Tag: BPS

BPS sign consensus statement asking for end of welfare sanctions

Image result for welfare sanctions

The British Psychological Society (BPS) has joined eight other leading mental health organisations in calling for the removal of social security sanctions for people with mental health conditions. The statement launched yesterday at the 12th New Savoy Annual Conference in London.

It calls for everyone living with a mental health condition to be supported in gaining financial security, whether through the social security system or appropriate help in returning to or gaining paid work. However, the statement makes clear that no one with a mental ill health should ever be forced to look for work, or face the threat of having their lifeline support reduced because of welfare conditionality and sanctions.

In the statement signed by mental health experts and charities, such as the Centre for Mental Health, Mental Health Foundation and Rethink Mental Illness among others, the BPS say: “We believe that everyone living with a mental health condition should be supported to attain financial security. Whether they need the support of the social security system or help when they would like to return to or gain paid employment, no one should have to struggle to make ends meet as a result of their mental health problem.

“Yet too many people lose their jobs or are denied opportunities in the labour market because of a mental health condition. And too often our social security system treats people with insufficient dignity and humanity.

“Combined, these issues can exacerbate or contribute to mental health problems.

“We believe that anyone living with a mental health condition has a right to be supported to work if they want to, and to live out of poverty.”

“No one with a mental health condition, however, should ever be mandated to look for work, or to face the threat of having their benefit payments reduced. Neither conditions nor sanctions have been shown to work or to be safe for people with mental health difficulties, and as a result we believe they should be stopped. 

“No one should be left in poverty because they have a mental health condition. We pledge to work together to achieve an end to the harm we have seen that sanctions can cause, and a start towards a meaningful entitlement to effective support, based  genuinely around the needs of each person.” 

Sanctions, under which people lose benefit payments for between four weeks and three years for “non-compliance”, have come under fire for being unfairpunitive, failing to increase job prospects, and causing hunger, debt and ill-health among jobseekers. And sometimes, sanctions have been correlated with deaths.

It’s not the first time the BPS and allied organisations have called on the government to make changes to controversial social security policies. In 2015, Professor Jamie Hacker Hughes, then President of the BPS, said:

“The Society has repeatedly asked for a meeting with ministers at the Department for Work and Pensions so that we can express our concerns over the Work Capability Assessment (WCA) – so far without success. We are particularly concerned that the government’s benefits policy may misuse psychological tools and techniques. We want to ensure policies are informed by appropriate psychological, theoretical and practical evidence.”

The Society published a briefing paper 2016, and an official Call to Action asking the government to commission an end-to-end redesign of the Work Capability Assessment (WCA) process – including its outcomes and periods for reassessment.

Last year, a collective of the UK’s leading professional associations for psychological therapies reaffirmed their opposition to welfare sanctionsThe British Association for Behavioural and Cognitive Psychotherapies, British Association for Counselling and Psychotherapy, British Psychoanalytic Council, British Psychological Society and UK Council for Psychotherapy between them represent more than 110,000 psychologists, counsellors, psychotherapists, psychoanalysts and psychiatrists who practise psychotherapy and counselling.

In a joint response to last year’s report of the Welfare Conditionality project, the organisations say:

“Our key concerns remain that not only is there no clear evidence that welfare sanctions are effective, but that they can have negative effects on a range of outcomes including mental health.

“We continue to call on the Government to address these concerns, investigate how the jobcentre systems and requirements may themselves be exacerbating mental health problems and consider suspending the use of sanctions subject to the outcomes of an independent review.”

The organisations reaffirmed the clear position against welfare sanctions that they previously took in a 2016 joint response

Dr Lisa Morrison Coulthard the British Psychological Society’s then acting director of policy said:

“We are delighted to sign this joint statement. The Society has seen increasing evidence that benefit sanctions undermine people’s health and wellbeing, and that people with multiple and complex needs are disproportionately subject to them.”

Last year, the UK’s most extensive study of welfare conditionality concluded that  sanctions are ineffective at ‘helping’ people into work and are more likely to reduce those affected to absolute poverty, ill-health and even survival crime.

The five-year longitudinal research tracked hundreds of claimants, finding that the controversial policy of withdrawing social security support as punishment for alleged failures to comply with jobcentre rules has been little short of disastrous. The report says: “Benefit sanctions do little to enhance people’s motivation to prepare for, seek or enter paid work. They routinely trigger profoundly negative personal, financial, health and behavioural outcomes.”

It was found that sanctions impacted negatively on people’s mental health, frequently triggering high levels of stress, anxiety and depression. 

The report authors called for a review of the use of sanctions, including an immediate moratorium on benefit sanctions for disabled people who are disproportionately affected, together with an urgent “rebalancing” of the social security system to focus less on compliance and more on helping claimants into work.

Labour’s shadow secretary for work and pensions Margaret Greenwood said: “The current sanctions system is immoral and ineffective. It is not helping people into employment and at the same time is leaving vulnerable people on the brink of destitution, without any source of income for long periods.”

Sanctions are justified and imposed by the government, who claim they promote ‘behavioural change’. Ministers tend to present narratives where individuals are held responsible for social and economic problems.

However, many of us believe we need a  fundamental change in the UKs’ socioeconomic organisation, because neoliberalism systematically excludes the poorest citizens, while generously rewarding the wealthiest. Power relationships within our society also need to  change, because the government is inflicting structural violence – socioeconomic oppression – on marginalised social groups, based entirely upon the government’s own traditional class prejudices.

If any ‘behavioural change’ (a euphemism for state coercion) is needed, it is most certainly on the part of Conservative policy-makers, not from those who are being systematically oppressed. Sanctions reflect the actions of a more broadly abusive and authoritarian regime. Sanctions mean that the poorest citizens’ only means of meeting their most fundamental survival needs – food, fuel and shelter – is removed from them as a punishment for simply being poor.

Yet we know the government’s misuse of psychology, embedded in their crib sheet justification of sanctions, is dangerous, cruel and boardroom psychobabbling utter nonsense. 

It’s time the public stopped being bystanders in the face of targeted state abuse.

Priti Patel uses techniques of neutralisation to discredit the concerns raised and the evidence presented that sanctions harm people’s mental health. She even disgracefully called this cruel and punitive state action “support” ,”help” and “fair”.

It is never acceptable to endorse an oppressive, abusive regime that deliberately removes people’s means of basic survival, to meet “labour market requirements”.

 

Related

New research shows welfare sanctions are punitive, create perverse incentives and are potentially life-threatening

Pointlessly cruel’ sanctions regime must be reassessed, says Commons Select Committee

The Minnesota Starvation Experiment provided empirical evidence that demonstrates clearly why welfare sanctions can’t possibly work as an “incentive” to “make work pay”

Short Version: 


 

I don’t make any money from my work. If you like, you can help me by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others going through disability assessment, mandatory review and appeal.

DonatenowButton

62 year old woman faces losing home because of unfair and pointless welfare sanction

b584

A 62-year-old woman says that she’s been forced to leave her home after the Department for Work and Pensions (DWP) sanctioned her – cut her benefits – for turning up late for a meeting.

Faith Hurford, from Hillesley near Stroud, who suffers with a range of medical conditions that haven’t been disclosed, says the benefit sanction means she is unable to afford the rent and has to move away from her home because of the DWP’s callous and unfair decision.

The Stroud News and Journal reports that despite her health problems, Faith had to travel a staggering 15 miles (one way) to attend a meeting about her Universal Credit claim in Stroud.

Due to heat, the sheer distance she had to cycle, as well as her chronic health issues, Faith was forced to stop and take a break at a Sainbury’s store to recover her energy, before continuing the arduous journey.

This meant that Faith turned up late for the appointment and was subsequently sanctioned for failing to turn up for the meeting on time.

Faith described the sanction as “unlawful” and tried to appeal the harsh ruling, but the loss of benefit meant she could no longer afford the rent and has to move away to Nailsworth.

“I had been a supporter of Universal Credit before – it helps you look for work and it’s simpler to use – but that sanction was unlawful.

