Work and Pensions CommitteeWritten evidence submitted by Richard Layard

Prof Lord Layard is Founder-Director of the LSE’s Centre for Economic Performance, now Director of its Wellbeing Programme. He has been a National Adviser to the IAPT programme.

1. Up to a half of mentally ill people on ESA are getting no treatment for their condition.1 This makes no sense. Moreover those in treatment are (by definition) in treatments which have failed—nearly all are on medication.

2. Yet psychological treatments exist which will cure at least a half of them and return many to work.2 These treatments are recommended by NICE, on their own or together with medication. The NHS is now providing these treatments nationwide in its IAPT services (Improving Access to Psychological Therapies).3

3. All mentally ill people on ESA should automatically be offered a place in IAPT. This could be done when the client first goes to the Jobcentre after the award of ESA. Ideally the client would meet the IAPT therapist there and then, at the Jobcentre—or, if not, very soon after.

4. Many details would need to be piloted to ensure this went smoothly. The IAPT service in Dorset, Bournemouth and Poole are enthusiastic to participate and the former PCT said it would finance the necessary volume of treatment. If that area is not suitable from a DWP point of view, some other area could easily be found.

5. The present situation is deplorable. If we want a speedy improvement it would be best to build on the only professional structure that currently exists, which is IAPT.

24 May 2013

1 The Adult Psychiatric Morbidity Survey (2007) showed that only 42% of mentally ill people on incapacity benefits were in treatment for their condition.

2 See draft chapter 10 of book by Layard, R. and Clark, D. available on request.

3 Clark, D (2011). “Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: The IAPT experience.” International Review of Psychiatry 23: 375-384.

Prepared 27th January 2014