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Engage to Change: enhancing employment opportunities for people with a learning disability or autism

The theme for World Mental Health Day 2017 is workplace wellbeing. We know that being employed can contribute to well-being through increasing income and helping people move off welfare benefit subsistence levels. Work can motivate people, helping to provide purpose, enabling contribution and stability.  In turn, it can enable greater access to goods and services and help to improve people’s material quality of life.

There is also a strong correlation between income and health, with higher income providing access to better housing and environmental conditions. Being employed also plays an important role fulfilling our psychological needs, with our roles influencing our personal identity and status in society.

People who are unemployed are more likely to experience depression and psychosis than those who are employed. Unemployment can have a detrimental effect on health, raising the level of personal dissatisfaction and stress that consequently increases the risk of developing a health condition. Being employed does appear to have a protective impact on mental health. People unemployed for more than 12 weeks are from four to ten times at higher risk of developing depression and anxiety. Unemployed people are more likely to experience depression and psychosis compared to those who are employed.

Certainly, being in a job can be stressful. Some researchers have suggested that an appropriate level of stress can lead to greater fulfilment and job satisfaction. However, if the demands of a job and ensuing stress levels become inappropriate, then people can experience poor physical and mental health. That is why it is so important that employers understand and create healthy working environments – it is in the company’s and the staff’s best interests. There are many resources out there that can help employers achieve this:

The first step is the most challenging

We know also that being in paid work is better for people’s mental and physical health generally, and that there is much that can be done to help people to maintain good health while in work. However, for all young people whether they have further or higher education or not, getting a job in the first place is a challenge in our current uncertain economic times.

If you are a young person with a mental health problem, or a young person with a learning disability or autism, getting a job is an even greater challenge.

Young people living with a learning disability and/or autism can face many difficulties with the transition to adult life. The culture in workplaces towards including people with a disability has improved greatly over the years, but we still do not see enough people with learning disability or autism actively working in our communities. Employment rates for people with learning disability are still too low, being only 6.7% for people with learning disabilities and 18% for people with autism compared to 48% for people with a disability in general and 78% for people without a disability.  New initiatives are needed to redress this gap.

Bridging the gap

We are conducting an evaluation of the Engage to Change project, which supports young people with a learning disability and/or autism, aged 16-25, to acquire employment skills, to have substantial work experiences and to gain paid employment.

The project offers paid work placements (lasting 6-12 months) to young people who are Not in Education, Employment and Training (NEET) or at risk of becoming NEET. The 5-year project is running across Wales, funded by the Big Lottery Fund in partnership with Welsh Government. The leading organisation for the project is Learning Disability Wales which is coordinating and disseminating the project. The project includes the voice of people with learning disabilities through a partnership with the self-advocacy organisation All Wales People First.

The job delivery partners are two popular supported employment agencies, Elite Supported Employment Agency and Agoriad Cyf who offer their job coaching skills and their long experience in the field of supporting people with disabilities towards their journey to employment. People with a learning disability or autism need a highly individualised support approach if they are to be successful in work. Elite and Agoriad use a process called Supported Employment to do this. This involves:

  • Vocational profiling: finding the unique talents people have that can be used to find people a paid job
  • Job finding and matching: finding an employer, a workplace and work tasks that match the person’s talents and where there is a strong business case for the employer to engage them.
  • Negotiating: Supporting the employer in the recruitment and induction process and, if needed, helping the employer to design reasonable adjustments under the Equalities Act to level the playing field for the incoming worker, and to obtain any government resources if needed.
  • Support planning: Helping the young person and the family manage the transition into employment, including travel training and negotiating welfare benefit changes to ensure the person is better off in work.
  • Training people on the job: Using a skilled Job Coach to teach people the tasks of the job in the workplace, fading their involvement over time to leave the person independent in the job
  • Providing longer-term support: Supporting the employer and the worker to maintain the job as natural changes occur. This includes promoting the person’s career development.

As well as working with a wide range of individual employers across Wales, Elite and Agoriad are also using the Project SEARCH model with selected large employers. This internationally recognised model provides internship opportunities over a year for up to 12 young people with each employer, using a unique structured model with the employment agency providing job coaching expertise and a local college a supplementary vocational curriculum.

The first of Elite’s Project SEARCH projects in Wales is hosted by Cardiff University providing apprenticeship opportunities, in partnership with Cardiff and the Vale College, and is in its second year. Agoriad’s first Project SEARCH is hosted by Ysbyty Gwynedd Hospital, in partnership with Coleg Menai. A further three projects are in the planning phase.

Mikey has benefited from the project

Photograph of a young man with his thumbs up in a coffee shop

Building a legacy

While collecting and analysing data to help evaluate the impact of Engage to Change is a primary part of our role, securing the legacy of the project is our ultimate goal. We are monitoring relevant Welsh and national policies, disseminating the Engage to Change outcomes to decision-makers and, crucially, how they have been achieved.

It is our vision, which is shared by the Big Lottery Fund, that the project leads to support being available that is individualised and “fit for purpose” for these young people, and that we can reduce their low employment rates in the future.

We hope to contribute to the culture change needed from the majority of us, people in the community, to recognise that people with learning disability or autism can be an important part of our workforce and from whom employers, co-workers and the wider community can benefit through their inclusion in employment.

The Engage to Change research team at NCMH is Andrea Meek, Dr Elisa Vigna, supported by Jacob Meighan, and led by Dr Stephen Beyer.

Find out more

You can learn more about the project by visiting

Dr Elisa Vigna

Elisa completed her PhD on Supported Employment and health outcomes for people with a learning disability at Cardiff University. She is a key member of the Engage to Change evaluation team at NCMH, leading on electronic data collection systems. Elisa has presented internationally on successful strategies for employing people with a learning disability.

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National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ

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