People struggling with their mental health need support, not sanctions  

16 November 2023
By Kadra Abdinasir

Last month, the Department for Work and Pensions (DWP) closed its controversial consultation on the Work Capability Assessment (WCA). The assessment enables DWP to determine people’s capabilities to work and what level of financial and other forms of support they receive according to their health condition or disability. Since it was introduced in 2008, the WCA has been widely criticised for failing to properly assess a person’s capacity to work, particularly for people living with mental health problems. 

People with serious and long-term mental health problems can face difficulties getting into work because of their illness, and often experience barriers such as the lack of accessible opportunities or getting the right adjustments once they’re in work.  

Over the last decade, we’ve seen a series of reforms made to the social security system which have had devastating consequences for people with long-term health conditions and disabilities. Despite this, the DWP are proposing further changes which may result in even more reductions to the benefits and support people receive.  

Some of challenges surrounding the Work Capability Assessment have been recognised by government and there are longer term plans to scrap the assessment altogether as part of the Transforming Support white paper, but there are concerns about what it will be replaced with. 

So what are the proposed changes? 

Ahead of the White Paper being implemented (and thus the ditching of the WCA) from 2025 onwards, DWP are putting forward options to better align the assessment to the Personal Independence Payment (PIP) assessment with the view of working towards a single health and disability assessment in the future.  

The consultation proposes changes to the categories that people who are assessed as not fit to work fall under, and the level of support they receive. The key changes in the consultation relate to the two following groups: 

  1. The Limited Capability for Work and Work-Related Activity (LCWRA) group – people who are in receipt of Universal Credit at a higher level and not expected to look for or prepare for work. 
  1. The Limited Capability for Work (LCW) group – people who aren’t currently looking for work due to their illness but could benefit from support to prepare them to work in the future. This group are subject to some forms of conditionality, such undertaking work related sessions, but they aren’t expected to apply for work and do not receive any additional payment of Universal Credit.  

The proposals set out in the consultation document suggest moving groups of people out of the LCWRA category and putting them into the LCW one.  

What are we concerned about? 

Overall, we feel that the changes proposed by the department will not get people with long-term conditions and disabled people into work – on the contrary, they will likely cause them a great deal of harm by reducing their incomes. If these changes are taken forward, claimants moved out of the LCWRA category could lose up to £390 a month. It also means they will face a greater threat of conditionality and sanctions. 

We already know that people with enduring and long-term health difficulties are much more likely to face financial hardship and poverty than others and for many, this inequality has been entrenched by the pandemic and the subsequent rise in the cost of living. Equally, research has repeatedly demonstrated how poverty worsens a person’s mental health.  People with mental health problems and other disabilities should be provided with adequate support in accessing and maintaining employment without the risk of losing income or facing sanctions.  

The evidence put forward by the department also makes huge assumptions about the availability and accessibility of home and hybrid working, and uses this as a basis for the changes without robust enough analysis on disabled people’s working preferences.  

Furthermore, we share the concerns raised by the Equalities and Human Rights Commission and others about the accessibility of the consultation, its timeframe, and the poor communication and evidence around how these changes could affect disabled people and those with long-term conditions. 

We therefore urge the department to reconsider these proposals which lack a sufficient evidence base. These changes appear to be more about cutting departmental costs than they are about supporting people into work. While money may be saved by not paying people the LCWRA element, there may be consequences and costs incurred elsewhere, such as the NHS, to support people adversely affected by the changes. 

What can we do instead to support people with mental health problems into work? 

There are many steps the Government could take to provide compassionate and effective support for people with mental health problems who want to work. 

Individual Placement Support (IPS) is a well-evidenced model which supports people with severe and enduring mental health problems into work. It focuses on tailoring work opportunities to people’s preferences and building relationships with local employers and IPS workers. The model also seeks to strengthen the support people get once they get a job.  

Through IPS, it is possible that people with mental health difficulties in both the LCW and LCWRA groups could be supported into paid work. Denying anyone who wants help with employment misses a chance to help them to get into work. But putting more people into the LCW group who are currently in the LCWRA group will not improve their job prospects. It will simply lose them money, at a time they need it more than ever to get by. Mandating work-related activity is fundamentally flawed and has also been shown through the evidence base for IPS to be unhelpful.  

The NHS Long Term Plan has already committed to expanding IPS support to 55,000 people by March 2024 so it’s vital that anyone who could benefit from this support gets it. 

In addition to this, future reforms as part of the White Paper must be based on evidence, co-designed with people with lived experience, and strengthen the support people with enduring health concerns receive. 

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