“By the time I got to Sainsbury’s after hours of cycling I couldn’t go any further, I was completely dazed.”

Faith says that she tried to explain the reason for her lateness but her reasonable appeals fell on deaf ears.

She says that the sanction has cost her nearly £200 in lost benefit payments.

“You need to take a person’s circumstances into account. The effort I went to was not recognised in any shape or form.

“I can’t recover from a sanction like that, I’m on a shoestring. I grow my own veg, I’ve reduced my food intake. There’s nothing else I can do,” she said, adding “I’ve fallen behind on rent and I can’t afford this place now. I’ve got to move out.”

Faith is currently looking for a new place to live while waiting to hear back about an appeal lodged with the social security tribunal.

Sanctions on welfare payments which have caused thousands of claimants to fall into hardship are being handed out without evidence that they actually work. The Department for Work and Pensions doesn’t even monitor and analyse its own data, making claims that sanctions “work” from an evidence-free zone. 

There is no evidence that sanctions work as the government insists they do

A report published earlier this year by the WelCond project, led by the University of York and involving the Universities of Glasgow, Sheffield, Salford, Sheffield Hallam and Heriot-Watt, analysed the effectiveness, impact and ethics of welfare conditionality from 2013 to 2018.

The findings of this report’s adds more evidence to a substantial and growing body that welfare conditionality within the social security system is largely ineffective and that benefits sanctions have severe and negative impacts on personal, financial and health outcomes, including mental health.

The report suggests that too much emphasis is being placed on negative consequences for not being engaged in job-seeking activities and not enough emphasis on more positive and individualised work-shaping activities to help people access work that they wish to be in.

In 2016 the British Psychological Society (BPS) and a range of allied organisations (British Association for Behavioural and Cognitive Psychotherapies (BABCP), British Association for Counselling and Psychotherapy (BACP), British Psychoanalytic Council (BPC)), stated a very clear position against welfare sanctions, in response to reports of a lack of efficacy and potential harm to mental health, as outlined in their 2016 joint response

The organisations say that key concerns remain that not only is there no clear evidence that welfare sanctions are effective, but that they can have such negative effects on a range of outcomes including mental health.

They go on to say “We continue to call on the Government to address these concerns, investigate how the jobcentre systems and requirements may themselves be exacerbating mental health problems and consider suspending the use of sanctions subject to the outcomes of an independent review.”

The collective organisations – BPS, BACP, BPC, BABCP and UKCP – are the UK’s leading professional associations for psychological therapies, representing over 110,000 psychologists, counsellors, psychotherapists, psychoanalysts and psychiatrists who practise psychotherapy and counselling.

In 2016, even the government’s technocratic team of behavioural economists and policy gurus at the Nudge Unit did a u-turn on benefit sanctions. They said that the state using the threat of benefit sanctions may be counterproductive”. The idea of increasing welfare conditionality and enlarging the scope and increasing the frequency of benefit sanctions originated from neoliberal behavioural economics theories of the Nudge Unit in the first place. 

It’s difficult to imagine how punitive sanctioning – psycho-coercion – which entails the removal of people’s lifeline income which was originally calculated to meet the costs of only basic survival needs, such as for food, fuel and shelter, could ever be seen as “helping people into work.” 

Commons Select Committee inquiry into sanctions 

The Work and Pensions Committee has published a report this month regarding the findings of an ongoing inquiry into welfare conditionality and sanctions. They say: 

“The human cost of continuing to apply the existing regime of benefit sanctions – the ‘only major welfare reform this decade to have never been evaluated’ – appears simply too high. The evidence that it is achieving its aims is at best mixed, and at worst showing a policy that appears ‘arbitrarily punitive’.”  

The Committee say in their report that the Coalition Government “had little or no understanding of the likely impact of a tougher sanctions regime” when it introduced it in 2012 with the stated aim, as the NAO describes it, that “benefits, employment support and conditions and sanctions together lead to employment.”

At that point, the Government promised to review the reform’s impact and whether it was achieving its aims on an ongoing basis. But six years later, Government “is [still] none the wiser.”

In their report, the select committee urge the government to reassess the sanctions regime. However, there is no evidence they ever assessed it in the first place.

Commenting on the Work and Pensions Committee inquiry, Chair Frank Field MP says:

“We have heard stories of terrible and unnecessary hardship from people who’ve been sanctioned. They were left bewildered and driven to despair at becoming, often with their children, the victims of a sanctions regime that is at times so counter-productive it just seems pointlessly cruel.

While none of them told us that there should be no benefit sanctions at all, it can only be right for the Government to take a long hard look at what is going on. If their stories were rare it would be unacceptable, but the Government has no idea how many more people out there are suffering in similar circumstances. In fact, it has kept itself in the dark about any of the impacts of the major reforms to sanctions introduced since 2012.

The time is long overdue for the Government to assess the evidence and then have the courage of its reform convictions to say, where it is right to do so, ’this policy is not achieving its aims, it is not working, and the cost is too high: We will change it.”

Yes, we must.

Related

Pointlessly cruel’ sanctions regime must be reassessed, says Commons Select Committee

New research shows welfare sanctions are punitive, create perverse incentives and are potentially life-threatening


My work is unfunded and I don’t make any money from it. This is a pay as you like site. If you wish you can support me by making a one-off donation or a monthly contribution. This will help me continue to research and write independent, insightful and informative articles, and to continue to support others.

DonatenowButton

The NHS is to hire 300 employment coaches to find patients jobs to “keep them out of hospital.”

Image result for cognitive therapy for unemployed protests

The government has a problem with the public actually using public services

The government announced the creation of the Joint Health and Work Unit and the Health and Work Service in 2015/16, both with a clear remit to cut benefits and “get people into work.” Given that mental health is a main cause for long-term sickness absence in the UK, a key aspect of this policy is to provide mental health services that get people back into work.

There has already been an attempt to provide mental health services for people who claim social security support, which includes a heavily resisted pilot to put therapists into job centresAnother heavily opposed government proposal was announced as part of the  health and work pilot programme to put job coaches in GP surgeries
The proposals have been widely held to be profoundly anti-therapeutic, potentially very damaging and professionally unethical. 

With such a narrow objective, the delivery will invariably be driven by an ideological agenda, politically motivated outcomes and meeting limited targets, rather than being focused on the wellbeing of individuals who need support and who may be vulnerable. I also discovered almost by chance back in 2015 that the Nudge Unit team have been working with the Department for Work and Pensions and the Department of Health to trial social experiments aimed at finding ways of: “preventing people from falling out of the jobs market and going onto Employment and Support Allowance (ESA).” 

“These include GPs prescribing a work coach, and a health and work passport to collate employment and health information. These emerged from research with people on ESA, and are now being tested with local teams of Jobcentres, GPs and employers.”  Source: Matthew Hancock’s conference speech: The Future of Public Services

GPs have raised their own concerns about sharing patient data with the Department for Work and Pensions – and quite properly so. Pulse reported that the Department for Work and Pensions (DWP) planned to extract information from GP records, including the number of Med3s or so-called “fit notes” issued by each practice and the number of patients recorded as “unfit” or “maybe fit” for work, in an intrusive move described by GP leaders as amounting to “state snooping.”

Part of the reason for this renewed government attack on sick and disabled people is that the government’s flagship fit note scheme, which replaced sick notes five years ago in the hope it would see GPs sending thousands more employees back to workto reduce sickness-related absence, despite GPs having expressed doubts since before its launch, has predicably failed.

The key reason for the failure is that employers did not take responsibility for working with employees and GPs seriously, and more than half (59%) of employers said they felt unable to support employees by making all of the legally required workplace adjustments for those who had fit notes signed as “may be fit for work.” Rather than address this issue with employers, the government has decided instead to simply coerce patients back into work without essential support.

Another reason for the failure of this scheme is that most people who need time off from work are ill and genuinely cannot return to work until they have recovered. Regardless of the government’s concern for the business and state costs of sick leave, people cannot be simply ushered out of illness and into work by the state to “contribute to the economy.” When a GP says a person is “unfit for work”, they generally ARE unfit for work, regardless of whether the government likes that or not.

