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	TX: 26.05.09 - Call You and Yours - Mental Health and Employment PRESENTER: JULIAN WORRICKER
	Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WORRICKER Hello, good afternoon. In today's programme employment and mental health. One in four people in Britain will experience some kind of mental health problem in their lives with anxiety and depression the most common disorders. Yet the work and pensions secretary - James Purnell - said last week there's a shameful employment rate in this area, it's as low as 10% compared with 73% for the general population. Well such stark employment figures, at a time when there are fewer jobs for us all, perhaps explain the dilemma people with mental health problems face whether in work or seeking work. Do they tell employers about their condition? Next month in what's thought to be the first case of its kind a court is due to rule on the case of Christine Laird, the former managing director of Cheltenham Borough Council. She's being sued by the authority which claims she withheld her history of depression when applying for the job. Mental health charities are concerned that if the council wins damages it will make the situation all the more difficult for potential employees. So today we'd like to hear your experiences, whether you're in work or looking for work. Have you told an employer about your mental health condition and if so what was the reaction? Or maybe you felt you had to lie because you feared losing your job if you were truthful. Are you comfortable filling in questionnaires about your health when applying for a job, can you be honest? Or perhaps you run a business and want to know about employees' conditions so you can help them or maybe you feel the present climate means you'd struggle to make the adjustments that might be needed to employ someone with a mental health condition. 03700 100 444 is the number to ring with both your views and your experiences. Calls will cost you the same as those to 01 or 02 numbers. You can e-mail via the website: bbc.co.uk/radio4/youandyours or you can text the word YOU and your message to 63399 and that will cost you around 15 pence. Well Melanie Abbott is in our phone-in room. Mel, give us some idea of the kind of comments we've received so far. ABBOTT Yes it's fairly busy here Julian and we're getting quite a few different comments. Caroline Anderson e-mailed in to say that she received extreme discrimination at work because of her mental illness, despite the fact that she had been able to achieve great things and bring up her family. And she believes that employers have to be educated and that if they spot things going awry with an employee they should immediately step in to offer help and support. And she points out mental illness has no discrimination, it can and does affect anyone. Now there's a feeling that not everyone does want to continue as if nothing has happened though if they are affected by mental illness. James, a university student in his third year, says that throughout his time he has been crippled by the spectre of depression and it has seriously, perhaps critically, affected his university career. But he says because he's young and not physically disabled he feels there is pressure just to carry on regardless and he says whether or not there is enough as a depressed person he feels there is not enough social acceptance of depression. Karen Kimberley is a hypnotherapist who says a lot of people suffering from anxiety and depression sometimes are not even aware of it themselves and never mind the employer being aware of it. She says that this is something to bear in mind. Now Wendy Sharp e-mailed in and she said that she is a manager who was faced with a member of staff experiencing severe depression, she wanted to be able to fully support that person who she said is extremely valuable to her team. She signed up with Mindful Employer, which is an organisation led by employers to try to increase the awareness of mental health at work and provide support for businesses. And she says that she felt that this was good to allay the fears of all her staff members and to get support herself for how to deal with this situation. And she says she's also introduced duvet days, so any person feeling they're having an off day, for whatever reason, can take a day off at the last minute and this comes out from their annual leave entitlement, she says it's dramatically reduced sick days and is guilt free and a win/win for all. WORRICKER Mel, thank you very much for the moment and we are going to talk more about Mindful Employer a little bit later on. Other points of view of course you'll hear over the next three quarters of an hour or so and yours on 03700 100 444. Let's go straight to the phones. Jane is near Basingstoke, Jane, what's your experience here? JANE I've been in IT and telecoms arena for about 17 years but I've found as a senior manager that particularly - that whatever your company mission statement or policies regarding the treatment of people is actually really is down to individual line management as to what treatment they give an individual that's suffering from mental health problems. And they can transpire in many different ways, whether you call it family problems or marital problems, I think that regardless of what the policy statement is when the crunch comes and performance is in the limelight then all of those good words go right out of the window. And if you're lucky enough, as I was, you have a very emotionally adept line manager who can actually help you but most of the time you don't. WORRICKER So you suffered was it depression in the workplace? JANE I suffered depression several times in several different workplaces but the last bout was after the death of my father, which hit me particularly hard, and I was very lucky to have a very caring immediate line manager, who was actually a man, interestingly enough, who gave me as much time and space as I actually needed, which meant me taking a month's compassionate leave. To be able to come back and actually get back into the job in a very high pressured situation but I came back five days after the death of my father and just fell apart in front of him and it almost took that before anybody actually took any notice of how badly I was suffering, everybody was pussy footing around me, I had a very large team, it was a very busy environment and people avoided the subject like the plague. WORRICKER And that adds pressure, doesn't it, I mean as you say you were