Mental health treatment in the Job Centre – what could possibly go wrong?

A Mental Health task force set up by Nick Clegg has decided to subject people on benefits to mental health treatment at the Job Centre.

Out of all the possible environments for mental health treatment, the Job Centre could the worst.

The treatment will take the form of talking therapy and computer-based Cognitive Behavioural Therapy. A posting on the governments’s Contracts Finder website reveals that the DWP intend to spend £21 million on the online CBT. It is not clear how much they intend to spend on human therapists, where they think they can get them, or whether they will actually have training and experience to do the job.

There are so many problems with this scheme that it is hard to know where to start. The biggest problem I can see is that there can be no meaningful consent to treatment in the context of the Job Centre. Where once the Job Centre was there to help people to find a job, these days it is more known for ruthless sanctions and cutting off benefits for whatever trivial excuse they can come  up with. If Job Centre staff tell someone that they need mental health treatment it will be backed up with words such as “your benefits may be affected if you do not attend” which is a barely-veiled threat that they apply to most “voluntary” tasks that they inflict on people.

The regime of sanctions and workfare means that the Job Centre is a direct cause of much mental illness among people on benefits. I cannot see anyone wanting to reveal this to any therapist in the Job Centre even if absolute confidentiallity is promised. There is too much danger of it leaking to vindictive staff who are eager to hit their targets for sanctions.

Computer-based CBT could be even worse. CBT does not work for everyone and there is a chance that staff will use failure to get better as an indication that someone is not trying, and an excuse to cut their benefits. CBT often makes people worse before they get better and it is not something that should be done in a public place where there is little chance of privacy. It could leave people in a raw emotional state and vulnerable while out in public, or the setting may prevent people from engaging at all. Indeed, the suspicion will be that Job Centre staff will monitor progress just like they monitor the Universal Job Match system.Whether true or not, that will be a barrier to a lot of people.

This whole scheme seems to have been set up with the primary aim not of improving mental health, but of getting people in to a job. There is no indication of how the DWP will treat people whose mental health does not improve enough to get a job, or even get worse. Clegg’s mental health task force seems to have no clue about the reality of unemployment, poverty or illness. Had they asked anyone in this situation they would have been told that this plan will be damaging, not helpful.

If there is money available – and seemingly, there is at least £57 million available – why on earth isn’t it being spent within the NHS to undo some of the savage cuts that have taken place? Lots of people including myself have been desperate to get proper talking therapy from the NHS for years but unable to do so. Tories and LibDems seem desperate to force unsuitable treatment without consent on people on benefits instead of properly funding NHS services. This scheme is a useless bandage on the gaping wound inflicted by this government and it will do more damage than it helps repair.

Related Links

Clegg announces plan for job centre mental health treatment scheme

Nick Clegg holds first meeting of mental health taskforce

Contracts Finder: Online Supported Cognitive Behavioural Therapy

 

Do unemployed people need a kick up the backside?

It is a common belief that unemployed people are mostly scroungers who need a kick up the backside to get them working. People believe that others choose not to work because benefits are luxurious. I argue not just that is wrong, but also that the reasons for not finding work are irrelevant.

There simply aren’t enough jobs for everyone. Although there are about 868 thousand people claiming Job Seeker’s Allowance and approximately 700 thousand advertised vacancies, those figures do not tell the whole story. The job vacancies that remain unfilled are for the most part not available to the people who are looking for work, because employers consider most remaining unemployed people to be undesirable as employees. Maybe that is because of their lack of qualifications, or gaps in their CV, their perceived attitude to authority, or simply the way they look. Many vacancies are filled by people who are leaving another job and are never open to unemployed people.

In some areas there are hundreds or even thousands of applicants for each job. The real availability of jobs for the average jobseeker is revealed in news stories like these:

Society is focussed on working for employers. It is unlikely that going self-employed or starting a business will be successful, and it is even harder under Universal Credit where a self-employed person is assumed to be earning at least minimum wage.