The government have planned to merge health and employment services, and are now attempting to redefine work as a clinical outcome. Unemployment has been stigmatised and politically redefined as a psychological disorder, the government claims somewhat incoherently that the “cure” for unemployment due to illness and disability, and sickness absence from work, is work.

The latest strand of this ideological anti-welfare crusade was recently announced: the NHS is to hire 300 employment coaches who will find patients jobs to “keep them out of hospital.” The Individual Placement and Support services (IPS) is aimed at ‘supporting’ people with severe mental illness to seek work and ‘hold down a job’. Job coaches will offer assistance on CVs, interview techniques and are expected to work with 20,000 people by 2021. Pilot schemes running in Sussex, Bradford, Northampton and some London boroughs suggest that the coaches manage to find work for at least a quarter of users. The scheme is to be extended nationwide. 

The roll out of mental health employment specialists across the country is based on  analysis of the pilots, which is claimed to show that 2,300 patients have been helped into work in the last year. However, the longer term consequences of the programme are not known, and it is uncertain if there will be any meaningful monitoring regarding efficacy, safeguarding and the uncovering of unintended consequences and risks to participants.

It is held that those in work tend to be in better health, visit their GP less and are less likely to need hospital treatment. The government has assumed that there is a causal relationship expressed in this common sense finding, and make an inferential leap with the claim that “work is a health outcome”.

However, support for this premise is not universal. Some concerns which have been reasonably raised are commonly about the extent to which people will be ‘pushed’ into work they are not able or ready to do, or into bad quality work that is harmful to them, under the misguided notion that any work will be good for them in the long run. 

Of course it may equally be the case that people in better health work because they can, and have less need for healthcare services simply because they are relatively well, rather than because they work. 

Undoubtedly there are some people who may be able to work and who want to, but struggle to find suitable employment without adequate support. This section of the population may also face the lack of knowledge, attitudes and prejudices of potential employers regarding their conditions as a further barrier to gaining appropriate employment. The scheme will be ideal for supporting this group. That is, however, only provided that engagement with the service is voluntary, and does not become mandatory. 

It must also be acknowledged that there are some people who are simply too ill to work. Again, it’s a serious concern that this group may be pressured and coerced to find employment, which may prove to be detrimental to their wellbeing. Furthermore, placing them in work may present unacceptable risk to both themselves and others. How can we possibly know in advance about the longer term risks presented by the impact of an illness, and the potential effects of some medications in the workplace? If something goes catastrophically wrong as a consequence of someone taking up work when they are too unwell to work, who will hold the responsibility for the consequences?

In the current political context where the public are told “work is the route out of poverty” and “work is a health outcome”, people feel obliged to try to work, when they believe they can. But what happens when they are wrong in that belief? Who is responsible, for example, when someone has a loss of consciousness or an episode of altered awareness, caused by a condition or medication, while operating machinery, at the wheel of a taxi, bus or refuse waggon? 

Harry Clarke, who believed that he was fit for work, suffered a loss of consciousness on 22 December 2014 while at the wheel of a moving refuse lorry in Glasgow city centre, resulting in six deaths and leaving 15 people injured. Following numerous warnings from the court about his right to remain silent, Clarke refused to answer key questions about numerous doctors visits and medical tests for dizziness, fainting, vertigo, heart problems, tension headaches, operations on hands and knee pain dating back to 1976. However, one of the biggest revelations of the inquiry was Clarke’s lengthy medical history, which showed he had suffered episodes of dizziness and fainting for decades prior to the tragic crash.

Yet during an inquiry about the case, a health care professional who assessed the Glasgow bin lorry crash driver for the renewal of his HGV licence in 2011 would have deemed him only “temporarily unfit to drive” if she had known he had fainted the year before the accident. Furthermore, Clarke’s conditions would probably not have made him eligible for Employment and Support Allowance (ESA). Dr Joanne Willox told the inquiry panel at Glasgow Sheriff Court that she saw Mr Clarke on 6 December 2011 at the request of his employer Glasgow City Council to complete a HGV renewal application form with him which was to be submitted to the DVLA. 

Dr Willox, an occupational medical adviser for the private company Bupa, on behalf of Glasgow City Council, did not have access to his medical records. She could have requested the records with the patient’s consent if she considered it necessary, though this was not the normal practice and it may have taken time to get the records.

She said it would have been “helpful” to have the records. The inquiry revealed that Clarke had a history of fainting and dizziness, and had in fact previously suffered a similar episode while at the wheel of a stationary bus, in 2010.

The horrific case highlights several issues, not least that employment of people with unpredictable or undiagnosed medical conditions does not only pose a threat to the person, but it may potentially be contrary to public safety, too. It also highlights that a privately contracted occupational health professional who had no knowledge of Clarke’s medical history, was unsuitably tasked to make a judgement about his potential ability to work as a refuse waggon driver. Employing people who are ill and later found to be unfit for the role is potentially in contravention of the Health and Safety at Work Act. 

Another horrific example of the dangers presented by placing trust in unqualified bureaucrats and the state – who have ideological interests that often lie in conflict with those of patients – to make decisions about citizens’ health and welfare arose when a manager at Birkenhead Benefit Centre in Liverpool wrote a letter, addressed to a GP, regarding a seriously ill patient. It said:

We have decided your patient is capable of work from and including January 10, 2016.

“This means you do not have to give your patient more medical certificates for employment and support allowance purposes unless they appeal against this decision.

“You may need to again if their condition worsens significantly, or they have a new medical condition.” (My emphasis)

The job centre manager was wrong. The health care professional, assessing the patient on behalf of the private company contracted to carry out the ESA assessment, on behalf of the government, was wrong. 

The patient, James Harrison, had been declared “fit for work” and the letter stated that he should not get further medical certificates. However, 10 months after the Department for Work and Pensions (DWP) contacted his doctor without telling him, James died, aged 55.

He was clearly not fit for work.

James’ grieving daughter, Abbie, said: “It’s a disgrace that managers at the Jobcentre, who know nothing about medicine, should interfere in any way in the relationship between a doctor and a patient.

“They have no place at all telling a doctor what they should or shouldn’t give a patient. It has nothing to do with them.

“When the Jobcentre starts to get involved in telling doctors about the health of their patients, that’s a really slippery slope.” (See Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died.)

It has become very evident over recent years that the labour market is not delivering an adequate income for many citizens and despite “record levels of employment”, the problem seems to be getting bigger. The government’s answer to the problem has been to extend punishment those on low pay, rather than tackle employers who pay exploitative, low wages.

The neoliberal narrative and Conservative antiwelfarism

Some of the underpinning language used to justify this approach also troubles me, as it is clearly couched in economic terms. It’s about cutting costs, propping up the economy as a whole and “rewarding” tax payers. Here, it is implied that people who are ill are somehow a burden on tax payers. However, most people who become ill have also worked and contributed to the Treasury. Furthermore, people who aren’t in employment also pay taxes, too, be it VAT, council tax, or a range of other stealth taxes from which even the poorest citizens are no longer exempted. 

Claire Murdoch, NHS England national mental health director, said: “Helping people with mental ill health to find and keep a job is good for individual wellbeing and good for the health of our economy. Tackling severe mental illness is not just about getting medication and treatment right, but ensuring people can recover to live independently with their condition, including the reward and satisfaction of getting and keeping a job.

In our 70th year, mental health is one of the NHS’ top priorities, and ensuring services are integrated, so people get whole-person care, means our patients get better outcomes and taxpayers are rewarded as treatment is more efficient. One in seven of us will go through mental ill health whilst at work, so delivering a safety net, to help people back in to work when they fall ill, will minimise harm and make our country’s workforce more productive.”

NHS England say: “As part of patients’ care and support package, work coaches in NHS Individual Placement and Support (IPS) services, offer advice about finding a job, help them to prepare for an interview and can speak with potential employers about how someone’s condition can be managed so that they can work effectively while staying in good health.

