by Marya Saidi
William Faulkner once said: “You can’t eat eight hours a day, nor drink for eight hours a day nor make love for eight hours — all you can do for eight hours is work.”
This may be true for the general population, but what about the members of our society who are incapable of doing so? People who are disabled, who are suffering from chronic health conditions, who have long-term mental health problems?
Monday’s (30/08/12) Panorama episode entitled “Disabled or faking it?”, promised to investigate the government’s plans to move people off of incapacity benefit (now Employment Support Allowance – ESA) and back into work.
Incapacity Benefit (IB) is paid to individuals who are assessed as being incapable of work and who meet certain contribution conditions (The Department for Work and Pensions 2012). The assessment is made through the Personal Capability Assessment (PCA) which measures the claimant’s ability to perform a range of every-day activities, and as portrayed on Panorama this week these may include lifting your arms or legs. Under the ESA regime, new claimants have to undergo the Work Capability Assessment and from February 2011 IB recipients also began to go through this assessment, which is currently being carried out by the private firm, Atos Healthcare.
Panorama depicted cases of people suffering from debilitating conditions being found ‘fit for work’, when they clearly were not, and accused Atos of suffering from ‘tunnel vision’ and forgetting that claimants are not only numbers and cases, but human beings as well, a view shared by Professor Malcolm Harrington (who will unexpectedly step down from his role as government advisor by the end of the year).
Panorama not only focused on health conditions, but raised the issue of people suffering from mental health problems as well, by presenting the case of a young man diagnosed with bipolar disorder who had been found fit to work while on section in a psychiatric hospital.
The latest figures from the DWP show that there are currently 759,100 beneficiaries of IB with mental health problems, costing an average of £53.94 a week; not a very substantive amount.
In my PhD study about specialist housing services for people with mental health problems in England, 21 service users (out of 86 who were mainly suffering from schizophrenia) confirmed being in some form of employment at present: 1 person was employed full-time, 3 part-time, and 17 were in voluntary work. Service users most commonly worked in charity shops, such as Age Concern or the British Heart Foundation, but also engaged in some gardening work in exchange for money. Of those who were not currently employed and those in voluntary and part-time employment, more people (39 compared to 21) did not have any desire to seek nor maintain a job. Still, even individuals who wanted to work expressed some doubts about their abilities and their capacity to maintain a job. Their perceived barrier to employment most commonly mentioned was their mental health condition and their disability, but many people also mentioned their lack of confidence and inability to cope, their fear of their benefits being reduced, their lack of education or training and discrimination from the public.
Interviews with service managers were conducted as well, revealing that many service users had been on work assessments, and found fit to work after performing a few basic tasks correctly. However managers expressed their concerns that these assessments do not paint the whole picture and are basically a snapshot of peoples’ lives. According to managers, most people who had been found fit to work were unable to maintain a full-time or even part-time job; the arbitrary nature of the assessment meant that these service users had been interviewed on a ‘good day’ – but who was going to get them to their place of work the next day when they are unable to get out of bed?
This is not to say that employment is not beneficial to service users with mental health problems – on the contrary. Many have stressed the importance of work in enhancing the mental health and quality of life of people with mental health problems (Shepherd 1984; Warner 1994). In addition to income, employment provides social contacts and social support, status and identity, a means of structuring and occupying time as well as a sense of personal achievement (Perkins and Rinaldi 2002). And results from the Pathways to Work programme (Jin et al. 2010) – which was set up to improve labour market readiness and opportunities while also providing financial incentives for claimants of income support with the intention of keeping them in contact with the labour market and eventually getting them back to paid work – have been positive amongst the mental health population (Hudson et al. 2009).
Hence, a more encompassing view of the life of the individual should be adopted, one that takes into account their health and mental health issues, as well as their everyday personal circumstances. People with mental health problems should not be scared into employment, as that will have a debilitating effect on their mental health. Employment should work around them and their lives, and they should be educated as to the advantages of employment as well as the ways to work around the benefits system, the so-called ‘benefits trap’, so as to maintain a decent standard of living (Directgov 2012).
As it was outlined in the Healthy Live Healthy People White Paper (Department of Health 2010), the promotion of choice and confidence amongst service users is crucial – so let’s do exactly that.
Department of Health (2010) Healthy Lives, Health People: Our Strategy for Public Health in England, The Stationery Office, London.
Directgov (2012) Disabled People.’Permitted Work’ – working while claiming Incapacity Benefit, from http://www.direct.gov.uk/en/disabledpeople/financialsupport/dg_10020667.
Hudson M, Ray K, et al. (2009) People with mental health conditions and Pathways to Work, from http://research.dwp.gov.uk/asd/asd5/rports2009-2010/rrep593.pdf.
Jin W, Levell P, et al. (2010) A Survey of the UK Benefit System, The Institute for Fiscal Studies, London.
Perkins R, Rinaldi M (2002) Unemployment rates among patients with long-term mental health problems. A decade of rising unemployment, Psychiatric Bulletin, 26, 295-298.
Shepherd G (1984) Institutional Care and Rehabilitation, Longman, London.
The Department for Work and Pensions (2012) Statistics. Tabulation Tool: Incapacity Benefit, from http://188.8.131.52/100pc/ib/tabtool_ib.html.