Nikki Bond, Senior Research Officer, Money and Mental Health

Shaping the future of health and disability benefits

8 October 2021

This week millions of people have experienced an enormous cut to their benefits – with the removal of the Universal Credit uplift. This will be devastating for many people with mental health problems and has rightfully received huge amounts of attention. But there is another issue we don’t want to let slip under the radar: the government’s plans to transform health and disability benefits – such as Employment and Support Allowance (ESA) or Personal Independence Payment (PIP) – currently out for consultation. 

This is vitally important as over the last five years, we’ve heard from hundreds of people with experience of mental health problems about how health and disability benefits are not working for them. In fact, only one in three respondents to our survey said they were satisfied with their most recent health or disability assessment. 

When the long-promised Health and Disability Green Paper consultation was finally published in August, we welcomed many of its policy proposals. These included the willingness to consider offering a wider range of communication channels to support people’s engagement with the system and the recognition of the need to provide advocacy support to people with complex needs. However, we were disappointed with the underlying premise of the consultation, its narrow framing and lack of ambition. The Green Paper predominantly focuses on encouraging people with health problems and disabilities into employment, with limited consideration of the role of the DWP to support people into good work, suited to their abilities and needs. It also fails to adequately provide for people who are unable to work.

The challenge people face

The reason people with mental health problems struggle to navigate the benefits system is two-fold. Firstly, common symptoms of mental health problems such as reduced concentration, depleted energy or motivation levels, or difficulties understanding and processing information, can affect our ability to engage in specific tasks necessary to navigate the benefits system – like completing application forms or attending assessments. Secondly, the system was not designed with people with mental health problems in mind. As a result, initial applications are often long, complicated and repetitive; collecting medical evidence can be confusing and arduous; and assessments are daunting with questions that are physically-health focused. 

Systemic change

Our response to the consultation is packed with more than 40 recommendations for how the DWP could improve health and disability benefits to ensure they work better for people with mental health problems. The most crucial of these is the need to restore trust in the system, by introducing greater levels of transparency and accountability. To this end, we support Mind’s call for the government to introduce an independent regulator for the benefits system. This would go a long way to helping the DWP deliver meaningful change.  

Five quick-wins

However, systemic change takes time, and people need an improved system now. Therefore, we’ve pulled out a handful of our top recommendations that the DWP could implement relatively quickly, without legislative change, to improve people’s experience of health and disability benefits.  

  • Reduce the administrative burden on people by making health and disability benefits more accessible.

    This should include routinely recording peoples’ communication preferences and needs (whether this is by phone, post or digital channels), and communicating with them via their preferred channel. As well as designing online health and disability benefit forms so people can save their progress, and pre-filling reassessment forms with basic personal details. 

  • Proactively offer improved processes for people with Severe Mental Illness (SMI).

    Such as ensuring assessments of people with a SMI – such as schizophrenia, bipolar or personality disorder – are conducted by specialist assessors with experience and knowledge of mental health problems, and decision-makers who only make decisions on conditions in which they are a specialist.     

  • Develop staff training to improve recognition and understanding of mental health problems.

    Requiring all customer-facing staff to attend not just introductory mental health training, but enhanced training with yearly refreshers. Also reviewing how customer-facing staff apply mental health training when dealing with customers.

  • Offer claimants advanced sight of assessment questions.

    This would help people who have difficulties understanding and processing information to give fuller and more accurate answers to questions – in turn improving the likelihood of more accurate decisions. 

  • Ensure assessments capture the day-to-day challenges faced by people with mental health problems.

    People are asked about what activities they can and can not do, but these questions are focused on physical health. Small changes to reflect fluctuations in people’s capabilities, and introducing questions that assess a person’s energy and motivation to complete specific tasks – would help to better reflect the experiences of people with mental health problems. 

These are just a few of our most urgent recommendations which we hope the DWP will act upon. To read our complete response to the DWP’s health and disability benefit consultation, click here