“The trained specialists also improve the health of people with severe mental illness, reducing the need for urgent hospital admissions and GP appointments. Research shows that type of support can free up as much as £6,000 per patient, which can be invested in other frontline care.”

Again, the language is loaded, it’s a narrative with a scattering of casual cost-cutting phrases and prioritises a ‘productive workforce.’ There isn’t any discussion regarding the claim to ‘minimise harm’, it seems to be assumed that work in itself will take care of that. It’s also a little worrying that employers and work coaches are to be included in the ‘management’ of employees’ illnesses. When I am ill, I don’t want the advice or ‘management’ of a boss or a work coach, I want impartial medical diagnosis, treatment and advice from my doctor, not a ‘nudge’ or trite armchair psychology and pseudoscientific platitudes from the state.

It’s difficult to see how someone with a serious, chronic or progressive illness, can actually ‘manage’ their illness and ‘move back into work.’ The use of the extremely misinformed, patronising and very misleading term manage implies that very ill people actually have some kind of choice in the matter.

Implicit in this narrative is the idea that illness is caused by deviant behaviours. The ‘cure’ therefore, is to simply address and remedy the faulty behaviours. 

The sick role and the resurrection of Talcott Parsons: disciplining disabled people

There is a lack of coherence within the narratives of contemporary Conservative governance, which is simultaneously neoliberal – grounded in free market principles and the ideal of a small, ‘non-intrusive’ state – and paternalism – which is founded on an authoritarian, large, extremely intrusive state, which is designed to tell people what is best for them and nudging citizens’ behaviours towards government defined policy outcomes.

The tension between neoliberalism and paternalism which outlines current policy approaches to disability and employment policy is filled with ambiguity, inconsistency and contradiction in its definition and understanding of the subject, the nature of the ‘problem’ and the policy ‘solutions’. On the one hand, neoliberalism is a doctrine that demands the withdrawal of social support mechanisms such as welfare, health care and public services, on the other, paternalism is based on state interventions designed to extend politically defined ‘optimal outcomes’.

These apparently contradictory narratives have been embodied in discipline of behavioural economics, which is largely aimed at enforcing the alignment of public expectations, attitudes and behaviours with neoliberal outcomes. It’s a prop for dogma and the status quo. Behavioural economics is concerned with reducing citizens’ expectations of social provision, while enforcing self reliance, and with providing justification narratives for neoliberal policies. 

I have written critical accounts of this somewhat draconian Conservative neoliberal paternalism on more than one occasion. The Conservatives place emphasis on highlighting the obligations of citizens, rather than on their rights, and this is why the work of Talcott Parsons in the early 1950s is especially appealing to them. 

Behavioural medicine was partly influenced by Talcott Parsons’ The Social System, 1951, and his work regarding the sick role, in which he analysed in a framework of citizen’s roles, social obligations, reciprocities and behaviours within a wider capitalist society, with an analysis of rights and obligations during sick leave. From this perspective, the sick role is considered to be sanctioned deviance, which disturbs the function of society. (It’s worth comparing that the government are currently focused on economic function and enhancing the supply side of the labour market.)

Behavioural medicine more generally arose from a view of illness and sick role behaviours as characteristics of individuals, and these concepts were imported from sociological and sociopsychological theories.

However, it should be noted that there is a distinction between the academic social science disciplines, which include critical perspectives of conflict and power, for example, and the recent technocratic “behavioural insights” approach to public policy, which is a monologue that doesn’t include critical analysis, and serves as prop for neoliberalism, conflating citizen’s needs and interests with narrow, politically defined economic outcomes.

We have a government that has regularly misused concepts from psychology and sociology, distorting them to fit a distinct framework of ideology, and justification narratives for draconian policies, usually entailing the diversion of public funds from public services and the provision of social security to wards rewards for the wealthiest citizens, usually in the form of tax cuts. Parsons’ work has generally been defined as sociological functionalism, and functionalism tends to embody very conservative ideas. 

From this perspective, sick people are not productive members of society; therefore this deviation from the norm must be policed. This, according to Parsons, is the role of the medical profession. More recently, however, we have witnessed the rapid extension of this role to include extensive State policing of sick and disabled people, and the introduction of increasingly coercive measures to push citizens into self managing their health conditions, while the medical profession have been increasingly politically sidelined in their provision of advice, care and support, regarding sickness and employment.

Last year, the government proposed extending ‘fit note’ certification beyond GPs to a wider group of non-specialist healthcare professionals, including physiotherapists, psychiatrists and senior nurses, to better ‘identify health conditions and treatments’ to help workers go back into their jobs faster. This is very worrying, since it entails the diagnosis and treatment of conditions by people who are not qualified to undertake this role.

‘Fit notes’ are specifically designed to ‘help’ patients develop a return to work plan, and are meant to be tailored to their individual needs. However, the introduction of fit notes –  a somewhat Orwellian title that refuses to acknowledge people get ill, or permit citizens time to recover, which replaced sick notes –  failed to produce an increase in a more rapid return to work for patients generally, mainly due to the fact that employers failed to support patients with adequate workplace adjustments to accommodate their return.  

It seems many of the psychosocial advocates have ignored the rise of chronic illnesses and the increasing pathologisation of everyday behaviours in health promotion. Parson’s sick role came to be seen as a negative referent rather than as a useful interpretative tool. Parsons’ starting point is his understanding of illness as deviance. Illness is the breakdown of the general “capacity for the effective performance of valued tasks” (Parsons, 1964: 262). Losing this capacity disrupts “loyalty” to particular commitments in specific contexts such as the workplace.

Theories of the social construction of disability also provide an example of the cultural meaning of certain health conditions. The roots of this anti-essentialist approach are found in Stigma bErving Goffman (1963), in which he highlights the social meaning physical impairment comes to acquire via social interactions. The social model of disability tends to conceptually distinguish impairment (the attribute) from disability (the social experience and meaning of impairment). Disability cannot be reduced to a mere biological problem located in an individual’s body  (Barnes, Mercer, and Shakespeare, 1999). Rather than a “personal tragedy” that should be fixed to conform to medically determined standards of “normality” (Zola, 1982), disability becomes politicised.

The issues we then need to confront are about the obstacles that may limit the opportunities for individuals with impairments, and about how those social barriers may be removed.

From a social constructionist perspective, emphasis is placed on how certain illnesses come to have cultural meanings that are not reducible to or determined by biology, and these cultural meanings further burden the afflicted (as opposed to burdening “the tax payer” , the health services, those with profit seeking motives, or the state.)

So to clarify, it is wider society and governments that need a shift in disabling attitudes, perceptions and behaviours, not disabled people.

The insights that arose from the social construction of disability approach are embodied in policies, which include the Disability Discrimination Act 1995, which included an employers’ duty to ensure reasonable adjustments/adaptations; the more recent Equality Act 2010 and the Human Rights Act 1998, which provides an important tool for disabled people to use to challenge discrimination, violations to their human rights and unacceptable treatment.

In contrast, Parsons invokes a social contract in which society’s “gift of life” is repaid by continued contributions and conformity to (apparently unchanging, non-progressive) social expectations. For Parsons, this is more than just a matter of symbolic interaction, it has far more concrete, material implications: “honour” (deserving) and “shame” (undeserving) which accompany conformity and deviance, have consequences for the allocation of resources, for notions of citizenship, civil rights and social status.

Parsons never managed to accommodate and reflect social change, suffering and distress, poverty, deprivation and conflict in his functionalist perspective. His view of citizens as oversocialised and subjugated in normative conformity was an essentially Conservative one. In fact, the instituted Nudge Unit at the heart of the Cabinet Office and a proliferation of nudge-laden behaviourist policies over recent years indicates this view is a Conservative ideal. 

Furthermore, Parsons’ systems theory was heavily positivistic, anti-voluntaristic and profoundly dehumanising. His mechanistic and unilinear evolutionary theory reads like an instruction manual for the capitalist state.

