12 hours ago
Mental health: The productivity puzzle
Photo courtesy of Elysium Healthcare
In the context of economic turbulence and rising workforce inactivity, the scale of unmet mental health need risks undermining the government's ambitions for productivity and growth. Despite growing political awareness, solutions remain piecemeal and often fail to match the urgency and scale of the problem.
With the imminent publication of the NHS 10-Year Health Plan, and the Government's pledge to 'Get Britain Working' a central pillar of policymaking, there is an opportunity to rethink the foundations of our mental health system to the benefit of those struggling with mental health difficulties and our economic future.
Mental ill health often sidelines people from work, but too often the focus is on tightening access to welfare rather than tackling the underlying drivers of poor mental health. The current approach misses the point: if we want to get people back into work, we must give them a system that helps them get well.
Recent data paints a stark picture of economic inactivity due to long-term sickness, with a record 4 million people not participating in the labour market due to a work-limiting health condition. Mental health is one of the leading causes among working-age adults, with 15 per cent of households reportedly taking time off work due to mental ill-health.
Among younger people, the statistics are even more troubling, as depression, anxiety, and more severe mental health conditions prevent entry into employment altogether. Mental ill health is now the most common cause of work-limiting conditions among those aged 44 and younger, and nearly 1 in 4 people out of work due to ill health are under 35. The proportion of young people out of work in the UK because of mental health problems has nearly doubled between 2012 and 2022.
The result is a growing cohort of people unable to participate in or contribute to the economy, not through lack of will, but because of the system failing to meet their needs. This is not just a health challenge; it is an economic one. Any serious strategy for restoring national productivity must reckon with mental health as a central pillar, not a peripheral concern.
What makes this crisis more urgent is the deeply uneven access to care across the country. Elysium has analysed available national and regional data resources to examine the stark variation in mental health service access, revealing pockets of particularly high need where local systems are struggling to respond. In some areas, patients face long waits, a lack of appropriate provision, and are routinely placed far from home.
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Indeed, hospital admissions for mental health conditions for children range substantially by region, between 70.04 (per 100,000) in the East of England, to 124.9 in the South West. Regional differences in inappropriate out of area placements (OAP) are also stark, with patients experiencing more than double the number of inappropriate OAP bed days in London by comparison with the South West. The number of people in contact with NHS-funded secondary mental health, learning disabilities and autism services ranges from 5,590 (per 100,000) in the South West, to 7,074 (per 100,000) in North East and Yorkshire.
Data reveals marked regional disparities in suicide rates, ranging from 7.3 (per 100,000) in London, to 14.7 (per 100,000) in the North West. People living in more deprived areas face a disproportionately higher risk: between 2017 and 2019, the suicide rate in the most deprived 10 per cent of areas in England was 14.1 per 100,000, nearly double the rate of 7.4 per 100,000 seen in the least deprived areas.
The link between socio-economic deprivation and poor mental health is well established: people living in the most deprived areas are twice as likely to experience mental health conditions, with earlier onset, greater severity, and less access to early intervention.
These disparities are no coincidence. They are the result of years of underinvestment, fragmented commissioning, and a lack of planning for high-acuity support. With patchy infrastructure and stretched local systems, people will continue to fall through the gaps.
There is a growing consensus that mental health reform is needed. But too often, policymakers reach for singular, simplistic fixes rather than recognising the need for wholesale, pathway-wide reform. Prevention and early support are vital, but on their own, they are not enough.
The Darzi Review was clear: demand for inpatient and acute care is rising sharply, yet the estate is crumbling and out of step with modern therapeutic needs. At the same time, long waits for community mental health services leave many without timely support. There is a shared ambition across the system to shift care closer to home and upstream, but this can only succeed if investment spans the entire pathway, from early intervention through to crisis response, inpatient care, and step-down support.
To meet the complexity of today's mental health needs, local systems must be empowered with the tools, resources, and partnerships to respond flexibly across the continuum of care. Independent sector providers can play an important role here. Working in genuine partnership with the NHS and local communities, they offer insights, agility, and capacity to co-design services that address local gaps, whether through crisis beds, specialised inpatient provision, or integrated step-down units. When done well, this collaborative approach ensures support is in place where it's needed most.
The Government must treat mental health as a fundamental component of its wider health and economic ambitions, not a secondary concern. Embedding it throughout the 10-Year Health Plan is essential to ensuring the system is equipped to meet levels of need, from early support to specialist care.
We won't build a more productive nation by restricting support or narrowing access to care. True recovery, for individuals and the economy, depends on early, sustained intervention across the full mental health pathway. That means reducing pressure on services, supporting people to get well, and ultimately helping them return to work and rebuild their lives.
We urge government to be bold. Reform must be rooted in evidence, backed by proper investment, and inclusive of the full spectrum of care. Elysium stands ready to work with national and local partners to deliver that vision, supporting a mental health system that is fit for purpose and capable of meeting the full range of needs across the country.
If you would like to discuss how we can work together to meet these challenges, please feel free to get in touch:
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