Critics say plans for London clinic come dangerously close to government proposal to give psychological treatments to the unemployed.
Mental health workers and their clients marched on a jobcentre in south-west London in protest at a scheme they say frames unemployment as a psychological disorder.
The Department for Work and Pensions announced in March that Streatham’s jobcentre would be the first to have therapists giving mental health support to help unemployed people back into work.
The DWP has now said that announcement was a mistake. But by coincidence, next week Lambeth council will open a £1.9m mental health clinic in the same building.
Joblessness Branded A ‘Mental Illness’: Cognitive Behavioural Therapy or Sanctions?
Last year this was reported by Brian Wheeler on the BBC site. June 2015.
Unemployment is being “rebranded” by the government as a psychological disorder, a new study claims.
Those that do not exhibit a “positive” outlook must undergo “reprogramming” or face having their benefits cut, says the Wellcome Trust-backed report.
This can be “humiliating” for job seekers and does not help them find suitable work, the researchers say.
But the Department for Work and Pensions said there was no evidence to back up the “highly misleading” claims.
The paper, published in the Medical Humanities journal, says benefit claimants are being forced to take part in positive thinking courses in an effort to change their personalities.
They are bombarded with motivational text messages – such as “success is the only option”, “we’re getting there” and “smile at life” – and have to take part in “pointless” team-building exercises such as building towers out of paper clips, it adds.
New benefit claimants are interviewed to find out whether they have a “psychological resistance” to work, with those deemed “less mentally fit” given more intensive coaching.
And unpaid work placements are increasingly judged on psychological results, such as improved motivation and confidence, rather than whether they have led to a job.
The report’s co-author, social scientist Lynne Friedli, described such programmes as “Orwellian”.
“Claimants’ ‘attitude to work’ is becoming a basis for deciding who is entitled to social security – it is no longer what you must do to get a job, but how you have to think and feel.
Then there was this: Mental health workers protest at move to integrate clinic with jobcentre. July 2015.
There has been much discussion on this Blog and our fellow Bloggers’ sites on these ideas.
They include the reasons why unemployment is being rebranded as an ‘illness’ or a mental problem and how this “reprogramming” is going to take place.
Putting JobCentre advisers into GP surgeries is part of the same push.
This year they took a step forward in their plans,
Disabled activists are to march on a surgery next month in protest at its involvement in a government scheme that is placing welfare-to-work advisors from a discredited US outsourcing giant in GP practices.
Six surgeries in Islington, north London, are taking part in the year-long pilot scheme run and funded by the Department for Work and Pensions (DWP) and Islington council.
Under the Working Better scheme, job coaches employed by Remploy – which is now mostly owned by the US company Maximus – are placed in GP surgeries for one day a week.
Patients who are unemployed and have long-term health conditions can ask their GP to refer them to “intensive and personalised employment coaching” within the surgery.
The job coaches “work with patients to establish their previous work experience, knowledge and skills, to build confidence, set goals and identify job or educational opportunities”.
But activists from the Mental Health Resistance Network (MHRN) and Disabled People Against Cuts (DPAC) say the pilot scheme will destroy trust between doctors and their patients, particularly those with mental health conditions.
They are particularly alarmed at the involvement of Maximus, which already runs DWP’s work capability assessment system and has quietly secured a string of other lucrative DWP contracts.
MHRN, DPAC and other activists are planning a protest march on 4 March that will target City Road surgery, one of the six GP practices taking part in the pilot project.
Today the Morning Star is to be congratulated for publishing this important article.
Forcing the unemployed to undergo therapies they don’t want or blaming their attitude for their plight is totally unethical, write RUTH HUNT and LINDA GASK
ON MONDAY February 15 the Mental Health Task Force, in its latest report, recommended various measures to improve mental health services.
They were broadly welcomed, but one passage within the report caused much consternation: “Of people with mental and behavioural disorders supported by the work programme, only 9.5 per cent have been supported into employment … Employment is vital to health and should be recognised as a health outcome. The NHS should play a greater role in supporting people to find or keep a job.”
“Gaining employment” as a major indicator for people with mental health problems is a matter of great concern.
This is not the case for any other form of health problem. Furthermore, recent research published in BMJ Medical Humanities — Critical Medical Humanities suggests that unemployment is now being regarded as a psychological disorder within workfare schemes, with participants encouraged — or coerced — to think positively or to change their attitude.
Employment does have positive health outcomes, but if someone with a mental health diagnosis returns to work too early it can cause further problems. For example, there is always a risk that they will have problems managing in the work environment — which can lead at the very least to loss of confidence which will affect future ability to get back to work, and then to more serious consequences, including relapse. And there is always the risk that they and their employers will doubt they will ever be able to cope at the level of work they did previously, which will be very damaging to their future prospects.
We know that Work and Pensions Secretary Iain Duncan Smith wants to target those with mental illnesses, who are receiving Employment Support Allowance (ESA) with plans to force then to undergo treatment if they declare themselves unfit for work. The implication is that it is the attitude and motivation of these people that is at fault.
However, in cases of severe mental illness, it is extremely difficult to see how someone who is struggling with everyday life could be considered at fault if they did not have the “right attitude” or motivation to work. They may want to return to work, but the priority should be to help them to get to the optimal level of functioning, and then support them back to work. This has been shown to be effective and helpful.
Placing all responsibility on those suffering simply adds to the burden experienced and can contribute to relapse rather than recovery. This is what we have repeatedly seen when people are summoned to assessments and told that they are fit for work, when it is perfectly clear that they are not.
It is also clear that more effort needs to be invested in early help for people with mental health problems to ensure that they stay in work. This is promised in the Mental Health Task Force report. However pushing people into unsuitable jobs has been shown to be as potentially detrimental to mental health as the impact of unemployment.
Cognitive behavioural therapy (CBT) both person-to-person and online seems to be the main thrust of the treatment proposed. Presumably if the individual refuses they will be sanctioned. But for therapy to be effective a person has to be a willing participant.
There is no therapy that can “motivate” a person to find work unless they are able to consent to participate in it and well enough to actively engage. Online CBT has been shown to be ineffective for depression when offered without the support required to help and engage the participant. Therapy itself is not without side effects.
Furthermore, it’s difficult to see how requiring unemployed people to participate in such online “therapy” is going to have very much effect, completely aside from whether it’s ethical.
Improving access to psychological therapies (IAPT) services are already faced with “back to work” targets but have managed to achieve them without therapy being too closely linked to assistance in getting a job. That’s great — but unemployment benefit savings were originally linked to funding IAPT because we were told this was the only way more psychological therapy could be funded. Now getting into work has become the key outcome in itself. We should be seeking to help people to recover from their mental health problems first.
There is always a danger when funding of anything is linked to targets that a person will be a) directed to therapy by benefits staff who have to meet targets — and, even worse, b) pushed towards work by healthcare workers whose funding is also dependent on this.
The rest of the article here.