Work will cure thee or how the government doesn’t listen to mental health experts…

Guest blogger Dawn Quinonostante shows quite clearly the difference between punishing regimes and co-operation between offical agencies and service users.

Let me be clear, I don’t hate MIND or the other Mental Health Charities neither do I deplore the Time To Change Campaign, but in stating that Government should be funding, resourcing and supporting people with mental health concerns in their localities and not propping up corporate mental health charities and national anti-stigma projects I get some heat, some hate and then largely ignored by them. I can take that; because I believe what I think is not at all unreasonable.

I’ve worked for MIND, for Rethink Mental Illness and been part of Time To Change’s campaigns. It was working for them that helped me recognise that the move away from community support groups, day services and into this ‘we’ll give you 6-12 one-to-one and that should pretty much fix you’ approach to mental health was failing the most disenfranchised and vulnerable mentally ill.

It’s clearly documented that the Work Capability Assessment fails the mentally ill. DWP sanctions and the test have been the cause of death recorded by the coroner for people with a mental health diagnosis. MIND CEO Paul Farmer has sat alongside DWP decision makers behind the scenes and refused to condemn tactics used that leave vulnerable claimants feeling bullied, terrified or dead.

Just this week many readers will have heard that MIND employee, Tom Pollard, has been seconded to Department of Work and Pensions for a year to advise on ‘policy’. It is of grave concern. He is not a medical practitioner, had the DWP wanted expert opinion on how best to serve those with mental health diagnosis there are hundreds of suitably qualified practitioners who would have leapt at the opportunity to have some realistic input. MIND is not impartial; they receive funding from Government, the same people who want to place ‘coercion’ units in Jobcentres to approach mentally ill claimants, to ‘support’ them back into work. There’s a narrative peddled by the press and Government that the mentally ill don’t want to work, and are too stupid to recognise that work will improve their mental health. Work should never be the desired outcome of any course of mental health treatment unless it is what the service user, the client has identified as their goal. For some employment is not something they can ever face, they should not be punished for this, but supported.

The question that concerns mental health campaigners is ‘why Pollard?’ Why not a medical expert? It’s not unreasonable to assume that since Work Capability and Personal Independence claims are assessed by staff with little or no knowledge of mental ill health that they’ve chosen him for the exact same reason. The fear is he can produce a host of ‘recovered mentally ill’ service users who are gainfully employed and thus validate the DWP remit to launch further attacks on claimants with mental health diagnosis.

Under the last Labour Government things began to change in how mental health services were funded. The idea that people were ‘dossing around’ in drop-in centres began to rankle those in high places, and services started to find their funding relied on accepting other initiatives. I was working for Rethink Mental Illness at that time and was introduced to *Julie from Pluss (not to be confused with Jobcentre Plus). She was brought in to the drop-in service to help anyone who had identified employment as a recovery outcome. There was no attempt at coercion, it was a trial. Her remit was to help Service Users access education, voluntary placements or employment and to work with educators, voluntary agencies and employers to help support people in these endeavours. She had no mental health background.

Julie’s first meeting was an astounding success, around a third of the attendees at the centre signed up. Amongst them was Harry, a highly qualified man in his early forties. *Harry was so excited by the initiative; he couldn’t wait to get back to work. He met Julie every week, his half hour appointment running into well over an hour as he discussed his work goals. After about three sessions Julie approached us, she couldn’t cope with Harry. Harry was very unwell. His manic depression, rapid cycling. He did indeed want to work; we all knew that, we’d spent time with him. His family had told him there was nothing wrong with him that a job couldn’t fix. They’d tell him to get back to work and he’d be well. He wasn’t looking for work for himself; he was trying to gain the approval of his family. It was sad to watch, and Julie was visibly upset by what she’d learned about Harry over the weeks she’s met with him.

Harry wasn’t unique. Many who were less poorly and wanted work found that Julie couldn’t find many employers willing to take on someone whom they felt may be unreliable. She became very frustrated and disappointed. She said she felt the approach was setting people up to fail and she was worried that this would further harm their health. Staff echoed this feeling, we knew from experience that people found the thought of opening up about their illness only to be rejected was damaging to their recovery.

There were from Julie’s initial sample group a couple of successful outcomes. One lady re-entered education and successfully completed a course and went on to work, another found work, with a truly supportive employer. Harry got some work volunteering in Oxfam, and this did improve his mental health, and his self-esteem. A successful outcome, that’s great. Others weren’t so lucky; they were rejected by employers, encountered workplace bullying or simply took on too much too quickly and became unwell.

Mental Health is too complex to prescribe work as a cure. It’s dangerous to try and amend the welfare system to include coercion and threats to welfare benefits for mentally ill claimants. Its unrealistic and cruel to parade a band of Shiny Happy Service Users to the public in order to demonstrate that further interference in the lives of mentally ill is justified and correct.

The entire welfare system must be more discriminating in how it offers people assistance and support back into education, training and employment but, and this is the sticking point the DWP can’t get beyond, it also needs accept that there can be non employment outcomes as well, and then to build in support to ensure people can still enjoy a meaningful life.

*Names have been changed