Mental Health Welfare Reform

Masood Khan Royal College of Psychiatrists

Nov 2014

“My Lords, there are winners and losers in life. Usually those who have the most are the winners, perhaps because they

are better able to advocate for themselves, and also because their needs

are better understood in government.”

Baroness Sheila Hollins 1

1 The impact on people’s mental health of the welfare reforms

2. The way welfare reforms fail to address the needs of people with mental health problems

2

Welfare Reform Act

• Bill introduced in February 2011

• Moved within parliament

• Became an Act in March 2012 3

Key Reform Concerns• Mental health needs to be a key consideration

• Light on detail/ vague definitions – inadequate scrutiny

• Heavy focus on increased severity of conditionality & sanctions

• Problems with time limits and benefit caps

• People missing out and an increased pressure on services 4

Impacts

• People inaccurately assessed

• Causing a lot of trauma

• Exacerbates mental health

= Debt, Hardship, potential Homelessness

• Appeals increase (Up to 40% overturned)

= All above compounded by re-assessment 5

Failure to Address• Benefit assessments do not address needs of those with

mental health problems

= ‘Descriptors’ are inadequate

= Do not factor in Fluctuating Conditions

= No system to seek, secure and analyse additional

medical evidence

= People placed in wrong benefit group

= Lack of/ inappropriate support into work 6

WCA Harrington Recommendations

• More detailed monitoring of some of aspects of the WCA as it changes over time

• Greater use of additional evidence from applicant’s medical and support staff in the assessment

• Assessors with specific expertise in mental health assigned to applicants with mental health problems

• A more considered approach to the rate of reassessment, taking into account the impact of the WCA on claimants

• A detailed examination of the role of welfare advisers and the impact they have on claimants receiving a fair assessment

• A fundamental review of what is meant by ‘work’ and how the assessment gauges applicant’s ability to work

7

Medical EvidenceRecommendations

• Improved information-sharing between NHS and DWP

• A summary of information from the claimant's medical records

• Fitness to Work statement submitted as part of the claim process before the WCA is carried out

• ESA50 questionnaire as an alert to DWP to people affected by mental illness who could face difficulty collating their own evidence.

•

8

Disability Benefits Consortium

DBC ManifestoThe next government:• Must recognise the extra costs disabled people are forced to pay, and take steps to tackle this financial disadvantage in the longer term. • Should ensure appropriate support for disabled people to work, and security for those who cannot. • Should take a lead role in changing the way society talks about welfare.• Should ensure overall spending on financial support for disabled people is allocated on the basis of need, not pre-determined limits to avoid disabled people losing the support they need in years to come. • Should take action to ensure that a person’s disability does not mean that they are disproportionately affected by policy decisions. 9

More Information

Royal College of Psychiatrists

Social Inclusion pages: http://www.rcpsych.ac.uk/policyandparliamentary/socialinclusion.aspx

Masood KhanPolicy Analyst

mkhan@rcpsych.ac.uk

x

10

A model for cost-effective, MH services to support recovery

Peer Support Workers (50%?)

Treatments(medical and psychological for both mental and physical health)

Recovery College(s)

Employment (IPS)

Housing

Social integration, local anti-stigma

Specialist teams(EI, crisis teams)

Inpatient wards(‘No Force First’, Joint Crisis planning)

Family support

Money (PHBs, welfare advice)