in charge of a large number of people, therefore you felt responsible for appearing to be in control of yourself at a time when it was very difficult to be that. JANE Absolutely. And as a woman unfortunately the worse thing you can do is burst into tears, people run a mile - men in particular - if you burst into tears, you know it really is the worst thing that you can do. But since then it also - once I returned to work - it made me much, much, much more mindful of the mental health of my own employees. WORRICKER And are you still in the same company now or have you moved on? JANE No I'm not, I left over a year ago and really because I don't want to get back into that very uncaring corporate sector I've started my own business and I deal with my own mental health by doing exactly what I like when I like and that makes a really big difference. WORRICKER And what about employing people now who have a mental health history? JANE I'm much more mindful of how that needs to be handled and because I've suffered myself I can understand the warning signs of when people are not coping with it or they're ignoring it or whatever and just asking them how they're feeling and how they're doing and being - and having the ability now, I have my own business, to be flexible is a huge benefit. And the better they are at home the better they are in the rest of their life, the better they are when they work for you and that's absolutely the truth. WORRICKER Jane, thank you very much for that. Some correspondence via e-mail coming in. This is from Chris who says I filled in my application form for my current job honestly, including six months off for depression in a previous job, my employer gave me a medical, everyone has one, and offered help and counselling if I needed it and I got the job. Ruth writes: My daughter refuses to seek help for an overeating disorder and she doesn't want to have to reveal this to a future employer. As health is confidential, how can it be right to tell a future employer - you don't have to mention a former broken leg yet it may cause days off in future pain because of arthritis. Matt Watkinson's in Scarborough, Matt, good afternoon, tell us your story here. WATKINSON Well I became ill - I worked in a very busy pressured environment for almost 20 years and eventually I suppose disputes in the workplace led to my becoming ill and not performing particularly well. I - eventually I was put on a programme to improve and that involved being summoned backwards and forwards to base and interrogated on a regular basis by a boss who didn't understand and who said that you should pull yourself together and I mean those for someone who, as I later discovered, had a mental illness are an absolute anathema, you just don't tell people who are mentally ill to pull themselves together because that's the one thing that they really would like to do and are unable to do. WORRICKER And when you pointed that out did it make any difference? WATKINSON Didn't make any difference at all, no, eventually I had to have six months off with work related stress and depression. When I went back to work and I dragged myself back to work because I did after all enjoy my work, I was just put back on that same programme again and of course my performance deteriorated and I was eventually relieved of my post which ... WORRICKER Part of today's discussion - and we'll get into this in a bit more detail - will involve this idea that for those who've had a history of mental health conditions they should be obliged to be truthful about them when filling out a questionnaire when looking to apply for a new job. Where do you stand on that? WATKINSON I think that's a very difficult one because your health, as has just been pointed out, is your own concern but of course if it does affect people at work then it becomes their concern as well. But at the same time people who have mental illnesses are very reticent about revealing details, it is a very private thing and there is quite a secretive nature to it. And I work for a mental health charity now offering support to people who have mental ill health and I know through my own family - my daughter is also a sufferer in a different way - and she finds it very difficult to make that initial step to talk to somebody. Now imagine if you had to write that down on a form and have somebody pick that up and use that word which you dread to hear - oh no there's another one, there's a nutter here - you know. WORRICKER Matt, I appreciate the call, thank you very much for coming on the line. This from somebody who'd like to remain anonymous: I'm a mental health nurse, recently went off sick from work for two months as a result of stress and depression. When talking to my GP about it he was reluctant to provide me with a sick note that only mentioned a temporary mental health problem and mentioned it only briefly in the supporting letter to my employer - a mental health NHS trust - instead attributing most of my time off to a viral infection caught as a result of a suppressed immune system from the stress. He felt that as a young employee it could be a hindrance to my personnel record to have a long period off sick with a mental health issue. I was stunned, if the health services don't wish staff to document they've been off sick as a result of mental health problems how on earth are regular employers supposed to fully grapple the problem? Monica Jansen's in Rye. Monica, good afternoon. JANSEN Hello. WORRICKER What's your story here? JANSEN Well I was working as a PA to a very high profile captain of industry who's in the news quite a bit at the moment, so I'm not going to mention any names but I was working there quite happily for three years and then I had a mental breakdown for personal reasons and in fact my doctor recommended that I went to the Priory, which I did. And I tried to do it on a daytime basis because I was so terrified of the reaction that I would get from my employer. And of course I couldn't do that, I was just broken down the whole time. So eventually I told them and I was away from work quite a long time and when I actually came back first of all they said to me, out of the blue, that my work wasn't up to scratch and then they tried to make me redundant, so it was a very painful experience. WORRICKER And when they said your work was not up to scratch you believe that was an excuse? JANSEN Yes and I happened to see anyway private e-mails from one of my colleagues that showed that they were just - there concerted effort was to get me out, no matter what