Parsons thought that social practices should be seen in terms of their function in maintaining order and social structure. You can see why his core ideas would appeal to Conservative neoliberals and rogue multinational companies (such as Unumwho had a hand in the government’s Work, Health and Employment green paper). Conservatives have always been very attached to tautological explanations (insofar that they tend to present circular arguments.)

One question raised in this functional approach is how do we determine what is functional and what is not, and for whom each of these activities and institutions are functional. If there is no method to sort functional from non-functional aspects of society, the functional model is tautological – without any explanatory power to why any activity is regarded as “functional.” The causes are simply explained in terms of perceived effects, and conversely, the effects are explained in terms of perceived causes). 

Because of the highly gendered division of labour in the 1950s, the body in Parsons’ sick role is a male one, defined as controlled by a rational, purposive mind and oriented by it towards an income-generating performance. For Parsons, most illness could be considered to be psychosomatic.

The ‘mind over matter’ dogma is not benign; there are billions of pounds and dollars at stake for the global insurance industry, which is set to profit massively to the detriment of sick and disabled people. The eulogised psychosocial approach is evident throughout the highly publicised UK PACE Trial on treatment regimes that entail Cognitive Behaviour Therapy (CBT) and graded exercise. By curious coincidence, that trial was also significantly about de-medicalising illnesses. Another curious coincidence is that Mansel Aylward sat on the PACE Trial steering group. 

Work will set you free


Arbeit macht frei
(‘work makes you free’) is a German expression which comes from the title of a novel by German philologist Lorenz Diefenbach, Arbeit macht frei: Erzählung von Lorenz Diefenbach (1873), in which gamblers and fraudsters find the path to virtue through work. The Weimar Republic in the 1920s, and later, the Nazis, found the leading character of Diefenbach’s book, whose achievements are defined by ‘concentrating on doing his work’, compelling.

The phrase was used to promote German employment policies. The slogan was placed at the entrances to a number of Nazi concentration camps. It strikes as an almost mystical declaration that self-sacrifice in the form of endless labour does in itself bring a kind of spiritual freedom. However, given the true role of concentration camps such as Auschwitz during the Holocaust as well as the individual prisoner’s knowledge that once they entered the camp, freedom was not likely to be gained by any means other than their death, the terrible and cruel irony of the slogan becomes clear. And the lie. 

Though the context and wording has changed –  “work is a health outcome” – and full employment at any cost is the neoliberal goal, the idea that work has some mystical benefit, such as curing illness, or even simply alleviating poverty and inequality, remains a lie. 

The British Psychological Society (BPS) has expressed concerns about the idea  that employment (of whatever type) should be recognised as a “health outcome”. The Society recognise that suitable work can be good for wellbeing – but this very much depends on the type and quality of work and its social context. 

Furthermore, my own view is that the IPS programme will make it more difficult to ensure and maintain the political independence of health professionals. The private and confidential patient-doctor relationship ought to be a safe space, where citizens may address medical health problems, and doctors can provide support for people who are ill. The government is creating yet another space for an intrusive, overextension of the coercive arm of the state to “help people into work”, regardless of whether or not they are actually well enough to cope with working.

Placing employment advisors in the NHS will not address inequality, and the social conditions that are the consequence of political decision-making and imposed economic frameworks, so it permits the government and society to look the other way, while the government continue to present mental illness as an individual weakness or vulnerability, and a consequence of “worklessness” rather than a fairly predictable result of living in a highly unequal, competitive society, and arising because of experiences of living stigmatised, marginalised lives because of politically expedient policy-directed material deprivation. 

Feeding a myth 

I found a document almost by accident, while researching the Health, Work and Disability green paper a couple of years back. It presents further evidence that government policy is not founded on empirical evidence, but rather, it is often founded on deceitful contrivance. The Department for Work and Pensions research document published back in 2011 –Routes onto Employment and Support Allowance– said that if people believed that work was good for them, they were less likely to claim or stay on disability benefits. 

It was decided that people should be “encouraged” to believe that work was “good” for health. There is no empirical basis for the belief, and the purpose of encouraging it is simply to cut the numbers of disabled people claiming ESA by “encouraging” them into work. Some people’s work is undoubtedly a source of wellbeing and provides a sense of purpose.

That is not the same thing as being work being miraculously “good for health”. For a government to use data regarding opinion rather than empirical evidence to claim that work is “good” for health indicates a ruthless mercenary approach to fulfill their broader aim of dismantling social security and relentless determination to uphold their ideological commitment to supply-side policy, regardless of the harmful social costs.

From the document: “The belief that work improves health also positively influenced work entry rates; as such, encouraging people in this belief may also play a role in promoting return to work.”

The aim of the research was to “examine the characteristics of ESA claimants and to explore their employment trajectories over a period of approximately 18 months in order to provide information about the flow of claimants onto and off ESA.”

The document also says: “Work entry rates were highest among claimants whose claim was closed or withdrawn suggesting that recovery from short-term health conditions is a key trigger to moving into employment among this group.”

“The highest employment entry rates were among people flowing onto ESA from non-manual occupations. In comparison, only nine per cent of people from non-work backgrounds who were allowed ESA had returned to work by the time of the follow-up survey. People least likely to have moved into employment were from non-work backgrounds with a fragmented longer-term work history. Avoiding long-term unemployment and inactivity, especially among younger age groups, should, therefore, be a policy priority. ” 

“Given the importance of health status in influencing a return to work, measures to facilitate access to treatment, and prevent deterioration in health and the development of secondary conditions are likely to improve return to work rates”

Rather than make a link between manual work, lack of reasonable adjustments in the work place and the impact this may have on longer term ill health, the government chose instead to promote the cost-cutting and unverified, irrational belief that work is a “health” outcome. Furthermore, the research does conclude that health status itself is the greatest determinant in whether or not people return to work. That means that those not in work are not recovered and have longer term health problems that tend not to get better.

Work does not “cure” ill health. To mislead people in such a way is not only atrocious political expediency, it’s actually downright dangerous.

As neoliberals, the Conservatives see the state as a means to reshape social institutions and social relationships based on the model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged. Social groups that don’t conform to ideologically defined economic outcomes are politically stigmatised and economically outgrouped.

Nicola Oliver, from Northamptonshire Healthcare NHS Foundation Trust, said: “Employment support linked to mental health means people can live the life they want to lead.

“If you help someone into a job they really like – which means they are inspired to get up in the morning and want to manage their symptoms – they’re likely to say to their clinician ‘This is what I want to do, help me to overcome these barriers.’ In this way, you’re motivating the person to manage their own condition” (My emphasis).

Mental health employment specialists in the IPS service are part of community mental health teams. They currently operate in parts of the country including Sussex, Bradford, Northampton and some London boroughs, which have seen 9,000 people in the past twelve months. NHS England will be providing £10 million funding to expand access over the next two years, with further investment to follow. By 2021, NHS England anticipates that 20,000 people with severe mental illness will receive tailored care and employment advice via the NHS, suggesting that around 5,000 people with mental ill health avoid unemployment thanks to ‘better health care’.

IPS is one of a number of integrated mental health services which are being introduced or expanded across England, as part of NHS England’s Five Year Forward View for Mental Health, described as a “transformation and investment programme to improve care between 2016 and 2021.”

People can only work when their basic needs are met

maslows_hierarchy_of_needs-4

Despite the government’s rhetoric on welfare “dependency”, and the alleged need for removing so-called “perverse incentives” from the social security system by imposing a harsh conditionality framework and a compliance regime – using punitive sanctions – and work capability assessments designed to preclude eligibility to disability benefits, research shows that generous social security regimes make people more likely to want to work, not less. I have written at length over the last few years about why a punitive welfare system can never work, as the government claim, to “incentivise people to find employment. See, for example, The Minnesota Starvation Experiment provided empirical evidence that demonstrates clearly why welfare sanctions can’t possibly work as an “incentive” to “make work pay”).

The government’s welfare “reforms” have already invited scathing international criticism because they have disproportionately targeted cuts at those with the least income. Furthermore, the government have systematically violated the human rights of those with mental and physical disabilities. In a highly critical UN report which followed a lengthy inquiry, it says: “States parties should find an adequate balance between providing an adequate level of income security for persons with disabilities through social security schemes and supporting their labour inclusion. The two sets of measures should be seen as complementary rather than contradictory.”

