Employment support for people with mental health conditions


Ceri, the Sun’s favourite mental health patient, is speaking with DWP staff on Monday about the support that people with mental health conditions need if they are to be able to work.

Cue a series of tweets from a range of people on what is needed. There doesn’t seem to be a lack of suggestions about what can be done, and as many seem to group round a few themes we may reasonably expect most of them to be helpful.

In contrast, the Tory conference fringe events that focussed on disability and employment were rife with phrases like ‘we’re leading on this’ and ‘no-one knows what to do’ when referring to support for people with mental health conditions. But Friday night’s tweets suggest that what is needed is known, at least in overall detail, but perhaps just isn’t politically acceptable.

One way to help is to ensure the provision of adequate treatment. When contribution based ESA is paid for only one year but the waiting list for treatment is longer than one year, who seriously thinks it is reasonable to cease paying ESA before recovery can even be expected to have started? Where treatment is provided, often it is restricted to one particular treatment type, even though it may not be appropriate, so people find that they still can’t access the treatment that would help.

The consequence is that the DWP seems to expect people with mental health conditions to recover without treatment. And then somehow it’s a failure of employment when these people don’t get and retain work, rather than a failure of healthcare. The DWP talks about people ‘abandoned’ to ‘fester’ on Incapacity Benefit because they weren’t made to try to get back to work, but is it not leaving people to live with severe mental health conditions that is the real abandonment? Surely a more appropriate way to help people get and keep work is to provide healthcare to improve their health so that they can work, rather than forcing them to expend their precious remaining health on  ‘work-related activity’ that, combined with the fear of sanctions and the time-limit for contribution-based ESA, often makes their health worse?

Linking in to this is support from Occupational Therapists. @claireOT pointed out that “vocational rehabilitation OTs can help both employers and employees with recruitment and retention of disabled/sick workers” and “can also use mediation & existing structure of ‘fit notes’ to enforce adaptations as required for retention.” Retention of people who become ill or disabled whilst in employment, coupled with early intervention, has been repeatedly highlighted as an issue that needs addressing immediately, but very little seems to have been done. Why has this issue not been addressed? Would it not be better to reduce the Incapacity Benefit and Employment and Support Allowance caseload by helping people to not need it in the first place, rather than by making a harsher test so that fewer people qualify?

Another ‘solution’ that may help some people is to make volunteering more accessible. This means not having to go through laborious ‘Permitted Work’ forms and not letting reassessments be triggered by people taking up a few hours of work. Voluntary work may also make it easier for the person to try different roles, or start with a few hours and slowly increase them, or stop the work if health made it impossible to continue. Encouraging and supporting voluntary work may be a suitable alternative to paid work that allows people to contribute in the way that they are able.

These are just three examples of what can be done. Other people may have other ideas, of things that helped them or that they have seen help others. But what we can’t say is that we don’t know what to do. We do know, we just need the political will to do.


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