cost, because they just didn't want someone like that around. WORRICKER And do you think it jeopardises your employment future now as well? JANSEN Well I was so upset about it, it had such an impact on me that I wrote a book last year and I've gone down the writing route really but I would be quite terrified of seeking references, I'm almost certain that there would be a bad reference or they would say that I was unreliable. WORRICKER Monica, thank you for calling. I mentioned this health questionnaire issue - if someone lies in a job application in relation to their health status and this is later discovered they could lose their job, it's called a breach of mutual trust. But research by the Chartered Institute of Personnel and Development found that one in 10 employers has withdrawn a job offer because the applicant had lied or misrepresented their health situation on a health screening questionnaire. Seven percent of employers have dismissed an employee while in employment for the same reason. Withdrawn job offers or dismissal on these grounds is twice as common in large organisations. Ben Willmott is a senior public policy advisor at the Chartered Institute of Personnel and Development. WILLMOTT The most recent evidence we have is from our 2006 absence management survey and that showed that about 70% of employers use some form of pre-employment screening, i.e. using some form of medical health questionnaire. WORRICKER Asking what sort of questions specifically in the area of mental health? WILLMOTT I think the questionnaires vary but will obviously a number of questions around whether you had a previous mental health problem. Some of them might give some sort of tick box options in terms of depression, anxiety, stress related conditions. WORRICKER And at what point during the recruitment process are those questionnaires put in front of people? WILLMOTT Well that's something that we're not completely certain about but it is a critical area. I mean I think from our perspective employers should ask for information once they've issued a provisional job offer. So the point at which the job offer is still subject to things like references. The danger is that if you - you're asking applicants to fill in a health questionnaire then there is an increased chance that discrimination may happen, that you're actually screening anyone out that has had a history of mental health problems, I mean I'm sure that the vast majority of employers don't do that but I think the temptation could be there that if you have that information up front you might make decisions about who comes to interview. From a business perspective it's also counterproductive because we know that one in four of us will suffer from some form of mental health problem. If you're going to exclude one in four people from the recruitment process then you're missing out on a lot of talent. WORRICKER The trouble is if you know there is discrimination out there and you're that potential employee and you've got to the point where a provisional offer is on the table and a form arrives, frankly you're going to be tempted to not be entirely 100% truthful aren't you? WILLMOTT At that point employees need to be sort of pragmatic and honest. They need to understand that they have to put factual information in the hands of their employer. If something subsequently happens where they then have to hold their hand up and say that they have not provided the information that they've been asked for then potentially that is a breach of the employment contract. WORRICKER But the trouble is, as you know, there is suspicion out there and fear of discrimination out there, I mean there's a rethink - a survey by Rethink of more than 3,000 people where they said over half felt they had to lie. Now they may not be right but you can see why they feel that way can't you. WILLMOTT I can and certainly the research we've done with our members shows that one in five employers said that they would not recruit someone - someone who had been a long term benefit claimant, who had a history of mental health problems. It is certainly an issue. The evidence we have is that where employers have recruited someone with a history of mental health problems their experience has actually been a positive one. So where employers have recruited in a fair way, which is based on getting the right person for the job, they have been more than happy with that individual's performance. WORRICKER In conclusion then do you think there is normally a case for employers to ask these sort of mental health related questions at the right point? WILLMOTT That's the key thing. I think it's in the employers interests and it's in prospective employees' interests to ask questions because in some cases employers will pick up on issues which means that individuals are not suited for particular jobs. Getting that information at the point that a provisional job offer is on the table is the right point and not at the point that you start the recruitment process. WORRICKER Ben Willmott of the Chartered Institute of Personnel and Development. Well Melanie Abbott has been finding out what some of these questionnaires about mental health actually include, she's in our phone-in room. So Mel, what kind of questions are people being asked and at what stage of the recruitment process? ABBOTT It varies quite a lot actually between the questions asked and the stage at which they are asked. Now Virgin Trains on their application form, for instance, they ask quite a lot of questions, now this is at the very stage of selection. Three of those questions focus on your attendance record. The first asks: During the last 12 months of employment the total number of days late for work. The form then asks for the total number of days sick and time off in the last 12 months and the reason for any periods of sickness with time off work. It also asks: Do you have a disability or condition which you would like Virgin Trains to know about and if so is there any assistance you would like Virgin Trains to provide for you. BT told us they don't do any pre-employment checks, considering that this raises moral issues and is valueless anyway. They do send a questionnaire with a job offer and tell us the only question they ask is: Do you have any health problems or disabilities that would affect your job, please let us know and we can try and help you? The BBC asks on its form - and this is a form sent out with a job offer: Do you have any illness or disability that may affect your performance or require adjustments or assistance