All Party Parliamentary Group for Mental Health

Notes of meeting: September 2003

Work and Benefits Seminar

Portcullis House, Westminster

Tuesday 16^th September 2003

Panel:

·          Dr Lynne Jones MP, Chair

·          Ben Stayte, Team Leader, Incapacity Benefit Strategy, Department for Work and Pensions

·          Dr Philip Sawney, Deputy Chief Medical Adviser, DWP

·          Sophie Corlett, Policy Director & Ali Cobb, Mind Benefits Campaign

·          Ruth Stanier, Deputy Director at the Social Exclusion Unit and Project & Leader for the Mental Health and Social Exclusion project

Lynne Jones MP: Lynne Jones introduced the seminar. The event was proposed by Paul Boateng MP when he addressed the Group in 1998 as a junior health minister. Mr Boateng discussed with the Group the difficulties which may be faced by people with mental illnesses when they are trying to navigate the work and benefits system. The All Party Group has remained interested in this area and the seminar provides an opportunity to discuss what progress has been made since then.

Ben Stayte: Bridges from benefit to employment – Pathways to Work Green Paper

Ben Stayte began by outlining the Department’s role, working with Jobcentre Plus (formerly the Benefits Agency) to develop a strategy to improve the delivery of Incapacity Benefit. He noted that the number of people claiming the benefit has quadrupled since 1979. The proportion of claimants with mental illness has also risen. The claimants incorporate a number of different groups including those with mental illness (who make up 35% of the caseload), muscular/skeletal problems and circulatory/respiratory disorders.

Mr Stayte explained the need for change with the illustration that once on Incapacity Benefit, a person is more likely to die or retire than to find a job. Also 40% of people on the benefit were out of work for two years before they applied for the benefit, which means they already have financial worries. People also may receive poor advice from GPs, saying they will never work again. The Green Paper was needed so that a better framework could be developed to help people back into work and provide more support through the benefits process

The Department is also looking at providing more support in the workplace through such mechanisms as making work pay through incentives and training in appropriate areas such as assertiveness. This will be done in consultation with stakeholders including health professionals. Trials are currently in place over 10% of the country. The new strategies have been prompted by research, which has given the Department a better understanding of the effects of worklessness.

Mr Stayte assured the Group that there was political will for improvements to be made and if the Pathways project does not solve the problems then alternatives measures will be found.

Sophie Corlett: Benefits and people with mental distress

Ms Corlett introduced the Mind benefits campaign, which centres around five key issues i.e.:

·          Improving the transition between work and benefits

·          Improving the benefit levels for long stay patients

·          Improving the navigability of the system

·          An improvement in the training and mental health awareness of benefits agency staff

·          Increasing take up of (Disability Living Allowance) DLA amongst service users

She noted that a more sophisticated back to work service is needed for people on Incapacity Benefit, which can be more responsive to their individual needs. Most people need a gradual passage back into work with support for attending interviews and filling out forms. Mind’s research shows that the benefits system itself can be a barrier to people because the forms are long and difficult to complete. Ms Corlett recommended that staff in Jobcentres be given better training to help those applying for benefits.

Local Mind groups have reported that they have found many people who are eligible for DLA but do not realise or have been put off by the process. Mind want to increase the take-up of such benefits with support from the Department for Work and Pensions.

The charity has also recently launched a snakes and ladders pack to support their campaign.

Ruth Stanier: Emerging findings from the Social Exclusion Unit consultation on Mental Health

Ruth Stanier reported that the Social Exclusion Unit (SEU) consultation period, which ran over the summer, closed in early September and that the results are now being collated. The report will be presented to other government departments and to ministers and will be published in Spring 2004.

Ms Stanier noted that the consultation was far-reaching, 1 in 6 people is affected by significant mental illness. Key findings include that lone parents are particularly at risk of developing a mental illness. The main barriers to finding work were identified as being:

·          The fluctuating nature of the illness

·          Low expectations of health professionals

·          Fear of losing benefits

·          Employer’s attitudes

The Department for Work and Pensions’ research shows that fewer than 40% of employers would take on a person who they knew had suffered from a mental illness. The SEU’s work shows that more flexible working practices are needed to help people with mental health problems to work, such as flexible hours and other benefits which working parents already receive from many employers.