However, the UK government have continued to conflate social justice and inclusion with punitive policies and cuts – dressed up in the language of “incentives” and “nudge” – aimed at coercing disabled people towards narrow employment outcomes that preferably bypass any form of genuine support and the social security system completely.  (See –UN’s highly critical report confirms UK government has systematically violated the human rights of disabled people).

It’s hardly the case that the state has an even remotely credible track record of assessing people’s medical conditions, nor is it the case that this government bothers itself with empirical evidence, or deigns to listen to concerns raised by citizens, academics, professionals and charities regarding the harm that their policies are causing. This is a government that can’t even manage to observe basic human rights, let alone care about citizen’s best interests, health and wellbeing. In a political context of savage cuts to essential support and services for disabled people, and such blatant disregard of the legislative frameworks that outline their fundamental rights, it is very difficult to trust that this government have the best interests of disabled people in mind with the formulation of Work, Health and Employment related programmes. 

The government’s aim to prompt public services to “speak with one voice” to promote work as a health outcome is founded on highly questionable ethics. This proposed multi-agency approach is reductive, rather than being about formulating expansive, coherent, comprehensive and importantly, responsive provision.

Employment is not therapy. Ultimately, the IPS programme is all about (re)defining the behaviours, experience and reality of a social group to ensure they conform to government ideological incentives and to justify dismantling public services (especially welfare, and increasingly, the NHS – see, for example, Rogue company Unum’s profiteering hand in the government’s work, health and disability green paper).

This is form of gaslighting intended to extend oppressive political control and behavioural micromanagement. In linking receipt of welfare with health services and “state therapy,” with the single intended outcome explicitly expressed as employment, the government is purposefully conflating citizen’s widely varied needs with economic outcomes and diktats, isolating people from traditionally non-partisan networks of relatively unconditional support, such as the health service, social services, community services and mental health services.

Public services “speaking with one voice” will invariably make accessing support conditional, and further isolate already marginalised social groups. It will damage trust between people needing support and professionals who are meant to deliver essential public services, rather than simply extending government dogma, prejudices and discrimination.

Conservatives really seem to believe that the only indication of a person’s functional capacity, value and potential is their economic productivity, and the only indication of their moral worth is their capability and degree of willingness to work. But unsatisfactory employment – low-paid, insecure and unfulfilling work – can result in a decline in health and wellbeing, indicating that it is poverty and growing inequality, rather than unemployment, that increases the risk of experiencing poor mental and physical health.

facade welfare

 


 

British Psychological Society reafirms its opposition to welfare sanctions

PAA-550x369

The UK’s leading professional associations for psychological therapies have reaffirmed their opposition to welfare sanctions.

The British Association for Behavioural and Cognitive Psychotherapies, British Association for Counselling and Psychotherapy, British Psychoanalytic Council, British Psychological Society and UK Council for Psychotherapy between them represent more than 110,000 psychologists, counsellors, psychotherapists, psychoanalysts and psychiatrists who practise psychotherapy and counselling.

In a joint response to the recent report of the Welfare Conditionality project, the organisations say:

“Our key concerns remain that not only is there no clear evidence that welfare sanctions are effective, but that they can have negative effects on a range of outcomes including mental health.

“We continue to call on the Government to address these concerns, investigate how the jobcentre systems and requirements may themselves be exacerbating mental health problems and consider suspending the use of sanctions subject to the outcomes of an independent review.”

The organisations reaffirmed the clear position against welfare sanctions that they took in a 2016 joint response.

Dr Lisa Morrison Coulthard the British Psychological Society’s acting director of policy said:

“We are delighted to sign this joint statement. The Society has seen increasing evidence that benefit sanctions undermine people’s health and wellbeing, and that people with multiple and complex needs are disproportionately subject to them.”

I’ve written a lot of critical articles over the last few years about the government’s controversial welfare policies. The Conservatives claim that welfare sanctions “incentivise” people to look for work. However, the authoritarian application of a behaviourist idea – that punishment somehow motivates people to “change their behaviour” – especially when such punishment involves the cruel and barbaric removal of people’s means of meeting their most fundamental survival needs – food, fuel and shelter – contradicts conventional wisdom and flies in the face of a substantial body of empirical evidence.

Making provision for meeting fundamental human needs so rigidly conditional is an atrociously brutal act. There is simply no justification for a government in a very wealthy democracy to behave in such an inhumane manner. 

Social security is a safety net that most people have contributed towards. It came into being to ensure that no citizen would face absolute poverty – hunger and destitution – when they experience hardships, in a civilised and civilising democracy.

Punitive welfare sanctions are an extremely regressive policy. It was widely recognised during the 1940s that absolute poverty reduces citizens’ motivation and prevents us from fulfilling our potential at an individual level and as a society. 

Click here to read the Society’s recent comment on benefit sanctions.

Click here to read the statement from the five organisations. 

I wrote about the extensive study of  welfare conditionality here: Research shows that Tory ‘hostile environment’ of welfare sanctions doesn’t help people to find work.

Related

Stigmatising unemployment: the government has redefined it as a psychological disorder

Psychologists Against Austerity: mental health experts issue a rallying call against coalition policies 

The power of positive thinking is really political gaslighting

Psychologists Against Austerity: mobilising psychology for social change

The politics of punishment and blame: in-work conditionality

Disabled people are sanctioned more than other people, accordingto research

The connection between Universal Credit, ordeals and experiments in electrocuting laboratory rats

Nudging conformity and benefit sanctions

G4S are employing Cognitive Behavioural Therapists to deliver “get to work therapy”

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

The importance of citizen’s qualitative accounts in democratic inclusion and political participation

Sanctions can’t possibly “incentivise” people to work. Here’s why

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton

It’s David Gauke and the government that need to change their behaviours, not poor people

Andrew Marr interviews David Gauke about the effects of welfare sanctions

David Gauke claims that the government’s harsh sanctions regime is to ‘change the behaviours’ of people who need to claim support from the welfare state. This is the welfare state that everyone, including those needing support, has funded through the National Insurance and tax system. Gauke clearly thinks that starving people and making them destitute will somehow punish people into working more. He’s riding the fabled rubber bicycle.

Gauke clearly needs to read Abraham Maslow’s work and the results of the Minnesota starvation experiment, because a vast amount of empirical evidence indicates that when people can’t maintain their basic living requirements – fulfilment of basic physical needs for food, fuel and shelter, which every human being has – then they simply will not have the capacity to fulfil higher level psychosocial needs, and that includes looking for work. 

maslow-5

Gauke tried to imply that more people are working and this is somehow linked to the punitive conditionality regime. However, he chose to completely ignore comments outlining how more people have become homeless, now face soaring debt and face more risk of experiencing mental health problems because of sanctions.

The government have ensured via systematic deregulation that the ‘supply side’ labour market is designed to suit the wants of employers and not the needs of employees. Much employment is insecure and wages have been driven down to the point where they are exploitative and no longer cover even the basic livings costs of workers. Wages have stagnated, and are most likely to remain stagnated for the foreseeable future.

So we now have an economic situation where even nurses and teachers are having to visit food banks because they can’t afford to eat. At a time when the government boasts more people than ever are in employment, cases of malnutrition and poverty related illnesses are actually rising. Work clearly does not pay.

An international study has recently shown that, rather than acting as a ‘perverse incentive’ as the Conservatives claim, generous welfare states tend to encourage people to work. This fits with Maslow’s framework, and findings of the extensive Minnesota starvation experiment, among many other reliable and valid sources of empirical evidence, indicating that sanctions cannot possibly work to ‘incentivise’ or motivate people to work.

If Gauke was remotely interested in ‘getting it right’, he would have surely paid a little attention to this and other important research findings. However, he seems very happy to operate from within his own and his party’s state of perpetual confirmation bias.

