Sharpe Richard Alan, Williams Andrew James, Goldstein Ruth, Taylor Tim
Public Health, Cornwall Council, Treyew Road, Truro, Cornwall, TR1 3 AY, UK.
European Centre for Environment and Human Health, Department of Public Health and Sport Sciences, University of Exeter, Penryn, Cornwall, UK.
Discov Ment Health. 2025 May 1;5(1):67. doi: 10.1007/s44192-025-00195-5.
Poor mental wellbeing costs society over £105 billion/year in England. Those with a mental health condition face significant health inequalities and lower employment rates. This feasibility study assessed the cost benefit of a public health intervention to help unemployed people with poor mental wellbeing to access employment.
Mental health employment advisors located in all 11 job centres supported people aged over 16 years. Support was provided over a 2-to-4-month period via an agreed action plan. Employment status, baseline and follow up wellbeing outcomes (using the Short Warwick-Edinburgh Mental Wellbeing scale) were obtained and used to estimate the return on investment.
Of the 540 people with baseline and follow-up wellbeing scores, a total of 57.79% had probable depression and/or anxiety when they accessed the intervention. The number of people with probable depression and/or anxiety reduced at follow up (23.82%). A total of 235 people accessed new employment after receiving the intervention. The resulting benefit/cost ratios were 8.4 and 17.6 (depending on whether a cost of illness or income equivalence approach is used to value the improvement in wellbeing).
This cross-sector public health intervention may provide a cost-effective way to reduce health inequalities for those who are unemployed, especially those whose mental wellbeing acts as a barrier to employment. The resultant outcomes may also be influenced by a range of other factors such as social isolation, financial precarity and housing. Despite this, the findings support the development of this approach to reduce health inequalities but is reliant on a close collaboration between local authorities, NHS, Department for Work and Pensions and the voluntary sector.
在英格兰，心理健康状况不佳每年给社会造成的损失超过1050亿英镑。患有心理健康问题的人面临着显著的健康不平等和较低的就业率。这项可行性研究评估了一项公共卫生干预措施的成本效益，该措施旨在帮助心理健康状况不佳的失业者获得就业机会。
分布在所有11个就业中心的心理健康就业顾问为16岁以上的人群提供支持。通过商定的行动计划，在2至4个月的时间内提供支持。获取就业状况、基线和随访时的幸福感结果（使用简短的沃里克 - 爱丁堡心理健康量表），并用于估计投资回报率。
在540名有基线和随访幸福感评分的人中，共有57.79%的人在接受干预时可能患有抑郁症和/或焦虑症。随访时，可能患有抑郁症和/或焦虑症的人数有所减少（23.82%）。共有235人在接受干预后获得了新的工作。由此得出的效益/成本比分别为8.4和17.6（取决于使用疾病成本法还是收入等效法来评估幸福感的改善）。
这种跨部门的公共卫生干预措施可能为减少失业者的健康不平等提供一种具有成本效益的方法，特别是那些心理健康成为就业障碍的人。最终结果也可能受到一系列其他因素的影响，如社会孤立、经济不稳定和住房问题。尽管如此，研究结果支持采用这种方法来减少健康不平等，但这依赖于地方当局、国民保健服务体系、工作和养老金部以及志愿部门之间的密切合作。
