Tag: Lynne Friedli

Workfare coercion in the UK: an assault on persons with disabilities and their human rights – Anne-Laure Donskoy

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Anne-Laure Donskoy
is an independent survivor researcher, this paper was published by the National Survivor User Network (NSUN) for mental health, which is an independent, service-user-led charity that connects people with experience of mental health issues to give us a stronger voice in shaping policy and services.

In a report, titled Workfare coercion in the UK: an assault on persons with disabilities and their human rights, she provides an in-depth consideration of psychocompulsion as a series of state-sponsored human rights violations. I recommend that you read this discussion in full.

She writes: While there is a lot of focus on coercion organised and implemented in psychiatry, less attention is being paid to state engineered welfare measures based on libertarian paternalism, which have coercive practices at their core. Among them are policies that strongly support behavioural change using positive psychology and cognitive behavioural therapy. Freidli and Stearn (2015) call this ‘psychocompulsion.'”

“The narrative of welfare is changing drastically. As Friedli says, we are moving from a “what people have to do [to find work] to what they have to be [demonstrating the right attitude to be employable]”. This is exemplified through the new ‘Work and Health Programme’ planned to be rolled out in England and Wales. This programme has many strands, including:−

  • Embedding psychological services within Job Centres
  • Placing ‘job coaches’ within GP surgeries for people with certain conditions (specifically people with mental health issues): the ‘Working Better’ pilot scheme is funded by the Department for Work and Pensions and the coaches will be provided by welfare to work agency, Remploy (a welfare-to-work subsidiary of the Maximus).”

She goes on to say: “It has come to light that these new programmes are also the subject of ‘research’.The new Work and Health Programme is currently at a research and trialing stage. As Kitty Jones writes, “Part of the experimental nudge element of this research entails enlisting GPs to “prescribe” job coaches, and to participate in constructing “a health and work passport to collate employment and health information.”

However, this ‘research’ (if one can call it so), has been heavily criticised because it is not sanctioned according to the usual robust ethical guidelines. Research that adheres to robust ethical guidelines would absolutely seek not to cause harm to its participants,and would seek their informed consent beforehand. This is not the case here where claimants are the participants, involuntary and ‘unconsented’, of an experiment they know nothing about, “There are a wide range of legal and Human Rights implications connected with experimentation and research trials conducted on social groups and human subjects.”

A spokesperson for Disabled People Against the Cuts (DPAC), talked of the UN CRPD Committee’s visit to the UK and described the situation thus: It means the UN will examine the vicious and punitive attacks on disabled people’s independent living as well as the cuts which have seen so many placed in inhuman circumstances and has led to unnecessary deaths.”

There is a more, and also, a very detailed and important consideration of the implications of current UK policies within the context of the Convention on the Rights of Persons with Disabilities (CRPD) throughout this excellent article.

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Related 

Cited on the article:

https://kittysjones.wordpress.com/2015/11/28/the-goverments-reductive-positivistic-approach-to-social-research-is-a-nudge-back-to-the-nineteenth-century/– The idea that it is both possible and legitimate for governments, public and private institutions to affect and change the behaviours of citizens whilst also [controversially] “respecting freedom of choice.”

https://kittysjones.wordpress.com/2015/12/14/the-department-for-work-and-pensions-dont-know-what-their-ethical-and-safeguarding-guidelines-are-but-still-claim-they-have-some/

Friedli L, et al.MedHumanit2015;41:40–47. doi:10.1136/medhum-2014-010622

http://www.disabilitynewsservice.com/coroners-ground-breaking-verdict-suicide-was-triggered-by-fit-for-work-test/

(amongst other work)

Watch – And This time its Personal Psychocompulsion & Workfare from wellredfilms on Vimeo.

Other related:

Cameron’s Nudge that knocked democracy down: mind the Mindspace

Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

Nudging conformity and benefit sanctions

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The Psychological Impact of Austerity – Psychologists Against Austerity

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A recent report from the Psychologists Against Austerity collective directly links cuts to public services with mental health problems.

Well-established psychological research that explains these links already exists. However, this knowledge has been missing from the debate on austerity so far.

Psychologists are often in a position to see the effects that social and economic changes have on people. We also occupy a relatively powerful position as professionals and therefore have an ethical responsibility to speak out about these effects.