It is no longer feasible to survive by building your own house and growing your own food on your own land. Back in the distant past there was work for everyone, just because keeping people supplied with food and shelter was so intensive. It used to be possible to remove yourself from society to build your own house and grow your own food but that isn’t true anymore. There is no land available to farm without paying for it, no way to be self sufficient without having taxes demanded of you. Even the smallest interaction with the rest of society requires money. There is no choice but to accept employment working for someone else or find a niche to start a business in, and there are not enough jobs and not enough business opportunities for everyone. There are enough resources for society to ensure that everyone is clothed, fed and given shelter, and even to have a high standard of living.

Work on it’s own is not always good for you or somehow virtuous no matter what you say. One study that the DWP likes to quote [PDF link] did say work is good for you but the definition of work used was far wider than just paid employment, and stability of work and income was considered essential for work to be beneficial. Doing something worthwhile will usually make people happier than doing nothing but that doesn’t need to be paid employment. As an aside, work for benefits schemes (“workfare”) can have the opposite effect especially if the work is perceived as pointless. And if the workfare is actually something that needs doing then it’s probably putting someone else out of work.

If employment is not beneficial in itself, and if there aren’t enough jobs to go round, and if there are enough resources for everyone in spite of this, then punishing someone for failing to find a job is simply cruel and vindictive. It is punishment for something people have very little control over. Moreover, it is punishment for failing to do something that is not necessary. If someone doesn’t want to work, what difference does it make to you if they don’t find a job and someone else fills any vacancy? It won’t lower the cost of social security. Would you rather they were unhappy just to make you feel better? A better solution is citizens income / universal basic income, or failing that, putting a stop to benefit sanctions. The all-too popular idea of “Don’t work don’t eat” is cruel and vindictive in this modern age.

“Lots of folk can’t afford a car”

I tweeted about the thousands of people that will lose Motability cars (and wheelchairs) when their DLA is taken away.

A clueless person replied

they get £2k when car is taken away! Lots of folk can’t afford a car at all no matter what their situation x

Lots of poor people are “trapped” without a car but they don’t get £2k to help x

Where do I start?

Most people can walk, or cycle, or get the bus without it causing pain and exhaustion, or get the train, or do a combination of all of that. And yes, if someone is a customer of Motability when their DLA is taken away, they’ll get £2K from the charity. (Part of Motability is a charity.)

It won’t go far.

I have to have a car that is

  1. big enough to get a wheelchair in,
  2. comfortable enough not to leave me in pain,
  3. automatic, with an electric handbrake and cruise control, otherwise, again, pain.

£2K will not buy that car. It will also not do many taxi journeys to doctors, hospitals and supermarkets while living out here in the countryside. So I’ll have to use my electric wheelchair and the bus. I’ve only got the wheelchair because I begged for donations – remember, some use Motability to get one, and it’s a choice of wheelchair or car.

Taking the wheelchair on the bus is extremely exhausting for me and ultimately, painful. If I run out of energy or get overwhelmed by pain half way, I’m screwed. So I’ll stop going out except for vital things, like the doctor. Without a car, that trip takes several hours.

Then I spend a week recovering.

If I stop going out, my already precarious mental health takes a dive. I’ll probably become suicidal again.

Problem solved for the DWP, I suppose.

Just in case you’re under the misaprehension that PIP/DLA is only being taken away from people that don’t really need it, here’s what the DWP themselves said, quoted at a Judicial Review last year:

“we were aware that the vast majority of recipients of DLA were individuals with genuine health conditions and disabilities and genuine need, and that removing or reducing that benefit may affect their daily lives.”

The government is deliberately taking help away from people who can walk more than twenty metres but still less than fifty, and they say they know that those people have “genuine need”, they just don’t care what cutting DLA will do to them.

Is it right to take DLA away from thousands of people because “Lots of folk can’t afford a car at all no matter what their situation”? Ask yourself if it has quite the same impact. Or why the hell you don’t ask why those other people aren’t paid enough to afford a car.