Written evidence submitted by the Mindfulness
Programme
1. SUMMARY
1.1 This document sets out evidence provided
by participants on the Mindfulness Programme of their experience
in the current benefits system, and how this relates to the migration
from Incapacity Benefits (IB) to Employment and Support Allowance
(ESA).
1.2 The Mindfulness Programme is supported by
the Department for Health and NHS North West, and delivered a
programme of work to help individuals with mental health issues
and in recovery from addiction to be more mindful. The programme
was attended by several individuals recovering from addiction
and with mental health issues, some of whom also had physical
health issues. Many were either claiming Incapacity Benefits or
had previously claimed some form of inactive benefit.
1.3 The evidence presented is a reflection of
the experiences of participants on the programme, and a summary
of the main barriers faced.
1.4 The document covers the main aspects of the
call for evidence, in particular:
— the
Department's communications to customers going through the assessment
and whether the information, guidance and advice provided by the
Department and Jobcentre Plus is effective in supporting customers
through the process;
— the
Work Capability Assessment (WCA) including the assessment criteria;
and
— the
appeals process, including the time taken for the appeals process
to be completed; and whether customers who decide to appeal the
outcome of their assessment have all the necessary guidance, information
and advice to support them through the process.
1.5 None of those providing evidence have undergone
a Work Capability Assessment yet. Whilst they are aware of the
process, they are not aware of when their assessment will be.
For confidentiality reasons, individual names have been left out
of this submission.
1.6 The evidence gathered identified three main
issues that individuals feel that they will face as part of the
migration to ESA:
— Communication;
— Support;
and
— Flexibility.
1.7 Communication is a key issue for those already
on IB. Many feel that they have not formally received enough information
about either the Work Capability Assessment (WCA), or the migration
to ESA and JSA. This has resulted in some emotional distress for
individuals who have been out of work for a long period of time,
and who feel that they may be considered fit for work or pushed
towards work at a pace that they are uncomfortable or unfamiliar
with.
1.8 As a result, the continuation of support
is essential to claimants. During the WCA process, individuals
may find themselves on a lower rate of pay, which may be further
extended beyond the initial 13 week period of assessment if they
decide to appeal the decision. Again, this adds unnecessary stress
and emotional discomfort to individuals who may be in a process
of recovery.
1.9 Lastly, participants on the programme identified
the need for flexibility in the approach. Having received no formal
information about the assessment or how this would affect them,
individuals were keen to stress that the WCA and ESA approaches
need to be flexible to individuals' circumstances, previous mental
and physical health and expected future health.
2. COMMUNICATION
2.1 Individuals who are currently claiming Incapacity
Benefits are aware that there will be changes to their benefits
in the near future. However, this information has not been provided
formally, and has often only been received from an informal source.
Whilst the information is available online, individuals feel that
they have not been formally provided with guidance or understanding
about the process.
2.2 This has placed undue stress on individuals
who may have mental health issues, or be in recovery from addiction.
For many individuals, receiving information that they will be
expected to attend a Work Capability Assessment will be the first
formal communication that their benefits will change. The lack
of communication in this respect can place unnecessary strain
on individuals and does not help to support their mental or physical
health. In particular, it was felt that this could lead to misconceptions
about the changes, and lead to potential further emotional distress.
2.3 Many have been claiming an out-of-work benefit
for a long period of time. This has meant that they are assured
of continued support, and as a result have the ability to develop
at an appropriate pace that does not rush them or place unnecessary
expectations or strains on them. The lack of communication around
the future of their benefits does not contribute to the mental
wellbeing individuals, who may fall ill due to unnecessary pressure.
2.4 The communication issue is perhaps hindered
by the fact that some individuals have only heard of the future
changes to their benefits through informal sources—their
friends, fellow claimants or through the media. A lack of official
clarity and communication heightens the likelihood for potential
misconceptions about the migration.
CASE STUDY:
IMPORTANCE OF
COMMUNICATION
2.5 The lack of communication has also added
undue pressure in terms of expectation of income. One individual
who is in recovery highlighted that their previous experience
of a change in benefits coloured their perceptions about what
may occur with the migration from IB to ESA. In particular, their
previous experience has included several instances of lack of
clarity and communication prior to changes to their benefits.
As a result of this, they expect a significant change in benefits
as part of the migration from IB to ESA. This has led to additional
and unnecessary pressures on this person. This is particularly
distressing, as the individual suffers from both a mental health
condition and a life-threatening illness. Further to this, when
the individual suffers mental ill health, her condition also manifests
itself physically.
2.6 In one instance, the individual in question
was claiming the high rate of Disability Living Allowance, alongside
Housing Benefit, as well as working with a health professional
on their care plan. In deciding to attend university to study
towards a career in support work, the individual also moved into
new accommodation with a friend. The expectation of responsibility
fell to her new housemate, leading to an overall reduction in
benefits. However, this was not fully explained or communicated
beforehand—despite the individual's obvious desire to move
towards employment, they felt they were not supported in doing
so.
2.7 As this person's benefits changed, they did
not feel they were given the same level of support towards employment
as they would have received had they stayed in their original
accommodation. Their belief is that when they are expected to
move towards ESA the change will again alter the support they
receive—to the detriment of this person's physical and mental
health, as well as this person's road to recovery and their road
to sustained employment.
2.8 Better communication in this respect could
reduce the fears and negative expectations of individuals about
the forthcoming change to their benefits. Some individuals felt
that the expected change could benefit their road to recovery
and employment. However, others felt that the lack of formal communication
did not assure them of continued financial, and subsequently emotional,
support towards employment and recovery.
