Written evidence from Rethink Mental Illness (DEG0183)

1. Introduction

1.1. Rethink Mental Illness

Rethink Mental Illness is a leading charity provider of mental health services in England. We support tens of thousands of people through our groups, services, advice and information. We train employees, employers and members of the public on how best to support someone affected by mental illness. All of this work guides our campaigning for the rights of people with mental illness and their carers.

In November 2020, Rethink Mental Illness, along with twenty-seven organisations, launched a campaign calling on the Government to pause benefits sanctions and work-related conditionality for people with mental illness and other disabilities.

1.2. End Benefit Sanctions campaign

The campaign is calling on the Government to:

•         Bring back the emergency pause on benefit sanctions and employment-related conditionality for 6 months

•         Use the pause to set out how they will end sanctions for disabled people for good

•         Improve employment support for people living with mental illness

1.3. The Work and Pensions Select Committee Inquiry into the Disability Employment Gap

We welcome the Work and Pensions Select Committee Inquiry into the Disability Employment Gap. Our submission focuses on the following:

Q1: How conditionality and sanctions can drive disabled people further from employment

2. The impact of sanctions and conditionality on employment for disabled people

2.1. Sanctions and conditionality worsen mental illness

Several studies have found that both the use and threat of sanctions can worsen mental ill health for people on benefits, in particular for people with existing mental health conditions. As well as the fact that sanctions have been a key driver of destitution[1], the threat of sanctions contributes to heightened anxiety and fear.

Research conducted by Glasgow University working with the Health Foundation found that the fear of sanctions could become overwhelming and at times be a driving factor for a mental health crisis. [2]

This worsening mental health of benefits claimants impacts their ability to search for employment. In a report released in 2020, Mind found that the fear of sanctions has resulted in many claimants with mental health conditions becoming fearful of attending Job Centers, seeing them as threatening and unhelpful places to attend. [3]

2.2. Sanctions and conditionality drive disabled people further from employment

Many people with mental illness and other disabilities state that they want to work or to take other steps that would allow them to live more independently.[4]

A 2018 a longitudinal study tracking fifty-eight disabled people’s experience of conditionality over three years, found that conditionality ‘did very little to move disabled people closer to the labour market’ but instead pushed disabled people further away from work[5].

The National Audit Office found that receiving an Employment and Support Allowance sanction resulted in reducing disabled claimants time in employment and increased the time they spent on benefits.[6] The Department of Work and Pension’s (DWP) evaluation of the Work Programme also found that sanctions and conditionality were not appropriate or effective in supporting disabled people into employment.[7]

2.3. Tailored employment support for people with mental illness can improve outcomes

Evidence shows that people with mental health conditions are much more likely to be successful in the labour market with a ‘no exclusions, no conditions’ approach such as Individual Placement Support (IPS) services, which are integrated within mental health services and offer intensive support to people living with severe mental illness

The EQOLISE project compared IPS with other vocational and rehabilitation services in six European countries and concluded that:

•         IPS doubles the access to work of people with severe mental illness;

•         The total costs for IPS were generally lower than standard services over first 6 months

•         Individuals who gained employment via the program were significantly less likely to be rehospitalised.[8]

3. Covid-19 and the current policy environment

3.1 The impact of Covid-19

The temporary suspension of work-related conditionality and sanctions for three months during the first Covid-19 lockdown was an important positive step, which was “communicated in a timely and effective manner” and “played a critical role in easing the pressures on destitute households during lockdown”.[9]

However, this suspension was not extended beyond the end of June 2020 and nor has it been brought back during either the November lockdown or the deeper lockdown that is currently in force (January 2020). DWP guidance has been amended to say that sanctions should only be applied where there is an up-to-date claimant commitment, and that claimant commitments, will be tailored to reflect Covid-19 restrictions such as those around shielding and caring responsibilities.[10]

On a practical level, we share the concerns of the PCS Union that failing to suspend conditionality and sanctions will put too much pressure on Job Centre staff, at a time when a very high level of claims need to be processed.[11]  More widely, given the negative impacts that benefit sanctions and work-related conditionality have on the mental health of disabled people and on their progress towards employment, we are not reassured by the Secretary of State’s statement that the resumption of conditionality and sanctions is part of a “return to normal”. We know that the “normal” that existed pre-pandemic did not work for people living with mental illness. The added pressures of Covid-19 and high unemployment (with whole sectors massively affected) risk making this situation far worse.

Although it is welcome that new job coaches are being recruited to meet increased demand, we are concerned that a situation will arise where DWP policy relies too much on compulsion through conditionality and sanctions, rather than tailored employment support. Instead, we believe that there is an opportunity to build on the positive action that Government took early in the pandemic to temporarily suspend conditionality and sanctions, and work towards longer term reform of the system.

This is why Rethink Mental Illness, along with twenty-seven other organisations, is calling on the Government for an emergency pause to sanctions and conditionality during the pandemic and using this pause to develop an approach to ending benefit sanctions for disabled people for good.

3.2 - Our asks of the Work and Pensions Select Committee

The Work and Pensions Committee can support this call by taking the following actions:

•         Raising this issue with the Secretary of State for Work and Pensions, Therese Coffery.

•         Recommending that the Government place a temporary pause on sanctions and work-related conditionality for another six months in response to the nationwide lockdown, recognizing the unique pressures on claimants and on DWP staff.

•         Meeting with us to discuss the campaign in more detail and how best we can work with the Committee to make the case for a different approach to conditionality and sanctions for disabled people.

4. Case study — Katie’s Story

Katie lives with several mental health conditions including an eating disorder and anxiety. She’s relied on benefits most of her life but - instead of supporting her through her illness - the welfare system has exacerbated her condition and made her afraid to seek support to go back to work.

Katie was first sanctioned when she moved from Kent to Yorkshire to be closer to her family for support. The DWP stated that by moving she has broken her claimant commitment and she was sanctioned for six months. This resulted in financial hardship and food poverty which worsened her eating disorder.

She was then sanctioned for second time and states ‘when I had decided to volunteer for a week with the girl guides – something I knew would help my mental health - the job centre swiftly told me they were going to have to sanction me because volunteering would make me ‘unavailable’ for work. But the irony is that I went for an interview while I was volunteering that week, and I ended up getting the job. They still sanctioned me.’

Katie was later assessed as needing to be in the Support Group for Employment and Support Allowance. This meant she was no longer required to work due to mental illness. However, her remaining fear of sanctions makes it less likely she will seek work in the future when she is feeling well enough to:

Sometime in the future, I’d like the job centre’s support to help me return to work – but the fear of sanctions really puts me off from telling them. Because if I do, I know they will change my benefit back to being subject to meeting job-seeking requirements again, that if I don’t fulfill, will leave me vulnerable to sanctions again.  I don’t want to have to choose between rent and food again.

January 21