So much so that even the harrowing findings of a United Nations inquiry into the government’s woeful record of systematically abusing the human rights of disabled people who need welfare support didn’t break their stride at all. They simply denied it. I’m surprised that the government didn’t accuse the United Nations of being ‘Momentum supporters’, as they usually dismiss their critics with that comment, or simply label us as ‘scaremongers’ or ‘marxists’. However, unlike the word ‘Tory‘, the latter isn’t actually a derogatory term outside of the minds of the Tories and Daily Mail journalists.

Pressing him on the harmful effects of benefit sanctions, in the interview, Andrew Marr quoted an open letter to the Independent signed by representatives of the British Psychological Society (BPS) and the other leading UK psychotherapy organisations. 

The letter called on the government, in the words quoted by Andrew Marr, to “immediately suspend the benefits sanctions system” because:

“We see evidence … which links sanctions to destitution, disempowerment, and increased rates of mental health problems …

“Vulnerable people with multiple and complex needs, in particular, are disproportionately affected.”

In his reply, Gauke completely ignored this, and simply restated that work ‘can help people’s mental health’, while Marr mentioned that the National Audit Office and Public Accounts Committee have both criticised the Department for Work and Pension for not knowing enough about the effect of sanctions. Gauke implied that sanctions are pretty much experimental – a sort of trial and error approach, that the government ‘doesn’t always get right’. 

Actually, it’s not a government that gets much right. It’s not so long ago that government officials admitted that claimant’s comments used in an official benefit sanctions information leaflet were ‘for illustrative purposes only’. The Department for Work and Pensions tried to claim, using fake case studies, and fake ‘testimonials’ that people were ‘happy’ to be sanctioned. The government attempted to manufacture evidence, in other words, to justify the use of despotic state behaviours. It’s not a government that feels any need to be transparent and accountable. It is one, however, thatlikes to get its own way, regardless of how harmful and damaging that may be. 

Something I have also raised concerns about on previous occasions is that behavioural economics – the ideological and experimental ‘libertarian paternalist’ approach of the government in changing the behaviours of citizens (note it’s mostly poor citizens that are being targeted for nudge ‘interventions’) – isn’t being monitored, nor does it operate within a remotely ethical framework. No-one seems to care about the potential for abuse here, or about the potential for the state to inflict lasting psychological damage on citizens via its imposition of psychomanagement.

It’s hardly surprising that an authoritarian government using psychological coercion on the poorest citizens by inflicting extreme punishments – in making food, fuel and shelter (basic survival needs) entirely conditional on citizens’ absolute compliance – is causing serious harm and psychological distress to those citizens. It isn’t how people expect governments to behave in a developed, very wealthy so-called democracy.

B.F Skinner’s lab rats were treated better than people needing welfare support. At least once the rats pressed a lever in the operant conditioning chamber during the experiment, they were fed. Some people are left for weeks, months and sometimes up to 3 years without the means to cover their basic survival needs, just to put this into perspective. The government is experimenting on the poorest citizens without their consent. Punishment is being inflicted by the state in an attempt to ‘cure’ state inflicted poverty. Take a moment to think that through.

Behavioural economics entails ‘nudging’ citizens without their informed consent to change their perceptions and behaviours, so that they meet politically defined economic outcomes. The idea of increasing the severity and duration of welfare sanctions came from behavioural economists, who claim, along with the government, that they know what is ‘best’ for citizens and society. Apparently, conditions entailing starvation and destitution is ‘best’ for poor citizens, while handouts, tax cuts and offshore banking is best for the very wealthy minority.

When citizens experiencing such a deep fear of being sanctioned that they are forced to sit through a jobcentre interview while having a heart attack, when vulnerable disabled people are taking their own lives, rather than face a precarious future in a country that is no longer kind; when the government’s actions are causing real and irreversible harm to people who are ill; when the government’s ‘interventions’ are killing people, when cases of suffering, malnutrition and other poverty related diseases begin to reappear, after decades of progress through the welfare state, now being undone when the government refuses to acknowledge these consequences and does nothing to change its own enormously damaging behaviours – simply continuing to deny these inevitable consequences of its own actions – we must ask ourselves if those political actions and the consequences are fully intended.

Policies are political statements of intent, they provide messages about how a government thinks society and the economy should be organised and this is being imposed on citizens. The more a social group suffers the adverse consequences of a failing economic system, the more the government punishes them. It’s despicable. 

Ordinarily, governments in wealthy democracies are supposed to reflect the needs of the public they serve. This government expects the public to reflect the needs of the government and meet economic policy outcomes. The neoliberal framework is profoundly damaging, however, to most ordinary citizens. It seems it cannot be imposed without a considerable degree of authoritarianism, and irrational, unevidenced and pretty vile ideological justification. The justification simply reflects Conservative class prejudices and an elitism. All of this of course turns democracy completely on its head.

Gauke showed not a shred of remorse or concern regarding the terrible impact of sanctions during that interview. He simply didn’t respond, insisting instead that conditionality is necessary for ‘behaviour change’, and as a ‘fair’ gesture to that mythological beast of burden, the ‘tax payer’. While Gauke is casually discussing the political misuse of the worst kind of brutal, punitive behaviourist pseudopsychology, which is designed solely to prop up a failing economic system and to justify the steady dismantling of the welfare state, real and qualified psychologists are telling the government about the unforgivable harm and damage they are inflicting. The Conservatives are simply refusing to listen and engage with citizens.

The welfare state has always entailed a degree of conditionality ever since its inception. However, Gauke tried to claim that the extremely impoverishing sanctions now being imposed for often arbitrary reasons – on people who are late for an appointment, who are too ill to attend a meeting, or for a range of other reasons that indicate barriers people may face in complying with often meaningless, trivial tasks – are somehow ‘necessary’. But we know that most people who need to claim welfare support are either past working age, or they are actually in work. 

So let’s get this straight, it’s a government that believes withdrawing the means of meeting basic survival needs of poor people is necessary. Let that sink in for a moment.

The arrogant and taken-for-granted assumption is that poor people need behaviour changing ‘state therapy’, when the fault lies with the socioeconomic and political system. Not only has this government done their utmost to pathologise poor people, and scapegoat them for a failing political-economic system, it is a government that is quite happy to watch people suffer. If people can’t meet their basic needs for food, fuel and shelter, they will die. This is a government that is OK with people dying because of government policies. Take a moment to think that through.

Gauke also claimed that work is the only sustainable basis for lifting people out of poverty. As stated previously, most of our welfare spending is on supporting people in work. The problem of low wages is not one that warrants the punitive ‘behaviour change’ approach aimed at those on poor pay and in precarious employment. It’s not as if the government values collective bargaining and trade union interventions. The behaviour that needs changing is that of exploitative, profit driven employers. Yet already disempowered citizens on low pay are being sanctioned for not ‘progressing in work’. This government is absolutely disgraceful, vindictive and unremittingly cruel.

Image result for welfare spending uk pie chart

‘Making work pay’ is a simply a Conservative euphemism for the dismantling of the welfare state – a civilised and civilising institution that came into existence to ensure that no-one faces starvation, destitution and the ravages of absolute poverty.

Gauke conveniently overlooked the fact that the majority of people needing support have worked, many move in and out of low paid, insecure employment, others are in employment but are not paid an adequate amount to meet even their essential living costs. In fact the majority are in employment. Everyone – in work and out – pays taxes and contributes to the treasury. Well, except for those with havens and the power to say ‘this is what we will pay, take it or leave it’ to the government. ‘Sweetheart deals’ generally don’t come from sweet hearts. These are people who don’t care if the welfare state, NHS and other gains made from our post-war settlement are being plundered and destroyed: they are the cheerleaders of social and economic destruction and the architects of absolute poverty for others.

Gauke also claimed that work was the only sustainable basis for ‘helping people out of poverty.’ However the original aim of the architects of the welfare state was to ensure no-one lived in absolute poverty. This is a government that fully intends to continue dismantling our social security system, regardless of the harm that this does to individuals and to society as a whole. 