at work? And also asks if you've had any illness or disabilities caused or made worse by work. Now one health consultancy - Medigold - this carries out pre-employment screening for around 300 companies including some of those in the FTSE 100 - has a 26 page questionnaire which includes: Do you have a disability as defined by the Disability Discrimination Act? And does explain how the act defines a disability. It also asks: Have you had any absence from work due to ill health in the last three years? And: What is your longest period of absence in the last three years? It asks questions about any major illnesses or surgery, any conditions that your relatives have had. Questions about your hearing and sight. Questions about if you smoke and how much alcohol you drink. And a couple of interesting questions at the end of this form, Julian: Are you usually engaged in more projects than you can realistically complete? I think a few of us here might say yes to that. And do you feel that your achievements at home/work are often unappreciated? Now Medigold, along with other companies that we have spoken to, point out that these questions are to assist the employer with making any adjustments needed to help the worker and are not in any way used as a screening process. WORRICKER Mmm interesting variety of questionnaire and questions there from Mel. What are the economic benefits and business arguments for employing and retaining staff with mental health problems? As we've been hearing a moment ago from Ben Willmott, for those who do employ people with mental health issues they are often very satisfied with the productivity and commitment of their staff. We heard mention at the start of the programme of the Mindful Employer Scheme, it's run by Devon Partnership NHS Trust, although it's open to businesses of all sizes nationwide. Organisations can sign up to its charter to show that it supports and actively promots employment and training of people with mental health problems. It put us in touch with Andy Kent, who runs Andy's Cars in Cambridge. Hello Andy. KENT Good afternoon. WORRICKER Tell us a bit about Andy's Cars - how many you employ and how many of those are people with mental health problems? KENT Andy's Cars is a small family run business, just outside of Cambridge and we employ 10 people but on a daily basis we have additional, what we call, day release clients, staff, name them as you wish, but there are people - of our 10 employed people eight of them have some kind of physical or mental disability - we call it a disadvantage, it's not so much a disability because what is ability? Ability is what you, as a person, can put forward. Of the - of those eight people six of them have what would be classed as either a current or a previous mental illness. WORRICKER And what's your own story and what prompted you to set the company up along those lines in the first place? KENT I - unfortunately in 1984 I had a cerebral haemorrhage which is basically a - quite a large bleed in the brain which caused its own brain injury, mental illness associated with brain injury and as brain injured people will recognise and will understand it has an effect on your mental ability to be able to cope with certain things at certain times, it doesn't necessarily mean that you have a lot of time off work but it does mean that coping with certain situations can cause problems. WORRICKER And presumably it meant that if you were upfront about that and explained it along the lines you just have to a potential employer there were sometimes problems? KENT The challenge was, first of all, getting a job and for many years I was denied work whenever they found out that I had a challenge of any kind. I've been very open about my challenges from day one, even to the extent that I tried to prove that there was nothing physically wrong with me with regards to being able to do the job that I had trained to do and that was as a motor mechanic. I went out and walked from Lands End to John O'Groats to prove that. But even so in doing that you still have the mental challenges of understanding, first of all, why it happened to you and everybody questions that, nobody's different from that point of view. But when somebody else questions it of you then it can become a challenge. WORRICKER And Andy just an observation from you as well, we were listening to Ben Willmott a bit earlier on who talked about the fact that those who do employ people with mental health issues are often very satisfied with the experience, what's your experience specifically of doing that now? KENT As an employer I feel that it's very important that we employ people that are capable of doing the job regardless of how they have been challenged in the past or may be challenged in the future, it's about how that person can cope with the job. And most of the people that we've employed and do employ at this minute have had a challenge of some description and we've benefited from employing people that have had a challenge because a. they want to be at home, they don't want to be sat at home; they get a better quality of life through being at work and being with other people and the sickness rate is far less, yes we can plan time off for them to go for their doctor's appointments and their hospital appointments but they don't come in and have a day off for the sniffle, for the Monday morning syndrome. WORRICKER Andy, I appreciate you very much coming on the programme, thank you very much indeed. Andy Kent of Andy's Cars. Let me go to the phones again with Sean in Wiltshire who's contacted us. Sean, you've had depression I think for 15 years, according to my screen here. SEAN Yes that's correct, since 1994 I was first officially diagnosed with that problem. WORRICKER And how has that affected you at work? SEAN In some senses I never took time off because of it, maybe there were times when I should have done but I think it has - I'm pretty sure I lost one job because of it when I did need to take time off, of course it was dressed up for other reasons - unacceptable time off and so forth. But my advice - and this sounds terribly cynical and completely against my own nature, my own instincts - is if you're applying for a job and there's a medical questionnaire and it asks about mental health problems just tick the box that says no. WORRICKER So tell a lie to put it bluntly? SEAN Yes, yes tell a lie, yes. WORRICKER Even though you know deep down you shouldn't and there might be legal implications of so doing? SEAN Absolutely yes because - well employers/companies