Psychobabble: Damned if you do…

By Keir Liddle

Work is one area where it can seem those who suffer mental health issues are damned if they do try to get and hold down a job and damned if they are unable to seek regular employment.—

People generally hold the belief that it will be hard or difficult to work with or employ people with mental health issues they imagine that people with mental health issues will be unreliable, emotional or that the “reasonable adjustments” that they are duty bound to make by law will be damaging to their business. It is no wonder that a recent survey by the charity Shaw Trust suggested more than half of all employers would not hire someone with a known mental disorder and that the same survey also suggested that 80% thought this to be “a risk” in a customer-facing role.

Though Royal College of Psychiatrists research suggests that of employers who did employ people with mental health issues  85% of employers did not regret doing so despite this the British public still worry about revealing to their co-workers they suffer with mental health issues. It was found in a yougov poll that— 92% of the British public believes that admitting to having a  mental illness would damage someone’s career.

Attitudes like this can promote discrimination against the mentally ill and discourage or otherwise make it difficult for the mentally ill seeking employment, in a sense making them damned if they do.

However far more insidious and disgusting is the attitude towards those who cannot work (for whatever mental health issues) who are seen as work shy malingers and damned because they don’t. — It is also this attitude that seems to have motivated the shake up of the benefits system with a focus on  ‘weeding out benefits scroungers’. However IB only has a fraud rate of 0.5% which is the lowest of all the benefits. Despite this 1.6 million people are due to go for a Work Capability Assessment (WCA) by spring 2014 to establish whether they are eligible for Employment and Support Allowance (ESA) or be moved onto Jobseekers Allowance (JSA) and expected to find work.

A French IT firm ATOS has the contract to provide these WCA and these have proved increasingly controversial particularly to those with mental health issues or that work with them. The tests determine whether an individual who has been on incapacity should be placed in a support group, work activity group or are in fact “fit for work”.

It is in my opinion highly questionable  that the ATOS tests are fit for purpose as current DWP figures for ESA claims (to November 2009) show that 6.8% of those with mental health problems assessed through the WCA were placed in the Support Group and 24% in the Work-Related Activity Group, whilst 69.2% were found to be “fit for work”. The equivalent figures for those with physical problems are 11.6%, 23.7% and 64.7% (Department for Work and Pensions, 2010a). The figure for those being found “fit for work” with mental health issues is higher than that of 49%  originally estimated by the DWP (Citizens Advice Bureau, 2010).

The tests are also highly wasteful as we can see— from the official statistics that, of the overall appeals against the decision of fitness to work, 40% of the decisions are overturned. Part of the reason for this is because the test is additive I know of one case where it is agreed that an person cannot leave their house but because they show insight into their agoraphobia and score highly on other elements in the test they are consistently found to be “fit for work” before appealing and having this decision overturned. They rather pointedly and poignantly told me that:

“If I were to jump out of the window during the test they would probably tick a box saying “No fear of Heights”

— The tests cause a great deal of stress and anxiety, particularly to those with mental health issues, the charity Mind polled over 300 people currently claiming IB for mental health problems before the upcoming reassessments and found that:

  • — 75% said concern about the WCA had made their mental health worse
  • — 51% reported it had made them have suicidal thoughts
  • — 45% have visited their GP or psychiatrist and 32% have increased their medication as a result of the anxiety caused by the prospect of reassessment
  • — 78% did not feel well informed about forthcoming changes to IB
  • — 95% do not think that they will be believed at their assessment.
  • — 89% believe that they will be forced back to work before they are ready or able.

Worryingly only 20% of people surveyed stated that they had got information about the changes from the Department for Work and Pensions with the most common source of information about the tests was TV or newspapers – 62% .

It is my belief that the WCA tests cause unnecessary anxiety and suffering for people with mental health issues and show that we have a low way to go as a nation in stamping out stigma and becoming a more tolerant and understanding society.

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0 Responses to Psychobabble: Damned if you do…

  1. stanze says:

    I’m sure this wasn’t your intention, but to me your article reads as though you are saying the WCA assessments exist solely to weed out ‘fraudsters’ on IB, which technically isn’t the case because really what is happening is that people on IB are being migrated over to ESA which has replaced it.

    Can I also ask when the survey by Mind was carried out? It’s my understanding that the DWP are still in the process of informing people who are close to the date of their personal capability assessment, so of course if that’s the case then there will still be a significant proportion of people who haven’t yet been told. If they aren’t doing what they’re supposed to be doing then that’s an even bigger worry.

    Otherwise I agree and I’m not defending the DWP at all. The ESA descriptors are useless, and combined with the WCAs the assessment seems to have no basis in reality. Apparently if someone can use a mobile phone to call a friend or family member they are capable of using a telephone in a work context as well. Context barely seems to be considered and assumptions are made left right and centre. Seeing as so many ill people are found to be fit for work because they managed to get down to the shops on their own once three months ago, I can only assume plenty of measures are being put in place to ensure the kind of work they would be capable of exists, and also to make it much harder for employers to discriminate against them. No? Oh right then.

  2. stanze says:

    Thanks. It looks like the migration began in October 2010 (http://www.dwp.gov.uk/policy/welfare-reform/employment-and-support/) so in that sense it’s not too surprising that not everyone will have been told by April, if the process is being staggered. That said I know it’s a fairly minor niggle in the grand scheme of things.

  3. AshPryce says:

    I was supposed to go in for the ATOS test but completely froze up. The idea terrified me. The sheer number of poeple found to be “fit for work” is ridiculous. Your personal doctor who knows you and your health says “No, you are not fit for work” someone who isn’t your doctor and not familiar with you, your condition and may not always be a doctor has a tick sheet and says “You’re fine”.

    There is something seriously wrong when anyone, especially the government, think this is okay to do.Fortunately I was only receiving my Naitonal Insurence stamp as my partner works, but even then the whole situation was quite traumatising and I just could ot get to the interview.

    I do feel there is no point in me going as it would only cause more problems for me. I know full well that by their criteria I would be found fit for work, and even if at an appeal that is over turned the situation is just way, way too much for me to handle.

    I am getting better and am certainly going out a lot more from the flat, but I am no where near ready to return to full time employment. In a couple of months, part time may be a realistic option, then maybe early in the new year I can progress to full.

    If the actual fraud rate is 0.5% then surely the money being spent on these tests combined with the appeals far outweighs the money saved? Any figures on that?

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