Introduction

The Coalition government since 2010 has implemented a program of cuts to public services and welfare that has disproportionately affected  the most vulnerable people in our society in the name of ‘Austerity’. Measures like the bedroom tax, cuts to disability benefits, the introduction of Universal Credit and cuts to local government, social services and NHS budgets have been presented by the Coalition as necessary to the UK’s economic recovery.

Ideas like ‘the nation has maxed out its credit card’ and austerity as a painful but necessary medicine have been used to frame these policy choices as unavoidable and moral.

We argue that recent cuts are both avoidable and immoral. As psychologists we are often in a position to see the effects that societal and economic conditions have on people.

Psychologists also occupy a relatively powerful position as professionals with access to resources like theory and research and therefore have an ethical responsibility to speak about these effects. Indeed, according to the British Psychological Society (BPS) code of ethics, part of the standard for competence is sensitivity to developments in our social and political context.

It is imperative to take into account the psychological costs of austerity for individuals and communities. Psychological impacts of recent austerity policies have been little discussed in media and policy debates, yet there is clear and robust research linking recent austerity policies with damaging psychological outcomes.

Work at an epidemiological level on social determinants of health like the Marmot Review and The Spirit Level shows robust evidence for the effects of social inequality on health, including emotional well-being. Mental health problems are associated with markers of low income and social economic status in all the developed nations, no matter which indicator is used. There are indications of higher levels of mental health problems following austerity, with a rise in antidepressant prescriptions, and GPs reporting increasing numbers of mental health appointments, and a rise in male suicides.

Since the financial crisis, suicides have increased in European countries that have adopted austerity policies (UK, Greece, Spain and Portugal), but not in those who have protected their welfare state (Iceland and Germany). In this paper, we assume that the emotional well-being of societies and individuals is determined by multiple factors that interact with each another. These include economic, societal, familial, psychological and biological influences.

We use the terms ‘emotional well-being’, ‘distress’ and ‘mental health problems’ rather than ‘mental illness’. This is because there is disagreement about whether emotional difficulties are best understood as a product of individual pathology, or a consequence of toxic environments and difficult life experiences. We use diagnostic terminology as a proxy for a wide range of experiences of distress, which are biographically unique. As psychologists, we believe that the diagnostic and medical understanding of ‘mental illness’ often neglects socioeconomic context.

As Lynne Friedli says:

“Mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual solutions.”

Psychological research provides evidence for some of the wide range of pathways by which increasing social inequality and austerity increase emotional distress. In this paper, we have outlined well-established pathways to short and long term psychological damage from austerity policies; we have called these ‘austerity ailments’.

They are:

  • Humiliation and shame
  • Fear and distrust
  • Instability and insecurity
  • Isolation and loneliness
  • Being trapped and powerless

Key conclusions

Austerity policies have damaging psychological costs. Mental health problems are being created in the present, and further problems are being stored for the future.

We have identified five ‘Austerity Ailments’. These are specific ways in which austerity policies impact on mental health. These experiences have been shown to increase mental health problems. Prolonged humiliation following a severe loss trebles the chance of being diagnosed with clinical depression. Job insecurity is as damaging for mental health as unemployment.

Feeling trapped over the long term nearly trebles the chances of being diagnosed with anxiety and depression. Low levels of trust increase the chance of being diagnosed with depression by nearly 50 per cent.

These five ‘ailments’ are indicators of problems in society, of poisonous public policy, weakness of social cohesion and inequalities in power and wealth. We also know what kind of society promotes good health.

Key markers are that societies are equal, participatory and cohesive.

Some important indicators of a psychologically healthy society are:

1. Agency
2. Security
3. Connection
4. Meaning
5. Trust

Mental health isn’t just an individual issue. To create resilience and promote wellbeing, we need to look at the entirety of the social and economic conditions in which people live.

Implications and recommendations

The evidence presented in this report indicates that a range of key psychological experiences can be directly linked to public policy, and are sensitive to macro social and economic changes.

It is therefore crucial that policy makers and service developers consider the psychological impacts of current and future policies. Creating the conditions for wellbeing and resilience directly helps to prevent distress in the short and long term, thereby saving resources and reducing suffering.

 We call for:

  • Social policy that works towards a more equitable and participatory society, to facilitate individual well-being, resilient places, and strong communities.
  •  Policy makers to take into account the psychological impacts of macro social and economic changes.
  • A social security system that empowers and supports, rather than punishing people in times of need.
  • Public services to increase focus on preventing distress, improving citizen participation and social justice, as well as help facilitate the five positive indicators above.
  • Co-production to be one such model of public service reform. This approach harnesses individuals’ and communities’ assets and expertise rather than viewing them just as passive recipients of and burdens on services.
  • A community-led approach to mental health and emotional wellbeing that develops collective responses to individual needs and by doing so works to strengthen communities and build on communal resources.

You can read the full briefing paper here.

 

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

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The current government has made the welfare system increasingly conditional on the grounds that “permissive” welfare policies have led to welfare “dependency.” Strict behavioural requirements and punishments in the form of sanctions are an integral part of the Conservative ideological pseudo-moralisation of welfare, and their  “reforms” aimed at making claiming benefits much less attractive than taking a low paid, insecure, exploitative job.

Welfare has been redefined: it is preoccupied with assumptions about and modification of the behaviour and character of recipients rather than with the alleviation of poverty and ensuring economic and social wellbeing.

The stigmatisation of people needing benefits is designed purposefully to displace public sympathy for the poor, and to generate moral outrage, which is then used to further justify the steady dismantling of the welfare state.

But the problems of austerity and the economy were not caused by people claiming welfare, or by any other powerless, scapegoated, marginalised group for that matter, such as migrants. The problems have arisen because of social conservatism and neoliberalism. The victims of this government’s policies and decision-making are being portrayed as miscreants – as perpetrators of the social problems caused by the government’s decisions, rather than as the casualities.

And actually, that a recognisable bullying tactic known as projection, (the vehicle for projection is blame, criticism and allegation), as is scapegoating.

The 2015 budget included plans to provide online Cognitive Behaviour Therapy to 40,000 claimants and people on the Fit for Work programme, as well as putting therapists in more than 350 job centres.

I wrote an article in March about the government plans to make the receipt of social security benefits conditional on undergoing “state therapy.” I raised concern about ethical issues – such as consent, the inappropriateness of using behaviour modification as a form of “therapy,” and I criticised the proposed Cognitive Behaviour Therapy (CBT) programme on methodological and theoretical grounds, as well as considering wider implications.

I’ve written at length about the coercive and punitive nature of the conservative psychopolicy interventions, underpinning the welfare “reforms,” and giving rise to increased welfare “conditionality” and negative sanctions.

In particular, I’ve focussed on the influence of the Cabinet’s Behavioural Insights Team or “nudge unit” and “the application of behavioural science and psychology to public policy. (See: The nudge that knocked down democracy, The power of positive thinking is really political gaslighting, and Despotic paternalism and punishing the poor. Can this really be England? )

I was pleased to see that the BBC reported a summary of the research findings of Lynne Friedli and Robert Stearn, which was supported by the Wellcome Trust. The report – Positive affect as coercive strategy: conditionality, activation and the role of psychology in UK government workfare programmes reflects many of the concerns raised by other professionals. I strongly recommend you read it. (See: Psychologists Against Austerity: mental health experts issue a rallying call against coalition policies.)

The BBC summarised from the report that benefit claimants are being forced to take part in “positive thinking” courses in an effort to “change their personalities.” Those people claiming benefits that do not exhibit a “positive” outlook must undergo “reprogramming” or face having their benefits cut. This is humiliating for job seekers and does not help them find suitable work.

New benefit claimants are interviewed to find out whether they have a “psychological resistance” to work, with those deemed “less mentally fit” given more “intensive coaching.”

And unpaid work placements are increasingly judged on psychological results, such as improved motivation and confidence, rather than whether they have led to a job.

The co-author of the report, Lynne Friedli, describes such programmes, very aptly, as “Orwellian.” She says:

“Claimants’ ‘attitude to work’ is becoming a basis for deciding who is entitled to social security – it is no longer what you must do to get a job, but how you have to think and feel.

“This makes the government’s proposal to locate psychologists in job centres particularly worrying.

“By repackaging unemployment as a psychological problem, attention is diverted from the realities of the UK job market and any subsequent insecurities and inequalities it produces.”