lie to people all the time, so you're doing no worse than they are. At the end of the day you've got to look after your own interests. Unfortunately the world isn't run by well meaning truthful caring people. WORRICKER No, I think we'd probably all agree on that. Sean, I appreciate the call, thank you very much. This via text message from somebody who's been in touch. I have bi-polar disorder, have worked for the civil service for 17 years, I experience hostility from colleagues who resented my "special" treatment at work. It's just after half past twelve, you're listening to Call You and Yours on BBC Radio 4 with me, Julian Worricker. And still to come we'll hear from the government and from a representative of small businesses on today's phone-in subject whether people who have suffered mental health illness can expect a fair deal when applying for jobs - 03700 100 444 is the number to call, whether you're a potential employer or employee. With me in the studio is Jonathan Naess, who's the director of the charity Stand to Reason, which campaigns against discrimination of people with mental health problems. Jonathan, thank you very much for coming in. Can we talk about exactly what we are talking about here, first of all, mental health conditions, what are they? NAESS Well it has to be an impairment that's lasted for 12 months or is likely to last for a longer period. So it will pick up fluctuating conditions. In my own case I've got bi-polar disorder and I've never been ill for 12 months but it's an ongoing condition so I would be regarded as a disabled person for the purposes of the DDA. I think a lot of people with mental health problems don't always think about themself [sic] as being a disabled person because there isn't that sort of shared consciousness with - on a pan disability basis and so it may well be that we're getting as many claims through under the DDA as we should do for that reason. WORRICKER Just explain DDA for those listening. NAESS Sorry the Disability Discrimination Act being the relevant legislation that gives protection to people with disabilities in the workplace. WORRICKER So what is the law as it stands at the moment with regard to people needing to be upfront about their past condition? NAESS Well the position is all employment relations are based on trust and confidence. So if - as you pointed out in response to one of the earlier callers - if you're starting off your relationship from a point of dishonesty that's not the ideal place to be starting off from. But we do recognise that unless - and the courts recognise - that unless the reason why your health problem had actually caused - was the reason for not to continue in that employment it's quite difficult to sack somebody on the basis of that per se. If there are other reasons why your relationship had broken down, from the trust and confidence point, then you're setting off from a weak point. And if the employer doesn't have notice of your condition then you don't get the protections offered to you under the Disability Discrimination Act, it would be very hard to prove that there was direct discrimination against you if the employer didn't know. WORRICKER Where do you stand on these questionnaires because we're told that about 70% of employers are now using them, can you see a case for them or not? NAESS Well I can see a case for them but we're very strongly against them. In America they're against the law altogether and it's one of the things that mental health charities like Rethink and ourselves and also the AIDS organisations, like Terrence Higgins Trust, are campaigning against them and hope to get rid of them in the Equalities Bill that's going through Parliament at the moment because of all the stigma and discrimination that relate to these intangible conditions. And what we're hoping will be the case is that if there's disclosure it happens after the interview, after somebody's already got a place, so any health related issues, which is the reason for having - I mean I think the quote was that these weren't - these were to allow - the screening was to allow you to make suitable accommodations for the person according to their health condition and there is a reason for that but if that's going to be a reason for direct discrimination then it's very hard to pick up on direct discrimination because somebody can always tell round to you and say well actually there were other reasons, we can always find a reason for not hiring somebody. And so very few cases brought under the Disability Discrimination Act are brought for - from an interview rather than actually being at work. WORRICKER We are going to hear the employers' point of view on this in a moment but just to give a perspective that they might have on this. Are they not entitled, especially if they're running a relatively small business where they are reliant on two or three individuals to deliver the success of that business, to know something potentially quite important about the health of one of their employees before they take them on because we can't pretend that in every case a mental health condition will not stop somebody working effectively can we? NAESS No, well that's why it was so nice to hear from Andy's Cars where you have an employer who is actually positively recruiting people with mental - he's being very positive about mental - about the talent pool amongst people with mental health conditions. The argument for small business does rather depend on having a very negative view and the assumption that if somebody's had time off in the past because of mental ill health that they will in the future and actually it turns out that the evidence shows that the severity and duration of the period that you'd had off in the past is not a good predictor as to how much time you'll have off in the future. Whether you'll be a good employee depends very much on whether you want to work and whether you're likely to be a malingerer. WORRICKER Jonathan we'll talk more to you and hear more of your thoughts as the callers come through as well in the next 20 minutes or so. But let's talk about the government's viewpoint here. The Work and Pensions Secretary, James Purnell, attacked what he called the shameful employment rate for those with mental health conditions last week - 10% compared with 73% for the general population. At a time when there are fewer jobs and fears that unemployment and debt will swell the numbers of people seeking help with anxiety and depression the government says it wants to help people find jobs and