Written evidence submitted by Rethink Mental Illness (RJ0047)
 

1)      About Rethink Mental Illness:

a)      Rethink Mental Illness is a leading charity for people severely affected by mental illness. We provide services in England to tens of thousands of people every year and we campaign for meaningful change to our health and social care system and to the way society views mental illness. People affected by mental illness are at the heart of everything we do. Their insight shapes our advice, information, and around 200 groups and services – from housing to employment, carer support to legal advice and benefit support.

b)      Rethink is a member of Mental Health UK – a partnership of four mental health charities in each UK nation. Mental Health UK delivers the Into Work Programme which is a holistic, community-based employment support service helping people living with mental illness secure and sustain meaningful employment. This voluntary programme is tailored to individual needs, with employment specialists providing one-on-one guidance over weeks or months. Support goes beyond job applications and interview preparation - extending to addressing other key barriers to work including money troubles, housing problems, and a lack of social connectedness, ensuring people have the confidence and resources to enter and stay in work. Into Work builds relationships with local employers - helping them make meaningful changes in their workplaces to better retain staff living with mental illness.

c)       Decades of experience, a deep understanding of mental illness, and our work supporting thousands of people across the country have shaped our perspective on what truly works in employment support. We engage people who are directly affected, hearing first-hand what helps and hinders their journey into work. Through this, we bring practical insights to discussions on employment and welfare reform, offering a clear vision of how Jobcentre Plus and wider employment services can change to better support people living with mental illness.
 

2)      Are the aims and purpose of Jobcentre Plus (JCP) sufficiently ambitious? How effectively is it meeting its aims?

a)      A Freedom of Information request[1] shows DWP holds data on “customer movement into work rates...for each Jobcentre” and that “Jobcentres are actively compared to understand performance variation and best practice where appropriate.” However, “Jobcentres all have differing labour market conditions, demographic make-up and caseloads, all of which can make direct performance comparisons a challenge.” The FOI confirmed that they do not publish the “into work rate information at Jobcentre level.”

b)      This lack of public data presents challenges on assessing whether Jobcentres effectively meets their aim. For upcoming reforms to JCP to be best delivered, evaluation of individual JCP effectiveness should be scrutinised. Publishing performance data for each Jobcentre would allow policymakers and organisations to analyse trends, identify gaps, and develop targeted interventions that improve employment support. It would also enhance local areas’ ability to deliver ‘Get Britain Working’ plans and strengthen the impact of trailblazer areas.

c)       Through our extensive engagement with people who have lived experience of navigating Jobcentres while living with mental illness, and insights from our frontline services such as Mental Health UK’s Into Work Programme, we know Jobcentres, are currently ineffective at supporting people living with mental illness into meaningful and sustainable employment.

i)        JCPs’ conditionality-focused approach increases distress and exacerbates symptoms, making it harder and more intimidating for people living with mental illness to engage in work or work-related activities.[2] We have heard repeatedly from people using our services and lived experience involvement that emphasis on sanctions and conditionality does not help and can result in unsuitable job placements, resulting in job loss and further instability.

ii)       We have heard from Into Work clients that employment support provided through Jobcentres does not meet the needs of people living with mental illness, particularly for people out of work for an extended period.[3] Standardised, time-limited interventions, and generic support (e.g., CV workshops), fail to address the multi-faceted barriers people living with mental illness face when trying to enter or sustain work. We hear from people that to be effective, employment support must be holistic and person-centred. Many need help with housing, money, navigating mental health services, but report that this help is not integrated into Jobcentre support.

3)      To what extent does JCP have an “image problem”? How might this be addressed?

a)      We regularly hear from people that they and people they know from find Jobcentres intimidating and untrustworthy. Engaging with Jobcentres can worsen anxiety and distress, hindering recovery and making it emotionally harder to engage with work. And these experiences exacerbate their lack of trust in the DWP.

i)        A big concern people frequently raise surrounds sanctions and conditionality. They say the possibility of being sanctioned for failing to meet work-related requirements or accept a role, regardless of its suitability, is not helpful in getting people ready to start and sustain work and creates more distress.[4]

(1)    Exempting people severely affected by mental illness from sanctions would help build trust and allow people to engage with Jobcentre and other employment support at a pace that supports long-term stability.[5]

ii)       The inconsistency in work coach interactions is another major issue we hear from people. While some report positive experiences, many feel dismissed, patronised, and pressured.[6]

(1)    This inconsistency could be improved with changes in training or hiring. While it is perhaps unrealistic for all work coaches to have specialised knowledge of mental illnesses, improved training and hiring practices such as ensuring a minimum baseline of skill and knowledge in mental health and trauma-informed training would help. Work coaches must be able to communicate sensitively and avoid exacerbating distress and retraumatisation.

iii)     From the experiences we have heard, work coaches are not well-placed to directly support people living with mental illness in finding and sustaining work. Relying on universal, generic employment support alone is insufficient, and we have seen from our Into Work evaluation that people benefit from having holistic, wraparound support to address (often, multiple, and complex) barriers that make finding and sustaining work difficult.

