One in five adults in the UK is economically inactive. What is the causal relationship between mental health and capacity for work?
By Dr Annie Irvine
Rising rates of mental ill health among working aged people, especially younger people, are causing significant concern to the UK Government. As of August 2025, one in five adults in the UK is economically inactive. Over recent years, mental health problems have risen to become the most dominant reason for economic inactivity, when captured in national surveys of employment status. Likewise, benefit statistics show mental health as the most prominent reason for health-related claims.
Rising rates of psychological distress among people across the age range are clearly evident. Less clear, however, is the causal relationship between mental health and economic inactivity. Qualitative research, which delves below the surface of statistical trends, reveals a more complex picture of the factors shaping employment opportunities and outcomes for people with experience of mental health problems.
My recent research, carried out in collaboration with the ESRC Centre for Society and Mental Health, unravels the complexity in the causes of economic inactivity, by paying close attention to the perspectives and life stories of people with lived experience of mental distress. Our findings point to important ways in which we need to broaden the approach to understanding the interactions between mental health and economic inactivity, and how social policies should respond in tackling the problem.
Mental ill health does not tell the full story of economic inactivity
Firstly, it is essential to recognise that people’s distress is real – genuine and sometimes severely impairing. But mental health problems do not exist in a vacuum. They are nearly always intertwined in highly difficult life circumstances and events. And those circumstances and events put up barriers to work at the same time as impacting people’s mental health. Using mental ill health as a blanket explanation does not tell the full story of why people become economically inactive or why they stay stuck in this situation.
This came through clearly in our recent study that included 70 people who had experience of mental health problems and had claimed out-of-work benefits in the UK welfare system. In our analysis, we looked in close detail at how people described the things that shaped and constrained their capacity for work. All 70 of these individuals had experienced times when the symptoms of mental distress and the functional impacts on work were very real and at times very significant. But paying close attention to people’s whole stories showed that many other factors beyond mental health symptoms were shaping their capacity for work and the realities they faced in the labour market.
People spoke about the difficulties of finding work that fitted not only with any ongoing health limitations but also with their wider life commitments, with caring responsibilities, with prior experience and skills, aspirations and preferences and the locations they could feasibly work in.
They talked about a much wider range of personal circumstances that shaped their opportunities to sustain work. Some of these–for example, homelessness, domestic violence, abuse, or lone parenthood–had contributed to their mental health problems. But these circumstances also had direct effects on their ability to stay in work.
People also talked about the structural barriers they faced, from constrained labour markets, precarious employment, migration status, transport barriers and inflexible employers. Some faced a ‘benefits trap’ where moving into employment risked leaving them worse off overall.
All of these things worked together in complex, interwoven ways, to constrain people’s capacity for work.
Tackling economic inactivity is complex and needs a holistic approach
The key message from these qualitative research findings is that we need a much more holistic approach to understanding and measuring the underlying causes of economic inactivity. National surveys that produce the headline statistics on economic inactivity offer people very limited categories to describe the reasons why they are not in work. But when we listen to people’s whole stories in qualitative research, being economically inactive ‘because of long-term sickness’ never fully explains people’s barriers or the support they may need. This is not because their mental distress isn’t real, but because it is only part of their story – it is an oversimplified description of the challenges they face. These challenges sit at the personal, interpersonal, socioeconomic and structural levels. This complexity is key to really understanding what is driving that upward curve in economic inactivity and what effective solutions will look like.
November saw publication of the government-commissioned Keep Britain Working Review. This independent Review, led by Sir Charlie Mayfield, former Chairman of the John Lewis Partnership, was tasked with understanding the drivers of rising levels of inactivity and ill health, and developing recommendations for practical actions. There is much to commend in the Review’s analysis of the problem and proposed solutions. However, there is still a lack of clear recognition that people’s difficulties staying in or returning to work are often about much more than ill health in isolation.To say it again, people’s mental health problems are very real. But the statistical trends that keep hitting the headlines do not tell the full story of why people are struggling to find and keep work. This is not a question of whether we are ‘overmedicalising’ people’s distress. It is about a need to take a more holistic approach to understanding economic inactivity. If policies persist with a narrow and individualised focus on mental health and psychological treatments, they will miss essential areas for intervention around employment quality and flexibility, around access to lifelong education and training, around childcare, transport infrastructure and secure housing, and around prevention and protection from interpersonal violence. Improvements in all of these areas are key to reversing the trends in economic inactivity alongside continued attention to improving the nation’s mental health.