stay in them. It's looking at schemes where people with mental health conditions could be placed in jobs, so they don't have to go through the stress of interviews and a review into other possible measures has been set up led by Rachel Perkins from the Mental Health Trust. Well we did ask the Work and Pensions Secretary on to the programme, he is on holiday this week but Lord MacKenzie is the acting minister for Work and Pensions and I asked him whether he thought it was shameful that the government had presided over a figure where only 10% of people with a mental health condition are employed. MACKENZIE James was right to point out that we have much more progress to make. I think it's also right to point out that we have come a long way in recent years. We have reformed incapacity benefit on to the Employment and Support Allowance which is focused on what people can do rather than what they cannot. Our approach to welfare reform has been predicated on work being good for people, including people with mental health conditions. But as James pointed out the current system is not serving everyone as well and fully as it should. WORRICKER But it's a shameful situation, to use his words, which lies surely partly at the government's door? MACKENZIE It's clear that we have not done enough, which is why James is focused on this and intent on moving forward to the next stage of welfare reform. You know the system is different to that which is used to be and that which we inherited in the past. People with health conditions - mental health conditions - were simply parked on incapacity benefit with no or zero support and frankly left there with no prospect of entering the labour market. WORRICKER Let's look then at some of the things he outlined by way of possible measures here. He talked, for example, about a placement and support approach which to some extent would bypass the need for an interview at least. MACKENZIE Well this is one of the proposals that we hope Rachel Perkins review will focus on. My understanding is that this almost turns on its head the traditional approach to helping people back to work which is we get them ready, we train them, give them work experience and then we seek to get them placed into employment. This proposition is to do it the other way round, that we get people into work and then support them actively on an individualised basis. WORRICKER Because there are cost implications here as well aren't there - when you look at some of the other things that have been outlined - subsidy to the employer is one option; funding for a personal advisor is another - there is a budget to back this up is there? MACKENZIE There is very significant budgets that the DWP has and of course what we need to do is to look at these things in the round, that supporting people now, helping them into employment and helping them remain in employment of course in due course we'll reduce benefit expenditure, we'll make sure that we have tax revenues that go with that. It's most importantly about making sure that everybody has the opportunity to progress, it's making sure that people can access work, we know it's good for people's health, we know it's good for their self esteem but we do need to turn our back on the past where benefits were just somewhere where people were parked and we just wrote them off. What we do need to do is to make sure that the stigma which is attached all too often to mental health is removed. And we know one of the challenges that employers, as well as our benefit advisors, face is concern, risk adverse around issues of mental health and we need to fundamentally challenge that. We do and that's why we do have a framework in place and developing to support employers as well who have a key role to play in this. WORRICKER What help is there for those who might want to take on those with a mental health condition or at least be open-minded on the subject but at the moment feel there are barriers to doing it? MACKENZIE It's a very important issue. There are a number of components of our policy there. There is the improving access to psychological therapies, Department of Health is rolling out across the country and we're working with devolved administrations and as part of that there is employment support coordinators being put in place. More specifically for small and micro businesses we're going to launch a telephone based occupational health service which is focused in particular on mental health issues and that will offer advice, indeed signpost people to the fit for work service which is being developed as well as the improving access to psychological therapies programme. So there's a lot of support in place. WORRICKER Lord MacKenzie. Well listening to that is Stephen Alambritis, who speaks for the Federation of Small Businesses. Have you heard anything in the last three or four minutes from the minister, Stephen Alambritis, which makes you think they would make a significant difference to employers and their attitude to those with mental health issues? ALAMBRITIS Yes I have and there are a number of proposals and polices and support systems that the minister addressed there. The confusion for employers is where to go to access that bit of help and what I would urge the minister to do and James Purnell to do is to ensure that everything is worked through Business Link, this is an institution in every major town that is there to help and support small and large companies, but in particular small employers. What we want is a one-stop-shop. So yes there's stuff there but the confusion will be where to go for it by smaller employers. WORRICKER And is this more of an issue for smaller employers do you think? ALAMBRITIS Yes certainly the large company would, we hope, have a personnel department, a legal department that would liaise and make sure they got all their polices right on making sure that their employment was without discrimination. For a small employer, typically employing less than 10 people, it's that very owner that needs to look into these issues and be wary of employing in their own image and to make sure that they are taking advantage of the 10 million disabled people who want to work, the £80 billion of purchasing power they have and a business that employs on the basis of the best person for the job but one that is inclusive would have a reputational aspect to them that would bring them into the community. But there are reality checks to be applied with regard to mental health and that is that it's not something you can see or touch or feel or