(1)    A more effective approach would be for JCP to function as a gateway to specialised employment services, such as Individual Placement and Support or Into Work, ensuring people receive targeted support from services that specialise in the effects and impacts of living with mental illness.[7]

b)      Improving JCP’s image requires visible, meaningful reform. People need to see and experience real improvements to build trust. This requires clear commitment to effective policy and practice changes, alongside mechanisms to monitor, evaluate, and publicly report on these changes.

4)      How effective is the support provided by Work Coaches, particularly to groups that experience disadvantages or particular challenges in the labour market (e.g. young people, disabled people, older workers)?

a)      Insights from Rethink Mental Illness’ ‘Set Up to Fail’ Report

i)        Rethink Mental Illness engaged with people severely affected by mental illness in a series of lived experience sessions. The findings, outlined in our report, describe experiences with work coaches as coercive, dismissive, and unhelpful, leaving people feeling unheard and unsupported. Many reported their Jobcentre appointments focused more on compliance with work-related requirements than on meaningful, tailored employment support. People frequently felt pressured into unsuitable job-seeking activities, rather than being guided toward sustainable employment pathways. Other key issues highlighted include:

(1)    People interested in self-employment had their proposals dismissed outright, leaving them feeling frustrated and demotivated.

(2)    Many lack access to crucial information about significant employment support schemes such as Access to Work, preventing them from securing financial support and workplace adjustments that could help them sustain employment.

(3)    Participants described UC Claimant Commitments as inflexible directives rather than personalised agreements based on individual circumstances, needs, or capacities. Opportunities to negotiate terms were rare, and many felt pressured to accept inappropriate work-related requirements or take unsuitable jobs.

(a)    One person told us, “They tell you what to do, and you just have to accept it—no kind of conversation”

(4)    One participant living with mental illness shared they had explained their difficulties with travel and leaving home and received reassurances that the UC Claimant Commitment could be later adjusted. However, they were later instructed to attend an in-person, five-day-a-week course for two weeks, with little consideration for their expressed mental health needs. When they requested a remote alternative, their concerns were dismissed, with their work coach stating that ‘others come from further away’ and that unless they were at immediate risk of suicide, they had to attend or face sanctions. Unable to attend, they were sanctioned and lost six months of financial support, leaving them in severe financial insecurity and emotional distress. They described the experience as “extremely damaging,” highlighting how the lack of flexibility and understanding worsened their mental health rather than supported recovery.

b)      MENTAL HEALTH UK’s Into Work Programme: Evidence of Insufficient Support from JCP[8]

i)        Clients of MENTAL HEALTH UK’s Into Work Programme report inadequate support from work coaches. Many describe work coaches as more focused on ‘box-ticking’ than providing meaningful assistance. Key challenges reported include:

(1)    Despite disclosing mental health challenges and medication side-effects, claimants reported being required to attend frequent jobcentre appointments and apply for a set number of jobs per week - exacerbating anxiety, depression, and low self-esteem, making the job search process feel overwhelming.

(2)    Clients feel pressured rather than empowered, with limited opportunities for meaningful dialogue about employment prospects and that JCP prioritises enforcement over support. Instead of personalised employment pathways, they report being handed job listings, regardless of whether they were the right fit.

(3)    An employment specialist and a client who contributed to the Into Work evaluation said:

(a)    “Most people just need to be listened to. They get seven to ten minutes with the GP and ten minutes with a DWP work coach…All they need is one person to listen and believe in them to make a change…”

(b)    “The Jobcentre… are more [like] ‘here’s a job, here you go.’ [The] Into Work [Programme] listens to what you want to achieve out of life…and help to point you in the right direction of what you want… it makes me want to put a bit more of an effort it.” 

5)      What opportunities exist for digital and AI tools to improve JCP?

a)      Nuffield Council on Bioethics commissioned Rethink to engage with people living with mental illness on the use of digital technologies in mental health support [9].. Key findings included:

i)        The risk of over-reliance on digital tools at the expense of human interaction is a significant concern. People with experience of mental illness said technology should supplement – not replace direct support.

ii)       Many people spoke of concern around trust and transparency in decision-making. They worried digital tools could be used to monitor or assess people without their full understanding or consent, resulting in inappropriate decisions.

iii)     The offering of choice in how people engage with technology is crucial. While some find it helpful, others reported it increased barriers due to lack of reliable internet access or digital literacy.

iv)     There is a compelling need to engage people with lived experience when designing digital tools, otherwise design flaws are likely to reduce effectiveness.

b)      A digital and AI-enhanced approach to JCP could focus on supporting JCP staff in making informed referrals rather than automating decisions about claimants. The introduction of a digital platform could allow work coaches to navigate a wider range of employment and social services, helping them quickly identify appropriate support for claimants’ needs. Our engagement work concludes that while digital tools have the potential to improve access to support, they must be designed and used appropriately.