Ms Stanier highlighted some good examples such as the Timebank projects and the Mainstream project in Liverpool. These provide a pro-active approach towards finding work for people in the community. Ms Stanier noted that supported employment (providing real jobs in the community) was much more effective at helping those with a mental illness into work, as opposed to sheltered employment (projects such as basket weaving etc. in a closed environment).

People with mental health problems are also excluded from other areas of society, such as jury work and school governorship and may also face tenancy problems if they develop arrears. The SEU will conclude that a joined-up approach is needed to provide support in all areas of a person’s life, including health care, employment services, education, housing and leisure.

Finally, stigma was mentioned by over 80% of respondents to the SEU consultation. This is clearly the biggest problem facing people with mental health problems.

Discussion:

The Group was impressed by the progress made by the Department for Work and Pensions. However an area of particular worry which was raised concerned the forms which must be completed in order to receive Incapacity Benefit. Many members of the audience felt that the forms (too much paperwork) and the lack of understanding from staff was a huge obstacle. Mr Stayte noted that the Department is working with the voluntary sector and professional bodies to improve the knowledge of their staff in the Jobcentres. It was also noted that most of space on the form was taken up with questions about physical health which often were not relevant but still had to be completed. It was suggested that a separate form for mental illness about be developed but the Department has no plans to take this forward (though it may do for DLA forms).

The meeting agreed that employers needed better awareness of mental health issues and the ways in which someone with a mental illness could be incorporated successfully into their workforce. Sophie Corlett noted that there are a wide range of jobs which can be done by people with mental illnesses. However, Mind have found it hard to communicate this to employers and generally among the public there still seems to be a lot of fear and misunderstanding about what mental illness is. Keith Foster of NIMHE noted that the Department of Health’s mental health campaign “Mind Out” had won support from many of the larger employers and had produced a pack for line-managers. The Starfish project was mentioned as an example of good practice by the UK Federation for Smaller Mental Health Charities.

The recommendations of the Health Select Committee report on employment were raised concerning the run-on period for benefits and it was noted that a different approach was being taken in the Pathways paper because primary legislation would be needed for the benefit run-on.

The discussion also touched on the overlap between mental illness and substance abuse and the added problems this can lead to. Dr Sawney agreed this was a problem particularly in certain parts of the country. It was noted that people are often given treatment for one problem or the other but rarely receive joined-up care.

Several people raised the point that service user involvement is vital in improving services and paperwork. However, the use of service user time rarely receives proper payment despite the expertise given. It was also noted that this sort of involvement can help service users back into work and be therapeutic. The Mental Health Foundation has produced guidelines on fair pay for this sort of consultancy work.

Conclusion:

Lynne Jones thanked all the speakers and those who attended as well as Agnes Wheatcroft for organising the event. The meeting proved to be very useful and it was asked that the speakers would keep the Group updated and involved in any future work done by their organisations in this area..

Members present: Dr Lynne Jones MP, Liz Blackman MP, Tim Loughton MP

Other organisations: Martin Aaron (JAMI), Prof. Nick Bosanquet (Imperial College), Carol Brennan (St George’s Hospital Medical School), Philip Dixon-Phillips (UK Federation of Smaller Agencies), Greta Downey (Meridian East Norfolk), Keith Foster (NIHME), Shazia Ghani (Outward), Emma Harding (St George’s Hospital Medical School), Caroline Hawkings (Turning Point), Sue Mason (Janssen-Cilag Ltd), Pippa May (West Norfolk MIND), Roy McKenna (NIHME Eastern), Brendan McLoughlin (London Development Centre for Mental Health), Sue O’Connell (St George’s Hospital Medical School), Shenée Parfoot (CAPITAL Project), Howard Pearce (CAPITAL Project), Celia Richardson (Mental Health Foundation), James Stibbs (APCO), Angela Taylor (St George’s Hospital Medical School), Natasha Vromen (Drugscope), Agnes Wheatcroft (Royal College of Psychiatrists), Lucy Widenka (Rethink)

Refreshments were kindly sponsored by Janssen-Cilag Ltd.

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