smell and that is why we need more education, more information especially for both sides, both for those who want work but have gaps in their CVs and don't come up front, as was told, the whole employment relationship is steeped in trust and confidence from the minute - go - from the first minute. And on the employers to make sure they're not discriminating. WORRICKER Okay, Stephen Alambritis thank you very much for coming on the programme. Let's go back to the phones. John's in Essex. John, good afternoon, what's your story here? JOHN Well I reiterate what one of your earlier correspondence said about the problem she had with her GP. I mean what happened with me I was having bouts of depression which I think really stemmed back to the fact that over a very short period I was made redundant, my son died and I sort had a divorce. But his attitude was that if I sort of sign you off to recover from this then your employer might get rid of you, so I'd rather - rather not do it. And - but then what was happening - I was breaking down at work and crying all over the place, one thing and another, and my boss arranged for me to see the local authorities medical officer of health and he said, yes, he actually recommended a therapist and I made the appointments but I found that depending on what shift I was on my ultimate boss would say yeah this is fine and I'd go off in my lunch break or the tail end of the afternoon or what it was but then somebody else would be - or say oh no, you can't - we can't spare you now and then I'd have to phone up the therapist and say I'm sorry I can't make it. I mean it's stressful enough having to go through that anyway without them having to un scramble appointments and that sort of thing. So part of the organisation was very sort of sympathetic and other parts of it weren't - there didn't seem to be any coordinated policy. And the other thing was that because the MOH didn't think it was work related, it was more personal related, so I actually had to pay for the sessions myself, although admittedly at a reduced rate but there didn't seem to be any sort of cohesive thing relating to the situation really. WORRICKER John, thank you very much for the call. What you were saying about GPs ties in with this e-mail. "Just about to turn 60", writes Linda, "having bi-polar since my early 20s, never gave this information to employers and my GP always put some other problem when I had to have time off. One job I did confess and they were great and gave me the job but made no further attempts to assist me though, where I had problems." Let's get one perspective on one particular area of employment. PC Heidi Portray is on the line from the West Midlands. Good afternoon to you. PORTRAY Good afternoon. WORRICKER What's your story here? PORTRAY To be quite honest I'm quite saddened by what I've just heard about how people have been treated in the past. My own story is that I've been a police officer now for 12 years doing various roles. In 1999 I suffered a series of bereavements of close family members and developed mental health issues similar to the last caller, with stress and depression. That seemed to get worse and my behaviour more erratic, I got suicidal, I started to self harm and in the early days I was very frustrated and I felt I was misunderstood - my colleagues thought I was awkward, I was even told that I was difficult to manage. Six years ago I was diagnosed with having borderline personality disorder, which is basically an emotional regulation disorder. And to be honest that was a great relief because as soon as they told me that it was a condition and not just me that made it a whole lot better for me. I kept quiet at first, similar to other people, didn't want anyone to know because I feared that I would be out of a job or they'd move me and then I heard about an organisation called the Shaw Trust, who work in partnership with the West Midlands Police, via a colleague who was getting support from them, and I was advised and supported to disclose my disability to the organisation. WORRICKER And when you did that what was the reaction from those on high at West Midlands Police? PORTRAY It was shock I think with some of my colleagues and managers that I'd actually got a recognised mental health condition. There was an element of now what do we do but on the whole - with the support that was in place and because we have a very robust mental health policy and a disability policy, there's a process that I was taken through and that process supported me all the way to be able to actually tell people - yeah, I've got this condition and now I work in a department that supports other people with those conditions. WORRICKER Heidi, thank you for the call. Jonathan Naess, that's a sort of tale you'd like to hear more often I'm guessing? NAESS Absolutely. The previous caller made the point I think that he was suffering under pressure of concealment and it was affecting his productivity. And so if people are able to talk openly and come out, if you like, about the problem that they're suffering there is - if employers have enough training - it's very much the line mangers rather than at the very top of the organisation because you can have all the policies in the world but if it doesn't pass the walk and talk the talk test then I'm afraid there's no good having the policies. So it's great to hear that the last caller had had a good experience. And I think we have to be positive. There are - I would agree that it's a scandal that there's 90% unemployment but there are 10% of us who are employment and we've got to continue to be open about this and show that I've had an uninterrupted career in three different city professions before I started running this charity and it's important to be very positive, I think, mental health and employment and highlight the good cases as well as the bad ones. WORRICKER Interesting I mean you mention the concealment issue, clearly doctors, according to some of our correspondents - e-mailers, texters, those on the phones - doctors know about it and are effectively taking part in the concealment process. NAESS Well I think there are two things going on there. There is a physicians bias that people with mental health problems will end up having worse outcomes because they spend 80% of their time dealing with the 20% who tend to have relapses and come back and use their services and they don't keep in touch with patients who go on successfully to get on with the rest of their lives. But I think there's also a real recognition of the