3. SUPPORT
3.1 As identified above, support, especially
the continuation of financial support, is an important issue for
existing claimants. The latest DWP figures (January 2011) show
that 33% of those who were found fit for work between October
2008 and November 2009 have had appeals heard by September 2010.
Furthermore, two-fifths of these appeals had a decision in favour
of the appellant. Whilst these figures are not final, it is estimated
by DWP that the number of decisions in favour of the appellant
will rise.
3.2 The appeals process resulted in a 9% reduction
in the number of individuals in the "fit for work" group—indicating
that the process may be pushing individuals who are not yet ready
for employment towards work. After the appeals process, the number
of individuals experiencing enhanced support towards work (in
the "Work Related Activity Group (WRAG)") increased
by 21%—indicating that over one in six currently in the
WRAG were assessed as being fit for work when they actually required
more tailored support towards employment.
3.3 In addition, a further one in 20 claimants
in the support group was initially assessed as either "fit
for work", or suitable for additional support to return to
work in the longer-term.
3.4 As a result, individuals expecting to be
assessed want to ensure that the WCA process does not result in
a reduced level of support—either financially, if individuals
feel they should be in the higher level support group; or towards
employment, training and education, if they feel they are in the
WRAG.
3.5 Individuals have identified a variety of
expectations: some indicated that the expectation of getting a
full-time job at present would benefit them, but that they would
need continued support towards employment; others felt that if
they were assessed as "fit for work", this could cause
significant mental health issues and emotional distress. Being
incorrectly categorised within the "fit for work" group
for those who feel they would need more enhanced support towards
work could potentially have an adverse effect on individuals suffering
from mental ill health, or in recovery, and therefore push them
further from employment.
3.6 Many individuals have expressed a desire
to move into employment, training or education. This corroborates
findings from previous research, which has found that 90% of psychiatric
service users wanted to go back to or into work.[67]
Individuals have identified the desire to attend university; to
start a new career in a variety of sectors; to learn basic literacy,
numeracy and IT skills to support their personal growth and recovery;
and generally to work towards a rewarding job.
3.7 However, for many, this also involves a period
of recovery. Whilst many individuals are aware of the positive
benefits of employment—especially in aiding recovery—the
need for support throughout this is important. If individuals
find themselves without a required level of support—either
towards work, or generally if the individual is unable to work—it
may take several months for individuals who feel they have been
allocated to the wrong group to have their appeal heard. In the
meantime, individuals are worried that the support received will
not be suitable.
3.8 The limited weekly rate during the assessment
phase can also promote mental discomfort and emotional distress.
Individuals moving from the long-term basic rate of IB to the
assessment phase of ESA see a drop of over two fifths (43%) in
their income—up to £40.80 a week—if they are
under 25; those aged over 25 see a smaller fall of £26.75
a week, but this still accounts for a fall of over one quarter
(28%) in their weekly income.
3.9 Similarly, if individuals are found "fit
for work", they would continue to receive the same amount
as in the ESA assessment phase—a significant reduction in
the income of individuals who would have to adapt, for at least
a short period of time, to a much lower level of financial support.
3.10 Seeing such a dramatic fall in financial
support throughout the assessment phase is likely to impact on
the emotional wellbeing of claimants. If individuals feel they
want to appeal this decision, the level of financial support they
receive could continue to be lower than expected until the appeal
is heard—further prolonging difficulties for individuals
who feel they have been assigned to the wrong group.
3.11 Further to this, and linked to the overall
issue of communication, is that the effects on other associated
benefits are not fully understood by many claimants. After a WCA,
individuals are unsure as to how their assignment to each group
would affect other benefits, such as Housing Benefit. Again, this
provides a needless cause of worry for claimants who have not
yet been assessed and may heighten misconceptions about the process.
4. FLEXIBILITY
4.1 One key factor reflected on by individuals
was the need for flexibility in the Work Capability Assessment
to take account of differences in mental and physical ill health.
An internal report has already identified the need for widening
the support relating to people's mental functions.[68]
A further review by Professor Malcolm Harrington noted the need
to involve mental health charities and organisations to help refine
mental, intellectual and cognitive descriptors for the WCA.[69]
4.2 Individuals feel that this is especially
important, as different people suffer different mental health
issues. Mental wellbeing is not consistent and, especially for
those in recovery from addiction, the path to recovery and employment
is not always a straightforward and easy one. Continued support
throughout recovery and towards employment should be something
an individual in recovery can rely on.
4.3 Individuals have noted a concern for the
WCA to take account not only of current mental and physical health,
but also of previous health and wellbeing. One individual noted
that, with a life-threatening illness, the medications they take
often vary. As a result, they would seem a confident and healthy
individual one day, but may not feel consistently well throughout
the week. As such, they may be fit for a part-time job, but not
a full-time job. The differences and sensitivities within the
WCA, without any formal communication on the issue, is a worry
for some individuals.
4.4 Therefore, the WCA should take note of previous
changes (especially regular changes) in medication as well as
in physical and mental health.
April 2011
67 Grove, B. (1999); Mental health and employment:
Shaping a new agenda; Journal of Mental Health, Vol 8, No 2, p
131-140. Back
68
DWP (October 2009); Work Capability Assessment Internal Review. Back
69
Harrington, Prof M (2010); Harrington WCA Review: Year 2 Recommendations-Timeline. Back
| 
