Work advisors attached to mental health services are pushing disabled people off benefits, research suggests

A flagship government scheme that links NHS therapy to employment advice is pushing disabled people who are in mental distress and not in work off the benefits that provide them with a vital income lifeline, new official research suggests.

The study – by the Office for National Statistics (ONS) – is the latest that appears to substantiate disabled activists’ warnings around the dangers of placing employment advisors inside the NHS talking therapy service.

The study shows that, three years after starting to receive employment advice alongside regular talking therapy, the likelihood of someone in work receiving benefits of any type* increased, compared with those who just took part in the talking therapy service.

For those working, the probability rose by over four percentage points (4.2).

Employed participants who were off sick showed the highest increase in the likelihood of receiving benefits – at five percentage points.

But for those not working, the impact on access to benefits was reversed.

The probability of accessing benefits dropped by 2.7 percentage points for the total population of those out of work.

ONS made it clear this week that it had not been able to research the reasons for this fall and suggested that some of those in this group may have moved into employment.

But one leading disabled activist suggested this week that the impact of providing employment advisers alongside talking therapy was causing some people with mental distress to disengage from the NHS and the social security system.

The ONS research shows that it was participants with arguably the biggest barriers to both work and the social security system – those it described as “Not working, long-term sick or disabled” – where receipt of income-based benefits in particular, such as universal credit, fell most sharply.

Disabled and long-term sick individuals who were out of work were less likely to be claiming universal credit or other legacy social security payments – described in the study as “employment support benefits” – after accessing employment advice sessions and talking therapy, compared to just talking therapy.

Three years after beginning the employment advice sessions, disabled participants’ likelihood of claiming universal credit or benefits like employment and support allowance (ESA) dropped by 3.2 percentage points.

For the same group of disabled people, a previous study in May found that, three years on from starting employment advice sessions as part of the talking therapy service, the probability of being in paid employment dropped by four percentage points.

This group also saw its average earnings fall by nearly £150 a month.

Together, the studies appear to suggest there can be serious consequences from embedding employment advisors in NHS treatment settings.

Employment advice sessions appear to have led to lower earnings, a smaller chance of moving into employment, and less likelihood of accessing the social security system for income support.

Paula Peters, a national steering group member of Disabled People Against Cuts (DPAC), said the “joining up” of NHS and DWP services “has always been incredibly concerning and downright dangerous”.

She told Disability News Service (DNS): “Mental health centres are for support and therapy, if you can get it; jobcentres are for jobs. They shouldn’t be interlinked.

“When people in distress see GP surgeries [and] mental health teams as jobcentres, not a safe place to get the support they need – because employment advisors are within these services – then people in mental distress can disengage because they do not feel safe.

“It’s then causing further crises and pressure on the NHS because distress is exacerbated.

“Disabled people go to the NHS for treatment, not be put under the cosh by work coaches with three weeks training.

“We are seeing huge cuts to Access to Work support, rise of benefit sanctions under universal credit, and work coaches pressurising disabled people in NHS settings, all of which are not supporting disabled people into work; it’s doing the exact opposite.

“It’s ramping up mental health crisis, the constant distress of financial support taken away or removed for months at a time due to a sanction further exacerbating crises and distress.

“The government should properly fund mental health services so that treatment is easily accessible, available and supportive.”

ONS said that it could not assume from its research that the overall impact of receiving employment advice alongside NHS talking therapy was negative for those who were long-term sick or disabled.

It said some of this group could have moved into paid jobs, while the findings also showed that this group had become more likely to receive non-work-related disability benefits such as personal independence payment.

It said the study had not been able to investigate the reasons for the drop in out-of-work disabled participants accessing benefits, but it would be carrying out further work in this area.

The study’s author, Dr Emma Sharland**, said: “This is an important reminder that people’s lives and experiences are often more complicated than we think.

“The next phase of research from the Support2Work project will help us better understand the complex challenges people face.”

DWP told DNS: “Long-term sick or disabled clients receiving employment advice may have more severe conditions and face additional barriers to work that are not fully captured in the data.

“That means the findings may not provide a complete picture of the impact of the advice itself.

“We are committed to ensuring customers receive the benefits they are entitled to and offer support through free channels.”

ONS published the study ahead of former New Labour health secretary Alan Milburn’s final report into the “drivers of the increase” in young disabled people not in education, employment, or training (NEET), due for publication this autumn.

Milburn is expected to recommend further embedding employment advisors in talking therapy settings.

He has signalled how the final report will set out that the DWP will expect young disabled people to engage with employment support programmes.

The new prime minister, Andy Burnham, echoed this sentiment in July, telling the BBC’s Laura Kuenssberg that he planned to make benefit access “conditional upon people taking opportunities that are presented in front of them”.

These comments are likely to increase the fear that Labour will bring in conditionality and sanctions on young disabled claimants who fail to take up employment “support” in NHS mental health services, despite repeated concerns raised about potential harm.

*The study assessed if participants received benefits such as personal independence payment, employment and support allowance, universal credit, income support, jobseeker’s allowance, and housing benefit

**No relation to Hannah Sharland, who researched and wrote this article