16 March 2018 | by BPS Policy Unit
The following article has been produced by Dr Lisa Morrison Coulthard, Acting Director of Policy for the BPS, and lays out some of the details of our current policy work and the impact it has had.
In 2015, we issued our Call to Action and Briefing Paper on Work Capability Assessment Reform. This was the start of a prolonged campaign to push for end to end reform and better use of psychological evidence to develop appropriate assessments and training for job coaches, as well as greater recognition that returning to work or gaining employment is not always an appropriate end goal for individuals with mental health conditions and disabilities.
Clearly a one size fits all approach is not fit for purpose.
This also resulted in a considerable amount of joint activity with the other main psychological therapy organisations (the British Association of Counselling and Psychotherapy, the UK Council for Psychotherapists, and the British Association for Behavioural and Cognitive Psychotherapists and the British Psychoanalytic Council) aimed at raising our concerns with the Joint DHSC/DWP Work and Health Unit about the potential co-location of psychological therapy services in job centres and the inclusion of psychology therapy within mandatory requirements for receipt of benefits.
More recently, this has focused on the incorporation of employment support within IAPT training and the various psychological therapy trials. We have also called for the suspension of the use of sanctions for individuals with mental health conditions subject to an independent evaluation of its effectiveness, and much has been made of the decision by Andrew Marr to question the Secretary of State for Work and Pensions, David Gauke MP on The Marr Show, where he directly quoted an open letter signed by representatives of the BPS and other leading psychotherapy organisations.
A key focus for this workstream is the Psychology at Work: Improving Wellbeing and Productivity in the Workplace report which was launched by the All Party Parliamentary Group in November 2017, and which emphasises the importance of meaningful work and a psychologically healthy workplace, the need to focus on the strengths of individuals with neurodiverse conditions, and how the use of psychological evidence could help policy makers design more effective employment support interventions and support systems.
Significantly, this report and its key findings has resulted in 9 Parliamentary Questions in the House of Commons in January 2018 and is the subject of a debate which is currently under consideration in the latest HoC ballot.
Parliamentary activity in this area is closely monitored so as to enable us to extend our network of contacts with key policy influencers, and we have met with numerous Minsters and officials to raise our concerns further.
We are also working with organisations such as SCOPE and Mind, as well as other mental health charities, to unite our voices on the need for reform.
Most importantly, as a result of our campaign work, we are part of the Expert Reference Group on Work and Health for the DHSC and DWP, in addition to being very active in various workstreams arising from the EAG, such a claimant engagement, the suitability of work as a health outcome and the revision of the consensus statement on work and health.
On top of all this we continue to push hard on our key policy asks:
End to end reform of the WCA and other assessment components of the welfare system (such as PIP) as the processes neglect the wider biopsychosocial picture of an individual circumstances, whereas a more holistic approach would/should consider not only the physical condition of the individual but also the circumstantial, social and psychological elements.
That the process of assessment is distressing, inaccurate and often results in inappropriate outcomes that do not match an individuals needs.
That the current process is driven by Government policy and not by professional best practice.
The need to ensure that specialist assessors are appropriately trained to assess complex, progressive or fluctuating mental health conditions. Parity of esteem for mental health should also mean parity of assessment and parity of training for the assessors.
The need to ensure that assessors are trained to be sensitive to the needs of those individuals, and understand that additional support may be required to ensure sufficient comprehension and understanding of the assessment and what is being assessed. A process of co-design with service users and professionals is essential.
The Governments approach to benefits, the employment situation within communities, and the opportunities for work within them is seen within a biopsychosocial model. This would help to ensure that assessments retain a focus on the reality of the claimant’s situation and reduce the likelihood of stigmatising individuals who do not, or cannot, find lasting employment.
That the Government recognises the importance of the social aspects of work for those with mental health conditions and disabilities. The concepts of social support at work is recognised as an important element for individual wellbeing and plays a vital role in the need to change attitudes towards disability and work.
That the Department for Work and Pensions explicitly recognises that work is not always good for health, and health and return to work goals need to be considered separately.
There is evidence of some movement towards understanding the need to recognise the value and importance of “meaningful activity” rather than just work. As set out in the White Paper on Improving Lives, there is a clear commitment to ensure that individuals received personalised tailored support.
However, the much needed end to end reform, especially of WCA and PIP, still seem too far down the political agenda. Without this reform, other improvements to the process and the system will fall far short.
As we keep emphasising, and as quoted in the Select Committee Report of the Inquiry into ESA and PIP assessments:
“any process designed to support those in need must uphold or improve the psychological wellbeing of those individuals.”
Reform is essential, as is the suspension of sanctions until their impact is evidenced and understood. Evidence based policy making is also essential. And all are long overdue.