Abstract
There is a two-way relationship between health and the economy. Poor health and health-related worklessness increase the burdens on the NHS/social care and the benefits system, whilst at the same time reducing the funds available to meet these demands1. The majority of public health interventions are cost-saving2 and are therefore a particularly good way to improve both health and economic development. Mental ill-health imposes economic costs3, as well as human and social ones, and reducing mental health-related worklessness will potentially increase funds available to spend on mental health, and health and social care, which in turn will further improve mental health. There is therefore a virtuous cycle between the mental health of the working age population and health and social care more generally. Interventions aimed at achieving better mental health have been subjected to economic evaluation across the lifecourse3 and favourable returns on investment have been found for programmes in many different sub-groups and settings4.
The workplace
A number of reports have highlighted the issue of mental health at work5, 6. In the UK four million people have a mental health condition, employment in those with mental health problems is particularly low, and amongst those aged 16-34 there has been a nearly 70% increase since 2019 in those citing mental ill-health as the reason for being unable to work 7. Being in suitable work is good for mental health and wellbeing, and improved working conditions can have a beneficial impact on the mental health of employees8. This can lead to improved productivity9 with the benefits accruing not only to the employers themselves but also to the health system10. A new report has recommended a range of measures to support those in the workplace with mental health issues11. Employers can therefore boost their own economic returns, and at the same time produce wider health and social benefits, by reducing stigma, supporting employees, and promoting mental health and wellbeing at work.
Primary care and the community
Primary care has a key role to play in detecting and managing mental health problems in the working age population at an early stage and in providing for, or referring those, who require specialist care11. Better management of mental health in primary care can also improve management of co-morbid physical health conditions12. A community wealth building programme in a disadvantaged area was associated with an improvement in mental health as well as in wage income13, and a project in a deprived area, which included help for unemployed people in returning to work, was associated with improved mental health outcomes, reduced numbers of people unemployed, and net economic benefits14.
Summary
Improving health and wellbeing, as well as being a good in its own right, is an important contributor to economic prosperity15. The total cost associated with mental ill-health in England has been estimated to have been £300b in 202216 of which more than £100b were costs to the economy. Better public mental health can contribute to wider economic and social aims17, can be achieved at relatively low cost and (for example through the targeting of interventions) in a manner that does not widen inequalities and may actually reduce them.
Sunjai Gupta
April 2024
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11 Sunjai Gupta, Rachel Jenkins, John Spicer, Marina Marks, Nigel Mathers, Lise Hertel,et al How primary care can contribute to good mental health in adults, London Journal of Primary Care, 2018 10:1, 3-7,
12Public Health England. Commissioning Cost-Effective Services for Promotion of Mental Health and Wellbeing and Prevention of Mental Ill-Health. Crown Copyright, August 2017.
13Rose, TC, Daras, K, Manley, J, McKeown, M, Halliday, E, Goodwin, TL. The mental health and wellbeing impact of a Community Wealth Building programme in England: a difference-in-differences study. Lancet Public Health 2023; 8: e403–10.
14Lighting the way for C2 Connecting Communities. Social Impact Valuation of the Beacon Project 1995-2001.Daniel Fujiwara, Ulrike Hotopp, Ricky Lawton. May 2016.
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