discrimination that there is in the workplace, you mentioned the CIPD figures, the Shaw Trust, where were mentioned earlier, have also done a survey saying that 80% of employers expected people to be truthful about whether they'd had a mental health condition but in the same survey less than 40% were prepared to hire somebody who had a mental health problem. So there's a clear do not compute there. WORRICKER Yes, doesn't quite match does it. Let's go back to the phone-in room with some more calls and comments from there. Melanie Abbott, what are people saying? ABBOTT Yes we're getting a few more uplifting e-mails now and calls as well. We've got one from Marilyn Harper who said that she had to - she's a teacher - had to take half of a school year off in 2008 as she began to experience what she later learned were panic attacks. The GP says it takes at least six months for cases like hers to return to normal but her employers and colleagues were marvellous at the time. And another e-mail from someone who wants to be anonymous. She says that she's seen both sides of the coin, if you like, she worked for a financial company and was suffering a mental breakdown and was expected to pull herself together, constantly reminded by her manager, she says, that we all have bad days, you just have to get on with it. Then went to work for a different company, was honest about her mental health history and found that the employers were understanding and supportive and the fact that she has been honest makes her feel more relaxed from the start, alleviating some of the anxiety in the first place. And Pam Harrington phoned in, she says that she has OCD but it doesn't mean that she can't do a job properly, she is a very successful garden designer. She wasn't diagnosed for 22 years but has found that going to work is very positive. WORRICKER Mel thank you. And I'm seeing some more positive callers on my screen now as well. Liz Sowden in Leicester. Liz, good afternoon. SOWDEN Hello. WORRICKER I think your university employers were very understanding, I'm reading here. SOWDEN Yeah well what's actually happened is I've had a long career in arts and cultural services and I've experienced periods of long term sick. I have to manage bi-polar mood disorder, so - but about a year ago I decided I wanted to go back into a university and get a qualification so I could do teaching and it was absolutely - I mean compared with my experience, even within the local authority, the support has been fantastic. They actually have a system where they kind of support you in what you may possibly need in order to be successful. And I was thinking your previous caller who was talking about Business Link and if Business Link could have situations - an office set up similar to how they do in the universities, which is a support service for people who are in employment, I think a lot of barriers would be eliminated and also I think that it would give people a lot more confidence to come out and say I'm having a bad day, maybe someone can liaise with their employers for them and.... I mean I've done a year's MA now, very successfully, I see someone once a week to help me manage my stress and time management and stuff like that. If I'm feeling a bit overwhelmed they help me, just give me very minimal support so I can offload ... WORRICKER Well it's good to hear a more positive story Liz and we appreciate you coming on and telling it, thank you. I want to squeeze another - well maybe one, maybe two - Carol in Nottingham, Carol yours is pretty positive as well I think. CAROL Yes it is. WORRICKER In what area particularly? CAROL I was diagnosed with depression in the year 2000 and I signed off sick immediately. On the same day my line manager rang to see if there was anything he could do, anything I needed. He alerted occupational health, who then arranged for me to see a counsellor on a weekly basis, this was free. And I just couldn't have more support. I was allowed to return to work part-time with no reduced pay and I was still able to see a counsellor for the next eight years, until I retired if I needed to. WORRICKER Good, Carol, thank you, it's nice to hear some positive stories at the end of the programme. And I think another one from Sheila in Warwick, Sheila Tompkins good afternoon. TOMPKINS Good afternoon. WORRICKER I think your experience was good too. TOMPKINS It was totally positive. I was a head teacher in Warwickshire and my employers - I'd personally disclosed immediately when I was diagnosed with clinical depression. I was offered counselling support, non intrusive visitors to ensure that I was okay. When I finally did become too ill because of my mother's dementia and various other factors in my life I was offered huge amounts of help. Nobody could have done anything better. My GP was superb, I was never treated as a liar and I have totally and always disclosed my mental health issues. WORRICKER Okay. Sheila, thank you very much for coming on the programme. Jonathan Naess, those last few stories, does that imply to you that there is significant progress being made in this area? NAESS Well I think there is reason to be optimistic, that there's almost a tipping point in society, that this has been a taboo for a long time and that with a fair wind and with government support, which is needed, actually the government is now looking at mental health both as a Department of Work and Pensions issue for sickness absence and also from a Department of Health point of view and doing a cross strategy between them which will be published in July, later this year. The government needs to pull together with employers but most of all I think it's at the ground level, that people don't back off and that the common sense that we've heard illustrated in the last couple of calls is something that we can all kind of work with to support colleagues coming back from mental illness. But the trouble is when you don't have a relationship established in work and you're in an interview situation it can be difficult because you know you're just being judged on if you like the data presented and people can make wrong assumptions there. WORRICKER Okay. Jonathan, thank you very much indeed from coming in and being part of the programme today. Jonathan Naess from the charity Stand to Reason. Thank you, as well, if you got in touch via any of our methods over the last hour. Back to the Transcripts homepage Back to the You and Yours homepage The BBC is not responsible for external websites

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