The BPS’s call for the suspension of benefit sanctions was repeated in our report Psychology at Work, which was launched last month. The report said sanctions should be suspended pending an independent review into the link between their use and their impact on the mental health and wellbeing of claimants.

The Society called on the government to commit to an end-to-end review of the Work Capability Assessment process in order to bring about the culture change needed to make it beneficial. 

Psychology at Work also made recommendations for creating a psychologically healthy workplace and supporting neurodiverse people at work. 

Here is the Society’s full open letter to the Independent:

The DWP must see that a bad job is worse for your mental health than unemployment

We, the UK’s leading bodies representing psychologists, psychotherapists, psychoanalysts, and counsellors, call on the Government to immediately suspend the benefits sanctions system. It fails to get people back to work and damages their mental health.

Findings from the National Audit Office (NAO) show limited evidence that the sanctions system actually works, or is cost effective.

But, even more worrying, we see evidence from NHS Health Scotland, the Centre for Welfare Conditionality hosted by the University of York, and others, which links sanctions to destitution, disempowerment, and increased rates of mental health problems. This is also emphasised in the recent Public Accounts Committee report, which states that the unexplained variations in the use of benefits sanctions are unacceptable and must be addressed. 

Vulnerable people with multiple and complex needs, in particular, are disproportionately affected by the increased use of sanctions.

Therefore, we call on the Government to suspend the benefits sanctions regime and undertake an independent review of its impact on people’s mental health and wellbeing.

But suspending the sanctions system alone is not enough. We believe the Government also has to change its focus from making unemployment less attractive, to making employment more attractive – which means a wholesale review of the back to work system.

We want to see a range of policy changes to promote mental health and wellbeing. These include increased mental health awareness training for Jobcentre staff – and reform of the work capability assessment (WCA), which may be psychologically damaging, and lacks clear evidence of reliability or effectiveness.

We urge the Government to rethink the Jobcentre’s role from not only increasing employment, but also ensuring the quality of that employment, given that bad jobs can be more damaging to mental health than unemployment.

This should be backed up with the development of statutory support for creating psychologically healthy workplaces.

These policies would begin to take us towards a welfare and employment system that promotes mental health and wellbeing, rather than one that undermines and damages it.

Professor Peter Kinderman, President, British Psychological Society (BPS)

Martin Pollecoff, Chair, UK Council for Psychotherapy (UKCP)

Dr Andrew Reeves, Chair, British Association for Counselling and Psychotherapy (BACP)

Helen Morgan, Chair, British Psychoanalytic Council (BPC)

Steve Flatt, Trustee, British Association of Behavioural and Cognitive Psychotherapies (BABCP)

It seems that real psychologists believe it is the government, rather than poor people, who need to change their behaviours.

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton

A bad job is worse for your mental health than unemployment, say UK’s top psychologists

PAA-550x369

Last month, the following letter was sent to the Independent, titled The DWP must see that a bad job is worse for your mental health than unemployment:

“We, the UK’s leading bodies representing psychologists, psychotherapists, psychoanalysts, and counsellors, call on the Government to immediately suspend the benefits sanctions system. It fails to get people back to work and damages their mental health.

Findings from the National Audit Office (NAO) show limited evidence that the sanctions system actually works, or is cost effective.

But, even more worrying, we see evidence from NHS Health Scotland, the Centre for Welfare Conditionality hosted by the University of York, and others, which links sanctions to destitution, disempowerment, and increased rates of mental health problems. This is also emphasised in the recent Public Accounts Committee report, which states that the unexplained variations in the use of benefits sanctions are unacceptable and must be addressed.

Vulnerable people with multiple and complex needs, in particular, are disproportionately affected by the increased use of sanctions.

Therefore, we call on the Government to suspend the benefits sanctions regime and undertake an independent review of its impact on people’s mental health and wellbeing.

But suspending the sanctions system alone is not enough. We believe the Government also has to change its focus from making unemployment less attractive, to making employment more attractive – which means a wholesale review of the back to work system.

We want to see a range of policy changes to promote mental health and wellbeing. These include increased mental health awareness training for Jobcentre staff – and reform of the work capability assessment (WCA), which may be psychologically damaging, and lacks clear evidence of reliability or effectiveness.

We urge the Government to rethink the Jobcentre’s role from not only increasing employment, but also ensuring the quality of that employment, given that bad jobs can be more damaging to mental health than unemployment.

This should be backed up with the development of statutory support for creating psychologically healthy workplaces.

These policies would begin to take us towards a welfare and employment system that promotes mental health and wellbeing, rather than one that undermines and damages it.

Professor Peter Kinderman, President, British Psychological Society (BPS)

Martin Pollecoff, Chair, UK Council for Psychotherapy (UKCP)

Dr Andrew Reeves, Chair, British Association for Counselling and Psychotherapy (BACP)

Helen Morgan, Chair, British Psychoanalytic Council (BPC)

Steve Flatt, Trustee, British Association of Behavioural and Cognitive Psychotherapies (BABCP)”

“Making work pay” for whom?

pie wealth

It’s a draconian, crude behaviourist and armchair technocratic government that would claim to “make work pay” by decreasing social security support for the poorest members of society, rather than raising wages to meet the rising costs of living. This approach was justified by claims that poor people became “dependent” on benefits because the welfare state provides “perverse incentives” for people seeking employment. However, there is no empirical evidence of these claims. Keith Joseph, a leading New Right advocate of the welfare dependency theories, set out to try and establish evidence dependency during the Thatcher era, and failed. Both Thatcher and Joseph wanted to extend Victorian bourgeois values of thrift, self-reliance and charity among all classes.

Such an approach has benefitted no-one but wealthy employers motivated by a profit incentive, as people who are out of work or claiming disability related benefits have become increasingly desperate. These imposed conditions have created a reserve army of labour, which has subsequently served to devalue labour, and drive wages down. We now witness high levels of in-work poverty, too. The Victorian Poor Law principle of less eligibility had the same consequences, and also “made work pay.” It’s shameful that in 2017, the government still believe that it is somehow effective and appropriate to punish people into not being poor. Especially when the government’s own policies are constructing inequality and poverty.

Last week I wrote about the Samaritans report: Dying from inequality: socioeconomic disadvantage and suicidal behaviour, which strongly links socioeconomic disadvantage and inequality with psychological distress and suicidal behaviours. The report reiterates that countries with higher levels of per capita spending on active labour market programmes, and which have more generous unemployment benefits, experience lower recession-related rises in suicides.

Research has consistently found that in countries with a generous social safety net, poor employment (low pay, poor conditions, job insecurity short-term contracts), rather than unemployment, has the biggest detrimental impact on mental health. This is particularly true of neoliberal states with minimal and means tested welfare regimes. It seems health and wellbeing are contingent on the degree to which individuals, or families, can uphold a socially acceptable standard of living independently of market participation, and on the kind of social stratification  (socioeconomic hierarchies indicating levels of inequality) is fostered by social policies.

Furthermore, despite the government’s rhetoric on welfare “dependency”, and the alleged need for removing the “perverse incentives” from the social security system by imposing a harsh conditionality framework and a compliance regime – using punitive sanctions – and work capability assessments designed to preclude eligibility to disability benefits, research shows that generous social security regimes make people more likely to want to work, not less.

The government’s welfare “reforms” have already invited scathing international criticism because they have disproportionately targeted cuts at those with the least income. Furthermore, the government have systematically violated the human rights of those with mental and physical disabilities. In a highly critical UN report last year, following a lengthy inquiry, it says: “States parties should find an adequate balance between providing an adequate level of income security for persons with disabilities through social security schemes and supporting their labour inclusion. The two sets of measures should be seen as complementary rather than contradictory.”

However, the UK government have continued to conflate social justice and inclusion with punitive policies and cuts, aimed at coercing disabled people towards narrow employment outcomes that preferably bypass any form of genuine support and the social security system completely. 

See – UN’s highly critical report confirms UK government has systematically violated the human rights of disabled people.

430835_148211001996623_1337599952_n (1)

Kitty.

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. The budget didn’t do me any favours at all.

But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton cards


%d bloggers like this: