‘Fitness for work’ test has led to deterioration in mental health, say researchers

Disabled activists have welcomed “timely” new research that concludes that the government’s “fitness for work” process has caused a deterioration in many people’s mental health which they have failed to recover from, and has even led to thoughts of suicide.

The research, Mental Health And Unemployment In Scotland, was carried out by academics at Scotland’s Heriot-Watt and Edinburgh Napier universities*.

Researchers spoke in-depth to 30 people across Scotland with mental health conditions who had experienced the work capability assessment (WCA) system, as well as staff from advice and advocacy organisations.

They concluded that the assessors, employed by the US outsourcing company Maximus, “do not appear to have appropriate expertise in mental health”.

And they added: “The WCA experience for many, caused a deterioration in people’s mental health which individuals did not recover from.

“In the worst cases, the WCA experience led to thoughts of suicide.”

Professor Abigail Marks, one of the report’s authors, said their research showed that WCAs were “fundamentally discriminatory to people with mental health conditions”.

The research emerged as disabled people’s organisations gave evidence this week to the UN’s committee on the rights of persons with disabilities about the UK government’s failure to implement the UN disability convention.

One of the areas the committee was expected to be told about was the UK government’s failure to improve the safety of the WCA process, and the links between this failure and the deaths of benefit claimants with mental health conditions.

The researchers say in the report that all of the claimants and advocacy workers they interviewed had said the process was damaging to wellbeing, and they add: “The uncertainty of being on ESA [employment and support allowance] and the stress of potential reassessments frequently led to a situation where recovery was impossible.

“There was a perception by participants that managing their mental health conditions is seen by the DWP as secondary to returning to employment.”

One participant described how his WCA took just 18 minutes and that all the assessor was interested in “was the bog standard ‘Can you wash, can you cook, can you do this, can you do that?’

“And as far as she was concerned, as far as the assessment was concerned, if I could do any of these things, I could tie my own shoelaces, wash my hair, that meant I was fit for work.”

Another described how she had been assessed just after a period in a psychiatric hospital, and was asked a series of 20 “stupid” questions in an assessment that lasted just 12 minutes. She was found fit for work.

A third participant said: “If you turn up for the interview as far as they’re concerned you’re well, but then if you don’t turn up for the interview your benefits get stopped – so you’re damned if you do, damned if you don’t sort of thing.”

Another described how her assessor had concluded that she was not experiencing anxiety or a panic attack during the assessment because she was not rocking in her chair, even though the assessor noted that she had been tearful throughout the assessment.

The researchers also described how most of the participants who had been volunteering stopped doing so after their WCA, often because the assessment process had been “so traumatic for individuals their mental health had been further damaged and they were unable to sustain any work-related activity”.

In other cases, people stopped volunteering because they felt that their experience of doing so had been used in their WCA as evidence that they were capable of paid work.

Among their recommendations, the researchers call for the WCA to be “entirely rewritten and redefined”, and say it is likely to be more effective “if it is not outsourced to contractors”.

Another recommendation, which again backs up long-standing concerns about the WCA process, is that “more weight needs to be given to recommendations and reports from GPs, psychiatrists and other medical professionals working with claimants”.

The report’s authors also say: “The assumption that engagement in voluntary work means that an individual is fit for employment should be eliminated.”

Linda Burnip, co-founder of Disabled People Against Cuts, said: “This timely research supports everything that DPAC has been saying about WCA assessments for many years.

“It is and always has been appalling that totally unqualified assessors who have no experience whatsoever of mental health conditions are able to carry out these assessments.

“It comes as no surprise to us to find that social security claimants are driven to think of suicide… and that in many cases people’s health worsens and they never recover from these harrowing ordeals.

“Only this week we’ve been contacted by someone who has had severe depression for many years caused by harrowing life circumstances who has been told he’ll ‘get over it’ without any support being provided, and who is being made more ill due to inadequate assessments which completely fail to take into account the reality of his situation.”

A DWP spokeswoman said: “Only 30 people [with mental health conditions] were interviewed for this report, which fails to acknowledge any of the significant improvements we have made to our assessments – particularly for people with mental health conditions.

“Last year alone at least 35,000 work capability assessments took place in Scotland to help ensure people get the right level of support that they need.”

DWP said that safeguards were built into the WCA from the outset, and that it had introduced further improvements to try and ensure the process dealt with people with mental health conditions fairly and accurately.

It also said that healthcare professionals underwent training in “disability assessment medicine” and must demonstrate up-to-date knowledge of relevant clinical subjects.

And it claimed that they were given training in assessing individuals with mental health conditions and received continuing professional education in order to remain up to speed with developments in the field of “disability medicine”.

*The research was carried out by Professor Abigail Marks and Dr Sue Cowan from Heriot-Watt University’s Centre for Research on Work and Wellbeing, and Dr Gavin Maclea,  from Edinburgh Napier University’s Employment Research Institute