6)      How well does JCP connect with external partners? For example, schools, further education, employment support organisations and the third sector?

a)      JCP’s ability to collaborate with external partners varies significantly across regions.

i)        The Into Work Programme has experience in some areas of stronger partnerships resulting in pathways that are better at supporting people into employment. In these areas, coordinated efforts between JCP and external services enhance access to specialist employment support, improving outcomes for people living with mental illness.

ii)       However, in other areas, collaboration remains limited. Into Work has encountered resistance from some JCPs. For example, some have supported Into Work teams to attend JCP on specific mornings to engage new clients. But, they have excluded Into Work from internal job fairs decreasing opportunities to promote support to people who need it.

b)      Learnings[10][11] from our involvement in the rollout of NHS England’s Community Mental Health Framework (CMHF)

i)        The CMHF established a vision for integrated, community mental health care. It focused on strengthening partnerships between NHS services and VCSE organisations to improve the local community mental health offer. We have observed areas where community mental health partnerships have been particularly successful. They have relied on proactive leadership, overcoming silos, overcoming preconceptions and improving relationships, equal partnerships, and coming to a shared vision.

ii)       A prime example is Somerset, where community mental health transformation has enabled strong, locally-led alliances of VCSE and NHSE providers to work together, improving outcomes for individuals and systems through more integrated, place-based support.

c)       Applying CMHT learnings to JCP

i)        JCP does not - but could have a policy framework to encourage a similar level of collaboration. As a result of the rollout of the CMHF and other initiatives, there are likely already VCSE alliances, providing a range of support including employment support, convening in many local areas. JCP could reposition itself as a connector between people and services, rather than operating in isolation. JCP could tap into existing collaborations, build trusting relationships with alliances, and strengthen employment support for people living with mental illness while also supporting mental health recovery. Where these partnerships are underdeveloped, JCP could play a role in facilitating them, learning from established good practices.

ii)       JCP could also draw on VCSE organisations who have established community trust and connections to create opportunities for co-production with people who have lived experience. This would help ensure that employment support is shaped by the experiences of the people for whom it needs to be effective.
 

7)      What change should a new jobs and careers service prioritise to move beyond the support currently offered by JCP and the National Careers Service?

a)      The Into Work programme has successfully launched a mentorship initiative in partnership with Bank of America, providing clients access to experienced professionals or peers who support clients transitioning into work. This has demonstrated the effectiveness of tailored mentoring in helping people living with mental illness, transition into work. By providing consistent, individualised support, mentors help participants build confidence, develop job-related skills, and navigate employment challenges.

b)      This suggests that if the new jobs and careers service prioritise person-centred, holistic employment support, which includes personalised one-to-one mentoring, it would help support people who have been out of work due to mental illness and face complex barriers to employment.
 

8)      How could JCP reach a greater number and diversity of employers in order to offer a wider range of opportunity?

a)      Following the lessons learned from CMHT, JCP could engage with employers in a more strategic way. Many VCSE service providers like Mental Health UK are already work with businesses to improve their workplace practices when hiring people living with mental illness, but JCP could strengthen these efforts by connecting employers with these services.

b)      More JCPs could also improve employer engagement by expanding sector-specific networking events, job and volunteer fairs, and ensure that available VCSE and NHS services are being given the opportunity to join and connect. These initiatives would broaden employer participation, increase awareness of available support in the area, and create more employment pathways.

9)      What change should a new jobs and careers service prioritise to move beyond the support currently offered by JCP and the National Careers Service?

a)      A new jobs and careers service should strengthen partnerships with mental health charities and prioritise investment in specialist employment support. For people living with mental illness, access to the right support at the right time is critical. A more structured and efficient referral system should be established to ensure swift connections to appropriate local services, enabling tailored employment assistance rather than a universal approach.

10)  How can a new jobs and careers service support people to progress in their careers?

a)      Greater investment is needed to understand the barriers to in-work progression for people living with mental illness and to develop effective solutions on how to support career progression. The new service should work closely with employers and VCSE organisations to design and implement tailored progression strategies, and offer opportunities for people with lived experience to feed into its development.

11)  Please contact Julia Bacci Aggio, Senior Policy Officer at julia.aggio@rethink.org if you have any questions.

March 2025