DWP’s fit-to-work tests ‘cause permanent damage to mental health’, study finds

A mental health charity said the in-depth interviews ‘reflect what we hear from people every day’

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The Government’s fit-to-work tests for access to disability benefits are causing permanent damage to some claimants’ mental health, from which they are not recovering, a new study has warned.

The research, conducted by academics at Edinburgh’s Heriot-Watt and Napier universities, found that the Work Capability Assessment experience “for many, caused a deterioration in people’s mental health which individuals did not recover from”.

It also established, through dozens of in-depth interviews of people who had been through the tests, that “in the worst cases, the WCA experience led to thoughts of suicide”. Mental health charities said the interviews’ contents “reflect what we hear from people every day”.

The study interviewed 30 people with existing mental health conditions who had taken the tests throughout 2016. Most suffered from depression or anxiety, while a smaller number had more complex issues like bipolar disorder or borderline personality disorder. In addition, researchers also interviewed a number of advocacy workers who had had close contact with the test.

The study’s participants reported a lack of expertise in mental health among WCA assessors and advice from the WCA that was not consistent with what they had been told by their own GPs. In one case recorded in the study, a participant recounted a doctor “actually physically gasping” during an appeal because of the poor quality of evidence initially recorded by a WCA assessor. 

Some study participants reported being in tears or having panic attacks during the tests, with others telling the interviewers that the assessments were “making me feel worse”.

The researchers said that the extreme stress having to deal with multiple stigmas of being unemployed and having a mental health condition became “self-reinforcing and self-perpetuating”, leading to the deterioration of claimants’ condition.

“Our research has reinforced the fact that people with mental health problems face more stigma and discrimination than those with physical health conditions and that this discrimination is built into the WCA,” the study’s final report concluded.

Professor Abigail Marks, the lead author of the study who is based at Heriot-Watt University, told The Independent that people who worked closely with such cases reported that deterioration in mental health conditions was an “almost universal” response to the tests.

Key causes of extreme stress were said to be a claimant’s fear of losing their income, the prolonged nature of tests, a lack of specialist mental health training amongst assessors, and the fact the test was clearly geared towards people with physical disabilities. 

“A lot of the people we spoke to were in a position where they are preparing to go back to work before their assessment – they were doing training courses, community initiatives, or volunteering,” she said.

“They said that after the assessment, because the assessment had caused them so much stress, they were unable to go back and take part in those activities because their mental health had had such a deterioration.

“Talking to the advocacy workers, as well, they said it was almost universal that after people had gone through an assessment there was a significant decrease in their mental health.” 

Report on mental health care

In October last year the Government announced that it would stop repeat Work Capability Assessments for people with chronic conditions, characterising the repeat assessments it was scrapping as “unnecessary stress and bureaucracy”.

Mental health charity Mind said the WCA was clearly “not fit for purpose” and that its lengthy and costly appeals processes could make matters worse.

“The findings of this report are concerning but sadly not surprising, as they reflect what we hear from people every day,” Ayaz Manji, the charity’s policy and campaigns officer, said.

“People with mental health problems tell us that the current fit-for-work test causes a great deal of additional anxiety. We know the assessors rarely have sufficient knowledge or expertise in mental health, meaning many people don’t get the right outcome and then have to go through a lengthy and costly appeals process.

“The current approach is not fit for purpose and needs to be replaced by an open and honest conversation based on each person’s individual needs.”

Debbie Abrahams, the Labour work and pensions spokeswoman, said the study was more proof that the WCA “is not only unfit for purpose, but is causing harm to some disabled people”.

She added: “That’s why I have committed Labour to scrapping these assessments completely and replacing them with a holistic, person-centred approach.”

The Work Capability Assessment was introduced in 2008. It is contracted out to private company Maximus, having previously been run by Atos. The system’s failure rate is controversial; figures reported by The Independent last year found that more than half of appealed WCA decisions were found to be wrong when taken to tribunal.

Responding to the study, a Department for Work and Pensions spokesperson appeared to dismiss the interviewees’ experiences as not statistically significant.

“Only thirty people 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,” he said.

“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.” In fact, 37 interviews were conducted for the study.

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