Friedli also criticised the way psychologists were being co-opted as “government enforcers” and called on professional bodies to denounce the practice.

Quite rightly so. It’s our socio-economic system, and the ideologues who shape it that present the problems, not the groups of people forced to live in it as its casualities – the “collateral damage” of neoliberalism and social conservatism.

“I don’t think anything can justify forced psychological coercion. If people want to go on training courses that should be entirely voluntary,” Lynne told BBC News.

She also questioned the aim of the motivational courses and welfare-to-work placements, which felt like “evangelical” self-help seminars.

“Do we really want a world where the only kind of person considered employable is a ‘happy clappy’, hyper-confident person with high self-esteem?

“That is a very a narrow set of characteristics. There is also a role in the workplace for the ‘eeyore’ type.”

Absolutely. Frankly, I would rather have health and safety programmes that are designed by a pessimist, capable of thinking of the worst case scenario, for example, than by a jolly, positively biased, state-coerced optimist.

I would also prefer pessimistic appraisal of social policies. That way, we may actually have impact assessments carried out regarding the consequences of Conservative policies, instead of glib, increasingly Orwellian political assurances that are on the other, more scenic, illusory side across the chasm from social realities.

Although pessimism and depression are considered to be affective disorders, in a functional magnetic resonance imaging study of the brain, depressed patients were shown to be more accurate in their causal attributions of positive and negative social events, and in self assessments, and assessment of their own performance of tasks, than non-depressed participants, who demonstrated a positive bias.

As a former community-based psychosocial practitioner who saw the merits and value of a liberationist model, the question that needs to be asked is: for whose benefit is CBT being used, and for what purpose? Seems to me that this is about helping those people on the wrong side of punitive government policy to accommodate that, and to mute negative responses to negative situations.

The socially dispossessed are being coerced by the state, part of that process is the internalisation of the negative images of themselves created and propagated by their oppressors.

CBT is not based on a genuinely liberational approach, nor is it based on any sort of democratic dialogue. It’s all about modifying and controlling behaviour, particularly when it’s aimed at such a narrow, politically defined and specific outcome.

The problem that we need to confront is politically designed and perpertuated social injustice, rather than the responses and behaviour of excluded, stigmatised individuals in politically oppressed, marginalised social groups.

CBT is founded on blunt oversimplifications of what causes human distress – for example, in this case it is assumed that the causes of unemployment are psychological rather than socio-political, and that assumption authorises intrusive state interventions that encode a Conservative moral framework which places responsibility on the individual, who is characterised as “faulty.”

However, democracy is based on a process of dialogue between the public and government, ensuring that the public are represented: that governments are responsive, shaping policies that address identified social needs. Conservative policies are quite clearly no longer about reflecting citizen’s needs: they are increasingly about telling us how to be.

As I have said elsewhere, as well as aiming at shaping behaviour, the psycho-political messages being disseminated are all-pervasive, entirely ideological and not remotely rational: they reflect and are shaping an anti-welfarism that sits with Conservative agendas for neoliberal welfare “reform”, austerity policies, the small State (minarchism) and also legitimises them. (I’ve written at length elsewhere about the fact that austerity isn’t an economic necessity, but rather, it’s a Tory ideological preference.) The Conservatives are traditional, they are creatures of habit, rather than being responsive and rational.

Conservative narratives, amplified via the media, have framed our reality, stifled alternatives, and justified Tory policies that extend psychological coercion including through workfare; benefit sanctions; in stigmatising the behaviour and experiences of poor citizens and they endorse the loss of autonomy for citizens who were disempowered to begin with.

Many of the current ideas behind “reforming” welfare come from the Behavioural Insights  Team – the Nudge Unit at the heart of the Cabinet. Nudge theory has made Tory ideology, with its totalitarian tendencies, seem credible, and the Behavioural Insights Team have condoned, justified and supported punitive, authoritarian policies, with bogus claims about “objectivity” and by using discredited pseudoscience. Those policies have contravened the human rights of women, children and disabled people, to date.

Nudge-based policy is hardly in our “best interests,” then.

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Pictures courtesy of Robert Livingstone


I don’t make any money from my work. I am disabled because of illness. But you can contribute by making a donation and 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.

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