu/doc/document/ST-15107-2015-INIT/en/pdf.
5. ⁴European Commission- Fact Sheet: Long-term unemployment -Commission Recommendation- Frequently Asked Questions, February 2016, available at: http://europa.eu/rapid/press-release_MEMO-16-302_en.htm.
6. Psychosocial disability is internationally recognised term, used in particular by the UN CRPD, to describe the experience of people who have long-term mental impairments which, in interaction with various societal barriers, may hinder the full realisation of their rights. Please note that not all persons with mental health problems are considered or considered themselves to be disabled. We therefore use mental health problems as a broader term in this document when necessary. Language is important when it comes to mental health, please see our glossary at: https://www.mhe-sme.org/policy-work/glossary/.
7. For more information on the IPS method, please see our website to learn more about our Tried and Trusted project: https://www.mhe-sme.org/our-projects/past-projects/tried-and-trusted/.
8. Fit Mind, Fit Job: From Evidence to Practice in Mental Health and Work, OECD, available at: http://www.oecd.org/els/fit-mind-fit-job-9789264228283-en.htm.
9. Concluding Observations on the initial report of the EU,2015, CRPD/C/EU/CO/1.