It may not always feel like it on a wet and windy January morning, but everyone knows that work is good for you, and not only to pay the bills. It’s about purposefulness, company, water cooler chat – that sense of being useful that is essential to human wellbeing.

So it seems uniquely unjust that people who need it even more than the rest of us are most likely to be excluded – those people who have severe mental illnesses.

What is most striking is that the professionals who work with people with conditions such as schizophrenia report that for the patients themselves, getting a job is the yardstick of recovery.

But on Tuesday the former coalition health minister, Liberal Democrat Paul Burstow, reported in response to a parliamentary question, that in some areas fewer than one in 100 people in contact with secondary mental health services are in work. In England, only 5.7% of people with severe mental illness have a job.

Even in the areas that performed well – take a bow providers in Derbyshire Dales, Somerset and Berkshire – the proportion was only around 20%. Yet this is not some tiny group. Population-wide, one person in 100 will have a schizophrenia diagnosis.

On all accounts, avoid Huntingdonshire. Poor old Huntingdonshire, home to the great Circle experimental franchise at Hinchingbrooke hospital and now recipient of the wooden spoon for helping severely mentally ill patients into work. Just 0.3% of those in contact their secondary mental health services have some kind of job to go to.

It’s true that not everyone with schizophrenia (one of the most common severe mental illnesses) can take paid work. But plainly if the figures can vary so widely it must be possible for the worst performing to do much better.

There is a common factor running through the success stories: patient support. That is, support to start thinking of finding a job again, support through the interview stage and then support in work.

The supply side is involved too. Rethink, one of the charities that the Guardian’s Christmas charity appeal supported, helped Berkshire’s community health teams to challenge the local employment culture.

That has meant tackling stigma, persuading potential employers to look again at people with mental illness, and matching the right patient with the right job.

But behind the visible achievements lies a changed management culture shaped partly by an earlier initiative between Burstow and the mental health charity Sane. Back in 2013, a roundtable with the NHS looked at how best to incentivise the NHS to maximise the number of mentally ill patients in employment.

Inevitably, finding a way to measure success had to be the starting point. It recommended outcome indicators for clinical commissioning groups. They are now in place.

It also suggested finding some form of reward payment, now adopted as Cquin, (commissioning for quality and innovation), which Berkshire, for example, used to incentivise community mental health teams to improve the employment prospects of their patients.

Even worse than the news that in some areas few people with mental illness are helped into work, is the latest report that shows the number of severely mentally ill people in work is falling even though in the wider population employment is rising.

As usual, as the cuts required of both the NHS and social care – commissioning for support is often jointly funded – bite ever harder, mental health services provide what are seen as the easy pickings. And within mental illness it is easier to cut support than clinical treatment.

As both Burstow and Marjorie Wallace, Sane’s chief executive, said, it is unacceptable that so many people who want a job find themselves excluded. The foundations are in place. Measuring is on the books. So is monitoring. Listen to the patients.

What do they say? Well, they want to get back to work.